Whatever happened to Amelia Earhart? W*
Who holds the stars up in the sky? I*
Is true love once in a lifetime? D*
Did the captain of the Titanic cry?... (*
("Someday We'll Know", The New Radicals)J*
Jane-Anne is as innocent as the pure, driven snow.
A true, corn-fed "country girl", Jane-Anne was born and raised in a tiny little town with only 2 traffic lights, about a 30-minute drive from Podunk. Jane-Anne only finished her LVN training a little over a year ago, and she is currently enrolled in an online program in which she is working towards becoming an RN. J*
Jane-Anne is only 21 years old. She is as freckled as a newborn fawn, and she usually wears her unruly blonde hair in "pigtails". She is the niece of my road nurse company's owners, and she works out of my particular branch office. The owners put her in my care in order that she learn the road nurse business from an experienced road nurse. Jane-Anne is a bright and enthusiastic student, willingly carrying her full share of the work load even though she's just a rookie. Few "newbies" to the road nurse profession have learned the ropes so quickly and cheerfully as Jane-Anne.
Jane-Anne is a good girl. Everybody loves her. She is unfailingly polite, always smiling, respectful of her elders, and has most likely never lied even once in her life. In fact, I truly believe that she is incapable of telling an untruth. She and her husband attend church with Jane-Anne's Mee-maw and Pee-paw, and they consult their family before making any large decisions. J*
Jane-Anne rarely cusses, although lately I've heard her utter the occasional "F-word", which she unfortunately learned from me--- and I hope against all hopes that her Mee-maw never hears that because she would whup Jane-Anne's butt with a flyswatter if she did.
Jane-Anne is a delight to be around. She is quirky, mischevious, and her naivete lands her into hilarious predicaments on an almost daily basis. She is one of the most loveable people I have ever met in my entire life.
And five months ago, Jane-Anne's world came crashing in when she was diagnosed withJuvenile Diabetes.J*
Jane-Anne was devastated to be told that she had this complicated disease at her very young age. Furthermore, to her horror, she was instructed into the grim reality that she must henceforth regulate every single morsel of food which goes into her mouth as she balances her dietary choices against daily insulin injections. She was prescribed two different types of insulins to help her achieve this balance. She was taught how to prick her finger with a "lancet" needle multiple times per day to determine her blood glucose level, after which she then calculates a certain dose of insulin to give herself via a syringe into her abdomen. A*
A set-back such as this might have broken the spirit of some young girls, and perhaps may have caused some to choose a different profession than the wild, unpredictable routine of being a Texan road nurse---but not Jane-Anne. After the initial shock, she courageously continued forth with her career plans, undaunted, while demonstrating on a daily basis the undying and pragmatic determination of someone raised with the Texan "never say die" spirit. "A*
"Ah've got this dang thing down, Bohemian," she told me in her lilting, Texan, "Daisy-May" drawl (pronouncing the word 'down' as 'day-own'). "Mah doctor told me how to do it---ah just need to learn how to do that dang thing they call 'carbohydrate counting'. Three times a day ah estimate how much carbs ah'm gonna eat, and then ah just have to give myself the correct dose of insulin to balance it all out."A*
And so she did. Jane-Anne learned how to "carb count".J*
Jane-Anne plunged into her work as a road nurse as enthusiastically as I've ever seen, driving the endless miles while toting her company nurse bag--- but with an added pouch containing her glucometer, insulin, and an insulin injection "pen". Like many young diabetics, she quickly and deftly mastered the art of sticking her finger, checking the blood droplet on a glucometer, and then giving herself the correct dose of insulin by injecting herself in the stomach. I*
In fact, I've seen Jane-Anne whip out her little diabetic pouch and twirl it in her hand just like Old West cowboy villains used to whip out a six-shooter pistol. She can perform the entire ritual of checking her sugar and then giving herself an insulin injection faster than anybody I've ever seen, the whole process taking her only about 2 minutes. Jane-Anne doesn't let her disease slow her up one bit.
Jane-Anne is everybody's "kid sister". For example, if a group of road nurses meet at Taco Bell or somewhere for a bite of lunch, you can always spot Jane-Anne in the thick of things, trailing the crowd while hollering something to the effect of: "Hey, y'all! Wait just a minute while ah check mah sugar and give mahself some insulin! Ah want me a Mexican Pizza!" And then she'll do just that---while standing over in a corner at Taco Bell, pricking her finger, checking the blood on the glucometer, and then giving herself an insulin injection--- just in time to rush back into the line and give her food order to the startled Taco Bell cashier. O*
Or else someone will bring food to the office, usually some sort of sweet treat like cake or donuts, and Jane-Anne will expertly eyeball the forbidden items as her brain quickly calculates how much insulin will be required to counteract the sugar's effect in her bloodstream, saying something like: "A half piece of chocolate cake? Ummm.....that's about 2 units of mah insulin". And then she'll quickly shoot herself with the dose of insulin so that she can eat the sweets without too great a consequence on her blood sugar level. O*
One Monday morning she told me that she'd gotten tipsy on vodka over the weekend. "*
"Vodka?" I said sternly. " You shouldn't be drinking alcohol with your diabetes.""*
"Oh don't be a spoilsport," she replied sassily. "Besides, ah've tested out all of the liquors---and ah found out that vodka is the only liquor that doesn't make mah blood sugar run up so dang high."I *
I fret about her constantly. I worry that she is still so new to the lifestyle of managing her blood sugar as a diabetic that she will become reckless and forget to check her sugar or give herself the required insulin, risking disaster. In fact, I am so concerned for her welfare that I've been guilty of "spoiling" her. Other road nurses frequently admonish me for "babying" Jane-Anne by doing such things as paying for her lunch, allowing her to leave work early, or making light of her foibles in the road nurse field. And I freely admit that I do all those things. But the reason for my soft heart is two-fold.F*
First, and unfortunately, Jane-Anne is an extremely "brittle" diabetic. Her blood sugar can wax frighteningly high or equally low very quickly, no matter how strictly she regulates her diet and insulin. And this worries me. I am forever nagging her to "be more careful" with herself. But every time I start harping, she'll just laugh my fears away and tell me that she's got everything under control. Most days, the first thing I ask her in the morning is "What was your fasting blood sugar this morning?" I cluck over her like an annoying mother hen. "*
"Aaaww, don't worry, Bo", she'll say. "Ah'm fine! It was only 45 this morning but ah made mahself eat a good breakfast to bring it back up to normal."T*
The other reason I worry so much is the ugly reality of employment in small Texan towns ---which is that Jane-Anne has no medical health insurance. She doesn't have any for the exact same reason that I don't have any myself. In fact, few Podunk road nurses have health insurance.
The fact is, here in Podunk most small-to-medium sized businesses don't provide health insurance for their employees, especially in the nebulous and precarious world of road nursing. Road nurse companies typically operate on the slimmest edge of their finances, slashing their budgets ruthlessly in order to make a profit. Thus, there are no frills for the employees. We have no health insurance, no paid sick or vacation time--- and no retirement plans.
Remember I told you that most road nurses do this work for the "love of the job"? It surely ain't for the benefits! And sure, I could move to Dallas and earn a lot more money with decent benefits---but then I'd have to leave my beloved Podunk.....
And so, because we have no insurance, we all subconsciously try to cling to good health as though we live charmed lives. And when we do get sick we rely on things like kind-hearted doctors who give out copious quantities of "free sample" medications, caring families who pitch in to help pay for medical bills, "time payments" on hospital bills, and weekly sales on medical supplies at Walmart--- and, of course, The Lord. J*
Jane-Anne doesn't make very much money on her LVN wages---salaries are astonishingly low here in Podunk. Her construction worker husband doesn't make very much money, either. And the financial burden of Jane-Anne's diabetes--- between the cost of the insulin, the syringes, and glucometer supplies--- has taken a huge financial toll on their living expenses. Twice, I have caught Jane-Anne shorting herself on her insulin doses because she was trying to make her supply of insulin "last" until pay day. I've also seen her giving herself insulin shots without using alcohol wipes to cleanse her skin first. W*
When I first caught her doing such things, I threw a hissy fit. I hollered at her, telling her to go into our company's supply cupboard and take as many syringes and alcohol wipes as she needed. And I offered to pay for her insulin myself. But she flatly refused to allow me to pay for it--as it costs hundreds of dollars per month.
Finally, when I forced her to confess the cost of insulin to the owners of our company---and the fact that she and her husband simply couldn't afford such an amount--- her uncle and aunt instructed her to charge her insulin to the company's account at the pharmacy. Additionally, I hit up one of my friends, a sales rep from a medical supply company whose mother works in one of the local doctors' offices. And the kind lady arranged for that doctor to supply Jane-Anne with some free insulin. And furthermore, I instructed Jane-Anne to ask her diabetes doctor in Dallas for some free samples of insulin--- which is another sore subject because Jane-Anne has to pay $300 cash each time she visits that doctor, since Dallas doctors charge a hell of a lot more for office visits than do our Podunk doctors.
And so it goes---life without health insurance in Podunk.T*
The last time I went to my own doctor for a severe sore throat, headache and nausea, he took one look into my throat and said: "Oh damn, Bo---you've got strep. Why couldn't you have the flu like everybody else? And you don't have health insurance, do you? Okay, honey just sit tight."
"I'm dying, doc," I told him melodramatically.
"You ain't gonna die," he said as he opened a cabinet. He*
He then mixed up two injections from four mysterious-looking vials in the cabinet---and I swear I have no earthly idea what in the hell was in those vials. And I was so ill that I didn't care. After he mixed up the shots he hollered down the hall at one of his nurses. "Tina-Lynn? Come give Bohemian these two shots." Then he told me: "I'll be right back."H*
He left the examining room for a few minutes, during which time Tina-Lynn came to give me the shots. "Bend over, Bo" she said. When she was finished giving me the two shots, she gave me some instructions. "Okay, Bo, these shots are going to make you very sleepy---and I know you live close by. So go straight home, rub Vicks salve on your feet, and then go straight to bed."
"Yep, your feet. And go to bed."I*
I sat there rubbing my smarting butt for a few minutes as I waited for my doctor to return. And then I perked my ears up towards the door---because I always like to eavesdrop when I go to my doctor. His busy office is the hub of a lot of good Podunk gossip. I could hear him out in the hall talking to another patient. She was asking him why she felt so rotten. "*
"Why do I feel so damn bad, doc?" she asked. "I feel like a horse that's been rode hard and put up wet. And half of the church congregation is sick, too.""Y*
"There's a nasty bug going around," I heard my doctor reply. "And you caught it. That's why you have those body aches, that cough, and the headache."
I heard another patient call out to him from her examining room: "Doc, I feel terrible, too. So can you tell my husband that I'm too sick to cook dinner tonight? I just don't see no reason why he can't just heat himself up a Swanson Pot Pie for his dinner, you know? And by the way, what is the name of this bug that is going around?""I *
"I have no idea," I heard him reply.
In a minute or two, he returned to my room. "Here you go, Bo," he said, handing me what he had in his hand, which was a Walmart sack full of medicine samples--- some Biaxin XL antibiotic and DuraMax cough/congestion medicine. He also handed me a written prescription. "O*
"The medicine in those shots should start working right away,"he stated."And then I want you to take these antibiotics and the DuraMax.And here's a pain-pill prescription for that headache---the generic brand won't be that expensive."
"Thank you, doc," I said gratefully. But he wasn't finished with his instructions.
"And then I want you to go home and rub Vicks salve on your feet and go to bed, okay?"
"I will, doc," I replied obediently. An*
And I did exactly what he told me to do--- I went home, put Vicks salve on my feet, and then went to bed. And I felt much better the next morning. I still have no idea what in the hell was in those two shots but they worked. I didn't even miss any work, which is a blessing because I really can't afford to miss work. None of us can afford to miss any work when we're sick. Because when your employer doesn't give you any paid time off, the sad fact is that if you miss work you don't get paid ----it's just that simple.
That's just the way it is here in Podunk. (*
(By the way---I worship the ground my doctor walks on. Not just because he gives me free medicines, but because he is one of the most dedicated and hardworking doctors that I have ever seen in my life. He works 24 hours a day, 364 days a year, and he is truly one of the unsung heroes of Podunk--but that's the stuff for another blog entry...)W*
Where was I?O*
Oh yes, I was talking about Jane-Anne. A*
Anyway, Jane-Anne has become so adept at her daily carb-counting that she's become a great teaching resource to our patients. She will patiently sit down with them for hours at a time, teaching them how to "carb count" for themselves. She goes over their diets and insulin regimes with them, encouraging them to comply with their doctors' orders. And she gets results. I've seen some formerly non-compliant patients suddenly stop "cheating" on their diets and start earnestly following their doctor's orders--- simply because they have developed a trust in Jane-Anne. They trust her because they know that she has to endure the same daily regimen as they do.
These diabetic patients adore Jane-Anne so much that they frequently cook her some "diabetic treats". It is not uncommon for Jane-Anne to return from her day's visits clutching a plastic Tupperware container full of home-made diabetic foods. "H*
"Hey, Bo! Look what Mrs. Madison made me!" she'll yell out as she bursts into the office, blonde pig-tails flying, a plastic container in one hand and her nurse bag in the other. "You ain't gonna buh-leeve it! Diabetic hushpuppies! There's cornbread and cayenne in 'em---but not a smidgen of sugar! They taste almost as good as Mee-maw's hushpuppies......but don't tell Mee-maw ah said that, okay?"J*
Jane-Anne is very naive about the outside world. Except for her trips to the Dallas diabetes doctor, she has never been anyplace else outside of Podunk except for one trip to Houston. She has been so sheltered here in Podunk that she is the proverbial "babe in the woods"---and it frequently shows. She says the funniest things, sometimes, and it just cracks me up. T*
The other day we were all having our daily "report", where we all sit around a table and give the details of the day's visits. Jane-Anne had been to see one of our elderly patients, an outspoken lady who frequently says somewhat "racy" things. "*
"Ah did the wound care on Mrs. Petrie's arm," Jane-Anne reported. " The wound looked okay but she hollered bloody murder when ah removed the bandage. She said that the tape pulls out her arm-hair when it comes off. Ah told her that she has the hairiest arms ah've ever seen---and she made a joke and told me that she'sa 'morphrodite'."I*
Up to this point I had only been paying half attention but at this comment I suddenly jerked to attention, almost falling out of my chair. "D*
"Do what?" I asked incredulously. I could see the other nurses suppressing smiles. "A*
"A morphrodite," Jane-Anne explained earnestly. "You know, a person who has both female and male characteristics. Mrs. Petrie said she has so much hair on her arms that she's like a morphrodite..."I*
And I will confess here that I still haven't been able to bring myself to correct Jane-Anne and inform her of the correct pronunciation of the term "hermaphrodite". It is simply too funny to hear her call it a "morphrodite"---and yes, I will let her slap me upside the head if she ever finds out the truth.... A*
And so Jane-Anne calls it a morphrodite to this day...S*
Sometimes during our daily report, we have to discuss the terrible consequences of the scourge of diabetes upon our patients' bodies---life-threatening complications such as heart disease, kidney disease, vision problems, skin ulcerations, dry gangrene on feet and fingers---and heart-breaking amputations of limbs. Jane-Anne will hear this stuff and become visibly upset. And this just kills my soul. A terrible helplessness rises up in my gorge and causes a lump in my throat--- because it hurts me to the core to see Jane-Anne's raw fear of this horrid, life-stealing disease--- and yet I know that there's not a dang thing that I can do about it.*
One day, Jane-Anne came to me and asked a question in a quiet voice. "*
"Ah'm going to die young, ain't ah?" she asked plaintively. "W*
"What in the Sam Hill makes you ask a fool question like that?" I asked gruffly.
I didn't want to have this converation!"Ah*
"Ah know it....ah know that ah'm gonna die early," she persisted. "Just like Julia Roberts did in that movie 'Steel Magnolias'---ah'm gonna die young.""O*
"Oh for God's sakes, Jane-Anne," I protested. "You are NOT going to die young. That was just a silly movie! They always make things look overly dramatic in movies.""*
"No, ah don't think so," she stated stubbornly. "My diabetes doctor in Dallas told me that ah shouldn't try to have a baby yet--- same as what happened to Julia Roberts in that movie.""T*
"That's because you were only recently diagnosed with this thing ," I said. "You simply need more time to get your system stabilized on the insulin before you go and get yourself pregnant. And besides, there are new treatments for diabetes being invented every single day. Just look at thatexperimentthe Canadians have done where they cured diabetes in mice---why, it probably won't be no time at all until they come up with a cure for humans...""E*
"Even if the Canadians do come up with a cure, ah sure as hell won't be able to afford it without health insurance," she replied sourly. "H*
"The hell you won't, Jane-Anne," I continued. "If the Canadians find the cure for diabetes, I'll pay for you to go up to Canada and get the dang treatment MYSELF, do you hear me? Just don't get pregnant this year like your doctor said....""*
"What's the state flower for Texas?" she suddenly asked, catching me off guard. "U*
I told her. "Why do you ask?""*
"Just asking..." she said. A*
And as she walked away, I thought I heard her murmuring something about "steel bluebonnets"....And*
And so I continue my daily hovering and "babying" of Jane-Anne. I worry about her because sometimes she makes mistakes...
One day this week there was only me and Jane-Anne in the office. I was piddling around in the supply cabinet, counting supplies, when I heard a strange sound. I turned around to see what had caused the sound---and I saw Jane-Anne slowly slumping to the ground by her desk, her glucometer rolling away on the floor where she had dropped it. The glucometer bounced several times and then came to rest on the floor by her nurse bag. "W*
"What the hell?!" I cried, rushing over to her. She was pale as a ghost---and little beads of sweat were forming on her skin. "A*
"Ah....ah must have overshot mahself," she said wanly. "Y*
"You gave yourself too much insulin?" I asked stupidly, kneeling down onto the floor by her. I took her head in my arms and tenderly cradled it into my lap. And as I held her close, I asked: "What was your blood sugar, honey?""A*
"Ah don't know...." she replied weakly. "Ah felt funny--- so ah was trying to check it---but then suddenly everything went kinely dark and woozy..."S*
Still cradling her in my lap, I reached over with one arm to retrieve the stray glucometer from it's resting place on the floor---I needed to see what the result of her blood sugar check was. To my utter mortification, I saw that Jane-Anne's current blood sugar level was a dangerous 37."J*
"Oh Good Lord, Jane-Anne!" I cried. "Your blood sugar is only 37!""*
"Oh hell," she replied shamefully, starting to cry. "Ah gotta get somethin' to eat....please....get me somethin' to eat....""I*
"I'll get something," I told her, panicking. "Hang on---I'll be right back...."I*
I gently set her head down on the floor and tore out of the office. I was heading for our building's small kitchen in the hopes that there was some juice or other sweet item there that would bring up Jane-Anne's perilously low blood sugar. I ran down the building's main hall, flying past all the oil paintings of the building owner and his oil wells. I bet he has health insurance, I thought to myself... I burst into the kitchen and threw open the refrigerator door. There wasn't much in there, but I found some apple juice. I madly tore open some sugar packets that I found by the coffee machine and poured them into the juice, stirring it in with my finger. I*
I ran back to Jane-Anne, trying not to spill the juice in my frenzy. I set the juice down and helped Jane-Anne up to to a half-sitting position against her desk. And then I carefully started pouring the ultra-sweet juice into her mouth---and she tried to swallow it as quickly as she could without letting too many stray drops of it dribble down her chin.
After she drank all the juice, we sat still there on the floor for awhile--- me holding her close as big tears rolled down her cheeks---as we waited anxiously for the juice to have its desired effect. F*
Finally, some pinkish color began to come back into her cheeks. I could see that the sugar was working, and I started to breathe a little easier. That was a close one! What if she'd been alone?
And then she stopped crying.... and she asked me, quite seriously, a question which must have been on her mind for awhile. "B*
"Bo, do you....do you ever get mad at God?" she asked. I*
I thought a minute before replying. And when I gave my reply, I was equally serious. "*
"Yep, I do, sometimes...""*
"Ah get so mad sometimes," she said in a strangled voice. "Because ah want to know....why me? Why did ah have to be a dang diabetic? Why, Bo?""*
"I don't know, baby," I replied sadly, putting my arms around her. "I just don't know. I frequently ask myself the same damn question. Why? Why did I have to be an alcoholic? And who knows? Maybe God puts these burdens on us as some sort of test. But whatever the reasons, we have to bear these burdens as best as we can. For me to stay alive I have to avoid alchol completely and follow AA teachings for the rest of my dang life. For you to stay alive you've got to check your dang blood sugar and take insulin shots every day. That's just what we've got to do, honey, ya know what I mean?"
"Ah guess you're right, Bo..." she replied and sighed deeply. I*
I sighed, too.
And we sat there for a little while longer, me rocking her back and forth as we waited for her to feel better. And in a bit, she felt well enough to get up off the floor....and to go on with her day. W*