FUO

I can't sleep.

It's probably the fault of the cup of coffee I had around ten this morning. We went to visit Pete's parents this weekend, and I forgot to take my antidepressant with me, and I think I revert back to my old caffeine-intolerant self when I haven't had the 'zac in a few days. (Fully medicated, I am able to drink an entire cup of coffee with no ill effects, which is a lovely little thing.)

Rather than lie on the dumb bed and listen to my mind chatter away, which was getting to be a little irritating, I thought I'd come let it chatter at the computer for a while instead. This insomniac mind has, oh gosh, just lots of tedious things to say, let me tell you. Well, I suppose it might have some interesting things to say too, except they're kind of getting lost in all the noise. With a hundred tiny thoughts rattling around like dried beans in an empty Crisco can, no one thought has any more value or weight than any other.

I've been running a low-grade fever for no apparent reason. I had this once before, when I was working as a geriatrics clinic nurse and absolutely running myself into the ground with work and stress. I saw a couple doctors, and as near as we could figure, it was just a different kind of manifestation of my chronic fatigue syndrome. The Infectious Disease doc thought it had something to do with an overproduction of cytokines. In the afternoons, my temp used to get as high as 101.5. I haven't measured in the afternoon this time around. An hour or so ago, it was only 99. But I've felt unpleasantly warm all day. Pink-cheeked. Febrile. It's annoying, but way better than the other kind of CFS times, because fever is the only symptom.

I got a wristwatch finally because if you're a hospital nurse, it's generally considered good form to actually be able to take pulses and respiratory rates. It was $20 at Filene's Basement. It has a metal band, which even with the maximum number of links removed is kind of loose, like a bracelet. I've always before had leather bands, so when I look down, it looks like I put on somebody else's arm by mistake. It makes me feel kind of chic and nonchalant and elegant. I remember when I was an adolescent, I really liked those few times when I'd be at a friend's house and end up having to wear her clothes for some reason (like maybe I'd sleep over when I hadn't been planning to). I felt so un-self-conscious in somebody else's clothes. Like I didn't have to bear the whole weight of my own geeky awkwardness if I wasn't in my own clothes, which, being mine, had become fully saturated with the unforgiveable essence of me.

Last week we practiced starting IVs. We each got assigned a hand with a wrist and brief stump of lower arm attached. The hands are cleverly made for just such an occasion, and come equipped with numerous plump, delicious, sproingy veins. When you take your little needle and access them and push in the IV catheter, they reward you with a nice "blood return" of red food coloring. We also tied one another's arms with tourniquets and cajoled out as many likely-seeming veins as we could, for practice, though we didn't then actually insert any pointy things into each other. My preceptor says that nurses on her unit start their own IVs. For the first time, I can kind of picture doing it myself. Well. You know. Sort of.

This week, our last two class days are devoted to EKG interpretation. My nursing school only offered that as an elective, and I took Nursing Theory instead (fun, if at times maddeningly dumb, and infinitely less practical). I went in this afternoon knowing pretty much nothing except normal sinus rhythm, and I walked out knowing more than that, so it was pretty satisfying. My favorites were atrial flutter (which I'd never before known was distinct from atrial fibrillation) and Grade 3 A-V block. In atrial flutter, there's this attractive regular rick-rack of atrial depolarizations (they call it "sawtooth," but I like my visual metaphor better) between the big ventricular jags. In A-V block, it's so wild because the atria and ventricles, instead of being tightly coordinated and in synch, are just going along, doing their own thing, entirely oblivious to each other. The atria can be contracting along 80 times per minute, and the ventricles can be doing their own independent plod at 25 times per minute, and they might as well be in different rooms rather than part of the self-same organ.

I've been writing out oncology drug profiles on little index cards so I can memorize them and show my preceptor that even if I'm terribly all-thumbs-ish when it comes to practical tasks, I care and am, you know, diligent and stuff. I'm also going to spend some serious quality time with my nursing procedure books and visualize myself doing dressing changes and spiking IV bags and stuff like that over and over again, so that maybe on Friday I can just go in and do some things smoothly.

Also, I have some more unsolicited product endorsements. Stain sticks (which you might think wouldn't actually work but really they do). Camisole/tank tops with shelf bras right in them. Steven Johnson's Mind Wide Open. Whole wheat tortillas. Extra-dark chocolate Petits Ecoliers.

Now that it's 1 am and therefore only 6 hours until I have to get up, I guess I'll try again to sleep. Maybe the noise in my brain will have died down by now.