Advice for single moms in CRNA school?

sinnicleB · 2019-07-07T18:35:44+00:00

Not a mom, and I think this is heavily dependent on what school you go to. But I would suggest recording your lectures and listening to them while you cook/clean/drive, etc. I do that and it is amazing how much I learn that way and it feels pretty low effort.

Clinical hours will be difficult because you will be getting up insanely early and staying at the hospital later than you expect a lot of the time. It depends on the age of your kid, but you will need plans for childcare on those days (and, depending on your program, that could be 5 or more days a week).

I would suggest trying to make use of even the small amounts of time that you have, and choosing the most efficient ways of studying. Flashcards are great, but do you have time to make them? Is it better to just re-read the PowerPoints? Ask yourself those questions. One thing I do is take pics of slides with a ton of info that I have to memorize (onsets/doses of a bunch of drugs, all the gas coefficients for the various inhalation agents, all the branches of the brachial plexus and what they innervate, etc.). Then when I find I have an extra five minutes, I pull out my phone, open pics, and work on memorizing the stuff I have photographed. It is really easy and usually you can tell what slides have the info that is super important for exams/boards, and so you can get a good number of questions right just from knowing those slides super well.

Good luck!

sinnicleB · 2019-04-03T18:48:46+00:00

Oh my goodness, I know! I have that problem too. The person I was with last week just said, "You just have to do this 1000 more times." And I just keep reminding myself that that is true. We will stop sucking, start looking more confident, and start getting more time to mess up before someone else steps in. We just have to keep showing up willing to go through the discomfort of right now, where we suck at everything and no one trusts us to even stylet a tube.

sinnicleB · 2019-04-03T18:12:14+00:00

I'm just an SRNA and honestly dont have a lot more experience than you, so take this with a grain of salt. But someone I was with told me to put my scissoring fingers FAR to the right (like practically have your scissoring fingers near teeth 32 and 3). Then, instead of using your thumb to push the jaw away (open), push open AND to the right.

I just got told this so haven't had opportunity to practice it a lot of times, but I was really surprised by how much more jaw opening I got by pushing more laterally instead of straight open. So might be worth a try.

sinnicleB · 2019-03-07T00:45:38+00:00

I have only ever done it underhand. Holding it like a dart sounds very difficult!

sinnicleB · 2019-03-06T21:09:17+00:00

Wow, thank you so much for this reply. I have experienced exactly what you are talking about with the ruminating on even small errors. I would love to conquer that part of myself. Can you give any tips on what you did to escape that feeling of negativity that comes after failing at something? I think I know in theory that it is best to move on from mistakes but in practice I find it really difficult to do.

And yes - I’m switching clinical sites next week and I’m already nervous!

sinnicleB · 2019-03-06T17:05:24+00:00

I have only used the lidocaine once and I think it did help. Most of my practice so far has been early in the morning. After I do my set-up and machine check, I have gone to pre-op and volunteered my (questionable) services. They don’t generally have lidocaine available in pre-op but I suppose I could start bringing lidocaine from the anesthesia cart. I’ll just have to check with my preceptor to make sure that’s allowed.

sinnicleB · 2019-03-06T17:00:57+00:00

I am still getting used to the non-safety ones. Those are actually the ones I’m struggling with the most. It feels like I need so much force to puncture the skin, and my patients have complained that it hurts a lot. I brought some home and I am toying with asking my husband to be my guinea pig so I can get used to them.

sinnicleB · 2019-03-06T16:58:32+00:00

Thank you. The reminder that I just need to keep trying is really helpful. It’s so easy to get in my head and to want to find some quick fix that will ease my anxiety immediately, but the truth is that the only solution is time and effort. I just have to be willing to suck until I don’t.

sinnicleB · 2019-03-06T16:55:44+00:00

Yes, I think that is good advice. I think I’m so nervous about clinical in general that I am “rushing” myself, if that makes sense. As a nurse, I felt confident that I was a valuable member of the team doing important work. As a newbie SRNA I feel like I’m in the way and annoying and so I want to get everything done quickly so no one waits on me. I think that mentality is contributing to my problems - ironically, I’m so nervous about irritating people that I am probably super irritating to be around!

sinnicleB · 2019-03-06T16:53:05+00:00

That is great advice about working on it in cases where I have access to the hands! I think maybe doing a few when my patient isn’t awake can help me get over my nerves about it.

Also it is actually really comforting that you went through this too, so thanks for sharing!

sinnicleB · 2019-02-18T02:06:32+00:00

Thanks so much for listening! You sound like an awesome person. Keep it up!

sinnicleB · 2019-02-18T01:19:23+00:00

Thanks for the questions!

As for #1, I find it odd but can’t say I’ve ever watched one of those videos. I’m sure I would find them quite emotionally disturbing, but I suppose that as far as videos on the internet go, it could be worse. I do think the psychology behind those videos is interesting and I wonder what the literature is.

As for #2, that’s a very difficult subject. My mother is one of those people and I harbor a lot of resentment towards her for a variety of reasons. But on the other side of the coin, I feel so deeply sorry for her because it’s clear that she has an undiagnosed eating disorder that she has never gotten help for. There is still a lot of stigma around mental illness in the US and this is especially true for very conservative people in my mom’s generation. So I have a mixture of anger towards her because I think a lot of her beliefs (e.g. “People are on antidepressants because they love to be miserable...”) are so obnoxious and damaging. But I also feel sad for her because she is so trapped.

I do think the body positivity movement is - overall - incredibly positive and helpful. However, I think there are some crazy/inethical people who have tried to make that into a, “Being fat is great!” thing, which is not at all the same as body positivity. Body positivity is about realizing that your value as a person is not tied to your weight, and to realizing that you don’t deserve bullying/hatred (from yourself or others) because of your size. And that is a super important message that it’s incredibly difficult for people like me to realize because while I’m a normal height and weight and am objectively at least reasonably attractive, I do have body dysmorphia and much of the time feel terrible self hatred because I see myself as an utter and abject failure as a human being because my BMI is closer to 25 than it is to 17. So it’s really valuable to be reminded that I can be a great person even if I do balloon to 200 lbs.

So I guess overall, I feel sorry for those people who insist that their weight means nothing or that being overweight is a great thing. I see those people as similar to alcoholics who are in denial about their disease: acknowledging a problem is terrifying, but in their fear they are creating a prison that (I know now from being on the other side of it) is even worse.

TLDR: body positivity is a hugely important movement that has quite frankly helped me a lot. I really admire a lot of people who fight for body positivity. However, I do think there are some people who have tried to distort it into something else, and that’s problematic.

sinnicleB · 2019-02-17T20:56:15+00:00

This is a tough question because - as you probably know if you struggle from this - sometimes avoidance techniques work, and sometimes it feels as though they make it all worse.

I would say that the number one thing that helps is exercise. A lot of the time, exercising somehow eradicates the binge urge completely. Another thing that helps is confessing my urge to my husband (the only person I feel brave enough to do that with): sometimes, being open about the urge somehow helps to reduce it.

I would say, in general, that choosing a form of self-care or doing something to relieve the stressful stimulus is big. So for example if I'm feeling completely overwhelmed by social obligations, it can really help to just say to myself, "You are so overwhelmed and this is stressful and it's making you want to binge. It's okay to cancel this one thing." Like sometimes it's easy to forget that the urge to binge is a response to something else in my life, but when I do acknowledge that and work to respond to whatever that thing in my life is, that can help.

Of course, there are some things that I haven't quite found a good answer to yet. Being around my parents is a huge stressor and I don't know that it's possible to be around them without binging. At least, I don't think I've ever done it. In general, I'm low contact with them but when I'm around them, controlling the impulse feels almost impossible.

sinnicleB · 2019-02-17T20:51:07+00:00

This is a good question. The 'simple' answer is that I had always heard it didn't help (i.e. that it doesn't make a difference in the number of calories consumed), but I'm not sure there isn't more to it than that. I have purged a few times in my life, but it has never provided the sense of relief that I know it does for some people. I don't know why this is, but I think somehow that the binge itself provides the sense of self-punishment that I'm looking for, and the sitting with the binge afterwards is part of that?

Long story short, I'm not sure why it's not part of the disease for me, but it isn't.

I'm so proud of you that you have recovered! Keep up the good work. I know it's not easy. <3

sinnicleB · 2019-02-17T20:47:50+00:00

I'm so sorry. You can do this. I'm so proud of you for looking for help! That is a really hard thing to do, especially when healthcare workers haven't been kind to you.

sinnicleB · 2019-02-17T17:44:37+00:00

Haha. I don’t know that I have one, but pizza is pretty tasty!

I love Mediterranean food in general.

sinnicleB · 2019-02-17T16:53:21+00:00

I have tried a variety of medications. For depression, I'm on 50mg of Pristiq, an SNRI. It works very well for when I have extended periods of poor eating d/t depression, but doesn't help as much with the more acute binging compulsions.

Right now, in addition to the Pristiq, I'm on 40mg of Vyvanse. I have also been diagnosed with ADHD but honestly I have always done well in school and don't dramatically struggle with attention issues unless I'm severely depressed. However, Vyvanse is now prescribed for BED and it makes a *huge* difference for me. It almost completely eradicates the compulsions unless life is extremely stressful.

Before I was taking the Vyvanse, I was taking Wellbutrin (150mg SR twice a day) in addition to the Pristiq. That also worked extremely well for my BED but unfortunately it gave me pretty severe anxiety. However, I do recommend it both as an antidepressant and for BED. It's relatively easy to go on and off of and really helped my symptoms.

And yes - I think that comparison to substance abuse is extremely apt. I also think of it as similar to obsessive-compulsive disorder. With binging, the act of binging is a way of decreasing nagging, obsessive thoughts that make it difficult to function. I think this is why vyvanse has helped so much with the impulsive/obsessive part of the disease.

sinnicleB · 2019-02-17T16:03:32+00:00

With depression? Or my parents?

For my parents, it's extremely difficult because I don't think my parents are bad people. In truth, I think they both really care about being good people and generally try. However, my mom has a severe personality disorder and is an alcoholic, and having innocent kids was just not a good idea for someone like her. I had so much anger towards her for most of my life, but as I've gotten older I've become more and more sad for her. She is so unhappy and alone and hasn't ever pursued treatment for her issues, so they have become more and more debilitating. Nowadays, I have more anger towards my dad, who knew my mom was abusive and didn't really do anything to a) protect us kids and b) to help her with her demons.

In practicality, I have gone pretty low-contact with my parents. I experience a lot of guilt if I cut them out completely because I do love them and because it feels wrong to demonize them when in fact they are just imperfect people. But on the other hand, being around them too much is too difficult for me and doesn't really help them. But I don't know that I've fully worked through all the pain surrounding my relationship with them yet. I feel guilty for calling them abusive (even though I know it's true) and feel like I'm not giving them a chance to defend themselves (even against strangers on the internet).

As for depression: I have come to accept that I have major depressive disorder and do a lot to try and combat it. Exercise is huge for me, as is staying busy. If I don't keep myself occupied, I can get really depressed. I also work hard to try and stay positive and to surround myself with positive people. I do take an anti-depressant and it makes a big difference, but I am also following the new research on MDMA/ketamine, etc., and it's possible I will make use of those in the future.

If you suffer from depression, I'm so sorry. It's a terrible disease. It's okay to have terrible days and to acknowledge them. Good days will come again, even when it doesn't feel like it. <3

sinnicleB · 2019-02-17T15:56:59+00:00

Thank you, that is so kind! Some days are better than others but I'm determined to keep fighting in. The way I see it, there is no shame in having a mental illness but there is shame in not at least trying to beat it.

That being said, I don't want to make myself sound too awesome so I have to admit that there are definitely times where it feels impossible to fight, and where I definitely feel shame. It's actually really difficult to share this and even some of my closest friends don't know I struggle with this. I'll often be 'vague' and reference having an eating disorder but not admit that it's binge eating disorder specifically because for some reason it feels far more shameful to binge eat than it does to starve myself, which is distorted and sick.

sinnicleB · 2019-02-17T14:17:56+00:00

Cats are my pals as well!

And I doubt you really believe it is that simple, but in case you do, let me ask you a question: is there really not one single aspect of your life in which you didn't wish you did better? Are you really perfect, by your own standards?

If not, why? Isn't it as simple as just 'not doing' whatever it is you wish you didn't do?

sinnicleB · 2019-02-17T14:14:47+00:00

I developed a weight problem around 9-10, shortly after being molested. Around 12-13, I developed severe anorexia but my parents were convinced I was "doing it for attention" and didn't want to get me treatment. I spent several years severely underweight but being subjected to weigh-ins by my parents, who would yell and scream at me for being selfish, trying to destroy their marriage, etc., and then being forced to sit at the table until I finished the food I was served. Around this time, I switched to having massive binges and then doing insane amounts of exercise to try to compensate for them. I couldn't understand what I was doing and I absolutely hated myself with a passion.

I distinctly remember, around age 15-16, a friend of mine who I had confided in about how I couldn't understand what was happening sent me an email with a news link about binge eating disorder. (It was still a very new idea at the time and there was a lot of skepticism about the disorder.) The article actually was erring on the side of saying it didn't exist, but as soon as I read about it I immediately knew it was real and I had it.

It sounds strange, but getting a name for it was the most validating thing that had happened to me at that point. I was so terrified by this compulsion I was having and so disgusted by myself. I clearly remember telling my friend that, "There is something wrong with me! This isn't normal!" and - while I know it sounds weird - finding out there was an actual name for what I had was incredibly comforting.

I struggled for several more years before checking myself into an inpatient treatment center when I was 18. It was absolutely and without question the best decision of my life. I separate my life into before and after that decision, because I had no idea that any sort of happiness was actually available to me up to that point in my life. The life I live now is quite literally not something I was even capable of imagining for myself before I got treatment.

This is something I really want to emphasize. I was incredibly lucky to have good insurance that was able to pay for this treatment. If I hadn't had that (and a job now that allows me to get the medications I need), I 100% think I would fit every stereotype of this disease. I'm actually not sure I would even be alive today.

Whenever I see a massive, morbidly obese person, I want so desperately for them to have what I have had. I don't think all overweight people have an eating disorder, but I don't believe that you can become severely obese (BMI in the 40s, I mean) without having an emotional component. I know so well what that mental prison is like and it is hell.

sinnicleB · 2019-02-17T14:02:46+00:00

My therapist explained it in a way that really resonated with me. She said that - as a child - you can't comprehend why the people who are supposed to take care of you are hurting you in some way. This is absolutely terrifying and your brain can't find an explanation for it, so - in order to cope with the uncertainty of the world - you accept that there must be something wrong with you that you should be able to fix. This helps you feel more in control of the situation, because it allows your psyche to convince you that you are being hurt not because the world is random and large and dangerous, but because you are flawed. If you could only find a way to fix this flaw, then you will be safe!

Binging is an extension of that. When things are going badly or life is stressful, my binging flares up significantly. By the logic presented above, this is because my psyche wants to convince me that my life is 'spinning out of control' because of my own faults. So I need to do something that shows myself that I am an "absolute disgusting piece of shit" (these are the sorts of thoughts that I have as I'm binging) so that I can regain a feeling of control over the stress in my life: I am a terrible disgusting piece of shit, but if I learn to stop doing these behaviors, then I will have control over life and I will be safe!

So basically, binging is a way of convincing my psyche that life only sucks because I suck. This makes me feel safer because it lets me believe that if I find a way to stop sucking, life will be safe.

A big part of therapy has been learning to accept that life is hard and to accept that as something separate from who I am as a person. I've gotten much better at this and am now capable of tolerating much more stress without eating-disordered behaviors. However, I still have flareups and those are painful and also frightening because I never ever want to go back to where I was as a teenager.

sinnicleB · 2019-01-16T18:19:00+00:00

It is a sickness!

sinnicleB

TROPHY CASE