For the past few months, I’ve been pretty quiet with writing. The reason?

My dad was sick.

On June 1st of 2018, my father was diagnosed with a Glioblastoma or in layman’s words, terminal brain cancer. The same cancer that robbed Senator John McCain of his life, except dad’s tumor was inoperable and he decided against treatment after three weeks. Our entire journey from diagnosis to death lasted 5 months.

As a healthcare provider for over twenty years, I dove into patient care mode. We healthcare people tend to compartmentalize, turn off the feelings to be able to provide the care needed. I was no different.

For the final three months of my father’s life, my husband and I were there, camped out in his backyard every evening, night and morning to help provide care alongside my mother and other family members.

Good friends lathered us in visits, cards, food, and so many prayers, providing the palpable presence of God each day. His steady, solid promise of peace wrapped us in his nail-scarred hands while we watched our brilliant, talented father lose his ability to work in his woodshop, speak, eat, and walk.

There are no words to describe the heartbreak. Cancer devastated every part of his physical body, but the one thing my father did until the day he died was love.

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He gave kisses to my mother, squeezed our hands or tried to give us a few jumbled up phrases of I love you. Those last days, I will always cherish, especially now in the aftermath of his death, when his earthly absence seems so surreal.

For all the caregivers out there taking care of patients with Glioblastomas, I want to provide some insight into his death, because when I searched there was a lack of information. So here’s a summarized version of the last week of my father’s life.

  • No pain. – Dad did not experience any pain. He did lose the ability to use his right side early on and often complained of numbness, but even that didn’t seem to bother him much the last week. We gave him morphine and lorazepam to calm his breathing the final two days of his life.
  • No seizures – probably due to the antiseizure meds he took from the beginning.
  • He did lose interest in eating – This was one thing he loved up until the last week. The nurse at Solace told me that when they stop asking to eat, then their body is shutting down naturally and they do not feel hungry. This information brought me some comfort.
  • He slept more and more every day and was not able to be awakened the last two days.
  • Clarity: Dad did have one moment of clarity the night before he died. He was alert, squeezed our hands, tried to talk to us. A beautiful time I’m so thankful for to this day.
  • Solace and hospice nurses provided everything we needed and were a constant support through the entire process.
  • Labored breathing: The night before Dad’s death, his breathing became labored. He did have what many call the “death rattle.” This was alarming at first, but once we gave him the morphine and lorazepam, then his breathing calmed.
  • Kisses: I gave him kisses every day. I knew our time was limited. I wanted him to feel loved even when he was not conscious.
  • His last breath: He died with one quick, audible, peaceful breath. I believe that was the time Jesus called his name and Dad left his earthly body, his soul uniting with his Savior in eternity. Now, he’s in the presence of the perfect, eternal love of Christ.

An estimated 23,830 malignant brain cancer diagnoses are predicted for 2018. My father was one of those, but many are still out there caring for their loved ones or just finding out their devastating diagnosis.

To all of the loved ones providing care, remember that even though the days and nights feel long, the time is short, so … Be like my father and show love until their last breath.Be Like My Father Tweet

In memory of my father, Don Moore, this blog will carry on his name – StoryMoore.

 

The Daisy Game

He loves me…he loves me not…he loves me!

When life hits us hard, sometimes we play the Daisy game and question whether God loves us or not.

But God doesn’t play games with His love. His word is clear. God loves us no matter who we are, where we’ve been, or what we’ve done. Nothing we do can make Him love us more or less.

Question is:  Do we love Him?

Are you a Frogger too?

 

frog-2581635_1920.pngI’m a job hopper.

Some might say I change jobs more than Kim Kardashian changes her clothes, although that might be a bit of an exaggeration.

Most people view job hopping as a negative trait, but most can agree that the days of staying with one company for your entire work life is almost nonexistent.

In my career of twenty years, I’ve stayed pretty much in the same genre but played at least seven different gigs. My work exploits have taken me from the halls of major US trauma centers to corporate life with travel throughout the country and world.

Some might find my Frogger work style to be appalling or at the very least unloyal, but for me, life isn’t about the 9-5 workday or achieving the perfect career with the perfect company.

Life is about glorifying God, finding what inspires us, and serving others with those passions.

Trust me, when it comes time for those same huge companies to make hiring cuts, their loyalty to their employees will be scarce.

Although I’m settled now in a career I love, the journey of getting here included much change.

Why did I do this? I’m glad you asked.

1) New Adventures

Day in and day out of doing the same old job just became boring. No one should have to sit at a desk and think, “I’d rather shove hot peppers up my nose than do this anymore.” Then off I’d go to the next work adventure.

Lessons learned: If it’s a new adventure you want, then always ask your manager for something new to combat the boredom. If they have nothing or refuse to change things up, then it might be time to try something new. My shortest stent was at a job for five months, when I realized I had to get out of the toxic environment. Most jobs I stayed at for at least 2-3 years.

2) Reinvention of myself

A friend brought this to my attention one day when we were discussing my latest endeavors. He said, “You always reinvent yourself.”

I’d never thought of it that way, but he was right. Job hopping doesn’t mean a person can’t get settled. I liked reinventing myself and trying new things. That should never be discouraged.

We all have more than one interest in our lives. Whether our passions included drawing, writing, singing, drama, teaching, performing ultrasounds, dabbling in technology or being part of a large corporation, we should always seek what inspires us and leave drudgery behind.

At the age of forty-four, I’ve done all these things and still pursue new activities I love. Right now, that is writing fiction stories, but tomorrow it may be flying a helicopter or scuba diving.

Lessons learned:  Don’t limit yourself. There is nothing wrong with trying out new interests, especially if you can pay your bills while doing the things you love.

Don't limit yourself. Try something new.

3) Money

Since we brought up paying bills, then one of the reasons I have job hopped is for money. Yes, I hate to admit, I’ve taken jobs solely to increase my salary, but I have. To receive a raise once you’ve been hired for a position is difficult these days. By the time I hit the pinnacle of my job-hopping days, I was making over six figures a year in a position that demanded I sacrifice more and more time from the ones I loved.

Lessons learned: Money’s not everything. Time with my family trumped my finances and I moved on.

4) Different people

When we try different jobs, we get to meet different people, expand our social networks. Some of the funniest, smartest people I know I’ve met through work … except for you, Hubbie. You’re the best.

Lessons learned: Always surround yourself with positive people who support your work and be a good colleague to them, as well.

5) Family

My last job hop was made to spend more time with my family. I had experienced the blue-collar work life and the amazing, traveling corporate life, but when I looked closely at my true desires, my family rose above all.

Lessons learned: Even if we hold the most amazing job in the world, our family and loved ones are still the most important treasure in our lives.

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Diving Beneath the Surface with Lynn H. Blackburn

She’s cute, bubbly and is learning to Scuba Dive! Who is she?

Lynn H. Blackburn, my friend and mentor.

Lynn

This woman and published author runs a household with three children, homeschools her kids and finds the time to write and publish amazing books. Want to know how she does it?  Read her interview below:

Q:  Often times authors run into unexpected conflicts within their plotline and create an idea that’s not plausible in the real world. When you were writing Beneath the Surface, did you have any areas in the book, where implausible conflicts popped up that you had to rewrite? Can you give us an example of one and how you fixed it?

I usually start out with plotlines that are a bit (maybe more than a bit) far-fetched! LOL! And then I have to rein them in and modify them as I do my research. It can be hard to let go of an idea but usually, once I give myself time to adjust to the new way it has to be, I like it better.

I had submitted Beneath the Surface before I realized the way I had written Dr. Sabrina Fleming (a secondary character in this book) was completely unrealistic. Unfortunately, I didn’t realize how much of a mess I had made until I started researching her profession more fully for the second book in the series, In Too Deep.

I reached out to the folks at crime scene writers, a yahoo group where writers can ask law enforcement and forensic questions and have them answered by professionals in those fields. I was put in contact with someone who actually does the kind of work Sabrina does. He was able to give me suggestions for ways I could make her realistic rather than a caricature. We brainstormed back and forth through several e-mails until I had a description of Sabrina that was plausible.

Fortunately, I was able to fix her scenes in Beneath the Surface during the revision process—yay for revisions! She’s still completely awesome, mind-bogglingly (is that a word?) smart, and has mad computer skills. But I brought her a little bit more down-to-earth and made her relationship with the sheriff’s office more believable than it had originally been.

Q: You are a female author, so what was the most difficult thing about writing for your male characters, Ryan and Gabe? (We love Gabe, by the way)

#TeamGabe I almost wrote his story second but I’m so glad I saved him for last (insert evil author laugh). 🙂

I love writing guys. I love guys in general. LOL! I have a degree in chemical engineering and worked as an engineer for five years before our daughter was born. Engineering isn’t a female-dominated profession so I spent a lot of time with guys. Working with them, eating wings and blowing off steam during study sessions with them, arguing with them 😉 and of course, I’m married to one and I have two boys. I love being a woman, but I also think men are awesome and I’m thrilled God made us the way he did!

I’m always looking for ways to be sure I’m portraying all of my characters accurately, but in this book one area where I was very intentional about my guys, well, being guys, was when they were dealing with Mrs.

(No Spoilers Here)

There’s an exchange between Ryan (the hero) and Anissa (the dive team captain) that l structured carefully. Where Ryan sees a sensibly dressed middle-aged woman, Anissa sees expensive shoes and a designer handbag. I know there are some guys who would recognize that sort of thing, but Ryan’s not one of them. LOL! And since I’m in Ryan’s head, I needed Anissa to be there to tell him, “Hey, this woman is used to very nice things” because that’s not something he would have picked up on.  It’s something I try to pay close attention to, and I notice it when I read other authors…does this guy act like a guy, know stuff a guy would know, and not care a bit about stuff a lot of guys don’t care about? If not, there needs to be a good reason and you need to justify it.

Q: Tell us about a section of Beneath the Surface when you were writing and planned for the plot to go one way, but something happened and the story took you in a different direction. 

In order to keep this spoiler free, let me just say that I intended a different character to act as the red herring. But another character just kept putting themselves in situations that made them look like they could be the guilty party. I love it when that kind of thing happens! I stopped fighting it and I love the way it turned out.

Q:  What was the hardest scene in Beneath the Surface to write?

These are hard to answer without giving anything away! There’s a scene where someone is drugged. I think I rewrote that scene four or five times because the way I initially wrote it wasn’t anywhere close to realistic. I don’t have any personal experience with drug overdoses and I had it all wrong—everything from the way he experienced the drug to the way the medical professionals responded to his distress.

Writing is a very sanctifying process for me! Every time I write a book I’m blown away by God’s faithfulness. There’s always a point (usually several) where I am 100% convinced I will not be able to finish the book. Nothing is working, I have no idea what needs to happen next, it will be too long, it will be too short, it will be so bad my editor will cancel my contract…you get the idea! I end up doing a lot of praying and crying and begging God for wisdom and direction and creativity.

And He always supplies. Always.

Want to know more about Lynn – Go to:    http://lynnhblackburn.com/

Bowl of Soup, anyone?

Nothing like a good bowl of tomato soup on a cold winter’s day. Maybe a little, grilled cheese on the side.

tomato soup

But would we be willing to trade a gift of fortune, power, fame, and prestige for that bowl of soup?

“Of course not,” we say.

Are you sure?

Esau was the oldest son of Issac and Jacob was his little brother. At the death of Isaac, Esau stood to inherit all of his father’s wealth, power, prestige, and reputation.

donald duck wealth.gif

It would be like Bill Gates saying, “Here ya go, buddy boy. Enjoy the fruits of my labor.”

Or like Walt Disney handing us the proverbial “keys to the magic kingdom.”

Or Oprah Winfrey naming you the sole inheritor of all her billions of dollars.

Can you imagine? How would you react?

Would you jump up and down, screaming ecstatically? All financial worry would disappear. You’d be free to do whatever you wanted, travel wherever you dreamed and never have to want for anything again.

That’s what Esau was being offered, but instead of being thankful, he chose to trade his future security for one earthly desire. Hebrew !2:6-7 gives us some insight:

That there be no immoral or godless person like Esau, who sold his own birthright for a single meal. For you know that even afterward, when he desired to inherit the blessing, he was rejected, for he found no place for repentance, though he sought for it with tears.

Esau basically told Oprah, “No thanks, chick. I’d rather have this bowl of soup.”

blinking shocked emoji

What was he thinking? How could he turn away from everything for one meal of food?

In his defense, his brother Jacob did make a mean bowl of stew. He was like the Bobby Flay of Bible times.

Bobby flay

Maybe the pressure was too much or Esau didn’t care.

Or maybe he didn’t believe His father would actually give his brother the birthright. He thought he could live any way he wanted, disrespect his father, his inheritance, his family, but in the end, he’d still get whatever he wanted.

Don’t we do the same thing?

God wants us with Him in His eternal kingdom, to be with Him forever, never separated from the One who knows us best.

God tells us to be obedient to His words in the Bible, yet many of us still choose to live our own way and reject His way. We choose sinful lifestyles over our God-given inheritance.

We think that one day when we stand before God in eternity and plead for His mercy, He will forgive us because we were ‘good people’ down here on earth.

That’s the same thing as saying, “No thanks, God. I’d rather have my own bowl of soup.”

Tweet

Loved one, never trade fleeting earthly treasures for the glory of God and peace of heaven. Our Savior offers us everything. All we have to do is claim it for our own by giving our ‘bowl of soup’ life to Jesus.

 

Captain America was almost right …

captain america

 

 

Come on Captain America!  You were so close. The surgical defibrillation scene in Winter Soldier almost got the details correct. (Spoilers below)

During one of the scenes, Fury is shot by the Winter Soldier. He is taken to surgery where the surgeon uses a defibrillator to shock his heart back into rhythm. Watch below.

A couple of good things followed: 

1) The actor gave a realistic reaction on the table when the paddles shocked him and his reaction was complementary to a real-life scenario. He didn’t bounce like a basketball on the table or wildly convulse when the shock was applied. His reaction was realistic.

2) A rhythm was present on the monitor. Many scenes and TV shows display a flatline before they drag out the paddles. By then, a defibrillation to the heart muscle is too late, because there is no rhythm to shock when a patient flatlines. Manual CPR must be activated when a patient flatlines. So kudos for providing a rhythm for the patient.

Now the inaccurate news:

Where the issues arise, is with the rhythm displayed on the monitor screen. This heart waveform is normal. Why would the patient need defibrillation with this heart rate? Sure the number is a little low but look at the waveform on top. A beautiful, normal cardiac rhythm. For comparison, I’ve added another normal to the right of the movie’s image. They are almost identical.

For clarification, review the two abnormal heart rhythms below. Notice the differences with Fury’s heart rhythm. These waveforms represent the heart in ventricular tachycardia and ventricular fibrillation.

Now, these abnormal rhythms are shockable, but you can look at the images above and decide if Fury really needed the defibrillator.

What movies have you witnessed healthcare related inaccuracies? Let me know by connecting with me through the sidebar links on this blog!

5 Tips for Writing ER Scenes

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The sitcom I was watching, showed the ultrasound of the baby. I could hear the heartbeat, but no rhythm was displayed on the screen.
As a registered medical sonographer (not to be confused with a court stenographer), instructor of the profession and healthcare enthusiast, I’ve performed hundreds of fetal heart rates with ultrasound. When they’re acquired, the pulse is displayed on the screen, but in the TV show, no rhythm was shown.
My inner healthcare hulk emerged. I believe I recall a few things being thrown at the screen, albeit they were pillows.
When writer’s of episodes or books misrepresent simple healthcare scenarios, it angers the 18 million+ people in the US, who are healthcare workers.
We read. We watch TV and are disappointed when a writer doesn’t do their medical research for accuracy.

So today, we start with the Emergency Room.  Here are 5 tips to writing ER scenarios.


1) Write fast-paced scenes for the ER
If writing an Emergency Room scene where the patient’s life depends on the skill of the medical staff, please write the scene with much action. A cacophony of sounds will fill the room. Beeping monitors, loud conversations, shouted orders, background sirens, and frustrated family members who have been waiting for hours, all need to be included in the scenes.

Several nurses, therapist, radiographers, phlebotomists, physicians, will all be moving within the space, simultaneously, to accomplish their goals. A specific trauma team may be called. Below is a realistic video clip of a fast-paced ER in Chicago as compared to the television show Code Black.
2) Include the smells. 

A bounty of different scents fill the ER and they’re far from lemony fresh. Vomit, stool, blood are just a few. These aromas may gross your reader out but will transport them into the setting of your story. Below is a short list of other smells one might encounter in the department.

  • Gangrenous extremities. Every smelled a bag of rotten potatoes. When a patient’s limbs are dying, the smell is ten times worse than that.
  • Burned flesh. A horrible tragedy for anyone who’s experienced such trauma. The smell is distinct and undeniable.
  • Patients who have not bathed in weeks, months or years. Tart body odor is putting it mildly.
  • GI Bleed. Imagine blood mixed with stool for days or weeks inside the bowel. Not pleasant when it emerges.
  • Medical supplies – latex gloves, plastic tubing and soiled linen.

Medical personnel combat these smells with several different methods. These antidotes add some humor to the scene.

  • Wear a mask
  • Apply peppermint oil under the nostril or dot inside the mask
  • Rub Vicks vapor rub under the nostril or dot inside the mask
  • Use essential oils in the mask or under the nose
  • Place filters of coffee grounds around the room to absorb the smells

3) Do not write about a defibrillator (shock) on a flat-lined patient

This has been addressed on the internet numerous times and still takes me by surprise when the mistake airs on television or in books.

A defibrillator sends a controlled electrical shock to reset an abnormal, irregular heart rhythm demonstrated on the heart monitor. Once the patient flat-lines (heart stops beating with no rhythm to shock), CPR and medications can be administered to restart the heart, but the defibrillator is not used. Below are some examples of different types of heart rhythms.

Normal Heart Rhythm

V-Fib

(Abnormal Heart Rhythm – Write in Defibrillator scene,

also, CPR can be performed in between shocks)

Flatline (Write in CPR)

4) Healthcare Professionals can only discuss patient’s medical care with others who are also providing care for the same patient. 

Stop using paper charts in your stories. As of 2016, all medical facilities receiving Medicare and Medicaid reimbursements had to be on electronic medical healthcare systems, called an EMR (Electronic Medical Record).

Also, do not let your characters violate the HIPPA code unless you want them fired. When we are caring for a patient, we can only discuss those specifics with others who are also providing their care.

For example, if I’m a nurse providing care and I need one of my teammate’s assistance, then she/he needs to know the patient’s medical information and we can discuss the case.

However, if I go to dinner and see a friend who is an oncology nurse with no ties to the patient, I’m not allowed to discuss the case with her.

Also, employees are not allowed to look up medical information on other patients unless they are providing care. So, if Tom Cruise is admitted to the hospital, unless we’re personally giving him care, we can’t look at his medical information.

To receive approved access to our own healthcare records, employees must go through the documented process to receive access. We cannot look at our own medical files without permission from the medical records department.

All medical information system keystrokes are tracked, flagged and can be audited for unauthorized use. If a healthcare professional accesses someone’s medical record or their own, without pertinent cause, they can be fired.

5) Narcotics are locked up tight in a Pyxis machine or other medicine dispensing cabinet. 

Those who have access to these cabinets must sign in with their username, password and, on newer systems, their fingerprint. The system tracks the number of narcotics removed from the cabinet. Any waste of the meds must be witnessed and signed off by another nurse in the system.

When writing a scene about administering meds, this is helpful to remember.

Conclusion

With over 18 million potential readers in the healthcare field every day, it is important to remember to research, research, research our medical scenarios. After all, I’ve put books down because of glaring inaccuracies and we don’t want that to happen to our books.