Rex patient "suffering from vapors"

I've had a rather high-maintenance but otherwise pleasant oncology pt since last week. She's a sixty-something newlywed, and as my preceptor says, she "suffers from vapors." If her drawl were any more pronounced, she'd be a true Southern belle. She asked me very seriously whether I thought it was safe for her to have her acrylic nails removed. Her Boost Glucose Control makes her feel too full. She worries that the cream soups (which are easy to eat while she has thrush) will make her gain even more than 30 lbs she's put on since being admitted. (It's mainly fluid, but it could have also been her husband bringing her ice cream instead of the Boost last week when she was feeling really sick, despite her blood glucose readings in the 400's.) She can't get settled on her side, so she continues to sit on a pressure ulcer. My favorite: "I think I have...what is it called...a urinary tract infection? yeast infection? Whatever it is, there's a burning around my vagina!" As if I could do anything about that...but at least this has afforded me the opportunity to talk with the oncologist and the wound care nurse as part of the team. She's also taught me about the difficulties that cancer pts face with eating and managing side effects. As the oncology RD says, you have to pick your battles and just be there to support the patient any way you can.

I also saw my first peds pt today - a 16 yo male who was thought to have a ruptured appendix, but it turned out that he had a grapefruit-sized mass in his abdomen, so he required an immediate ileocecectomy. His bowel sounds are just now returning after 5 days, and I'm hoping to see him progress to eating again soon. They suspect he has Crohn's, so I may get to do some education, too.

Tomorrow, I get to go to the NICU for the first time!