So Productive

I drove to Portland yesterday afternoon, spent a nice evening with hubby, and fell asleep before he went to pick up his brother from the airport (sorry hubby). It WAS a day that started at 6am (4am if you count the numerous times I woke up between then and my alarm going off at 6) and had a 6 hour drive in the middle of it, so I don't feel super guilty for being so tired when I got here, but I know hubby would have liked it if I had come with him to the airport.

But today I'm feeling super-productive. I got up at 7:30, spent an hour relaxing then chatted for a while with bro-in-law, which was really nice. I went and had coffee and breakfast, organized my pharmacology notes, cooked half of Thanksgiving dinner (everything that could easily be made ahead), got a second giant binder for my pharm notes (they FILL two 3" binders), ran 4 miles, and now am out studying pharm. It's only just now 6pm. Feeling pretty good...

My new fave place to study in Portland is Staccato Gelato in Sellwood. The original Laurelwood location was my favorite gelato place in Portland (there are a few). This location opened in the last 6 months, and is only a few minutes from our apartment--conveniently just a block away from our favorite sushi restaurant. This one serves lunch and really good coffee, and the gelato is served in little tiny scoops, so I can have a scoop without feeling too guilty. Gelato is made with milk, as opposed to ice cream which is made with cream, and it has less fat than ice cream, plus it's so delicious. So, getting a tiny scoop of gelato is a pretty low-impact guilty pleasure. They also have free wi-fi here, and it's not very busy and quite spacious, so it's a great place to study.

When I'm adequately caffeinated and wishing to avoid buying something (or being tempted by delicious food that I don't need), I go to Reed College to study. It's also nearby, and the library is big and quiet and filled with studious Reedies, which helps me concentrate. The wi-fi is free there too, of course, and it has a sufficiently collegiate feel to keep me on task. But this week they are on limited hours because of the holiday, so I am at Staccato Gelato.

I am slowly getting my running miles back to where they were before the accident and subsequent curtailing of my running schedule. It feels good to be back on track (even if the weight loss still isn't happening--at least I'm not gaining). If anyone is considering taking up running, I'd like to encourage you in your interest. I always thought I was too heavy to run, and I felt like if I couldn't run a mile straight through, I shouldn't even bother. But here are some great reasons to take up running:

• It's free, except for shoes. Of course, you CAN spend lots of money on specialized running gear: clothes made of high-tech wicking fabrics, heart rate monitors, MP3 player, Nike + iPod sport kit, etc. And those things can make running more enjoyable--but are totally optional. All you really need are running shoes that work for your feet and gait and fit well. I swear by my Asics 2130s. Get fitted at a quality running store, it's worth it.
• You can do it just about anywhere. No membership required.
• You don't have to be able to run a mile, a half mile or even a block all the way. You can start out the Couch-to-5K way (many people start running using this method, and it works great): run 15 seconds and walk 45-60 seconds, repeat for up to 20 minutes.
• You don't have to be at or near goal weight. You should get clearance from your doctor, of course. You may have bad knees if you've been overweight for a long time, and that's one of many good reasons to check with a doctor first. But many, many people start running when they are significantly overweight, and most of them have nothing but positive results--as long as they don't overdo it. The key is not advancing too quickly (speed, distance, or intensity), and not outrunning your fitness level. (I highly recommend reading Jeff Galloway's Running: Getting Started. Also check out his website, jeffgalloway.com.)
• Runner's high is real. You won't believe how great you feel when the endorphins start kicking in. Plus, the sense of accomplishment and pride in actually being able to call yourself a runner--especially when you're like me, starting out morbidly obese, and having no experience running since junior high--will make you a believer.
• It doesn't take much time to have a great fitness effect. I get way more fitness benefit from running than an equal amount of time spent in almost any other cardio activity (the only exception that I've actually done lately is swimming laps). Run for 20 minutes (or walk/run) and ditch your 45-60 minute elliptical routine.

I know there are lots more reasons--which can be supplied by my running friends She Smiles, Thinspiration, Angie, and others. If you're thinking about it, I say go for it. You just might become one of those crazy runners, too.

A busy week

The weekend is here...and hubby is not. :( He had to work overtime this weekend. I have studying to do, and I plan on running today, but it's been nice to wake up slowly and relax. I've been getting caught up on my blogs.

This week was very busy. We all gave presentations on Tuesday and Wednesday. (Let me tell you, listening to powerpoint presentations for 6 hours is a bit much.) I had 2 presentations to give: one a case study presentation on multiple sclerosis and anesthesia implications, and one in pharmacology about the anticonvulsant (antiepileptic) drugs. That was about 30 minutes, about the cellular pathophysiology of seizures, and many of the drugs used to treat them, mainly about their pharmacology, drug interactions, and anesthesia implications. If you hadn't thought about it before, anesthesia has interactions with many drugs that people take routinely, and many underlying conditions that people have. So those presentations were big deals. Then we had a pharmacology midterm (on antibiotics) and got back out test on central line placement, so now we can place central lines--woot! (With direct supervision, of course, while we are students.)

I placed my second spinal block yesterday, too. That is a very satisfying thing to do--getting the needle placed correctly and getting that CSF back just feels like you've really done something, and then when the block works and the patient tolerates the surgery with just a little sedation--that is super cool.

I was reading in one of the other blogs about the idea that you can defeat your band by drinking while you are eating. This is the main basis for the no-drinking-with-meals rule--you'll render your band ineffective, basically, and eat way too much. But I have discovered that if I drink after I eat (and usually I don't) I actually get more full. Especially if what I have eaten is something that can swell with moisture, but it seems to happen with most things. I avoid drinking with meals now mainly to avoid overfilling my pouch and stretching it. There are times, though, mainly when I take a break from clinicals in the morning, and I want to eat my breakfast AND I MUST get some coffee in...and the coffee is too hot, but I only have 15 minutes...I drink the coffee after I eat. You know, it seems I don't get hungry any sooner than when I don't drink. (Ha, you thought a bandster couldn't eat in 15 minutes? You never met a bandster anesthetist!) I think many people can "wash the food through" their pouch with drinking, and I am not recommending trying it. I'm just noticing for myself, it doesn't seem to work that way. But then again, I never get food stuck or PB, and I still seem to have restriction. So it seems some of the usual band things don't apply to mine.

Okay, time to get my day going...

Rant for the day

Just got done with clinicals, and am heading out for a run. At the end of the day I had a baby patient (18 mos old) for a quick little anesthetic just to remove some sutures from her face. Often little ones won't let their doctors do stuff like that without deep sedation or anesthesia, so here she was. She was attacked a few months ago by the family pit bull. The child had a depressed skull fracture that punctured into her brain, plus the injuries to her face which thankfully will heal with minimal scars. She seems fine now, but she is lucky to be alive. This story, of course, prompted a round of exclamations about how a parent could have a pit bull around a baby. There are cities in the US that now make it a felony for a minor to handle a pit bull. There are insurance companies that won't give homeowner's insurance to people with pit bulls.

Of course, pit bulls aren't bad dogs, it's the bad owners, right? That sounds like the argument for another thing we regulate (a little) in the US--guns. Which got me thinking: Why don't we have similar regulations for owning breeds of dogs like pit bulls who are known to be dangerous, especially when improperly handled and trained? I don't think pit bulls are inherantly "bad" dogs. But I don't see why we can't have a law that requires potential owners to attend a safety course, have a background check, basically some of the same things we require of people who want to own a deadly weapon. You have to have a trigger lock and a lock box if you own a gun in a home with a small child--why is it fine to have your family pit bull hanging out with your baby, when we know that small children might be harmed if they pull the dog's tail or even just start crying and startle the dog? The arguement goes round and round about how these dogs are fine if they are properly handled and trained--but we as a society do nothing to ensure that the dogs are owned and handled by people who are responsible and educated in how to handle a dog like this. It's not okay to have a lion in your house with your baby--why a pit bull?

That's what I'd do, if I was Queen of Everything.

People who don't want to regulate things like that have similar arguments against helmet laws--both for bicyclists and motorcyclists. But as a former trauma nurse, I saw the public health implications of people who don't wear helmets, or seat belts in cars. They become a burden to the taxpayer. We can be all for personal freedoms and say it's our own business if we don't want to wear a helmet when riding a bike or a motorcycle. But when you get that head injury that you don't recover from, that you end up in a nursing home on a feeding tube instead of back out working at your job and being a productive member of society--all because you wanted the "personal freedom" not to wear a $40 bike helmet--that is a public health issue. I'd better stop there, because I can really get going on helmets! If it just affects you--do what you want. When it starts becoming a burden to taxpayers (to ME), or when it involves not protecting the weakest members of our societies (the very young and the very old), that is when we need to regulate. That's my opinion.

Ok, off to run now. Lost 3 of the 4 lbs...slowly getting there. Everything is slow. This is Hell Week for the semester--lots of stuff due in the next 2 days, tests and presentations and papers. I spent the whole weekend at the library, and I'll be going back once I finish my run.

Newly fat?

Well, I for one am feeling newly fat, again, although I know I'm not really. The past few weeks of sporadic, rare feats of running, and stretches of poor eating choices, plus Aunt Flo, has added up to an extra 4 lbs. I'm trying not to freak out about it, but it's making me feel a little worse than I already do, with family emergencies and dramas and my schooling winding ever tighter into a big ball of overwhelming stress.

But today, finally, I ran again, and felt better. It's harder now that it's getting dark so quickly. I'm putting together strategies for how I can run on days that seem impossible. Some days ARE impossible: I leave before dark, I get home after dark, and I still have hours of homework to do before going to bed for a few hours of sleep. But others aren't quite as bad, like today, and I could get in a nice 5 miler before the sun set at 4:30. I can't run in my neighborhood after dark, not because I'm afraid of being mugged, but because there are no streetlights and my neighborhood has dangerously cracked sidewalks. I'm pretty sure I'll end up with a newly flattened nose if I try to brave the roads in the dark. So I either have to find a lighted running path somewhere, or find a way to run during the daytime, or run indoors, which is my LAST resort, and which I'll eventually have to start doing anyway, when it gets too snowy and icy to safely run.

I really liked that article that I posted below because I think all of us who have gotten close to goal weight and stayed there long enough to know people who didn't know us when we were MO have had these experiences. It's so weird for people to assume that they can talk smack about fat people because you aren't fat. It's really bad in health care, because you can get badly hurt taking care of the morbidly obese, so a lot of providers have a hostility toward fat people. It's sad, because of course we all deserve dignity and to be treated as a patient who deserves good care, not a liability or a burden. But people are people, even if they are doctors and nurses. It's going to be more of a problem, and I hope that my fellow health care professionals learn how to do their jobs without getting hurt and without treating patients poorly as the population grows more obese and needs more health care. (Of course, I hope the trend towards rising obesity rates starts to reverse. But it hasn't yet.) But even just among friends, it is weird when you overhear someone talking amongst their thin friends or coworkers and realize that you are hearing things you never would have heard when you were MO. People would make sure not to say them in your earshot. (Or sometimes they wouldn't...ouch.) At first it's exhilirating to be thought of as someone who was never obese. But then it's sickening, to realize the way many thin people think of fat people. I know that just because I was MO didn't mean I was lazy, or refused to exercise (I exercised more than most normal-weight people), or ate buckets of greasy junk food (I ate a sensible, vegetarian diet, much like I do now...just with more cookies and ice cream). And people who knew me wouldn't have thought those things either, I don't think, but people who didn't know me probably did.

How It Feels To Be Newly Thin (Newsweek)

http://www.newsweek.com/id/74075

My Secret History
I may be thin now, but that doesn't mean I share your opinions about fat people.
By Megan Northrup Newsweek Web Exclusive
Dec 6, 2007

It's almost surreal how I find myself privy to the hushed conversations thin people have among themselves. I'm part of this insider group, but I carry a secret identity that renders me an impostor to some degree. I spent most of my childhood and the entirety of my adolescence overweight, and eventually morbidly obese (a very difficult health category to own up to). My core identity was once tied to being an outsider to this camaraderie of thin people. But my identity shifted rapidly in February of last year, when I underwent the kind of "medical intervention" that Star Jones recently acknowledged was the reason for her own weight loss. People I've met in the last year don't know me as I knew myself before I underwent gastric bypass surgery. They take for granted that my physical presence—I am now 130 pounds, having dropped 135 pounds after my operation—has always been this way, and I let them believe this myth because I see now, more than ever, how much judgment is directed toward the overweight and obese.

My best friend Bea places nannies in elite homes in Los Angeles, and more than once she has been explicitly asked not to send overweight applicants, no matter what their qualifications. Recently she had a candidate of the highest qualifications and glowing references, but this particular candidate wore size 16 jeans. When she found the courage to share this last detail with the client, the client immediately justified her prejudice by explaining that there were a lot of expensive antiques in her home, and narrow hallways. Fat, this woman believed, was simply unacceptable. If I had been there, I'm sure I would have simply nodded in quiet acquiescence.
I did as much recently when I went on a date with a young doctor. As I batted my eyelashes and enjoyed my newfound attractiveness, he recalled his morning spent helping in the delivery of a baby. "The woman was morbidly obese," he leaned over and whispered. Who, he wondered, would have wanted to have sex with that nine months ago? I said nothing and just let him buy into the illusion of me as someone who has only ever known a normal, healthy weight range.

I survived the day-to-day humiliations of obesity, the looks of pity and the "you have such a pretty face" compliments. In a moment I consider emblematic in the story of my struggles, I was once even stuck inside a dangling car tire six feet off the ground. I was 19 years old, participating in a ropes course retreat with my collegiate peer group. Somehow my assigned "bonding" group managed to hoist my 265-pound body up and into the challenge element (goal: get entire group through car tire) where my hips promptly announced themselves to be larger than the tire's opening. Bea (thankfully present for this ordeal) pushed from behind. The strongest male pulled from the front. Nothing. I was completely stuck. After a few more minutes of audibly difficult pushing and pulling by the group, I was free. Weeks later I still had the bruising around my hips to remind me of this embarrassment.

Two years ago Bea was also thankfully present when a nurse in the hospital yelled across the nurses' station, in reference to my need for a chair, "Has anyone seen the extrawide wheelchair? You know, the really big one?" Under her breath, Bea responded to her with, "Has anyone seen my friend's dignity?" We like to re-enact this moment from time to time, overexaggerating the extent of the nurse's yelling and complete lack of consideration for me as a human being. It's funny and we laugh, but we both know that this day, the day of my medical intervention, was the most difficult day of my life.

I've had nothing but success, healthwise, from the decision to have gastric bypass surgery. I've even run a half-marathon since then (not a superhuman feat by any means, but one almost unimaginable to that girl dangling in that tire). But every day I struggle with who I am and what this new membership to the normal-weight group means to me.

When you take on a new identity, and you've let others believe that this is your one true identity, it's easy to find yourself completely disowning your previous self. Recently my mother and I were going through old pictures of me—all those years of photographs and truths that I've hidden from new people in my life—and, picture by picture, my expressions of disdain and disgust grew louder. Fully acculturated to the thin insider group, it took my mother's tears to shake me out of my judgment. With wet eyes she said gently, "Be careful what you say about that girl. I loved her very much." And although my words could never carry the power of my mother's quiet admonishment, the next time someone leans over to me in the assumption of shared judgment, I can only hope that I will not remain silent.

Northrup lives in Charlottesville, Va.

I'm serious...

...about Google Reader, folks. It rocks! And if you already have a Blogger account, the two work together. No new login needed.

While I'm getting caught up (instead of writing a paper, naughty me!) on all your blogs, I was checking out Thinspiration's latest pics--girlfriend is over 100 lbs lost! And looking so fantastic. So I just wanted to give her a shout-out over here...

...and also to my friend, who had RNY about 4 years ago, and finally got her tummy tuck and looks like a million bucks. She was quite thin, but had extra skin that was making her feel bad, so she went out and did something about it for herself. Self-esteem is just as important an outcome of WLS as improved health is. I won't give you away here, but you know who you are. She looks so beautiful. Congrats to you, lady!

We all need each other...

Observing the "brave new world" following Tuesday's election has been interesting. What is reported in the dreaded "MSM" is a previously unseen spirit of cooperation from the White House and in politics in general. This is mainly mandated by the Transition Act, which budgets and requires processes for a smooth transition in government. But it's obvious that folks in Washington have been anticipating this particular power shift prior to Nov 5. What isn't reported, of course, is what is probably REALLY happening. All in due time, I'm sure.

But I've been giving some thought to the filibuster-proof majority that didn't happen for the Democratic Party. That, plus listening/reading some of the chatter about Republican rebuilding. I am glad the Republican Party's reign of terror, er, power is over. But I am also glad that the supermajority did not happen in the Senate. The parties need each other. Absolute power corrupts absolutely, and all that.

Let me be clear here: I may be left-of-center, but I don't trust or like either of the parties. I'm not a loyal Democrat, but their ideals usually fit mine better than the Republican ones. Not always. I personally think that most politicians, when placed under just a little pressure, turn out to pretty much be the same. I realize that is a very cynical viewpoint, but I don't think I am alone. I hope we've just elected an exception to this rule.

What I WOULD like to see is a new focus on public service, as has been promised by Obama's campaign. I think we could do a lot in this country if we just organized people's natural desires to be involved in the community and the world. Our citizens are our greatest natural resource, and most of them have been alienated by politics and policies of the past 20 or so years, at least. That's the change I'd like to see.

How about this WLS stuff? Well, weight is still hanging in that same 3 lb range that it has been sitting in. After taking a few days off, I ran again today. I haven't felt up to it--a little depressed, maybe--but today I just got sick of my own laziness and excuses and got off my butt. It felt a lot better to do something good for myself.

We need each other in this WLS arena, too. I get a lot of inspiration reading all of your blogs about your own journeys, at all different points along the way. Some are newbies, some long-time bandsters, some are just starting the pre-op process. And some aren't having surgery at all. I haven't really been frequenting the boards lately--that really fell off my radar once my free time started to disappear. But reading my sistas' blogs--including Achieving Me (She Smiles), Laura (I'm a Pretty Girl Momma), losingjusme, Diz, Angie (Journey to a New Me), Love My Lap Band (Lori), killthefatman (Manatee--right, not a sista, sorry man), Lise the Loser, and Pasta Queen, and Thinspiration (I'm sure I'm forgetting someone here, sorry! see sidebar for all my peeps)--you guys keep me inspired and moving along. I'm starting to formulate a bit of a plan in my brain to lose the last 10 after this semester is over. I'll let you know if I come up with anything concrete, but I think I'll be in the thinking phase for a bit here. Thanks everyone, for keeping it real.

Evelyn 1919-2008

Yesterday was a strange mixture of sadness and joy for me. Sometime in the early morning hours, my grandmother died. I learned that she was near death on Sunday night, and my deliberations about whether to go see her or not settled themselves quickly. It was really too late to leave on Sunday, but I finished my second case in the OR on Monday and excused myself to make the 6 hour drive, hoping she would still be there when I arrived.

I arrived around 9 pm. She was not conscious, and her breathing was halting and irregular. I wanted to remove the oxygen that was still being delivered to her, to avoid prolonging the inevitable unnecessarily. But I knew that the facility she was in couldn't do that without the doctor's permission (or at least hospice's okay), and I didn't want to put them in a bad position by doing it myself--plus the rest of my family might not have seen it the same way I did. At any rate, I don't think it mattered much. I held her hand and sang to her a little bit, told her I loved her and told her it was okay to go when she was ready. I left around 10pm, and she died a few hours later, in the early hours of Election Day.

My grandmother was a staunch Republican, for whom even Sarah Palin was not conservative enough. Oregon is an exclusively vote-by-mail state, and she made sure to vote while she was still able. That remained important to her even as she knew she was dying. I'm actually not certain if her vote was legal if she died on Election Day, but I'm certain it was counted nonetheless. She was resigned to the fact that John McCain was not going to win the election, though.

But my politics were very different from both of my grandparents. I have nothing but tremendous hope and pride in my country for our historic participation in democracy, and in our ability to elect one I feel is a transformational leader, Barack Obama. The only way this could happen in America was for people who really believed they could make a difference to get out and vote, and for people to really consider the man and his arguments rather than his race. Here on the "Left Coast" I think people take for granted the kind of advancements that the country has made in the last 50 years, and in doing that I think we tend to believe that we have advanced further than a realistic look at race relations in all of America actually reveals. There is still a great deal of oppression, more covert than in years past, and we have taken one step forward in this election--even people who did not think Obama was the best candidate seem to recognize this achievement. And I for one was really touched by McCain's classy concession speech, which seemed like a return to the John McCain we knew before the campaign really got heated. (I understand that there are politics in play with any concession speech, but I felt he meant what he said.)

All in all, I was proud of this country yesterday, and today. I hope that we can all come together to face the challenges of today and tomorrow. I think my grandmother would have recognized this if she had lived to see it, even if the person she voted for didn't win. For all her conservative politics and fundamentalist Christian beliefs, she had many surprises for us all. I remember growing up believing that she and my grandfather were racist, and perhaps they were--but in the last 10 years they both proved to me that this was either untrue or that their views had changed. This is a remarkable thing to happen so late in life, by people who lived in an insular farming town where ethnic diversity was composed entirely of Mexican migrant workers showing up on their farm for day labor.

My grandmother had a long career as a special education teacher, in addition to raising 3 kids and being a farmer's wife, which is itself a full time job. She received her master's degree around the time that my aunt, her middle child, graduated high school, and contemplated pursuing her doctorate but decided against it--this was still very rare in the 1960s, much less in a rural farming town. She was educated in the natural sciences as well, and had a zeal for learning and for teaching that influenced everyone around her. Even this year, she was mentoring teenagers at her church who she felt had the promise and ability to go to college but no one to encourage them in their abilities. She was the kind of Christian woman who sought out the holy books of every religion and sect and read them to better understand what they all were about. Her bookshelf had her well-worn and annotated Bible sitting next to copies of the Torah and the Book of Mormon, and numerous other religious books that she read for the sake of education. This was also unusual for a farmer's wife, but my grandmother was an unusual woman. Her intense curiosity must have been part of the impetus for my grandparents' globetrotting--they visited almost every continent after their retirement, and travelled extensively within North America. (They decided to retire from international travel when my grandfather was 90--it was becoming too difficult to make connecting flights and navigate complex itineraries, and keep up with their tour groups.)

My grandmother also played a significant role in the rearing of every one of her eight grandchildren. Three of them grew up on the family farm, which my aunt and uncle farmed. Their house was across the driveway from the stately farmhouse that my great-grandfather built, where my grandfather was born and lived his entire 92-year life. Two others lived at least part of their childhoods with my grandparents, and the rest of us spent summers and weekends and holidays there. Grandma definitely helped raise us all. She also taught my cousins how to read, long before they started elementary school, and provided extensive pre-school education to them, because teaching was as natural to her as breathing. In addition to the eight grandchildren, they had nine great-grandchildren and one great-great-grandchild.

One remarkable thing about both of my grandparents was that they were not sentimental about old things or old times, and always strived for progress. My grandfather always sought out the latest and best methods and equipment to run his farm, which he took great pride in growing as a profitable business as well as a physically beautiful place. My grandmother was similarly minded about embracing progress, and not the least sentimental. She cleaned out the farmhouse of all but the most cherished antique things, and donated them to the county historical society, where she worked for many years in her retirement. She then redecorated and remodelled the place, and fought to keep the house off the historical register so that they wouldn't have to have every change they wanted to make to their home approved by the county. I would like to think that these ways of thinking contributed to their growing acceptance of the more diverse world as times changed, and that even though they feared rising taxes and other signs of impending liberalism, they would have seen the good in what happened in yesterday's election.

November already

Halloween 2008 is now a distant memory. I went to a work party on Saturday...you all know how dangerous those can be. We didn't stay too long. I was Marilyn Monroe (one of 3 there!) and my hubby was a fantastic Elvis. I drank a bit...more than I had originally planned, but not enough to embarrass myself in front of the people who are my preceptors for the next 18 months, thankfully. But this year I was more bothered than I have been in the past by the costumes that are commercially available for women. Why are they all so slutty? It was very hard to find something that I thought was work-appropriate, yet still attractive. It turned out that many of the women there weren't that bothered by the notion of dressing like a skank in front of one's coworkers.

I decided today that if I plan on not becoming tremendously fat again soon, I ought to start cooking again. I've been sort of getting by on things I can throw together quickly, which don't tend to be the best for you, of course. So I pulled out some favorite cookbooks and got started. The first thing I made was a "hot dish" type of casserole that is traditionally laden with sour cream and cheese, but I made it healthier (and more protein) by using nonfat greek yogurt instead of sour cream, and adding Morningstar Farms fake ground beef for a little more protein. It's quite yummy and not as sinful as the original by far. Later I plan on making some Wasabi Mashed Sweet Potatoes. Doesn't that sound strange and yummy? Decent nutritional profile too, though I'll have to dream up a way to get some more protein in them.

My grandmother is doing worse than before, and I need to evaluate tomorrow whether I ought to come back to Salem to see her before she dies. Everything in me longs to just go see her now, but I at least need to get through clinicals tomorrow first, and I want to call my aunt and uncle to see if she is alert enough to know if I am there. But either way, I'm torn on what I should do. I feel like I should try to get as much school in as possible, since it's so easy to get behind and so hard to catch up. But this is my grandma, probably my favorite person in my whole family (maybe just my favorite person, besides my hubby). And it's hard for me to concentrate on my schoolwork when I know she is dying. It's so hard to make these kinds of decisions. If I was still working I wouldn't be able to take this much time off at all--but then, if I was still working I'd be in Portland, and I'd be able to see her within a 45 minute drive, and I never worked more than 3 days in a row as an ICU nurse so I probably would have been able to see her more even if I couldn't take much time off. Not that it matters. My grandma is just a wonderful person, and I'm so lucky that I've had her in my life for over 35 years. It's hard to let go.