I can’t believe it’s already April. It’s been an intense year so far, and the twilight-feeling – with all the uncertainties – is still part of our lives. I was hoping things would get more “stable”, but so far, it has just gotten more… let’s call it complicated.
I am actually one day late with this update, since it was yesterday (April 4th) when my ADR surgery took place six years ago. I just didn’t have it in me. But better late than never, right? Well, with everything else going awry in my life, I am beyond grateful that my back (and LP-ESP) is still unchanged. No pain or limitations; in fact, I started working with a personal trainer to safely get back in shape and lift weights. I am hopeful that this part of my body will hold up like this for years to come.
Even though we are barely in month four, a LOT has happened – from work-related travel (twice!) to more hospitalizations (also twice!), a destroyed kitchen (again!), and serious health issues for myself (for a change).
The first trip was to attend and present at the IMSH 2024 Annual Convention in San Diego in late January…
… followed by a trip to the hospital with Ralf (sudden-onset bowel obstructions) beginning of February…
… followed by my second trip to implement my Introduction to Clinical Simulation course in Las Vegas mid-February (that included arriving on Super Bowl Sunday, a wedding, and zip-lining with Helen)…
… followed by me getting REALLY sick with a respiratory infection the week after I returned…
… followed by Ralf’s second trip to the hospital with another round of bowel obstructions…
… followed by severe water damage manifesting in our kitchen ceiling, caused by a leaking pipe from the upstairs bathroom. Apparently, the water has ever so slowly leaked into the ceiling for a long time, before it finally reached the threshold and ultimately cause the plaster from the ceiling to collapse. Repairs are underway as we speak – with no idea what the financial damage will be yet. At least we were able to safe the stove and cabinets. Not having a functional kitchen poses a significant challenge, especially when it comes to maintain Ralf’s nutrition and food-related limitations. But, we can shower again, so that’s a plus!!
In the meantime, I finally got my lung CT done, in an effort to find out why I have been coughing for a year. Results suggest permanent scaring and damage to my lungs due to Bronchiectasis – a rare chronic condition that is usually observed in patients with cystic fibrosis. That most likely is the reason why I had so many respiratory infections (including flu and covid last year), and why I was so sick in late February. Got my appointment scheduled with a recommended pulmonologist in a week from now, so I am anxiously waiting to find out what this means for me in the future.
Now I can print myself a t-shirt with “it’s NOT Covid!”, to wear when I cough my lungs out in public.
Certified (AGAIN) at Last As a nurse, I always believed that being certified in your specialty is a must. It shows dedication and commitment to your profession – and let’s face it: nurses LOVE to add letters behind their name/signature block. But these certification exams are so nerve-wracking, especially since I have significant testing anxiety. And just like with the Certified Emergency Nurse (CEN) certification, I made plans for taking the Certified Healthcare Simulation Educator (CHSE) exam but then never actually signed up. But eventually, I paid the (hefty) fee, and set a date. Granted, I had to wait until I could show two years of experience in healthcare simulation, but that was also the excuse of being in the “I will” vs. “I do” mode.
When it became clear that I had to look for a new (simulation-related) job in October last year, I revived my efforts and participated in a ($350) CHSE Blueprint Prep course. But I still put the actual CHSE application on my “I will” list. However, In February, when I started my new position as National Simulation Educator, I kicked my own butt and got the process started. I prepared as good as I could, did sample questions, read up on simulation operations policies, learning theories, and the like. I didn’t really get into study mode until three weeks prior, which is exactly what happened when I took the CEN… Fast forward to May 6th, 2022, the day had come.
Driving to the testing center is always a challenge, especially since I had to drive across town and was a bundle of anxiety. What if I don’t pass this ($495) exam?? I didn’t want to announce to others that I was taking the CHSE, but a few people knew. By the time I made it, I was already in need of a shower and change of clothes… But at least I found the place and arrived in one piece.
It doesn’t help that the “intake process” at the testing center is rather intimidating. It feels like going to prison, where all your belongings are locked away and you must turn your pockets inside out to prove that you don’t have anything on you to cheat. Like that could even happen, with cameras capturing your every move during the exam.
The nice lady then showed me to my computer and started the program. My eyesight has been very funky over the last few weeks for some reason, and the bright white background and font that was so hard to read, and that didn’t help me relax at all. I started the exam, and when I clicked “next” after question 14, I got he “circle of death”, then everything went white. Awesome, I broke the computer… I alarmed the lady, who ended up shutting down the computer to reboot the system. At least my input up to that point was saved, and I (again drenched in sweat on the verge of a nervous breakdown) continued on the torture’s path toward question 115. The moment when I hit the “are you sure you want to submit?” button, I was so nauseated that I thought I’ll toss the breakfast cookie I forced myself eat that morning. “Circle, circle, circle”…. Score: Passed! I actually blurred out a “ooooh, thank God!!!”, then slapped my hand over my mouth. Kind of like the library, make no noise!
When I exited the testing room, I felt so relieved. The lady on the other side (second testing area) looked at me and asked, “Haven’t I seen you here before?”. Yes mam, this is the place I tend to return to torture myself. First NCLX, then CEN, now the CHSE. Let’s see if I can keep my own “never again” promise to myself this time.
More letters! Iris Appenrodt, MSN, RN, CEN, CHSE
The Forgotten Florida Adventure Grateful to have crossed the CHSE off my “to-do” list, I was now ready to focus on the next adventure: The Forgotten Florida bikepacking event. This is the last official Singletrack Samurai bike event of the season, and Ralf was (nervously) looking forward to take Coco out for her first serious outing. Over 200 miles through Florida’s most remote and beautiful countryside. Since hotel options were rather limited, we decided to book a hotel in Perry, Florida, which was strategically located sort of in the middle of the loop that Ralf was riding by bike. About 30 minutes to get to the pick-up/drop-off locations was actually not too bad at all, and not having to move every day to another hotel was actually nice.
The first night, however, we stayed in a very small hotel in Steinhatchee, about a three hour drive from home. But I must say, it was… charming and had a laid-back kind of atmosphere. That entire place felt like a blast from the past… from check-in (sporting a mounted phone by the entry) to the actual accommodation. The front desk lady was super-nice, and after she handed us the (actual!) key to the room, we were ready to settle in. The bathroom was tiny, but the closet was as big as a studio apartment in New York City. I did like the kitchen area and overall space though. Wifi was spotty, and you kind of lost signal when moving to the bedroom. But the only real “complaint” we had was the noisy air conditioner, which would kick in randomly throughout the night like a rocket ready to launch into space. Ralf has been a tad scarred from the “Tour de Roach” experience during the Huracan event, but I must say that the room was spacious and clean – just a tad… dated. I do appreciate these opportunities to experience the many facets of Florida that you don’t get to see under normal circumstances.
Steinhatchee was pretty remote, and the only four places to eat there were all owned by locals, with two locations being closed that day. But again, everyone (mostly locals) was very pleasant and welcoming. We ended up going to choice number two, Kathi’s Krab Shack, less than a mile away. We had an awesome Mahi sandwich with fries – a perk when staying in an area that is most famous for freshly caught seafood. After that, we went back to the hotel to prep for the morning and get some rest.
Day 1 (65 miles): Steinhatchee to Mayo, Florida The main reason for picking the “Steinhatchee Inn & Marina” was the very close proximity to the starting place, which was less than 10 minutes away. Poor Brian had to drive up that morning from Deland – about a 3-hour journey. This was Brian’s first bikepacking adventure since his hip surgery (and subsequent recovery from a blood clot complication) – team Cyborg reunited, so to speak. At least, Day One take off was scheduled for 10 AM, which meant we didn’t have to get up at 4 AM to get ready.
On the short drive over to the Steinhatchee library parking lot (a library combined with recreational outside pavilion and wooden playground), I couldn’t help but notice that the main way of advertisement in this area appeared to be by old-fashioned road signs… a lot of them.
When we got the parking lot, many of the fellow riders were already busy getting their bikes and gear ready for take-off. Brian had also arrived, so we pulled in next to his car and got going as well.
After a group prebrief by Karlos (aka Singletrack Samurai), it was time to get this show on the road.
One thing about May in Florida: bugs are a thriving force – biting yellow flies included. Those mean pests don’t just take a bite out of you by chance: they pursue you! Great motivation to pedal at least at 10 mph on your bike, I suppose. Well, I was not out on a bike but sitting in the driver’s seat of the Element, ready to get to Perry. But first, I had to evict one of those predators that I discovered sitting on the INSIDE of the windshield.
Now it was back to me, the Honda Element, and Red Hot Chili Peppers (Californication). I don’t really have CDs anymore, so this one happens to be the only music on CD to keep me company. Kind of a tradition at this point, lol.
The drive to Perry was very straightforward. In fact, most “major” roads in this part of Florida tend to be straight, which reminded me of driving through rural Indiana. When I got the Holiday Inn Express, I was told that check in wasn’t available until about two hours later. Plan B: find the closet supermarket and get some supplies. Luckily, Walmart was less than a mile away and offered what I needed, including air conditioning.
At last, I was ready to check in and inspect the room. Again, dated but (pretty) clean. Fun fact: the closet in the Steinhatchee Inn was humongous and the closet at the Holiday Inn barely big enough to hang my travel bag. What ever happened to happy medium? But anyways, I got all the suitcases, bags, and groceries upstairs and settled in.
Now the “GPS stalking” began, where I am gauging when to leave to arrive about the same time wherever Ralf’s first check point would be – so far, I always found him. This time was no exception, but I am always relieved when I actually see him (and Brian). I pulled off the road, onto the short side path leading to a barricaded entrance a primitive camp site, right at the Suwannee River, around 6:20 PM. I delivered a gallon of water to Brian, who stayed behind for the camping part, and collected Ralf and Coco. Ralf was sad that he again missed out on the camping and camaraderie, but there was just no way for him to do that part.
Day 2 (83 miles): Mayo to the Big Bend (Scouts Lodge) Roll-out was at 8 am, which meant a very early start for us. Ralf and I have his morning routine down by now, which helps to reduce anxiety. We arrived around 07:30 AM at the same spot where I picked Ralf up the evening before. While Ralf was getting Coco ready, small groups of riders emerged from the wooded path behind the barrier, including Brian. Finally, just after 8 AM, team cyborg departed for the next segment of the Forgotten Florida adventure.
And me? I was actually grateful that I was able to return and stay in the same hotel. No packing, hauling luggage, and hunt for the next early check in. After I got back to the Holiday Inn, I intended to take a shower but discovered that the maid took all the used towels but didn’t leave any fresh ones. After a trip to the front desk, I was informed that the towels needed to be washed first before they get re-distributed. Hmmm, ok, that’s a new one. But ok, I decided to get some breakfast in the meantime. After a couple hours the towels arrived, and I took a leisurely shower, followed by an assassination attempt of the ancient hair dryer that was mounted to the wall. When I was drying my hair, a teeth-shattering “BANG” originated from the device, which was unfortunately close to my ear, then the hair dryer started smoking… “shit, shit, shit!!!”, I quickly pulled the plug and made sure no flames were in need to be extinguished. Awesome. Since I needed a hair dryer to also blow-dry some of Ralf’s bike outfits, I again headed down to the front desk. They actually delivered a spare Conwair dryer that looked much fitter than its deceased predecessor.
Smoking gun...Replacement
In the meantime, I also found other creative ways of drying Ralf’s shirts. Fun fact though: when I returned from picking up Ralf and Coco that night, I realized that the shirt in the window was now very visible and kind of looked like someone was hanging there, lol!!!
Oh, yeah, speaking of picking up Ralf from the second check point. The second night, most riders stayed at Scouts Lodge, which is an amazing structure in the middle of Florida’s “Big Bend” jungle. Getting to the general area was easy enough, but after I made the left turn on an unpaved path, my silly GPS happily announced, “you have arrived!”. Ahm, I have?? But, where..?
I had two choices: turn around or keep going. As it turned out, I was lucky that the GPS said anything at all, since suddenly I lost signal –not even one bar, a true “no signal” scenario. Again, awesome. Well, I took option two and slowly bounced along on the beating path ahead in hopes of a sign. Ha, and there it was: the sign was there in form of Ralf, who raced back from Scouts Lodge to find me (even though he wasn’t sure which way the GPS would end up sending me). Boy, that was a relief for both of us, lol.
Ralf loaded Coco in the back and then we drove another couple miles through uncharted territory, back to the lodge where the other riders where indulging in pizza and beer. Did I mention the bugs though? Yeah, being out there in the jungle, especially at dusk was… intense. I had doused myself in Deet, but holy fudge, those mixed clouds of flies, mosquitoes, and god-knows-what were all over the place. But the Scouts Lodge itself was AMAZING! Wow, wooden cabins on stilts, in the middle of nowhere. So cool! In fact, they were air-conditioned and had inside plumbing! The inside look somewhat like the cabins at the Wallaby Ranch. Maybe next time, Ralf could try and stay there overnight. The best part to me though was the owner’s super-friendly, cute doggie that was roaming the grounds. Puppy!!!
Now it was time to get back to the hotel. Ralf needed to get his routine and meds going, and it was getting late. In addition, he discovered a tick on his leg – thank goodness for his multi-tool device, featuring tweezers. However, we now have invested in an official tick-removal tool for future reference.
Day 3 (68 miles): Big Bend back to Steinhatchee
Take-off on day three was scheduled for 9 AM. The hosts of the Lodge offered home-made biscuits and gravy for the riders, and I brought some doughnut holes as well. We were early enough to hang out a bit and say hello before Brian and Ralf mounted their bikes to tackle the last leg of the journey.
Puppy!!!
As I waved Ralf and Brian good-bye, I dawned on me that I now had to find my way back to civilization myself. There were only two turns to be made – just the right ones, lol. When I came up to the very narrow “bridge” though, I knew I was on the right track. Made me feel a little like Indiana Jones (and not the screaming female sidekick).
I negotiated a late check out for noon at that Holiday Express. Better than nothing, I suppose. The initial projected finishing time of day three was around 4 PM. However, poor Brian began to struggle with the heat and associated dehydration a bit. Besides, he was still recovering from the past year’s surgeries and complications, so this started to add up. That put Ralf and Brian way behind schedule, so the new projected time was closer to 6 PM or even later. Therefore, I had to plan my day accordingly.
When I opened the door to leave five minutes to noon, the poor maid was already waiting right in front (scaring the living hell out of me), ready to clean the room. Even though that made me feel a tad guilty, the hair-dryer incident and towel thievery from day one justified giving me refuge for my last day, I think.
As I opened the rear of the Element to load the luggage, I found a stow-away, which I am pretty sure we picked up at Scouts Lodge. Anybody who knows me is aware of my arachnophobia. I don’t do spiders, like hell no! So here it was, brown, big, and disgusting, sitting right behind the driver’s seat in the rear. Out of reflex, I grabbed the first available spray (a bottle of Deet), in hopes to permanently disable the creature. I know, I know, since Deet is a repellent, all it did was making the spider a loner, since none of her buddies would go near her now. But it doesn’t really kill anything… and boy, she was FAST! I sprayed, she ran, and disappeared …. somewhere. Awesome. I looked for her everywhere, but she was gone. Nothing I could do about it. I was still in Perry, Florida – 3 hours from home. I still had to pick up Ralf in Steinhatchee (eventually). So I put her out of my mind for now…
I ended up sitting in the hotel lobby at a desk until 4:30 PM, writing my proficiency report for work. Not very exciting but necessary (and airconditioned). At least I got that off my pretty full work to-do plate. According to GPS tracker, Ralf and Brian were still a couple hours away. It would take me about 30 minutes to get to Steinhatchee but I also wanted to pick up some snacks and Subway sandwiches to feed Team Cyborg upon their return. I bounced from Walmart to Subway, hoping that the cooling elements will last long enough to keep the food cold(ish). Then I decided to hit the road, which was thankfully a two-lane, straight shot. I saw movement in my lane from the distance, so I was able to safely swirl around the creature the was trying to cross the road (no idea why). As I looked into rearview mirror, I was overcome with guilt: should I pull over and help the creature across to avoid getting hit by traffic? Well, if it was a tortoise, absolutely! But this was a small alligator… sorry dude, I really don’t think you would have appreciated the gesture. I truly hope he made it, though.
Without further incidents, I made it back to the parking lot of the Steinhatchee library. Sadly, the only car left there was Brian’s… all other riders already finished and dispersed.
But that’s ok, Team Cyborg will make it, with no man left behind. So I parked the Element and waited…
I did stay inside the car though, especially since mutant-bugs were filling the air during the late afternoon hours. I could hear them “pong, pong, pong” off the windows. In fact, I was surrounded, lol!
Shortly before 6 PM, the GPS indicated that the arrival was eminent!
I had my (iPhone) camera ready to go to capture the moment, and at last: Here they come!!!
After some recuperation, change of clothes, and food, Ralf loaded Coco in the rear and Brian packed up his gear. We felt really bad for Brian that he had to drive the 3-hours back home alone… But that was unfounded: his awesome wife Kim stayed on the phone with him the entire time to make sure he stays awake and makes it home in one piece! Now it was time to make the final journey back home ourselves. Thankfully, Ralf insisted on driving – despite my insistence to volunteer. A good decision, as it turned out…
The forecast predicted a significant thunderstorm for later, which was unavoidable. But we were still two hours out when the real drama unfolded. We were somewhere on a highway, Ralf driving in shorts and sandals, when he suddenly said, “something is crawling on my leg”, while simultaneously reaching down to scratch said leg, and when he put his hand back on the steering wheel, there she was!!!! The Deet-sprayed, stow-away spider from the morning, taking the wheel!!! I am so proud of myself, as I started to chant “ooookay, oooooookay, oooookay”, while controlling my breathing and initial instinct to just leave the car to the creature and exit the car at 65 mph. Ralf was also not too happy about this invasion but calmly put on the signal and pulled over. When he was moving the steering wheel, the spider followed counterclockwise to defend her position. Ralf stopped the car, got out, and tried his best to evacuate the spider. The Deer clearly didn’t slow her down, so instead of leaving, she found a crack and disappeared somewhere into the dashboard. Awesome. I guess she was determined to relocate to Orlando. In the good news department: as proud as I was on my subdued response, I don’t know what would have happened if I was in the one driving… in hindsight, I WAS driving half the day with that very possibility. I just didn’t know it…
Needless to say, the remaining two hours where a little more filled with anxiety, especially when it was getting dark. I did manage to capture a beautiful rainbow on the way, which unfortunately turned out to be the precursor of the looming thunderstorm we were about to drive into.
Despite zero visibility and a spider on board, we made it home unharmed. Welcome home, Ralf, Coco, and persistent spider, welcome home.
What an accomplishment: 215 miles through Florida’s nature -against all odds.
And here are some pictures Ralf and Brian took, which are a lot more scenic than mine:
Someone in the group (Pedal Power Adventure) made a nice video of the Forgotten Florida event.
Happy Birthday May 26 also marked another year under my belt. I almost forgot but was reminded by Ralf, who calls it “the most important day of the year”. I am not quite as enthusiastic about my ever-progressing age, but since it was inevitable, I enjoyed a nice Margarita at Don Julio’s. As a surprise, Ralf booked a beach resort getaway in Vero Beach for June, so that trip is coming up shortly! Let’s see if I can get bikini-ready in time, lol.
Last MCI I’ll be honest: when I was asked by the (new) Orlando VA Emergency Management (D50) person in charge to not just help plan, coordinate, and participate in the Mass Casualty Incident (MCI) community disaster drill, but to be a Nurse Lead for the event, I was not sure what to say. After what happened to me in my previous position, which prompted my transfer to SimLEARN, my first impulse was,” yeah, no, thank you, I'll pass”. However, I also knew he needed help from a D50 nurse, who has had experience with those MCIs and the common pitfalls and challenges associated with it. That, and being supportive of my friend Bonnie, who also was filling the role of Nurse Lead but couldn’t possibly tackle that beast alone, led me to accept. And since the Orlando VA is in VISN 8, which belongs to my Engagement Group responsibility in my mentorship-role at SimLEARN, it was still technically associated to my new position.
To make a long story short: I have done these MCI events with the Orlando VA since 2014, so I know what I was getting myself into. Historically, it was always the same limited group of D50 team members, who would actually show up. Supply carts we painfully put together (mostly Bonnie and I over the years) would be a hot mess when they reappear from some forgotten storage area, and now that a couple years had passed without taking out the tents and supplies, it was even more frustrating. Between COVID and the long stretch of no team-training activities, we lost some key-members. That left us with mostly untrained members, who were not familiar with MCI guidelines, decon, and/or disaster triage protocols. I strongly suggested a dry-run to leadership (as in, take out the tents, set up the equipment, etc.), but that didn’t happen… Oh well, I tried.
I am not going into details, but Bonnie and I ended up running around, filling in a variety of roles to get us through… at one point, I heard my name being yelled from five different directions, but I just can’t split myself in half. Somehow, we made it through, but it wasn’t pretty.
No, no, no, you can’t park here!!! Still waiting for decon to be ready to go…Well, I guess I will transport the victims to the treatment tent myself… … AND I will do the assessment, no problem
I was just glad that nobody got actually injured, and at the end of the day, we had all teenage victim volunteers accounted for…
Aaaand, it's a wrap!
Last Good-Bye When Mikey passed away last year in August, it was one of those “it can’t be” moments. I am so grateful that Ralf was able to make that trip to Tampa a couple days prior, to say good-bye, but given the fact that Mikey was taken so quickly after his cancer diagnosis, this still hits very close to home. Cancer is an asshole. And Fay? She got cheated out of many years of spending her retirement with her mate. So unfair. Mikey was special and left a huge void. April 2022, the Wallaby Ranch hosted the “Mikey Barber Memorial Boogie”, celebrating his life and the legacy he left behind in the hangliding community. I do believe he would have been so pleased, bringing together hundreds of friends and family, some of whom flew in from around the world, to spend time together and remember the many stories surrounding him. There was an amazing live band playing, great food and drinks, dogs and kids running around, people laughing and sharing stories. A special day for a special person. Bitter-sweet for sure. But I am glad Ralf was well enough to go and not just honor his longtime friend but also reconnect to the Wallaby Ranch community. Time is precious.
It was already getting dark outside when we had to leave, and just at that moment an enormous tree was lit up (I am still puzzled how they wrapped it in lights like this). A magical moment where the real world doesn’t seem to exist. We love you, Mikey!
Welcome, Coco! As I said before: time is precious, so what are you waiting for? Ralf has been debating on getting this new Curve bicycle, which is made in Australia. He has been flip-flopping between “I really, really want this bike” and “how can I justify spending so much money on a bike when I may not be around for much longer”. To me, those moments were the most heartbreaking ones. True, due to the nature of his cancer, nobody has been able to give us a prognosis. Could be 6 months, 5 years, 20 years? But you know what? That is EXACTLY why he should buy this bike NOW. Tomorrow is not guaranteed for nobody, so if that brings you joy, go for it!!! After a year of back and forth, along with supply issues, the Curve bike finally arrived.
Ralf still had to drop off the frame to JC’s Bike Shop in Deland, where Ryan was on standby to get to work and assemble the final product. Then the day had come: we got the call that we could come over for Ralf to test ride and pick up his brand-new Curve bike!
Ready for the virgin voyage!
So, I have the habit of naming things. I really don’t want to, it just kind of happens by default. However, since this was Ralf’s baby, I wanted him to name his new ride (yup, my habits may have rubbed off). Unfortunately, I already named her (in my head) the first time I laid eyes on the frame, which sports a beautiful Cockatoo on the stem… Coco!!! While I told Ralf that he should name his new ride asap, I started to refer to her as “Coco”. Ralf would usually reply with “her name is NOT Coco!”. A couple weeks later, Ralf said to me, “I need to bring Coco back to the bike shop before the Forgotten Florida ride…”, it was settled I suppose. Welcome home, Coco!
New Hope for Ralf
Ralf’s GI issues, abdominal pain, and inability to even consider international travel because of the unpredictability of his symptoms, among other considerations, has left such a negative impact on our quality of life. He has been to multiple GI specialists, but nobody was a good fit or offered different approaches. Then I saw an ad from Orlando Health, advertising a new GI section at their facility, promising the best of the best. Ironically, it was around that time the Ralf’s friend Brian also complained of ongoing, debilitating GI issues, so I mentioned that place to him. He actually made an appointment for the following week and really liked the specialist he ended up seeing. We decided to give Dr. Gosalia a try – but to be honest, I wasn’t really getting my hopes up. We had been disappointed too many times… But as it turned out, this GI specialist was refreshingly different! And he was even familiar with Ralf’s rare diagnosis and brutal CRS/HIPEC surgery. It appears that he understood the physical and mental toll all of this had on Ralf. And, he offered different solutions: an new drug, Motegrity, that is still very new on the market (no generic) but has shown great results by affecting the “gut nerves”. Ralf has been on this med for a while, and it really seems to make a difference… new hope at last!
The Rise and Fall of my SimLab As I mentioned quite a few times during the past four months, I experienced a series of devastating events that shook my world. With Ralf's (day-to-day) unpredictable health issues, becoming a caretaker after Karl-Heinz' stroke, my mom's struggles, my own struggles under the constant stress, the freaking pandemic … the SimLab gave me a new sense of purpose. It became my "happy place", where I was able to create something positive, something I had some control over and could make a difference - until it was taken away by someone I not only invited into my world, but whom i trusted.
I am now ready to reflect on it, but I will not go into a detailed rant. I am just grateful that I found a solution, but I admit, this was a hard life-lesson I had to learn. I guess what made this experience so much more devastating was the fact that I poured my entire heart into this place.
When I received the keys to the SimLab back in June of 2020, I had no idea where this opportunity would lead me. I can proudly say that I built this amazing resource for clinical staff to practice a variety of skills in a safe, efficient, and innovative environment that wasn’t available before. I loved my SimLab, and I loved witnessing the impact it had on staff and patient outcome. I loved the autonomy and trust that I received by my then-supervisor to transform simulation-based education at my hospital and dabble in the wonderful world of innovation. In fact, this video was taken by the Innovation Specialist and later featured as a SimLab Quality Improvement Project (for which I won an 5S award for):
After all the great outcomes I produced and all the praise I received from leadership, I never thought this could all go away overnight – until it did.
Let’s make a long story short(er): as the SimLab expanded and gained momentum, I realized that I needed help. My vision was to build an interprofessional team that included an MD and a Sim Tech, maybe even another simulation educator down the line. Since I really clicked with this MD during the development of an interprofessional airway course in late 2020, I decided to mentor and include her in the wonderful world of healthcare simulation. We were such a great team with a joint vision and ambition – or so I thought. I have no idea why I didn’t see it coming, no red flags, nothing! But I guess when you create something shiny and valuable, the predators will come, which was a lesson I was about to learn.
And that is how I see her now (hindsight 20/20): a predator who used me and my friendship to gain a huge promotion based on my work. After her “hostile takeover”, she tried to break me by taking away everything that was dear to me. And let there be no mistake. She knew exactly what she was doing and kept me in the dark until it was too late.
When the day came where this MD was supposed to join the team as equal counterpart, she finally revealed her true intentions during the introduction staff meeting. Just like that, without a warning. She became the new Chief of Simulation and assumed “ownership” of the SimLab and all operations. My autonomy, decision-making skills, and my ability to collaborate with vendors or any outside parties were revoked, along with our friendship. Apparently, my immediate leadership decided that it was time to create a new section for simulation within the department, and that an MD had to be in charge, not a nurse. I guess it was an “immoral offer” that this MD couldn’t resist. Gaining power, recognition, and an enormous promotion from clinical staff to Section Chief without having to do any of the work is a pretty sweet deal.
But what made this even worse: she took everything she learned through and about me and used it against me. She bullied me, tormented me with “it came to my attention” emails, and locked away all electronics that I needed to run simulations, requiring me to ask for permission every time I needed something. She prohibited me to collaborate with any outside stakeholders, especially if they were associated with national programs. I wasn’t allowed to initiate any projects anymore, appointing herself as the sole point of contact, while cutting me completely out.
When I tried to escape through a detail to the Innovation Department, she twisted some inside knowledge, which she gained through me, in such a way that it actually shut down an entire section of innovation within the facility for a while. No way out. And there is so much more that happened, the many ways she tried to break me; I have an entire binder full of evidence. But leadership decided to look the other way – I was completely on my own.
I realized that I have lost my precious SimLab. My mental and physical health took quite a beating, leaving me with insomnia, anxiety, and chest pain. That is when I decided that it was time to let go and leave it all behind. And as it turned out, losing the SimLab in such a cruel, painful manner finally caused me to look outside this organization, which had been my professional home for the past eight years.
Here is a motto that has proven to be so true:
When I finally accepted “what is”, I was ready to turn the page. Timing was just right when the National Simulation Center (SimLEARN) posted an RN position in late Fall of 2021. I actually completed a simulation residency at SimLEARN back in 2019, where I was able to build many relationships and connections, so joining the national VHA system turned out to be a natural progression. After lots of uncertainty and unexpected turns, I ended up accepting a new position as Simulation Educator with SimLEARN, which is ironically the national recognition that the MD has been after so desperately.
I am proud to say that despite the pain and suffering I had been through because of this, I still gave my full effort to give staff the best simulation-based activities whenever I was able to…
I would lie if I said that I didn’t enjoy the moment when I broke the news to the MD. At that time, she must have believed that she finally broke me, since I kept my head down and just complied with her (often ridiculous) orders. I just got my start date for February 28th, which was for less than two weeks away, when I told her face to face.
About to accept the firm offer!!!!
She didn’t say much but it was pretty obvious that she wasn’t pleased. Too bad, so sad. Now she had to find someone else who was competent in healthcare simulation and would do her work. The final days were pretty nasty, but I had my eyes on the prize and made it through in one piece.
I actually got lots of kudos and even a farewell “party” from my peers, which was very humbling. Then my last day arrived, and it was bitter-sweet when I logged out of my computer for the last time, exchanging my office space in the SimLab with my home office. Yes, I now get to work a lot from home – just one of the perks that came with my transition to National. New page, new chapter.
New Year’s Day Drama January 1st, 2022: Facing the new year in high hopes! The current “circumstances” over the past 3 months have had me on edge for quite some time, but with the growing anxiety was also a growing hope for change. In fact, I was hoping for the much-anticipated resolution any day now.
With that being said, Ralf and I decided to take the new Origami Paddler out for a trial. I supported a crowdfunding project about a year ago, and I finally received the fold-up paddleboard we had been waiting for. Our storage space in the garage (or elsewhere) is tight, so a traditional paddleboard would be difficult to store and transport with our current setup. This Origami Paddler sounded like a great idea at the time, but to our dismay, it didn’t quite work out as we had hoped. It is a solid product, but the maneuvering of this thing is much more difficult than anticipated, and the seat option to convert the Paddler into a sit-on-top kayak was completely unsuitable for Ralf and me. Since a lot of other users appear to be happy with the Paddler though, I may try to sell it on the Facebook group page.
I wasn’t in the right state of mind that day either, which may have contributed to our disappointing floating attempt. I guess that’s why I didn’t really take any pictures (Ralf did one).
So, even though it was a beautiful, sunny day, we decided to fold up the Paddler and hit home after a short while. And that is when our day was going from bad to worse. While driving on one of the country roads, we saw a beautiful Gopher Tortoise trying to cross to the other side. It all happened so fast: Ralf pulled over immediately to run and pick up the tortoise, who already made it ¾ across the lane. But there was traffic coming and sure enough, the second car that passed drove right over that poor thing. We both saw it coming, screamed and articulated widely with our arms to alarm the car to pay attention, but to no avail. It was absolutely horrible! The tortoise was tossed to the side of the road, Ralf ran over and picked it up. When he beelined back to our car, holding the poor creature in his hands, I could already see the blood dripping. The shell was crushed but the Tortoise was still alive and moving. Now we both had a brief meltdown, sobbing by the side of the road and still screaming after that oblivious driver. Now what? We couldn’t just leave it out here to die a slow death. So, we wrapped it into a towel, nestled it securely behind the paddler in the trunk, and call (yet again) the Back to Nature Wildlife Refuge in hopes of some guidance. Given that it was New Year’s Day, it bordered on a miracle when Bonnie picked up the phone. She gave us the number of Carol, who was running a wildlife rescue operation out of her house close by. She too picked up the phone and told us to come over right away. After an emotional 15-minute drive, we pulled into her wooded driveway. To this day we are beyond grateful to have the doomed tortoise taken care of in the most humane way possible. Ralf donated to her cause, but not money can ever repay the dedication and selfless care 365 days a year people like Carol provide. And you know what? After we left Carol’s place, Ralf actually looked at me and said, “please don’t take this as an omen for the new year”. I admit that thought had crossed my mind, but I was trying hard to convince myself otherwise. And you know what? Unless proven otherwise, I am clinging to the hope that maybe she was able to save the tortoise after all. And we decided to become monthly donors for the Back to Nature place. After all, we have called there already on several occasions while trying to save various animals.
Trying to grow stuff
Ralf and I have looked into ways to improve and enhance our diet, which included also regular juicing and eating more fresh greens. However, it has become a real challenge to find any fresh produce at Publix, and oftentimes, the kale and other greens look rather sad. So we decided to try and grow our own. This would be much more efficient if we actually had a backyard, but since we are renting a home without such outside opportunities, we bought the Hamama microgreens starter kit.
We read the instructions, put the first sheet with kale seeds in the pan, and lovingly added the water. Then we waited. A couple days later, the first sprout actually peeked through, which was very exciting! But the amount and rate of growth was… sub-optimal? I added a desk lamp to shower our little sprouts in light, hoping to expedite the project and awaken the other sleeping beauties. But after about a week and a half, our first harvest was a tad meager. Maybe a handful at best. I guess we need to wait for our future backyard after all.
I also killed Tumi, who initially grew so nicely just to succumb to the Florida heat on our patio. I am not giving up though: Tumi 2 has been planted, and I will do my best to not become a serial killer…
Huracan 2022 Bikepacking Event/Tour de Roach
The Huracan 300 Challenge is one of those major bikepacking events put together by Singletrack Samurai (aka Karlos Bernart). It entails over 300 miles (more give than take) of biking a variety of trails and connecting roads, starting at the Shangri La campground near Ocala, going to Brooksville, then Clermont, Altamonte Springs, before looping back to Ocala. This is the most challenging event that Ralf has done so far (twice), and he was so looking forward to doing this again after his gruesome surgery! And to make this even more special, his good friend Brian Fleming is joining him again. Those two have been riding buddies for years now, and Brian also has had many recent health issues to overcome before attempting this event again. He had a spinal fusion a year ago and a hip replacement last fall, with some added drama in form of a blood clot in his leg. Long story short, Ralf and Brian are now "Team Cyborg" and were riding the Huracan 300 together for the first time since their respective surgeries. Here is to perseverance and friendship!
Of course, Ralf had to carefully manage his health and stick to his strict routines to function. That is why I came along again with all the essentials, checking into hotels/motels along the way. The night before the start on February 5th, we stayed in a hotel about 10 minutes away from Shangri La. That actually worked out great, and it was really helpful not having to get up even earlier than 4 am to get ready and be where we needed to be on time. Unfortunately, the weather-God wasn’t in a good mood, as evidenced by a nasty cold front rolling in overnight. Bah! The day before it was in the 80s and sunny, that morning it was grey, cold, and rainy. Oh well, so be it!
Day 1: Take off from Shangri La to Brooksville I was looking forward to see the guys off to their adventure. While we were still getting ready ad the hotel, Karlos finally announced the direction (clockwise or counter-clockwise). I had a list of hotels to book but had to wait until the morning off to find out in which order. Luckily, I got rooms for both, Ralf (and I) and Brian even on short notice: check!
I remember dropping Ralf off in 2019 for the same event. The Ponce was with us, and that was the first and last time I saw my indoor dog eat horse poo. We are still laughing about that one, he was such a character! I was also looking forward to catch up with Brian’s awesome wife Kim, who dropped her bionic husband of that morning as well. Ralf was nervous, but after we made it to the trail head and he started to get his bike ready and connect with the group, all was good. Awesome!
And off they goooo! After all was said and done, I talked to Kim some more before taking off myself. Since it was very early, I decided to check out the cute town of Inverness, which was on the way (sorta) to the hotel in Brooksville. I wished the weather was nicer, but I got lucky and explored the historic town district while staying dry. Inverness also has Florida’s longest paved bike trail route through, the Withlacoochee State Trail. It reminded me a little of the Cady Way trail we used to ride when living in Winter Park but at 46 miles in lengths, this is by far the longest.
After some sightseeing and late breakfast, I drove through the countryside to the Days Inn in Brooksville. Let me just say, when we pick hotels to stay in, we are very restricted by what’s available, especially in more rural areas. This Days Inn was… an adventure? And the patrons I encountered on the grounds prompted me avoid eye contact, lol. And the hooded guy, who was sitting on a picnic bench right outside the room, apparently didn't have a care in the world while he enjoyed smoking some weed.
Well, the hotel served its purpose, but I wouldn’t recommend walking barefoot in that place or look too closely in the corners. It had a fancy remote control though for the ancient (and sticky) air condition unit and a separate heating unit (did I mention it was COLD out there), which I repurposed to dry Ralf’s cycling shirt the next morning, which I dared to wash in the sink that had seen better days.
Finally, around 6:30 PM, Ralf and Brian finished their first leg of the journey (in one piece). While they showered, I ordered pizza for a quick and carb-loaded meal. Ralf still had to do his evening routine as well to ensure that he stays “out of trouble”.
After that, the two started to deteriorate and shortly thereafter, it was lights out. Day one was a wrap!
Day 2: Brooksville to Clermont Since the guys were going to take off from the hotel, we didn’t have to pack up and load everything into the car already. That removed the stress of having to be at a remote starting point at a specific time to meet the entire group. We got up at 5 AM, which was an improvement compared to the 4 AM wake-up call the morning before. While Ralf was dealing with his morning routine, I checked out the free continental breakfast. It wasn’t surprising to find a rather slim selection of cereal bars, bagels, and muffins. Oh well, at least there was mediocre coffee to be had, lol.
Now it was time for Ralf and Brian to take off to Clermont. It was 8 AM and the weather-God was still in a foul mood. Cold, grey, and drizzly rain on and off. But those two were in good spirits, ready to tackle the 100 miles ahead before getting tonClermont.
Since I had a late checkout, I took my time, packing up and finally loading the car. I decided to stop by at the Yalaha German bakery & restaurant in Howey-in-the-Hills, since it was only a minor detour on my way to Clermont, and I needed to kill some time before I could ask for an earlier check-in. I had a Bratwurst for lunch, along with a Koestrizer Bier, and got some Bienenstich cake and pretzels to go for the guys.
Now it was time to get to the Roadway Inn and try to check in. Good news: the rooms were ready. Bad news: this turned out to be another “interesting” motel, but for different reasons. The view didn’t improve much and featured an almost empty parking lot across from another (abandoned!) motel complex. I found the stranded car that clearly was in an accident particularly strange.
The rooms turned out to be a challenge as well: first of all, there was no coffee maker and no continental breakfast either. Secondly, there weren’t enough outlets to plug in our devices. In fact, I ended up unplugging a lamp to have at least one outlet available. And thirdly, there appeared to be a shortage of lamp shades. That one made me actually laugh out loud! So, in our room, we had two bedside lamps mounted either side. However, the one on my side didn’t work and when I investigated, I realized that the power cord waaaay too short to reach the only outlet behind the bed. I don’t think that lamp was ever in use, unless someone stole a pre-existing extension cord. But both had a shade. When I checked on Brian’s room, he only had one lamp mounted, and his only source of light had no shade (only the bare bulb). Easy fix! Since I had a mounted lamp with a shade that didn’t work, and Brian’s room had a mounted lamp without a shade that DID work, I simply took ours and attached to his. Tadaaa! When I later mentioned this to the front desk lady, she looked confused and then stated that the hotel had a lamp shade shortage…. Okee-dokee.
So we traded a sticky, dirty room with sufficient outlets with a (still dated but cleaner) room with missing lamp shades and no almost no power outlets (and NO coffee maker!). I still had plenty of time before the guys would arrive, so I headed out to the nearest Publix to stock up with water and instant coffee and creamer. I also pre-screened dinner options to be delivered via Doordash or Ubereats. Then it was time for a nap.
By the time the guys finally arrived, it was already dark. I guess it was pretty cruel that after riding almost 100 miles in freezing and wet weather, the last several miles included the steep hills Clermont is known for. Needless to say, both were pretty beat upon arrival. So after a shower and food, both retired to the chambers.
Day 3: Clermont to Altamonte Springs Since this leg of the journey was the shortest route, the guys decided on a later start, just around 10 AM. The instant coffee (Starbucks brand) turned out to be a good choice, and since we had instant oatmeal to go with, the missing continental breakfast wasn’t an issue either. Then it was time for the departure to Altamonte Springs, which was “only” around 50 miles. Not too bad, right?
This time I kind of sucked as video-producer…
I didn’t bother with a late checkout this time because I decided to drive home before checking in to the Altamonte Springs Mainstay Suites hotel. Since Clermont wasn’t that far away from home, it made more sense to go home to shower and drop off dirty clothes. I promised a friend to help with a teaching a virtual TNCC class online, but that wasn’t until the later afternoon. However, since Ralf and Brian would be in Altamonte relatively early, I wanted to check in and settle in the room prior to their arrival. So around 2 PM, I was walked into the lobby of the Mainstay Suites in Altamonte – not anticipating the humbling experience that awaited me.
This hotel struck me as strange from the moment I arrived: there was a lady in front of me, who was trying to convince the front desk clerk that she should have enough reward points accumulated for a free night. Then a guy came to ask if he qualified for clean towels. “Did you bring the dirty ones?”, the clerk asked, which is when the guy handed her an old plastic bag filled with towels. Odd indeed. Now it was my turn. I was only able to check into one room since the second one wasn’t ready yet. That kind of sucked since I needed to be online by 3 PM for the TNCC class. So I grabbed a cart from the lobby and l headed to the parking lot. I now really noticed the tall building close by. If you live in Central Florida, chances are that you know about this abandoned project along Interstate 4 – a building that has been ridiculed by the locals for years for some reason. Well, I never thought I would ever stay right across from it.
I loaded all the luggage and bags on the cart to bring to our room for now. As I pushed the trolley down the hall towards our room, the smell of freshly smoked weed was pretty evident. The whole feel of this place was more like a run-down apartment building, rather than a hotel.
The room setup itself wasn’t bad at all because it had a complete kitchenette, with full-sized fridge/freezer, sink, silverware, small dining table, and decent-sized bath. However, there were mysterious stains on the armchair a “stale” odor in the room. But every lamp had a shade, and outlets were present in sufficient number.
Not really enforced, I would say...Nope, not sitting here - EVER!
After unloading the luggage and logging into Zoom with the free wifi for the TNCC class, the front desk lady called me to let me know that the second room was ready as well. Awesome! I beelined to the lobby to pick up the key card when one of the other “guests” just came in. She looked like she came from work, and the front desk lady stopped her by saying “I think you got mail, but I can’t read the label because I lost my only glasses when I was in the hospital, and everything is blurry…”. The lady took a package, checked the label, and confirmed that the mail was indeed for her. Now I started to get it: this was a place where people without permanent housing tried to stay when they could afford the $80/night and/or had enough (Choice Hotels) points accumulated for a free night. Then I remembered the voices of young children I heard from a second-floor room while unloading the car… I had to put it out of my mind or now, especially since I had to be online and fully present in about 10 minutes. I grabbed the key for the second room, which was thankfully next to ours, and quickly brought Brian’s bags and supplies over to his suite. I just made it in time for the class and had to give it my full attention. As it turned out, the free wifi in this place was rather spotty, so the Zoom call was also not the quality I was hoping for, and my virtual trauma manikin didn’t load even once.
Fast forward to 5 PM: Ralf and Brian already arrived from Clermont, which was even faster than I anticipated. I was still finishing up the TNCC class, so Ralf quietly took a shower and then settled into bed to rest until I was done. Thank goodness I was just finishing up with the class when poor Ralf jumped out of bed in horror! Apparently, the mattress was wet allover, so when Ralf laid down in his clean clothes, the moisture made its way through until he noticed. We lifted the mattress to see what was going on, and sure enough, an enormous stain was find underneath. Since it didn’t have a potent odor nor yellow color, I was hopeful that this wasn’t what I first thought it was… but nevertheless, this was disgusting!
Ralf was so exhausted and angry; it broke my heart. Managing his condition so that he could complete this bike packing event was difficult enough, and this clearly almost made him give up and go home. But he had come so far, and I really, really wanted him to finish! So, while Ralf was packing up our belongings, I went to the front desk to ask for another room. Brian’s room was ok, and he didn’t have any major issues, but we definitely needed to move. The poor front desk lady (who lost her glasses) was so apologetic, and a tad overwhelmed, especially since there was no manager coming in until the next morning. It wasn’t her fault, and she clearly was distraught by the situation. Long story short, we got a new room down a different hall, and when we checked underneath the mattress, there was no evidence of critters or any kind of fluids. It’d been a long day, and this was only for one night, so we quickly moved our stuff over and then ordered burgers through Doordash delivery. Brian came over when the food arrived to join us for dinner, then we all retired for the night.
Day 4: Altamonte Springs back to Belleview (Shangri La): Without any more dramatic events, we made it through the night. At around 6 AM, I went to the front desk to give Ralf time to do his morning routine. I now was very curious what the continental breakfast would look like in this place. I read on a sign that breakfast needed to be picked up at the front desk (one per person), which was a new concept. As I was walking down the hall towards the lobby, I saw a very young woman, dressed in a pink jogging suit and a tiny Chihuahua on a leash, standing there. As I got closer, I first thought that someone had punched her in the face because I noticed a bruise-looking discoloration under her left eye. But then I realized that it was a tattoo (some writing that I couldn’t quite decipher). I said “hello”, padded her adorable puppy, and asked her if she was waiting to pick up breakfast. She said yes, but that the guy behind the front desk had disappeared and was nowhere to be found. As we waited, we made some small talk, and when the front desk clerk finally appeared, I took the opportunity and requested our breakfast. The young women said her good-byes and returned to her room.
I sat in the only chair, across the counter, close to the entrance. The two small (stapled) paper bags I was handed contained the pre-assembled breakfast. I opened one bag to investigate and found a cup of instant oatmeal, a small bottle of water for said oatmeal, a fruit cup, and a breakfast bar. A pretty sensible choice, since I assumed that many of the folks staying here depended on it. I observed a few people who were clearly leaving for work. Then a lady in scrubs arrived at the front desk, trying to pick up her breakfast. She appeared to be in a hurry, looking for the clerk (who again had disappeared). A couple minutes went by, and the lady got more and more anxious, most likely because she needed to get to work and needed the food. I grabbed my second, unopened bag and offered it to her, stating that I didn’t need it. She thanked me, grabbed the bag, and beelined out the door.
As I sat there, in the lobby of this dated place that clearly wasn’t used by guests on vacation, I was overcome by gratitude of what I have. Nobody is safe from falling into bad circumstances, especially when you take the repercussions of the pandemic into consideration. Not everyone is a “screw up” or drug addict. Most people I encountered were trying to make ends meet, going to work, surviving on a budget that clearly wasn’t enough to cover food and permanent shelter. I was once close to living in my car, after my abusive ex-husband from another lifetime had ruined me financially and professionally, forcing me to start from scratch. So yes, I am grateful that I was able to rebuild my life, grateful for all the things I do have: sufficient income, a roof over my head, quality food, a car to get me where I need to be, ability to fly back and forth to Germany to take care of my family, and the means to pay for healthcare. This last hotel stay turned out to be a humbling experience and a good reminder to be grateful.
In the meantime, Ralf was ready to rumble. A check with Brian confirmed that takeoff was going to take place as scheduled.
At 7 AM, it was time for Ralf and Brian to tackle that last 100 miles back to Shangri La near Ocala. The weather forecast was NASTY, but those two were in good spirits and adequately layered in rain gear.
I went back to the rooms, packed everything up quickly, and loaded the car. I didn’t want to wait for the manager to come in at 8 AM to address the wet-mattress incident, but the front desk lady (who had returned) promised me that she’d follow up. It took me a little longer to get home, especially since I got caught in morning rush hour, but I finally made it home. HOME! I still had to finish up the TNCC class on Zoom at 10 AM, but then I took a glorious shower and washed all the clothes right away. I went to the store to stock our fridge, cooked a homemade chicken soup, and waited for Ralf and Brian to get closer to the finishing point. Brian’s awesome wife Kim was bringing Publix sandwiches for everyone, so I didn’t have to think about what to feed Ralf upon his arrival back in Shangri La.
Due to the weather, their arrival was now estimated for around 8:30 PM but was still a tad unpredictable, and the drive to/from Brooksville was also about 1 ½ hours. So Kim and I took off at 6:30 PM (her drive was a tad longer from her home), in order to be there early, just in case. It was still raining and pitch black, with heavy traffic on the turnpike. I hate driving in the dark to begin with, so I was glad when I entered the Shangri La parking lot.
It was so cold, so I stayed in the car while I waited for Kim. She made it about 30 minutes later, and since she had the sandwiches ready to go, we sat in the car, ate our share, and waited. I checked the GPS tracking again and had to realize that the guys are still at least an hour away. But that was ok, especially since this gave Kim and I time to catch up. Last time we were here, in the same place for the same event, was in 2019, just a week before Ponce passed. In fact, with a heavy heart I remembered Poncebear, who came along that night, tucked away in his stroller, to pick up daddy. A memory I actually share with Kim.
Just after 9 PM, Kim and I walked over to the pavilion of the campground where Ralf and Brian would eventually arrive. It was cold and dark, but at least the rain had stopped. And finally, at 9:26 PM, we saw some lights and voices approach: the eagle had landed!
The guys were completely exhausted, dirty, and a tad discombobulated, but so happy! They just finished a 350 miles loop around Central Florida, despite nasty weather and physical challenges. After we took some pictures, the guys changed into dry clothes, and then Kim and I stuffed them in our respective cars to make our final drive home. Ralf ate half of his sandwich, then fizzled out.
Wow, what an experience for both of us! I am beyond proud of Ralf for this accomplishment, finishing 350 miles on trails, gravel, and pavement, despite nasty weather and ongoing health issues. Being able to do events likes this is always a “hit or miss”, depending on how he feels, which makes this even more special. Me, I have a renewed appreciation of my blessings, thanks to the “Tour de Roach Hotel”, as Ralf calls it...
Foreword This is always such a difficulty situation: I really want to post updates more often, especially when a lot of events happen in such short period of time. However, the most recent event (and this one shook me to my very the core), I never saw coming. I have been in flight-or-fight mode over the past month, and I just couldn’t get myself to do the reflection necessary for updating my blog. I guess part of it is denial, not mentally ready to deal with what happened.
So, I decided to separate two significant events that started/happened recently: one is a personal milestone for Ralf and me, the other one is of the most detrimental, evil nature that I have ever experienced (besides a cancer diagnosis). So, let me focus on the positive in this update, since this milestone deserves to be featured without being contaminated by evil. I hopefully will be able to post the next update in a week or so. As always, baby-steps…
Self-Maintenance
My hip has been sore, and I can feel the scar tissue burning and pulling deep inside my thigh. I have been using a myofascial massage roller, and PT used a Gastron “scraper” to break up more tissue. Bruising is expected, I suppose, but it makes it awkward to go to the pool for rehab swimming… But I am still making progress, my range of motion is improving, and PT has gotten me on the right track for recovery.
I concluded the last update with a preview of the IV Lounge project. Ralf has had a lot of issues with staying hydrated and getting certain nutrition because his diet has been restrictive in many ways, and his GI system doesn’t function normally anymore. So, we looked into IV hydration/supplementation. In my time as ED nurse, I witnessed first hand how a liter of fluid administered IV could “perk up” a sick patient, especially in cases with underlying GI issues. When I saw a dear friend post about her great experience with the IV Lounge, we decided to give it a try. Covid numbers had been improving, so the benefit was worth the risk at this time. Ralf and I are an item, and I am always game if it helps my mate get better. Besides, the couple that infuses together, stays together, right?
But seriously, we are both very hopeful that adding IV infusions to Ralf’s (and my) monthly maintenance program would be another angle to improve our health. I admit, I have started many IVs in other people, but I am actually quite phobic of needles myself. Getting poked on purpose took me some courage, but I am getting better with that. We have done weekly infusions over the past month, which entailed one liter of normal saline with added electrolytes, amino acids, vitamins, and minerals. Especially for Ralf, this appears to be a promising intervention, so we signed up for a couples membership to see where it goes. Expensive? Yes. Worth to enhance quality of life? Absolutely.
Happy Birthday and 2nd Anniversary
October 21st marked Ralf’s birthday and our 2nd year Anniversary. The evil that already entered my life the week before did unfortunately contaminate this time of celebration a bit, but it was still a great day. This day marks the birth of a survivor, who has overcome the impossible, and despite all the curve balls, uncertainty, and pain, he never gave up.
Our landlord doesn’t allow pets, and even though we talked about the possibility of adopting a new furry son or daughter, that will have to wait until we find a new home. In the meantime, I got Ralf a Tribble. Since I introduced him to the wonderful world of Star Trek, I believe this is the perfect first furry pet. We named him Kelvin, and when you touch him, he shakes and purrs. I am glad though that we didn’t end up with a house filled with Tribbles while we were gone on the upcoming trip – and it actually makes me feel a little old when I realize that many people I know will have no clue as to what a Tribble is.
Ralf’s First Bikepacking Event After relentless planning, prepping, troubleshooting, and reassurances, Ralf finally attended his very first bikepacking event since his cancer diagnosis: the River-to-Sea Loop, which was a three-day, 200 miles bicycle ride, mostly off road, and with long stretches “off the beaten path”. The event started in Seville (30 minutes North of DeLand), to Palatka, to St Augustine, and then back to Seville. Ralf had done such rides in the past, and he'd made great friends who he hasn't seen for a very long time. One of the reasons why I decided to come along and book hotels along the River-to-Sea route was to bring all the specific food items and medical supplies that Ralf needs every day to function. His routine needs to happen in a certain order and requires a lot of time. That’s why he couldn’t go camping with the group this time around. But you know what? It didn’t take away anything from this experience, and he ended up riding the entire course. I couldn’t be more proud if I tried.
Starting Point/Day 1: DeLand/Seville to Palatka After a visit to the IV Lounge for “pre-hydration”, we made it to DeLand on the evening of October 21 (Ralf’s birthday & our anniversary). We checked into the hotel, the first time in years, and got ready to meet a dear friend and his awesome wife, Brian & Kim, for a nice dinner. On a side note, when we entered the parking lot of the hotel, we passed a car that was parked there and caught my eye. I guess being from Europe, I am still amazed when I see stuff like that, so I had to take a picture…
...However, HE did not save your eyesight or parking skills...
After a very nice dinner with our friends, we walked back to the hotel to get Ralf’s strict evening and morning regimen set up. We both had to get up at 4 AM in order to be ready in time. We were pretty nervous because this was the first time since his cancer surgery in 2019 that Ralf had been away from home overnight. But even though it wasn’t perfect, it worked out. When we left the hotel, the lobby was still completely deserted, and even the coffee place wasn’t open yet.
It took us about 30 minutes to get to the starting point in Seville. Our GPS routed us to the wrong place at first, but since that happened to 90% of the other riders as well, we didn’t feel so bad, lol. After someone called the organizer, we got some clarification and the group caravanned to the right spot, which was about five minutes away. One by one, cars loaded with bikes arrived, and everyone was busy setting up their gear and getting ready for take-off.
You know, going through what Ralf has been going through is bad enough, but the isolation due to Covid had certainly added to the mess. That made this event even more meaningful, and my heart was full when I watched him assemble his bike, saying “hello” to old friends, and getting ready with the group to start this new adventure.
And at last, the River-to-Sea 2021 is officially on the way!
After the group had left, I got into the Element, put on the “Red Hot Chili Peppers”, and drove towards Palatka to check into the hotel at check point 1. I had Ralf’s tracker on my phone, so I was able to see where he was at (approximately) and gauge an estimated time of arrival.
The group was supposed to meet at a Beef O’Brady’s, just across from the St. John's River bridge that leads to Palatka. I joined the group for (an outside) dinner before picking up Ralf and his bike for the evening routine.
After we got to the hotel, Ralf took a shower and completed his Avazzia (electrocurrent) abdominal treatment. When I looked over to ask him a question, he was already out…
Second Day: Palatka to St. Augustine After another early morning, Ralf was ready to start the second leg of the journey. It takes a lot of do his routine, along with all the planning and packing/unpacking to keep organized, but it went better than expected.
Getting to the second starting point was a lot more adventurous than Seville – even without getting lost. The deal was to meet the group at a trailhead parking lot in the middle of the Etoniah Creek State Forest. Besides the lack of paved roads, it was still pitch-black, completely remote, and given that it was the week before Halloween, pretty spooky. As we were bumping along on the washedboarded gravel at snail-speed, movies like the “Chainsaw Massacre” came to mind…. But I am happy to report that we didn’t encounter any werewolves or mass murderers, and after three miles deep into the woods, we found the trail head.
After we pulled into the parking lot, Ralf got to work, setting up his bike and gear again. We still had to wait for the group to assemble, since the other riders were camping in a nearby primitive camp site and needed to get ready as well.
While he was busy doing that, I took a stroll around the trailhead to see where were are actually at. Funny enough, werewolves were not as common as bears here, so in hindsight, I am glad we didn’t run into one of those furry guys on the way.
After everyone was accounted for, Ralf rode off with the group to the next check point: St. Augustine.
Meanwhile, I put the address for the next hotel into the GPS to get to St. Augustine myself. But first, I had to make my way back to civilization. Slowly at first, very slowly, until I had pavement again under the wheels… at least now it was full daylight, which took away feeling of being part of a horror movie.
I made it to St. Augustine by mid-morning, and it was BUSY! I didn’t realize that it was not just tourist season but also homecoming weekend. I couldn’t check into the hotel until the later afternoon, so I parked in the hotel’s parking lot, changed into shorts and sandals, and walked into town. I have been here before, many years ago with Ralf, my mom, and Karl-Heinz, I believe. But this time, it felt a lot more “touristy” to me. I walked to the famous Castillo de San Marcos National Monument but after I saw the line, decided to just sit by the water and listen to some music for a while. My anxiety and panic attacks were still there, even though I tried hard to put it away.
I kept checking on Ralf’s progress on his tracking app, and I still had a lot of time before we were going to meet at the Ice Plant Restaurant and Bar later that evening. So walked through the “old town” section of St. Augustine, ate some lunch, explored the residential areas, and talked to my friend Sharon on the phone.
I finally got to check into the hotel, freshen up, and walk about a mile to the Ice Plant to meet with Ralf. Due to the amount of traffic and people, it appeared more logical to walk a mile, rather than taking the Element. A wise choice, as it turned out.
Ralf finally made it to the restaurant around 7 PM. However, he was very beat, and there were just too many people at this place. So, we decided to skip dinner and walk straight back to the hotel. And as it often happens: you keep on going until you relax, then you crash. That’s what kind of happened to Ralf. I ended up ordering pizza through DoorDash, and after he ate, it was again “lights out”. That was until a MASSIVE muscle cramp in Ralf’s right calf disturbed the night, I mean, that was a bad one! Thank goodness for the mustard packages I took from the previous hotel. Ralf guzzled down two packs, and the cramp finally let go. Yes, mustard is a remedy for these kind of muscle cramps, and so far, that always worked.
Third Day: St. Augustine back to Seville
The last early morning of the River-to-Sea had arrived. Given that we had no idea how staying in hotels and managing Ralf’s medical routine would work out away from home, I was so incredible proud of him for what he already had achieved. It hasn’t been easy, but being able to ride in this event so far exceeded our expectations.
We left the hotel to get to the last meeting point, about 20 minutes away. Ralf looked tired but also happy…
The last check point wasn’t’ very scenic. In fact, it was a tiny Subway plaza right off the main road. After we arrived, Subway was still closed for another 30 minutes, which sucked because we both needed to pee. For the last time, Ralf took out the bike and got his gear ready. The group was again camping at a nearby campground, but at this point, riders would take off for the final destination without assembling as a whole group. So when three of Ralf’s friends arrived, the four of them decided to take off, in order to make back to Seville by daylight.
Me, I waited another 10 minutes for Subway to open to go pee, then I had to kill some time. It was only 9 AM, and because there wasn’t another hotel to check in, I decided to explore a state park near Palatka. It was only a 45 minute ride, and I read online that the Ravine Garden State Park was nice.
When I got there, I tried to take a power nap, but my anxiety was not letting me rest. So I did what I did before: I put in my headphones, turned on some music, and power-walked the 2-mile trail – twice! I also explored some of the many side-trail and climbed down to the bottom of this enormous sinkhole to walk around some more. It was actually really nice, even though I was now sweaty and grimy.
Now it was time to get close to Seville to wait for Ralf’s arrival. My internet connection was rather spotty, and I had a hard time getting an update on Ralf’s tracker app. So I drove to the nearest place before Seville, where I could get a snack and wait. That turned out to be a Winn-Dixie, where I got some food and water for myself, and also for Ralf. After collecting him, we still had to drive 1 ½ hours back home.
I must say, I was very proud when I gestimated my arrival so perfectly that Ralf and I arrived exactly at the same time. He was still with the same group of friends, which made me very happy.
He was tired, beat, and his behind was most certainly hurting. But he DID IT! Halfway home, he snoozed off – well deserved, I must say.
Words cannot describe how proud I am of this man! From being given a death sentence, to surviving a morbid surgery and hot chemo treatment, 16 days at Moffitt Cancer Center, countless setbacks, ED visits in the middle of the pandemic, being let down by healthcare providers left and right, let alone the mental agony of processing it all and still press on, Ralf has fought through it all. He is setting an impressive example of perseverance and strength.
First sunlight in two weeks after CRS/HIPAC surgery at Moffitt Cancer Center November 2019
Just finished 200 miles River to Sea Bikepacking Event October 2021
With that being said, the evil that has disrupted our lives has already impacted us, mentally and physically. I have to make some tough decisions very soon to protect my family. But that is for next update.
Ever since I started writing this blog, I never missed an update. Until now. In fact, I missed two updates. Thinking of the words of the son of my dear friend Libby, who just passed away from chemo complications a couple weeks ago: “Life is difficult, life is hard”. The last few months have been brutal, putting me in a constant state of anxiety and depression. But I am trying hard to overcome this, the effect of this unprecedented pandemic has had on my mental health, Ralf’s setbacks, finding my way in a new job, then having to travel to Germany for a family emergency… it is just getting a bit much.
Good-Bye Emergency Department – Hello Education! But let me start by recapping the month of June – my last weeks as ED nurse during this COVID-19 pandemic. Ironically, I got the new job as Simulation Coordinator already back at the beginning of March. However, due to the dire circumstances, I was on hold until June 22nd. I admit that after the first COVID wave somewhat subsided, things were less scary and dangerous during the first part of the month. It was about two weeks after Florida loosened the restrictions and opened the bars again, when almost overnight we experienced a consistent influx of sick Corona patients. I remember the day I was in triage, shortly before my transfer, where I was more exposed to COVID in this one 12-hours shift than during the past three weeks!!! It was scary! And those Covid patients weren’t old or compromised, they were in their mid-twenties! I remember that bartender who couldn’t finish a single sentence because he was so short of breath, with a fever of 103. I was locked in with that 27-year old guy for over an hour, doing blood cultures, EKG, and trying to keep him stable until I transferred him to the ICU. Same day, I cared for a 25-year old girl, who went to the bar with friends for a drink… and on and on it went. It was amazing to see the obvious pattern. So many people just got careless, acting as if the pandemic was over and there was no need for masks or social distancing. And I get it: I have been more than depressed with what life has become. I am mourning the freedom to go to the movies, or a restaurant, hug my friends, or go grocery shopping without fear of a deadly disease that has taken over the world. But I have seen the truth, the sick, the repercussion of letting your guard down. And it’s not just about me: what if I take that virus home to Ralf?
However, just as the second COVID-19 wave was taking off, I finally got to my new destination: The Education department as the new Simulation Coordinator – a job I was very much looking forward to! During most of my graduate education, I was fascinated by and focused on healthcare simulation. Now all the hard work finally paid off, and on June 19th, I worked my last day in the Emergency Department. This was a bitter-sweet moment: I always wanted to be an Emergency Nurse, and I consider myself very lucky that I got to open up a brand-new Emergency Department at the VA Hospital in Lake Nona in 2015. But now it was time to say good-bye…
Last Day in the ED!
Natalie
Cindy
Jonathan & Gary
Joel
Jodie
Angie
Bergie
Diane
Dr. Velez
Bonnie
Ralf was so excited for my new job, he got me flowers on my last day!
Fast forward to June 22nd, 2020: the day I was finally starting my new position as Simulation Coordinator at the VA Hospital in Lake Nona! Here’s to a new chapter in my nursing path! But I must say, the last day in the ED was quite emotional, and I will miss my patients and my peeps for sure…
First Day in Education
Traded my locker...
...for an office
I admit, I was pretty nervous on my first day, not knowing what to expect. The good think is that I have been around the Orlando VA for so long that I know my way around – as well as a lot of people. What was “unique” about this position was the fact that the previous Simulation Coordinator had been gone for almost a year, and even before that, the lab wasn’t quiet utilized as intended. And the madness of the pandemic, when stuff was just taken from the Simulation Lab, never to be seen again, made my job an even bigger challenge.
Having a Predictable Schedule With my new job came also a predictable schedule: Monday through Friday, 0800-1630, weekends and holidays off! I also got a government laptop to work from home if need be, which added a new layer of flexibility (extremely important feature as I found out in July…). So, Ralf and I went on some outings on my days off – and it was so much less stressful all around. No more fear of exposure, no more 12-hours shifts, coming home late… I didn’t realize how much of a difference this would make.
We explored the north entrance of the Lake Lizzie Preserve on a rainy day, then the south entrance the following weekend. We also went for a bike ride at Triple N Ranch, were I haven’t been in so long. It reminded me what outdoor adventures in Florida during summer time always have in common: LOTS of water, and lots of turtle activity!
Life in Isolation Even though Florida started their phase 1 of re-opening the state, Ralf and I decided to stay put. In fact, the virus is still out there and with people returning to their “normal” life activities, the spread of COVID-19 will continue to increase (in my humble opinion). Especially Ralf can’t risk getting sick, and it is already pretty nerve-wracking that I am his number one risk factor. When I go to the store (every 10 days or so), I make sure to wear my mask and stick to a “disinfection routine” to minimize the risk.
I can attest that the mandated isolation and restrictions were actually working in reducing the cases of COVID-19 significantly. In our ED, we still isolated and treated patients with certain symptoms “as-if”, but the actual cases of infected patients has gotten less and less. Still, I have maintained my decontamination routine at home by taking off all my clothes in the garage, showering in the guest bathroom, and washing all contaminated items separately. I do feel a little less anxious right now, though, given the reduced numbers of COVID patients (for now…). I am afraid of another wave coming our way as the restrictions are loosened ... Time will tell!
With that being said, being isolated from the world takes a toll on mental health and restricts what we can do in many ways. I admit that I actually mourn the loss of a world that will never be the same after this. It is hard to adjust to this new reality, and it saddens me that even simple tasks like going to the grocery store provoke anxiety and cause stress for me. I am also so sad that we wont’ be able to celebrate our wedding at the Wallaby Ranch in October as we had initially planned, nor do I know if I get to spend Christmas with my family this year. So Ralf and I have been trying to get some dear “outdoor-time”, which isn’t easy when State Parks and State Forests are actually closed…
Cabin Fever!
Running Again! I am happy to report that I finally started running again! I ran/walked two miles, which may have been a little ambitious since my poor thigh muscles were on fire the next day. However, my back was not complaining at all, which is a victory…
Running again for the first time!
We also continued our garage workouts, but I admit that my motivation level hasn’t been very high lately…
I hope that by the end of June, things will get a bit more structured when my work schedule finally changes to bankers hours: yes, I finally got a start date for my new position! June 22nd is my first day as Simulation Coordinator!
Happy Birthday - Pandemic Style May 26th happened to be my birthday, and since going out wasn’t an option, Ralf decided to pick up a three-course dinner from Nona Blue! Yes, restrictions have been partially lifted, and many restaurants offered limited dine-in options, but as I said earlier, we are not taking any chances… In any case, we dressed up, put some music on, and had a wonderful dinner at “la casa”!
Next month will bring Ralf’s official post-op follow up with Moffitt, and I will start my new job on June 22nd… Let’s see how it goes!
2-Year(ish) Follow-up X-Rays Due to the shutdown of all non-essential services during the pandemic, I wasn’t able to get my 2-year x-rays done until now. I wasn’t all too worried that something was wrong, but it always gives me peace of mind to get confirmation. I haven’t sent my images to Dr. Desai yet but from what I can see, my ESP is exactly where it was before. Also, the disc space of my L4/L5 is well preserved, which means no signs of accelerated degenerative disc disease! The report stated the same, and since I have gotten all my x-rays there in the past, the radiologist reading my film had the comparison images available as well.
I wanted to add that even though my “old” back pain never returned after surgery, I have been feeling very sore and tight all over - from my neck to my ankles, I am a knotted mess. Stretching has helped some, and I know I should be doing more rehab workouts, but I am so stressed and often so tired that I just don’t do it… working on it though.
So, here they are:
L5/S1 Close-Up
Flexion
Extension
Oblique Right
Oblique Left
Being "Essential" Working in an Emergency Department during a global pandemic has been so many things. Scary and unreal come do mind, actually. I am however grateful that A) I have a job, and B) I am physically able to do my job. But being repeatedly exposed to COVID can be mentally exhausting. It almost is a feeling of “doom” whenever I pick up a suspected COVID patient from the outside holding area to take him/her to an isolation room for bedside triage. Closing the door behind us, my co-workers would stay outside the glass door, ready to fetch something I may need. Being in that closed room for a considerable amount of time doing necessary patient care trigger thoughts of “what if”, but you still give your patient all you’ve got – they often are as scared as you are.
When the number of cases was starting to increase, the issue of having appropriate PPE came to light. When I got my first paper bag with my name on it in which I was supposed to keep my disposable N95 to be reused, I couldn’t believe it. The procedures for PPE use have changed multiple times as the crisis unfolded, and the VA showed great efforts to keep us safe. I was eventually fitted for a half-mask that is meant to be cleaned with soap and water. I learned the hard ways that wearing N95s really hurt your face after a while, but the red marks hopefully mean I got a good seal… Ralf also bought me some face shields for protection. I have been wearing my surgical mask for multiple days (gross!) but finally got washable face masks from Ebay, which I now use instead.
First issued N95 (under the surgical mask)Upgrade to N95 half-face maskLeaving a mark = hopefully good seal (ouch)
Thank-You Parade around the Orlando VA Medical Center by local law enforcement!
Trying for some Normalcy A global pandemic like this is scary enough, but with Ralf’s recent hospitalizations and post-surgical issues, it adds an additional layer of anxiety (for both of us). We lost our primary care provider, who left the practice mid-March. Ralf also wasn’t able to establish care with the GI specialist. This was actually very disappointing because Dr. Lepane was assigned to his case during the latest hospital admission at AdventHealth Celebration, and we really wanted to get established with her for Ralf’s GI-related needs that have nothing to do with his cancer. However, she refused to take him as a patient, referring him back to Moffitt. She didn’t even talk to us directly but brushed us off through a middleman. Very disappointing indeed.
Regardless of all the anxiety, uncertainty, and fear, Ralf and I really tried to keep some sort of normalcy in our lives. Even though we got married in October, our unofficial anniversary has always been April 1st. That was the day I moved in temporarily to take care of Poncebear while Ralf was away for the weekend – and then I never moved out, lol. So when April 1st came around, Ralf clipped some branches from the plant that grows over our wall, right in front of our door. That was so sweet!
We also did a few light workouts out of our garage, where we have some equipment stored. Unfortunately, I just can’t get it together enough to be consistent right now…
Whenever I was off from work, we also went for long walks around the neighborhood. We are very fortunate to live in a safe, gated community with lots of lakes and walkways. Before the official lockdown, we also did a couple outings to Split Oak or Hal Scott Preserve but ever since the official lockdown, we haven’t left the neighborhood. Funny enough, we still got our gator encounters and examples of the “circle of life” away from the woods!
Gator in Split Oaks
Gator in Village Walk
Freshly caught from a Village Walk lake
Easter 2020 was pretty much non-existent, even though I was actually off this year. Found this old picture and thought it pretty much sums it up:
We did have plenty of time though to really improve meal prepping and healthy eating. Due to the virus, all groceries are getting disinfected in the garage before entering the house, which is quite an operation! We also realized that we need a bigger freezer because we are running out of space. In addition, we ordered a gas grill online and managed to assemble it on our patio.
Overall, life feels very strange these days and I am sure the world will adjust but never go back to how things used to be, at least not completely. But at least I am going through this without a broken back, and my heart goes out to all those who suffer from crippling pain in the midst of a global shutdown.
Foreword Let me just start by saying that I if I had my surgery scheduled for today instead of two years ago, it would have been a complete nightmare. Back then I was in so much pain that wasn’t able to work anymore. I was depressed, and I had no quality of life left. Making the decision to go overseas to have spinal surgery is scary enough, but having a global pandemic happen is an unforeseeable disaster I am glad I didn’t have to deal with. My heart goes out to all the people in severe pain, who have to live through this pandemic not knowing how this will affect their ability to fix their back, or when.
I am not going to lie, being an Emergency Department nurse during a global pandemic is petrifying! I am not so much worried about me getting sick but that I take this virus home somehow to infect Ralf. I wear all protective PPE at work that I can, but being locked into an isolation room with a very positive, very sick Covid-19 patient for 15 minutes while doing the triage and providing direct care causes a sickening knot in the pit of my stomach – which you push out of your mind until you did what you could for your patient. My peers and I are on edge, but we have each other’s backs and will care for our community with all we’ve got.
Mobile Medical Tent
Full PPE
TRIAGE!
Best crew to work with, plus the medical director who stopped by
The Good
This 2-year update is not quite how I envisioned it, especially since I won’t have my follow-up X-rays until June (maybe), but gauging from how I feel, I would say that nothing has changed. After I have the images, I will send them to Dr. Desai in Cologne for review and confirmation, but that will not happen anytime soon.
Looking back at the past year, there is a lot I was able to do. As many of you know, Ralf and I have always been very outdoorsy people, so we continued to go on many biking adventures in various Florida forests and Wildlife Management Areas, and I never had any issues with my back, even if I had to carry my bike through bodies of unexpected waters. We also went tent camping in the Everglades, and I was riding 30 miles of muddy trails during a monsoon.
I also continued to advance through my workouts with Angela at her Crossfit Lake Nona gym. However, due to unforeseen circumstances, full-time work, and graduate school, I was not really able to truly establish a routine. Honestly, I envisioned myself being super-fit and able to do several pull ups which was one of my goals. Did that happen? Not really… Life appears to have a way to throw curveballs that can mess up all the good intentions and plans that were made. I don’t know about you, but 2019 really was an intense and pretty awful year.
We visited Key Largo in August of 2019 where we tried out sea-kayaking for the first time. This was truly a test to see how my back would behave since it required me to sit in a cramped space for over two hours while paddling and navigating the kayak through open water. I did feel a little stiff at the end but once I got out of the kayak and stood up, I felt great. Absolutely no pain or soreness. Definitely something we can repeat!
Another water activity Ralf and I started exploring involves a packraft. Ralf has gotten pretty serious with bikepacking, and a packraft is designed to be carried on the bike, which then gets strapped to the raft to continue via water ways. We received the pack raft also in August but due to what came next, we only took it out to the lake a couple of times so far. It’s a lot different to maneuver the raft compared to the sea kayak, but it appears to be a very fun activity for the future.
An impromptu wedding was also on the agenda, which ended up with just him and me in the courthouse. Ironically, the reason why we didn’t get married sooner was the difficulty of getting friends and family from around the world together at the same time. Ralf sometimes said, “let’s just elope…”, which is ultimately what happened!
Another major life-event was my graduation (finally) from my MSN Nurse Educator program in December. To be honest, with everything going on, I really didn’t want to go. However, here I was, getting my regalia on, taking pictures with Ralf in the driveway of our home because he was not able to come. At the arena, I ended up standing backstage with my group for 1 ½ hours before marching inside, just to sit for another 3 hours on a hard plastic chair. At least Ralf got to see me walk on livestream…
At work, I participated in various Emergency Management activities, such as retrieving a mock-victim from her car in the community and help with shooting a decon training video that required me to not just dress up in full gear but also tonrepeatedly kneel, lift and twist while transferring a mock-victim from the ground to a stretcher.
The Bad Looking back at the past year, I must say it was awful in terms of certain life-events and stress but at least I was able to be there and do what needed to be done when it was most important.
Being able to go back to work as an ED nurse was one of my major goals, and it came to pass without issues. However, there has been a lot of negative energy developing in my department due to changes in leadership at the time. That in turn made going to work a very stressful time, but at least I got to care for my veterans again without physical restrictions.
Moving on to August: as it turned out, the Key Largo trip was the last time Ralf and I had normal lives. A few days after we got home, Ralf had a CT scan done that revealed stage 4 peritoneal carcinomatosis – a very rare cancer that grows in the abdomen and around all associated organs. This has truly been a life-altering shock, and it took me two weeks to pull myself together to come up with a plan. If you read my blog, you know the emotional roller-coaster we have been on. To make a long story short, against all odds, we found the only treatment option for his condition which was cytoreductive surgery with HIPEC (heated intraperitoneal chemotherapy). We decided to go with the Moffitt Cancer Center in Tampa, which is one of the top 10 cancer centers in the world. Lucky for us, Tampa is only 1 ½ hours away which made traveling there a lot easier.
It was so hard to focus on school in the light of Ralf’s diagnosis. All this happened just before my last semester of my MSN program, which entailed a 180-hour internship I had to finish while working full time. To be honest, I almost dropped the semester, but Ralf really wanted to see me graduate in December, so I pulled myself together and pushed on. I think the hardest part was to be away from home pretty much all the time, either completing internship hours or going to work. Ralf’s surgery at Moffitt was set for November 22, so I had to get everything done before that date – including getting married and finish school!
I don’t know how, but I actually managed to get everything done a week before surgery. I can’t even imagine what would have happened if my back was still broken – constantly on the move, pushing on. In addition, while Ralf was admitted at Moffitt, I got to sleep on a pretty flimsy cot for 16 days, which my back tolerated just fine despite the bend in the middle of the mattress.
Fast forward to February: Ralf was recovering so well, and we started to go on hikes and some mellow bike rides. Everything was going so well until mid-February, where he had a sudden episode of severe abdominal pain that didn’t subside, so I had to take him to a local ER. Having a rare cancer is scary enough but getting admitted to a hospital where the doctors and nurses have no clue is downright petrifying. After the acute pain had somewhat subsided, Ralf was discharged without a diagnosis.
Two weeks later, the same thing happened to him but this time the pain was so much worse! I took him to a different ED in a much better hospital where he was admitted again. Besides pain control, they wouldn’t touch him either but at least they had him transferred to Moffitt where he needed to be. The final verdict now is severe adhesions and scar tissue that is strangling his gut, which is an unpredictable complication we didn’t see coming, but we have a plan once the pandemic subsides.
During the last admission, I got to sleep on two different guest cots, and I must say Moffitt wins the price despite their flimsy contraption! That thing I slept on at AdventHealth Celebration was so hard, I woke up stiff and in pain – from neck to low back, stiff like a board. No, the pain was nothing like my pre-op back pain; it was just a result of sleeping on something too hard and uncomfortable. I came to realize that I am not 20 anymore either: ADR surgery restored my back but it can’t protect me from age-related aches and pains, I suppose.
Conclusion So, what’s the overall verdict at 2-years post-op? Number one, life WILL happen – with or without a broken back. However, ridding myself of the disabling, crippling, soul-sucking pain enabled me to do what needed to be done and be a support for my husband, rather than a burden, when he needed me most. It also prevented me from having to file for disability and losing control over what’s important to me. My LP-ESP is still going strong and doing its job well enough so that I can do mine!
I haven’t really made an announcement, but I just accepted a new position within my hospital as Simulation Coordinator, and I am pretty excited about this opportunity! Everything I worked so hard for during my MSN program and beyond has paid off. I really love healthcare simulation, so this job is the perfect match. In addition, this position will give me bankers hours: 8 am to 4:30 pm, Monday through Friday, weekends and holidays off. That way I can be home with Ralf in the evenings, when he tends to be more uncomfortable, and we can also better plan our lives due to my predictable schedule. However, I won’t be transitioning until the pandemic is over, since my services are needed on the frontline right now.
