Sunday, January 20, 2013

Meltdown

It's my first post of 2013 and I'm somewhat glad/sad that what the reason I'm blogging is because I had a mini meltdown the other day.  It only lasted about an hour or so... I guess I can consider it a blessing that it was so quickly alleviated.

A week ago, I took some notes on the sermon preached and I wanted to take the time to flesh out my thoughts.  I didn't get around to doing it though but today's peek at my last journal entry helped remind me of stuff I wanted to think about from last week.

Embrace my limp

The sermon was on Jacob and his wrestling match with God.  Jacob didn't quit and subsequently was blessed.  He also left the encounter with a limp for the rest of his life.  The limp kinda crippled Jacob, but instead of getting down about the limp... we should embrace the limp and remember that it is a joyful reminder of God's love.

I thought about my life and I felt like my widowhood was my limp.  That was the obvious answer.  It is my beautiful contradiction... that which should have destroyed me has made me stronger.

Upon further inspection though... I think I've been really struggling with a couple things.  Fear of being unprepared and a fear of inadequacy.

It took me a while to even realize that I was struggling and/or stressed.  If I take a look back, I can recognize these fears surfacing... even if I didn't exactly FEEL stressed... I probably WAS stressed.

For example, last month, I kept having recurring dreams with similar themes.  I would dream that I'm late for work and my entire closet was barren... no scrubs.  No clean scrubs; not even any dirty scrubs.  It was a dream full of panic.  I had another dream where I went on vacation and for some reason didn't have any luggage.  I tend to be one of those people who overpack rather than underpack.  All the what ifs really get to me.  I've been trying to learn how to pack the bare essentials and just pick up the things I need locally if necessary.  I haven't really traveled anywhere exotic lately either.  Regardless... the dreams were my subconscious alerting me of my fear.

A couple weeks ago, I had class for a week straight.  That particular week, my period arrived a week late (which used to happen a lot during finals week) AND I got cold sores (which I hadn't gotten in 4 years or so... since the last time I was in nursing school).  While I didn't FEEL the stress, I think my body was trying to give me hints that I WAS stressed.

These two fears... do have the potential to cripple me.  I broke down and admitted to myself that I needed to ask for prayer.  I felt like a bruised reed... just barely hanging on... structurally.  Prophylactically, I sent out a prayer request to some people.  I didn't even send it out to my usual support system... I actually didn't think it was that big an issue until...

A few days ago...I listened to a patient and I couldn't hear a heart murmur. On the drive home from clinicals that day, I had a meltdown.  I took surface streets because I didn't want to sit in Friday traffic and during that hour-long drive home, I was bombarded with feelings of inadequacy.  I felt like quitting my NP program and going back to regular nursing in the hospital.  I kept telling myself that I wasn't good enough to see patients in this kind of role... I'll never be good enough... I know nothing... I'm a horrible person and a horrible nurse... and I'm not good at anything.   I was crying and also eating cheddar cheese popcornopolis... so I have a couple of oddly-shaped tissues in my car... oddly shaped probably because of the dried tears and also look extra weird because they're speckled with cheesy finger smears.

Even though I was having a mini meltdown... I was also soothing myself.  It's really weird how I can be freaking out AND counseling myself at the same time.  I usually think about what I would say to someone who was going through this kind of meltdown and it did kind of help.  I remembered that I'm at the very beginning of my education and I can't compare myself to people who have been in practice for 20 years.  I'm still a work in progress.  And I had to ask myself why I was overreacting to something so small.  When that happens, it's usually because I've bottled up all the bad stuff and it came pouring out because of something really insignificant in the grand scheme of things.  It was definitely time to do some self-examination.

The unexamined life is not worth living. -Socrates
Today's message was focused on examination of our lives as well.  It was pretty timely since it's something I've had to do to figure out why I had this meltdown to begin with... however, I think I was ready to push past the examination and move on to the assessment and plan.  I will attempt to SOAP myself.  Don't critique it.  It's just semi-applying what I'm doing for my school assignments to my real life situation.

Subjective:

  • Chief Complaint: emotional meltdown
  • History of Present Illness:  Patient is a 30 year old Asian-American female enrolled in a graduate nursing program who recently transitioned from working as a staff RN to a full-time student last week.  She started her clinical rotation 6 days ago and reports experiencing mood swings, extremely unusual loss of appetite, irregular sleep pattern, irregular bowel pattern, and unusually long menstrual cycle x1 month.
  • Social history: Pt is widowed since 2009.  She lives at home with her parents who provide her with a good support system.  She still mourns the loss of her best friend and recognizes that she needs to be extra careful to practice effective coping mechanisms because she no longer has that one person who took primary care of her mental, emotional, and spiritual health.  
Objective:
  • General: No acute distress
  • HEENT: some temporal tenderness, spontaneous clear drainage from bilateral eyes, furrowed brow, muscle tension/spasm noted on bilateral trapezius muscles
  • Extremities: orange powder stains on right thumb and index finger, bilateral foot tenderness 
Assessment/Plan:
  • Stress: Pt has been in denial about the effect the external stressors and role transition on her mental, emotional, and spiritual health.  Recommend reminding herself that there are many external stressors present in her life and she needs to be cognizant of them and her response to them.  
  • Fear of being unprepared/inadequacy: She is feeling overwhelmed by her new role and the vast amounts of information she is expected to master as a nurse practitioner.  
    • Prioritize: place God first and foremost in life, stop activities which waste time and choose activities which will be beneficial
    • Perspective: maintain a gospel-centered viewpoint and not a self-centered viewpoint
    • Stress relieving activities: maintain social activities, maintain contact with friends, exercise
    • Remedy knowledge deficits: study hard, study well
  • Popcornopolis addiction: Orange powder stains will resolve after last cone of cheddar cheese popcorn consumed.
  • Foot tenderness likely from wearing heels for the past week.  Recommend foot massage.
So... after today's message... I was left pondering... am I living a life that reflects hope?  Why should I hope in God anyway?

Sometimes people think that faith is blind.  It's actually not blind or illogical.  It does not always defy reason... but it almost always defies our natural tendencies or our fleshly impulses.  

If I really take the time to think about it... to pull myself out of my own situation for a bit, I remember why I should hope in God.

  • The past
    • His goodness to me, to other believers I know, as documented in the Bible
    • His faithfulness to me, to other believers I know, as documented in the Bible
    • His provision to me, to other believers I know, as documented in the Bible
  • The future
    • His promises
    • His plans are perfect
    • He is in control
  • The present
    • (see below for explanation)
Within a few hours of arriving at home after my cheesy popcorn meltdown in the car, God provided two friends to comfort and encourage me immediately.  It can be tempting to hide my feelings when I'm not feeling great.  There's always a split-second choice... when someone asks me how I'm doing... I can say "fine" or I can tell the truth if I'm not fine.  I chose to tell my friend that I wasn't fine and because I did that, she was able to minister to me and I was reminded of how amazing my friends are.  After I finished talking to my friends about it, I went down and checked my mail and got a postcard sent from New Zealand from a friend reminding me how amazing it was that we've gone through some pretty crazy stuff in the past and have survived it all.  And then I checked on today's devotional reading and it was this passage and this devotional by John Piper:
1Let not your heart be troubled: ye believe in God, believe also in me.2In my Father's house are many mansions: if it were not so, I would have told you. I go to prepare a place for you.3And if I go and prepare a place for you, I will come again, and receive you unto myself; that where I am, there ye may be also. John 14:1-3 
Here in we meet an unholy heart-turmoil. “Let not your hearts be troubled.” This is a fretful failure to trust God fully for the problem we are facing. At first it may look like Jesus is addressing an anxiety that isn’t the one you’re dealing with. But hang on, because Jesus takes a surprising turn in this story. 
You recall how this Gospel works. John tells us in John 20:31 what his goal for you is: “These are written so that you may believe (trust, be assured, treasure the reality) that Jesus is the Christ (the promise-fulfilling Messiah), the Son of God (the presence of God himself - God the Son - among us), and that by believing you may have life in his name.” And when he says “life” he means the connection with God’s life, through connection with Jesus. And that life includes the power not to have unholy turmoil of soul. 
So what we encounter in this Gospel is the living God, the creator of the world, present among us humans, in our world in his Son - the infinitely loved, eternal, image and radiance of his essence and through faith, through believing and receiving him for all that he is, we are connected to this on and through him to the Father, and so share in eternal, supernatural life, even now."I Am the Way, the Truth, and the Life," sermon

And so it came back to the gospel once again.  The greatest macro reason why I can have hope in God is because of what Jesus did on the cross... conquering sin and death and giving us the power not to have unholy turmoil of the soul.  The micro reasons are all the little things He does in between that show me that He's concerned with both the entire world and with little, insignificant, inadequate me... freaking out about not being able to hear a murmur in the middle of my nurse practitioner program.  God's timing was, and always is, perfect.  He did meet me where I was and He will continue to do so every day for the rest of my life.  The evidence is clear.

In the days after my meltdown incident, more and more friends have reminded me about how awesome they are and how blessed I am to have them in my life.  Whether it be through a random massage at a bridal shower, or friends to push me to exercise more, or friends to eat with, friends to laugh with, friends to talk about makeup stuff with, a friend who always sits next to me at church so I'm never sitting by myself, a friend who will notice I got a haircut and will offer to do my nails for me...

I'm still in recovery... and find that I'm very quick to be impatient and annoyed but overall, I feel much better post meltdown.  It also kinda reminded me of this passage...


He will sit as a refiner and purifier of silver. (Malachi 3:3) 
Our Father, who seeks to perfect His saints in holiness, knows the value of the refiner’s fire. It is with the most precious metals that a metallurgist will take the greatest care. He subjects the metal to a hot fire, for only the refiner’s fire will melt the metal, release the dross, and allow the remaining, pure metal to take a new and perfect shape in the mold. 
A good refiner never leaves the crucible but, as the above verse indicates, “will sit” down by it so the fire will not become even one degree too hot and possibly harm the metal.And as soon as he skims the last bit of dross from the surface and sees his face reflected in the pure metal, he extinguishes the fire. Arthur Tappan Pierson
The meltdown serves to purify me.  The refining fire only lasts for as long and as hot as necessary... as soon as the work is done, the fire is extinguished.

I look forward to the extinguishing but I also look forward to the end result of all of this.  I look forward to learning more even if it's trial by fire.  I look forward to graduating and hopefully finally being done with school. I look forward to growth and I suppose that also means I look forward to the growing pains that come along with it.  If I'm going to overcome, I need to embrace my limp and utilize my fears of inadequacy and being unprepared to push me to be a better student, a better practitioner, and a better person in general.  I need to push myself to remember that my worth and significance doesn't come from my job or my friends or my family... it comes from God.  I could fail and become a horrible nurse practitioner and kill people left and right (OK I REALLY hope that doesn't happen. I'd like to think that I would quit long before that happens) but that still doesn't mean I'm not valuable as a person.  My value comes from my identity in Christ and nothing can change that.  This is my process of refinement... uniquely tailored for me... with a fire set at the perfect heat to do the work He needs to do in me.  I look forward to Him doing a greater work in me and for His face to be reflected in me.  In this way, I can trust in His process and look beyond the heat to His master plan.

I'm still not feeling very confident but definitely a lot better after having been reminded of all of this.  Hopefully, next week will be better than last week.

Thank you for being my friends/family.
<3 p="">Tiff