So very tired. I can't really describe how tired I am. But, being me, I will try. I know that fatigue is a hallmark symptom of early pregnancy. I went through that and I thought- thought I was out of it. But the past few days have been so completely overwhelming I almost feel as though I have taken a step back in time. Last week I was going to the gym, exercising and starting to feel kind of normal. If you'd call this whole pregnancy thing normal. But I wasn't really wishing for anything. This week I am backtracking, as though I hadn't paid full due on the fatigue and nausea bills I was racking up months ago. There was a little balance and this is the week the repo-man comes to repossess. I suppose this is a better week than most, but there really isn't ever a good time for earth shattering fatigue.

I haven't been good about contacting my patients lately. Nor have I been good about calling in my schedule at hospice. I want to work one day a week, instead I work two days a month at best. They don't think too highly of me there.

I got a new patient the other day who really takes the cake. She's in her 50's and has ovarian cancer and lives in a pretty yucky housing complex. The most interesting thing? When I got to her house, some guy took me up to her apartment, knocked on the door, then physically picked up the door and moved it out of the way so I could go inside. He moved the door! No hinges, no handle, just a big piece of reinforced wood protecting her from the outside world. He explained that they were waiting for the landlord to come fix it, and I bet they've been waiting for that landlord for quite a while already.

This patient was nice enough, but I could tell she didn't trust me at all. I hope to develop some sort of relationship with her, but it's hard to do my job when people refuse to tell you the most basic parts of their health history. I asked her if she had any other existing health conditions and she said no. Then, twenty minutes later she offered up that she has a vascular access device implanted in her chest. Oh, really? when was that put in? last year, she tells me. Apparently she didn't think that the bout with colon cancer was significant enough to tell me about when I asked her the first time.

I hope she learns to trust me. I hope we can have some sort of relationship, because this woman needs help. And, that is my job. This is like the dream nurse practitioner job....

moving on. I have work to do. big suprise.