Day 5 MDDFC

night shift

 

No, I don’t dispatch calls – ok, well, I kind of do.  I sometimes save lives of little people and direct mini intensive care units to go retrieve them…but I also coordinate the transfers of these sick kiddos from places that aren’t equipped to take care of them to the hospital that I work for because that’s what we do, 24 hours a day.

Yesterday I mentioned that I would let you in on my sleeping habits and environment.  Once I took the position at the hospital, it became apparent that in order to function on the many night shifts I’d be working I was going to have to figure out how to sleep.  Don’t get me wrong, I’ve worked over night before when I used to run rescue (that’s what we call working on the streets, or working in the field, or working on an ambulance as a medic), and I’m sure I did it all wrong.  On an ambulance you can actually cat nap, whether at a station or mobile posting behind your local Kroger (we’ve found some super interesting spots to hide our load diesel box to catch a few zzzz’s), in a hospital that doesn’t seem to be common practice.  There is no sleeping on a stretcher tucked away on a unit that’s empty, or folding yourself in to a ball on a captain’s chair to rejuvenate thy self.  Company policy is that you get canned on the spot if you’re caught, I know someone who had just that happen and haven’t seen her since.  So, if I’m going to work under the darkness of night, I must actually make my body think it’s daylight.  And the reverse of that is that I must figure out how to sleep when it’s bright and beautiful outside.  It has taken some experimenting, some googling, some informal polling of coworkers and physicians, and it still isn’t perfect…but it works.

Why night shift you ask?  Well, as most of us zombie employees will tell you, the night shift is AWESOME and it would be even AWESOME’er if it was during the day, but then it wouldn’t be night shift, would it?  There’s a TON less drama, less administrative staff, a lot more teamwork to get shit done, more financial incentive, less traffic, and it’s just more fun because all the cool people work at night.  However, it sucks.  I lost any sense of a social life when I was working full time nights, my memory was slowly drifting away, my body hated me, I got super bitchy on the third night in a row (and sometimes the first) and I felt like I the only thing going on in the world was at the hospital because that’s the only time I was conscious.  My wife said that it was similar to me going out of town for four days, only I was home and she couldn’t be for fear of waking me.  I still work nights, just not as many (which some would say is worse on the system)…and I am thankful that I am able to experience life outside of the ED again.  Oh, hello wife, I’ve missed you!

Let’s talk about sleep, baby….Here’s what has been the best for me, and it may help you, or maybe you have some suggestions?

  1. Reverse the schedule in it’s entirety – I was skeptical at first, but it’s actually true.  The more you make nights the habit, the better off the sleep will be during the day.  Rumor is, it will NEVER be ideal – like sleeping at night – but it will get as close to it as possible.
  2. Wear sunglasses as soon as I leave the building.  And I leave them on as long as possible, looking like a rockstar or like I have a killer hangover if I go anywhere other than home.  Those orange/amber glasses you may have heard about…yep, those help too.  Trick the brain, you gotta.
  3. DO NOT drink/consume caffeine after the halfway mark of the shift.  So if my shift is 7:00pm-7:00am I won’t drink caffeine after 1:00am.
  4. Eat!  If I go to bed hungry in the morning, then I’ll wake up in the middle of the day (my night) hungry.  Horrible, since now my sleep pattern has been shattered in to little pieces.  Enter grumpapatomus.
  5. Exercise.  I am not one to exercise after work, I’m better before work – which means it’s an afternoon or early evening workout on those days.  However, if I didn’t sleep well or I have a batch of night shifts in a row, I will forego the intense workout for more sleep.  An intense workout will just create additional stress on the body (increased cortisol) creating a huge cascade affect that you can google about in your spare time.  Basically it just does not do a body good…so I don’t do it.
  6. Walk the dogs.  For the love of god, why do they need to serenade me why I’m sleeping?  They don’t pull that shit at night!  If they’re exercised they are happy and relaxed and look forward to a nap.  Also, see #2.  Super pimp.
  7. Supplements.  After countless hours of research and experimentation this is what has worked for me.  Vitamin D: 2,000IUs.  Go figure, my vitamin D levels were on the low end of normal.  Shocker.  But, most of ours are…not because we don’t get enough light but because our food we ingest doesn’t either.  ZMA, which is 30mg of zinc, 450mg of magnesium, and 15mg of B-6.  This is to help with recovery from my workouts, also to help rebuild and maintain a healthy system overall while I sleep.  (Side note, #bruteyogi says it has really helped her with restless leg!  Bonus!)  I also take Vitamin C: 2.25g which is a decent hit, but when the immune system fails everything else fails along with it.  And to help maintain energy I also take a Vitamin B complex, only when I wake up (take that shit before bed and bye bye sleep!).  Fish Oil: a combined total of 3,000+mg of DHA and EPA daily….it’s just good for you….do it.  And last, but not least, a digestive enzyme with every meal.  I eat a fairly high protein, high fat, high caloric diet and this enzyme has helped me a TON to keep everything flowing well through the ole digestive tract if you catch my drift.  Of course – this works for me, and may not work for everyone…don’t go and nag to me that you went and fucked up your body because you didn’t listen to it or your doctor.  I exclusively take the purest form of any of these supplements that I can, liquid or powder preferred and nothing added that doesn’t need to be there.
  8. Sleep enhancements.  I’ve tried tons.  Recently I’ve learned that those fun ones you get from the doctor – Ambien, Lunesta, etc – just render the body unconscious.  I used to take Ambien and was able to sleep 5 hours, max.  Then I tried Lunesta – and didn’t get the hangover that other drugs gave me, so I stuck with that one for a while.  And I noticed something, I would get 5 hours of solid clean sleep, or so I thought, and felt somewhat rested.  So after listening to these two podcasts with Dr Kirk Parsley, I decided to forego the chemical enhancements for a supplement. Here’s the links to the podcasts:  The Paleo Solution and Barbell Shrugged – do yourself and listen to them….AWESOME!  Now I can get away with melatonin before bed and feel more rested than with the expensive drugs, and I’m not putting nasty ass chemicals in my body.  My body is already working hard enough with this wacky schedule, why make it work harder?
  9. Shower.  Clean off the 12+ hours of work to sleep clean!  Especially when I’m in the ER, I shower all of the coodies of the sicky face kiddos off of me – it has absolutely kept me healthier and more importantly my wife.  The first year I worked at the hospital I think we were sick more than we were healthy….it sucked, plain and simple.
  10. Sleep environment.  Be comfortable!  Even though I am ready to fall flat on my face after a night shift I make sure my environment is just so each and every time.  Call it obsessive, but ask me if I sleep?  Yeah, thought so.  I make the room as dark as possible to mimic a nighttime environment, color/light blocking curtains, eye mask (this is personal preference thing, find one that works for you), use a large box fan to block any noise from the non third shifters in the neighborhood, sleep in a cool room – your temp drops as you are getting ready to sleep naturally, so I mimic that as much as possible and since I’m a hot box naturally despite freezing my ass of before I go to bed, keeping it cool is a priority.
  11. Sleep training.  I stay in bed for the length of time I need to even if I wake up before I’m scheduled.  So, if I’m supposed to stay in bed until 5:00pm, I may end up laying there for a little while if I’ve woken up.  Doing this sleep training I have taught myself to sleep longer and I can now sleep at almost any time.  I also do my best to stick to a bed time that gets me as close to 8 hours of sleep as possible.
  12. Have an awesome partner in crime/spouse/wife.  I’ve done this before her and my record of sleep vs not sleep was not great.  With her I have less worry, and while I hate having an opposing schedule at times I know that she’s supporting my odd sleeping habits and taking care of the world while I’m sleeping.

Today’s Menu:

12:45am

  • almost the entire cilantro ginger chicken breast….I thought I was hungrier that I was
  • whole avocado
  • Chai tea (I love that stuff)

5:15am

  • yummy coconut cream parfait – a few spoonfuls post mobilization (see below)
  • handful of plantain chips

8:00am

  • 2 pieces of no sugar added bacon (and it does actually taste delicious!)
  • 2 eggs
  • 4oz raw milk (not only do I love it, but it’s supposed to help with sleep)

12:30pm

  • sweet potato hash with sausage and peppers
  • 1 twin egg on top

3:00pm

  • handful of almonds

6:00pm

  • farm chicken breast baked with fresh veggies in coconut oil
  • we ate dinner outside on our porch, that was a real treat!

9:00pm (post cooking frenzy)

  • big ass bowl of fresh fruit salad (blueberries, strawberries, bananas, pineapple)

*Side note: other than a little bit too long between lunch and dinner, today is the first day I really feel satiated…I think the sugar withdrawals are finally calming themselves.

Movement/Exercise/Mobilization while in the box:

Foam rolled EVERYTHING for about 30min.  Then listen to Diners, Drive Ins, And Dives while doing Aadil’s beginning hip series, opening my shoulders with a lacrosse ball, and some other random stretches and mobilizing.  My wife would’ve been proud.  All in total it was about 75min of mobility and rolling around on the floor in the box.  I wish I could make time for this type of mobility everyday!

Sleep:

I did manage to get a solid 3.5 hours of sleep this morning after work and felt great when I woke up.  Usually I feel like I’ve been run over by a truck about five times, so I feel like I earned my sleep points!

Today’s Total: 15 (5 bonus points for having 4 perfect days in a row!)  

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