donorcycle

More about Less

2011-11-29T13:25:00.001-05:00

over at this blog...

http://normalnewjersey.blogspot.com/

come by and see what else I'm up to that has nothing to do with anyone's organs.

Update on the Update :)

2011-08-11T00:03:00.003-04:00

Creepy statue outside of work. The child in the middle is the real one.

So, funny story, I started to post an update, got called away by mommy duties and instead of hitting "save" I hit "post." Cause I thought, no one is going to read this right now...I'll have time to come back and edit it.

Little did I know. Apparently I still have 3 groupies left. Thanks, guys.

Anyhoo, I've been enjoying summer and having 4 days off every week. More than making up for it with (usually) grueling 12 hour shifts. Last week I stayed 4 hours over to make a little, extra $$. Meaning I worked from 7am to 11:30pm. The next day I was good. for. nothing. Some may say that's my usual state, but seriously, I was tired.

I have managed to see several of my former patients in the ER, never a good sign. But all of them turned out ok apparently. I still call 8 Tower whenever they page a code blue overhead to find out who's coding....although that has only happened twice and my ER coworkers think I'm bonkers. But you know, you get caught up with these people. Transplant has been busy too, so I'm rather glad I'm doing my 3 12's and going home. The job is nice in the sense that 1. I go into every shift with no "to do" list. Whatever comes in, comes in. That may be anxiety-provoking for those folks who like to know what they're getting into. However, coming from 3 years of feeling like I was never caught up, walking in the door each day with a list of things to do as long as my arm...it's a nice change. And 2. I get to leave. On time. If I don't leave on time, I get paid more. And when I hand off my patients, I am done. So although it's 12 hours of non-stop chaos, it also feels like a big break.

School starts in a few weeks. I am easing into it with 1 class: Health Assessment across the Lifespan. Can't wait. I get to be a Rutgers student again! Unfortunately, they do NOT give a family discount. Ah well. Hopefully, in 3-5 years I'll be a nurse practitioner. We'll see. One class at a time and the next class may well be statistics, so we'll see if I survive.

Ciao, y'all. I will have more time to blog, but not sure what to blog about. I'd like to blog about something that will be fun, informative and pay my way through college, so if you have any ideas, let me know.

Weekend Update

2011-08-07T20:44:00.002-04:00

Does anyone still read this thing? Just in case, I thought I'd give a little shout-out, you know, and let you all know what was up. I moved on back to the ER, for starters.

That's me on the left.

(Truth is, I once got a haircut so short that I *did* look more like Noah Wylie than I will *ever* look like Julianna Margulies.)

Votes, please!!

2010-02-09T12:30:00.002-05:00

Some of you may have heard me mention my friend, Ali, PICU nurse-extraordinaire and her blog,

alirae.net/blog

For the past 2 (?) years, she's been serving on the SS Africa Mercy, a hospital ship that visits a different county each year and provides full service medical care to people who ordinarily don't have access to it. Want to know the ratio of folks to doctors around the world? Go here. I'll wait. For the tl;dr crowd, I'll break it down. In the US, there is generally 1 doctor for every 390 people. Meaning you can't walk outside without tripping over a nephrologist (and don't even get me started on lawyers). But in parts of Africa, there is only 1 doctor for every 50,000 people.

Most of all, I love Ali's blog because it's just like her: caring, honest, smart and funny. So pretty please, with stevia on top, vote for her for Best Charity Blog.

Thank you, that is all.

Mama, what do you DO all day?

2010-01-03T21:45:00.004-05:00

That's a question The Pooter asks me frequently, upon greeting me at the end of the day, "Mama, what do you DO all day?" It's part curiosity, part challenge, I think. Like she's thinking, "What can this woman possibly be doing for the whole time she's apart from me?" After all, not everyone can have a jam-packed, exciting day at pre-school. Work, even organ donation, pales in comparison with the fun of dress up and arts and crafts.

When I ask her the same thing, invariably she just gives me an enigmatic smile and says, "Nothing."

What DO I do all day? People all seem to have the same response when they ask what I do for a living. Transplant Coordinator. Sounds important. Then I try and explain what I do and a small shadow passes over their face, sometimes ending with rapid eye movement and a small stream of drool from the corner of their mouths. "Well, you know, I make phone calls. I make sure people know how to live with their transplant, blah, blah." They must think to themselves, "and they PAY you to do that?"

Sometimes I ask myself what the heck I'm doing all day. I do spend a large part of the day on the computer and fielding phone calls.

Call #1:

"Hello, Kidney Transplant. How can I help you?"
"Hi, this is Beavis McButthead. I'm vacationing in Borneo and it seems I've just plum forgotten to pack my prograf. Can you overnight me a prescription? And please make sure it's written in Malay, I don't think the pharmacist here can read English. And make sure I get it before noon, we're rafting after lunch."

Call #2

"Hi, Kidney Transplant."
"Hi. Can you please fax my latest lab results to my nephrologist? And my cardiologist, endocrinologist, neurologist, personal trainor and taxidermist? Thanks."

Call #3

"Transplant."
"Hi, this is Ima Nofollowup. I haven't been to clinic in 4 years, but you did my transplant 4 years and 3 months ago. For the past 6 months I've had swelling in my legs and my blood pressure's up and I hardly ever pee anymore...is there something you can give me for that? Can you call something in? What do you mean I need to go to the emergency room. I can't sit in there all day, I have things to do." *

Lest I give the impression that my patients are all sluggards and dimwits, this only represents a SMALL FRACTION of my patients. And yet, they are the most memorable. The ones that make me scratch my head and wonder if a career in food service is for me.

So what do I do in my 40 hours a week? When I was on the procurement side of the organ biz, I wrote many and lengthy posts on my exciting job. So I figured it was time I at least mentioned what the heck I'm doing and, believe me, it's not surfing the internet and drinking coffee, like some people I won't mention who live with me seem to think. Here goes, I hope you can handle the excitement.

Monday:
Clinic 8am to 12noon. We see probably 30-40 patients, some new, some out for many years and in between. Everybody gets blood work, then sees one of the post coordinators and one of the docs. All the labs are hand transcribed into their charts. Don't ask why-now excuse me while I use my abacus to calculate this drip rate.

I start transcribing at about 10am, in between patients. At noon, I take my charts and head downstairs to my office, grab a bite to eat and listen to my phone messages, which are legion. I check the fax and mailbox to see if any outside labs have come in. Then I keep transcribing until the prograf levels come back, about 1:30pm. Then we review everybody's labs with one of the docs. Depending on the amount of patients and the doc in question, this can take as little as an hour or last until 5pm. Then I call EVERYBODY and say, "increase your prograf or decrease your magnesium or get a biopsy panel next week and drink more water." That sort of thing. Then I go home and dream about potassium levels until morning.

Tuesday:
Is catch-up day. I go through my follow-up book to see if all the folks who were supposed to have repeat labs or tests or biopsies actually did them and that they were reviewed. Not a big deal, except I have a case load of about 250 people, give or take, with maybe 100 who are active and in my radar at any one time. And remember, I'm using an abacus. Next budget, we intend to ask for some papyrus, but perhaps that's just a pipe dream.

Wednesday:
More catch-up in the am. In the afternoon, we have our big, multidisciplinary meeting where we listen to the cases of people who were recently evaluated for transplant and decide if we are going to list them. I always thought this would be fraught with tension and excitement, that we'd be debating the ethics of who should get a kidney or not, but mostly it's pretty boring. Occasionally we get someone who is in a bad way, medically speaking, and we turn them down because they probably wouldn't survive the surgery, but mostly it's just listening on and on about stress tests and cardiac clearances and such. NOT that this isn't terribly exciting for the person who wants a kidney, I'm just saying it lacks the drama of House or Three Rivers. (I expect, anyway. The only medical show I watch is Scrubs, because it's the most realistic).

Thursday:
Same as Monday, but I cover 8am rounds of the in-house patients.

Friday:
Rounds again, and sometimes more meetings. Wednesdays and Fridays are nice in that I sometimes actually take an hour lunch, away from my desk, sometimes with other people. That's nice. But Fridays are busier because we do a lot of teaching on Friday, especially with living donors and their recipients.

The initial teaching takes a few hours. I split the bulk of it with the pharmacist. We cover wound care, monitoring I&O's/vital signs/blood sugars(which the patients have to do on their own at home), activity, diet, OTC meds, transplant meds, signs and symptoms of rejection, how and when to call the office, clinic schedule and routine, infection control, ureteral stents and a little something called "lifestyle modification".

Lifestyle modification covers everything from washing your hands frequently to not having a bird (too many diseases) to what to do when your kids get a live vaccine to whatever. It depends on the individual. We had a guy who inspected garbage dumps for a living(who knew!) and needed to wear a certain type of mask when he was on site inspecting. Transplant patients have left behind chronic disease only to replace it with life long immunosuppression. Usually, that is a change for the better, but it comes with a lot of risks, including strange, nasty infections that the non-compromised have never heard of. It's a lot to cover. Of course, it's not just one day of teaching, the teaching is ongoing and we see them in clinic twice a week for several months, so we're always reinforcing things. That's a nice nursing term-reinforcement. But it's true, living with a transplant is a lot different from having a knee replacement or even a cardiac bypass and that's why, tedious though it may be at times, the patients get a coordinator.

Inevitably, it is Friday afternoons when I get the 4:30pm emergency. The nephrologist walks in and tells me I need to book a patient who's in rejection for IV solumedrol over the weekend or someone calls that they're going to the ER and I have to call round and let the team know. Then I'm off, for two glorious days we call, thanks to unions, the weekend. There, I'm officially a 9-5er, a corporate slave, a cubical dweller. It does not sound great, but in truth, I do like it. If I can think of a way to tell you without violating any HIPAA laws, I will, but that's another post.

(*All calls are fictitious and represent a composite of calls I may or may not actually receive. All patients are theoretical and not actual. Also, objects in mirror may be closer than they appear. Thank you."

Happy 2010!

2010-01-01T09:41:00.003-05:00

Well, maybe it'll be the year I make contact, anyway.

Happy Happy! Pooter is especially excited that I'm off today. "To celebrate the New Years?" she asked. Yup. I'm grateful for two 3-day weekends in a row(three, actually, I took the 18th off, also).

Off to play. May your year be full of blessings and goodness.

Hello, is there anybody out there?

2009-12-30T21:34:00.002-05:00

I haven't blogged in a while. Did you notice?

I haven't been in seclusion, like Syd, don't worry. It's just the job.

Truthfully, I've been a tad nervous to even talk about work. I learned at my last job that things like this don't stay anonymous for long.

Then, too, are my hours. I'm working 9-5(well, 8-4:30), but sometimes that translates to 8-5 or even 8-6. Plus the on-call. It's not as bad as taking call for an OPO, as in I don't have to leave my house at an ungodly hour and drive to Nowhereville Hospital. On the other hand, when my call is over, I'm still expected to show up at work at 8am, looking freshly pressed, pretty and ready to put in my 8 hours. When I get home, I act like a mom for a few hours and then put Pooter to bed. Often, I fall asleep with her. If I manage to stay awake, I have to share our (now)solo computer with the husband. Then, on the rare occassion I have the computer all to my self, I'm more likely to mindlessly surf than come up with some snarky post. Weekends, I'm doing the mom thing and/or cleaning.

We did have a tremendous Christmas-I love spending Christmas with a 4 year old. She got a new dress and gasped "Just what I always wanted!" Where does she get THAT from? Last night she watched "The Wizard of Oz" for the first time. We had already been reading the book, so she was a little familiar with the story. "When's that ole tomato going to get here?" As in "tornado". It was too cute to correct.

Work has been blessedly slow for the past few weeks. Only the newly transplanted schedule appointments on Christmas or New Year's eves, because they have no choice. Actually, on woman missed her first 2 post transplant appointments and we had to have a little talk because THAT CRAP don't fly. It's been brutal at work. We are busy enough that if I or the other post transplant coordinator are out for even a day, we get backed up. I was sick 2 weeks ago and then took off one day to go to Pooter's Christmas party at school and I'm still catching up. Then we had 2 patients die right before Christmas. It's been stressful all around. I'd have dozens of things to post about, but I fear I'll be canned if I write about any of it, so there you go.

Suffice it to say, we are building our program. That means everyone is working their fool heads off. The Pre transplant side has been working REALLY long hours, cleaning up the waiting list, bringing in new and re-evals and generally expanding our waiting list. This means that in a year or two, we are going to be hopping. We've already seen the results in post-a lot of people who were status 7 were reevaluated and made active and then got immediately transplanted. Sept and Oct were busy, busy. These folks are just coming up on their 90 day mark and most are doing great.

Anyhoo, if I can figure out where this blog is going, I'll post more. God knows, I need to vent, but that's not possible, again I'm afraid of being "outed" at work. Ah, well.

Happy New Year.

2009-11-15T23:38:00.001-05:00

post script

2009-09-11T04:23:00.002-04:00

I just finished "The Curious Case of Benjamin Button." Ebert didn't like it, and I hold much stock in Ebert. Movies are watched or not watched, good money is spent or not spent, in my household, based on what Ebert has to say about a movie. But in this case, Ebert is wrong. Well, maybe not wrong. I don't think anything he said about the movie wasn't true. I think, probably, the movie offended him. Offended his sense of what is right and true and that's not either wrong or right. In any case, I thought it was grand. Of course, I cried like a baby for the last half hour. I'm not ashamed. That was because of me, not the movie. When Julia Ormond starts reading the post cards from the father she never knew, well, I was a mess, mostly because it reminded me of a valentine's I once received that was 36 years in the making, but that's a story for another day.

Anyway, what struck me most of all, was how common Benjamin was. The whole movie he works as a laborer (well, not at either end, but in the middle). He's just anybody. No one will remember him, he didn't do anything great and yet, the movie is a tale of greatness. It's not the story of an extraordinary man, it's the story of how all of us can have an extraordinary life, even those who seem quite common. To get even trippier, how would you know that many people don't age backward. No matter how many people we have in our lives, there are hundreds or thousands who pass through our lives for no more than a few seconds. If you were to pick out Benjamin at any one moment in time, he would appear quite ordinary, maybe even forgettable (OK, it's Brad Pitt, maybe not so forgettable). I'm not seriously proposing that people age backwards and end up as babies. My point is that the guy who parks your car, or mops the bathroom where you work may have the most amazing story. That's my point.

Another amazing movie I recently watched was Everything is Illuminated. I can't even tell you what it's about. It's about a Jewish guy who goes searching for his roots in the Ukraine. It's about the crazy absurd Ukrainian family that acts as his tour guide/translator. To say it's a Jewish movie is like saying Torch Song Trilogy is a Gay movie. Suffice it to say, Liev Schreiber does the most amazing direction his first time out. I can't believe I didn't hear of this movie earlier. Check out Gogol Bordello, too. Eugene Hutz plays the part of the narrator/tour guide in the movie and the band does some of the soundtrack, which you can check out on the new playlist over here-->

So, there you have it. Enough blogging for one month. I'm off to read reddit.

Nothing ominous here.....

2009-09-11T03:10:00.007-04:00

Ominous. I think I spelled that right. In fact, I've just been working, taking care of the family and trying to get 5 or 6 hours of sleep a night. Here's an example of my time shortage. I started watching "The Curious Case of Benjamin Button" on Sunday night. It's Friday morning and I still haven't seen the end of it. When I do get on the innernets, I tend to find mindless stuff like this to take up my time:

"It's a Lie!"

Oh, those crazy Republicans! When they're not creating hideous monsters, they're busy disrupting our President with their rude shenanigans. BTW, hope you didn't go to school this week, if you did, you might have heard our President tell you to buckle down, work hard and stay in school. If Nancy Reagan had said it, a thousand comedians would make jokes about it. If our first black President says it, well, you might as well move to Cuba cuz we're all Communists now.

So, that's part of the reason I'm not blogging. Too much of what I want to write about is political and I don't think this is the place for it. I don't want folks to think that you have to be liberal to donate you organs or some such. I didn't think people were that stupid, but then I started watching these town hall meetings and my respect for my fellow Americans dropped into the cellar. I mean, I understand if people are acting like that in Bumble Hills, Arkansas (no offense), but in New Jersey! I can't believe that the people I live with, work with and curse at in traffic would heckle a woman in a wheel chair.

That being said, I LOVE Medicare. I LERV it, even. I had no idea, working on the floor or in the ER, how mindlessly irritating, utterly idiotic and possibly dangerous insurance companies can be. That was before I spent half my life getting prior auth's on meds that MY PATIENTS CAN'T LIVE WITHOUT. Not tomorrow, not next month, not EVAH. And yet, once a year I must continue to justify their use to a beaurocrat. Medicaid, on the other hand, can kiss my ass. I was on medicaid, for a few years when I was young and poor. Medicaid doesn't get you anything except a doctor's scorn. And don't think that the new Medicaid HMO's are any better. You still can't find a doctor that takes it and then they wonder why you show up in the ER at 2am with an earache. Recently, NJ wanted to make medicaid recipients pay copays. Because when you make $11,000 a year, what's $5? Nothing, except maybe a Happy Meal for your kid. But I digress.

So, I've been thinking of starting another blog, but I just haven't had the time. Work is sucking me dry and not in a good way, for those of you with dirty minds. It's not the work, per say, but the office politics. The old boss had run the program into the ground and then lo-and-behold CMS came and everybody had to sit up straight and look smart. Finally, management could no longer deny that everything wasn't happy scrappy. Then came regime change. Tears were shed, heads rolled and now we have a new boss. Who I actually like. Lord knows, she's making changes and I have yet to see a work place respond well to new changes, no matter how much they're needed. I've also been laying low because this blog would NOT be tolerated if it was found out and as I found out at the OPO, it's easily found out. So, I've just been keeping my head down and doing my job and trying to fly under the radar. Then I come home, play with Pooter, eat dinner, yell at the teenager, walk the dog (when I remember, honey) and fall asleep by 9. Until the occassional night when, after a 5 hour nap, I awake at 2am and surf the internet for a while.

So, imaginary internet friends, there you have it. My life or something like it. And now, I'm going to finish "Benjamin Button."

But first, I share with you this:

Tonight I put a ninja to bed

2009-06-29T00:44:00.005-04:00

I'm Mulan! Aiyah!

No, it's not a euphamism. Lil Poot has been giving us a hell of a time going to bed lately. She's learned to play us like a xylophone, but I'm on to her tricks. And so we have the 5 stages of bedtime:

Denial: No, it's not bedtime. It's still morning time. (that means it's daylight out)
Bargaining: One more minute.
Anger: No! I don't WANT to brush my teeth!
Depression, actually Despair: "Waaaaahhhhh!!!!!" (Imagine crying with a doppler effect as I walk with said kid under arm down the hall)
Exhaustion: But I'm not sleepzzzzzzzzzzzzzzzzzzzz.....

So, back to Ninja Kid. The Poot has the most amazing imagination I've ever encountered. It's not just active, it's actually elastic and pliable and can stretch around corners and into crevices.

True story:On Mother's Day the Sunday school people had the kids make little plastic stained-glass thingies for the kids to paint. I come to pick Poot up and she's crying her eyes out and I can't really get at what's bothering her. I think she's telling me that she didn't get to make one and now they don't have any left and she's upset. Except that, while I'm sitting in the hallway of church trying to console her, another mom, who's in the hallway also with a crying kid, says, "I know she made one." And then, "Hey, what's her name?"

Little side note: We just discovered Monsters, Inc. Of course, we have to act out EVERY part. "You be Sully and I'll be Boo." "You be Mike and I'll be Sully." "You be Smoochy Poo and I'll be Mike." Ad infinitum. Except that she got bored being the good guys and started pretending to be Randall, the scary monster and so we became accustomed to her flinging herself at us and growling and we'd have to act scared and she'd be screaming, "I'm RAndall! I'm RAndall!"

See where this is going?

When I dropped her off in Sunday school, she told everyone her name was RAndall. And the person who took her craft and wrote her name on it, wrote Randall. Mystery solved, I found my Mommy gift and the waterworks were shut down.

So tonight, on the 3 attempt to get her into bed, she wangled into her red Ninja costume and brandished her sword at me. Fortunately I pulled some fast Tommy Wu moves, disarmed her and carried her off to bed. Sad to see a ninja cry, really. Finally, I put her into her little bed that we've been transitioning to. Got the pillow just so, put a pad under her(still toilet training), pulled the covers up and kissed her. I climbed into my bed. A few minutes later, from the dark, I hear, "But Mama, I miiiiiisssss youuuuuu." How can you even be mad at such cuteness. She's a scamp and a rascal and I love her to pieces.

Quote of the day is from an old post on Revive Hope, from a young man named Nate who became an organ donor:

"A little girl hugged me today. I think maybe I’m on the right path. I’m not sure if I like where the path might lead, but it is a really nice path. Is it possible that we, as a culture, focus too much on the light at the end of the tunnel, the pot of gold at the end of the rainbow. Isn’t it enough to realize you’re standing on a goddamn rainbow."

Zen and the Art of Teenager Maintenance

2009-05-27T16:30:00.001-04:00

(with apologies to Robert M. Pirsig)

Teen daughter calls me not too long ago.

"I got a new piercing!" She says.

"Where?" I ask, more than a little afraid of the answer.

"I got an 'Industrial.'" She says, skirting the answer.

I sigh. "WHAT part of your body is that in?"

"My ear." I sigh again, this time with relief. "Your ear is fine. Be home before midnight."

Seventeen years ago I thought that parenting just entailed a good manual and a lot of love. My older sister gave me her copy of "Your Baby and Child: from birth to age 5" by Penelope Leach. I figured I was set. And believe me, Penelope didn't steer me wrong. It's just that over the years circumstances came up that weren't easily solved by a book. What to do when your choice is between working nights or working a day job but taking a $15,000 a year pay cut? And how do you find a baby sitter when you're working the overnight shift, anyway? How do you date with a small child? And most important: how to explain to small child why the guy she calls "Daddy" isn't really available when she needs him most.

I'm sure someone, somewhere has covered these problems in a book, but that's not really the point. The point is that no matter how prepared you think you are, mistakes are going to be made, stuff's going to happen. I look back on my 20's and wonder how someone (me) could be so clueless and still be entrusted with the care of a child. I compare with how I'm raising a child in my 40's. I have more patience, less energy. I can stick to a routine better. I certainly have more money, although outside of dire poverty or extravagant wealth, children don't really notice, I think.

I had a coworker once tell me that she wasn't going to breastfeed her second child because she couldn't breastfeed the first and she didn't want to give one an advantage the other didn't get. As bizarre as I found her reasoning, I can empathize. I worry that teen daughter will be scarred for life if the toddler has something she didn't have: listening to classical music, trips to the Met, an appreciation of sushi at an early age. I don't know what all, just that Mommy Guilt is alive and well and a terrible thing. Coupled with it is the strong suspicion that anything bad she does is the result of the time I came to pick her up from daycare late. She was the last kid there and every emergency contact had already been called and my daughter cried when anyone was late picking her up ever again.

This past year, said daughter(now the teen with the piercings) worked on an independent project for school. On her own she found a mentor, kept a journal, worked for a year on her chosen subject and then presented her project to a group of invited friends and relatives. She even made her own programs for the presentation. Her subject-Fiber Arts-spinning, weaving, knitting and felting. Her mentor owns a Saori weaving business on the Upper East Side. Saori embodies the principles of Zen, there are no teachers, only practitioners. Every Saturday, she ventured forth to the Isle of Manhattan and learned how to set up and work a loom. In exchange for free lessons, she helped around the shop, including helping the students who came in for lessons. One Saturday, I came in to film her on the loom for her presentation. Yukako, her mentor told me how helpful she was, how good she was at spinning and weaving. Jen even had a piece she made exhibited at an art show. It was amazing to hear someone else describe my daughter to me. I know she's helpful and kind and talented, but too often that gets lost in the worry that my teenager is too obnoxious, too moody, too unmotivated. I worry that her inability to keep her room clean with translate into a later inability to find and keep gainful employment. Her mentor told me that Jen had helped teach a class of disabled children and was very good at it. Several worries popped all at once, like the soap bubbles we used to blow when she was little.

Later on, I let her direct me on the subway. "No, Mom, we go THIS way." She made her way through Manhattan like a native. I let her guide me, proud that she was coming into her own and I was just "Mom". Earlier in the day my taxi driver had asked why I was in the city and I said, "I'm visiting my daughter." The words seemed grand coming out of my mouth, but very right. The feeling won't last forever, but for right now I'm sure she'll make her way in the world just fine.

That night I left her in the city to shop for a prom dress. A few hours later I get a text from her. With a picture. "Is that ANOTHER PIERCING!" I yell to my husband. "IN HER MOUTH!" Sigh.

Some Stuff

2009-05-05T23:03:00.005-04:00

Work has been a drag, for the most part. I feel like I spend 8 hours day making phone calls. Or worse, getting phone calls. "I'm peeing a lot, is that ok?" "Can you fax my test results to my cardiologist, my nephrologist, my endocrinologist, my primary MD and my garbage man?"

I'm still not completely caught up from February. Seriously. My partner and I could really use our own personal assistant, not the least of which is I would have someone to fetch me coffee. Well, I can dream, can't I?

In other news, the first US face transplant has spoken out. I used to think that I would draw the line at donating my face. I mean: come on. It's. My. Face. But at AOPO a couple years back I attended a session on face transplant and saw pics of people who needed a face transplant. One woman hadn't seen her grandchildren, EVER, because her visage would scare them too much. That's about as sad an existence as I can imagine. So, all right. You can take my face, too. If you want to see how beautiful I am, you're just going to have to see my mug in person while I'm still alive. Speaking of beauty, Connie Culp has shown all of us her true beauty and courage by speaking out.

My hubbie sent me an email a few weeks ago, saying, "What's this all about?" Apparently, someone's gone ahead and invented a outside-the-body lung pump. In my neck of the woods, we pump kidneys, which seems pretty straight-forward: you attach the vessels to plastic tubing and keep the thing flushed with an iced solution. But some clever chap has invented a machine to not only circulate but ventilate the lungs for a period of time outside the donor body prior to transplant. According to the article, in addition to testing how the lungs function, doctors can actually repair problems in the donor lungs before putting them in the recipient. Watch the video, it's totally cool.

I had a blue funk in work after lunch today. And no, it wasn't the Cinco de Mayo tacos. I was reading "Family Fun" magazine while I ate and all the sudden I thought, "I should be home doing arts and crafts with the Pooter, not working 9-5." Short of hitting the Mega Millions, I don't think it's going to happen, although I did peruse the nursing help wanteds and entertained the notion of going back to work for 3 12's a week. My horoscope said that my whole life is going to change by July, so we'll see. Naturally, I take the pessimistic view and think that means I'll be in a body cast or something, but I'm still playing the lottery, just in case.

2009-04-11T17:15:00.000-04:00

2009-04-11T11:28:00.002-04:00

It is so nice to be off. I used to hate working a 9-5 job, but I'm enjoying it pretty well right now. Another sign that I'm getting old. It stinks not to have off during the week, but it makes sleeping late on Saturday so much sweeter. Actually, I don't usually sleep late ANY day, but last night we were at church til late, so the Poot slept til 9:30. Huzzah.

Godspell went GREAT!! I didn't suck, or forget my lines or anything and I got a couple big laughs. I'd rather make people laugh than impress them with my singing anyway, although I think I can carry a tune. My new motto is: "There's a lotta notes, I'm bound to hit some of them."

Work is coming around, now that I have my new, awesome partner. She's so sweet that she actually makes me be nicer. Cause you know, I can be downright cranky sometimes. I'm almost caught up on my phone calls and BK virus results. What? You've never heard of the BK virus-don't worry, neither has anyone else. I'm going to write a post about it soon, but I want to try my hand at a funny graphic to go with it.

Anyhoo, Happy Easter, Merry Passover and have a Spectacular Spring! We have Spring Things planned for the next, several weekends and I can't wait for it not by cold and damp anymore.

See what happens when the baby finally falls asleep...

2009-04-06T22:10:00.006-04:00

I can blog! However, I've been up since before breakfast, so I may no longer be coherent.

I'm in a production of Godspell at my church and the free time that I don't have has all been given over to that. Hopefully, after this week, what with the play being over and a slow work week, I can get my act together and catch up on other stuff. Who'm I kidding, I've been trying to get my act together since Kindergarten. But I can dream.

As I may or may not have mentioned, April is National Donate Life Month. With soundtrack, here at donorcycle. Also, for no extra charge, I have a cool video from the folks over at Donate Life Illinois.

Included are a couple of folks I heart a lot, too.

Over at youtube are some video responses to it.

I was trying to think of why I became so passionate about organ donation. I only ever knew one person who needed a transplant: he was a neighbor who died waiting for a heart transplant. However, being young and not veru close, I don't think that played any role. I do remember the first time I heard someone talk about being a transplant coordinator. It sounded terribly exciting-running off at all hours to save lifes, leap tall buildings, dodge bullets and so forth. That was when I was a young, bright-eyed nurse who still stopped at traffic accidents and signed up at every opportunity to be on the hospital's Code Blue team. I have since stopped looking for excitement like that, but occassionally it still finds me.

It took about 8 more years before I got my dream job as an organ procurement coordinator. Stay awake for days at a time-check. Console grieving families-no problem. Deal with difficult doctors-bring 'em on. My motto was, " A 12 hour shift is only a half-day." Humility has always been a challenge for me. In fact, I own a button that says, "No. My powers can only be used for good."

Working for the NJ Sharing Network was different from being a trauma nurse or responding to codes. Resuscitating someone who rolls through the doors of an ER is pretty impersonal. Bringing them back is more about personal pride than selfless assistance. Working with donor families changed the way I thought about the end of life. I had always been afraid to die. Working in a trauma ER only cemented that: now I was afraid of dying in graphic detail. Or afraid of how my loved one's could die. It was only when I started to work with donor families that I lost my fear of death. The more personal it got with them, the less it was about me. The more I understood how to savor every day.

I always considered myself good with grieving families, although I never let down my composure in the ER. As a transplant coordinator, I have cried with so many family members. Before, I logically knew that different grief reactions were normal. With donor families I was a part of their anger, their disbelief, their guilt, their hope. So many times I had my heart stretched out so that I thought it would burst, then it would expand some more. And so many times making the decision to donate opened the door to their healing. It usually came during the "med-soc" AKA the medical/social history. If you've ever donated blood, you've done an abbreviated form of one: it asks about your medical history, including any risky behavior. Ours lasted about 20 minutes, ranging from questions about recent vaccinations to Chagas' disease. When we got to the "risky behavior" questions, I'd preface it by saying, "Now some of these questions are very general and some are, well, personal."

I tell you, there's no ice breaker like asking if Grandpa had sex with men for money.

Seriously, you'd think they'd want to slug you right then and there, but these are people who had been throught the most agonizing days of their life. This was small change. Almost always they'd start laughing. "Oh, if Henry was here he'd be so mad that you asked that." It was like giving them permission to break the tension. Then they'd start talking about the person who died. What they liked and didn't like. What cracked them up. They turned a corner. What had been "how could this happen" now became "how are we going to move on from this?" Organ donation helped. These families wanted to know that somewhere, somehow their loved one's heart still beat, their eyes could still see. I know there are people who regret donating. The law of averages says there must be. Let me know if you find any.

Working with donor families made me believe in the kindness of our species again. Go work in an ER for 5 or 6 years and you may come away with a dim view of humanity. It's not fair, of course, you don't get to see people in their best light. But as a TC, I would walk away after a case, over and over again amazed at how people in the worst moments of their lives could find it in their hearts to help another, a stranger they would most likely never meet. It touches me still.

Today at my hospital we had a table for National Donate Life month. Next to it was one of our donor quilts. I looked at the names and recognized several. "Oh, that's the kid who was killed trying to break up a fight. He had just gotten engaged. There's so-and-so's son, his only son. His parents were just devastated when he died. There's Mr. T-, I remember I had to get consent from all 8 of his brothers and sisters." My friend Pam was amazed I could remember so many. How could I possibly forget? Their names are written on my heart. If I never do anything else again in my life I know that, for a short time, I helped do some good.

Here's the playlist, as promised!

2009-04-05T22:52:00.003-04:00

Hope you like it. It does include My Heart Will Go On. `It's inclusion, STEVE, shows the depth and breadth of my affection for you. The fact that it's an instrumental means I am more in line, musically, with Laura. It's not too late for suggestions, if time and project playlist allow. I did want to put in Dancer to the Drum by Beth Nielson Chapman, but couldn't find it on the ole playlist site.

It's eclectic. Boogey Woogie. Enjoy.

We need more monkeys!

2009-03-29T14:48:00.003-04:00

It's been quite a coupla weeks. Two Thursdays ago the Hubby and I went off our diets and ate some Chinese food. Tasted good when we ate it. I spent the night throwing up and yet somehow I found the fortitude to go to work. I had to go to work because my co-worker, the only other post transplant coordinator, was canned last month. Oh, if only I could fill you in on that drama, but I'm still trying to stay on the QT when it comes to work specifics. Let's just say that the regime change is complete. Everyone has been chipping in to help me, which allowed me to stay on vacation and only come back a day early. Nonetheless, nobody else really knows the patients and we are not set up with a system that involves someone to step over my cold carcass and take over instantly, should that need ever arise. In fact our technology involves, I think, punch cards and a computer that looks like it should say, in a tinny voice, "Would you like to play a game?"

So here's the rundown of last week:

Sunday night: I feel fine before bed. Wake up with tummy upset a few times, think maybe it's something I ate again and wake up feeling like I've hardly slept. Go to work and an hour into clinic think that I'm going to heave. No, I'm not pregnant. People tell me I look pale. I go home at noon and blessedly the husband and little one are out. I eat what will be my last solid food for 2 days: soup and ginger ale, and go to sleep.

Tuesday: I think I can go to work. I am wrong. Dr. L. the nephrologist comes into my room and says, "Oh my God, are you okay?" I leave again at 12 noon to go home and moan.

Wed'day: feeling better, I eat some yoghurt and tea. Make it through a whole day of work. Go home and eat a big, hearty dinner. Big mistake.

Thursday: I feel odd again, but still manage to make it through a day of work. I don't actually DO much, but I'm present. Eat hospital salisbury steak for lunch. BIG MISTAKE.

I'll spare you the gory details, but let's just say that Thursday overnight I got very well acquainted with my bathroom. Let's also say that I'll never take anyone's cellcept-induced diarrhea lightly ever again. I have to go in to work. I'm 3 days behind on phone calls. My favorite patients think I don't love them anymore. My unfavorite patients think I'm a slacker. I crawl into work around 11:30.

Somewhere in all this, I came home to find parts of Pooter's Curious George puzzle in amongst the rubber tree. It looked like a cartoon crime scene. With dirt everywhere, natch. I asked the hubster what gives. "She planted them. She's trying to grow more monkeys."

Because what this house needs is more monkeys.

This week I have been on the mend. However, Monday morning I had 45 phone messages and a full clinic. Fortunately, I have A. New. Coordinator. She is six shades of awesome. She's friendly, competent, experienced, diligent and she knows everyone in the hospital. She's already covered my ass. And she reminds me of Doggett. In case I haven't mentioned it, I LERV the X-files. I've seen every episode and every movie. I didn't think anyone could replace Mulder. And then they brought on Robert Patrick, who's also 6 shades of awesome. Did you see him in "Walk the Line"? Anyhoo, I digress, but she's a female Doggett and I'm happy as a clam at high tide. And she feeds me. Those in the know know that I have a special affection for anyone who provides me with nourishment. I think it's a childhood issue, whatever. Anyways, hopefully after next week we'll be all caught up again and I can stop stressing.

We said goodbye this week to our pharmacist, who's pretty, smart and works like 3 people. God knows how we'll replace her. They've already hired 1 1/2 people to fill her spot. At the farewell my other coworker had me desperate with laughter. See, we have this thing at work were one person picks the "Friday Colors" and we all try and wear those colors on Friday. It is, in a word, gay (no offense). I do my best to fit in, although I'm not really a good fitter-inner. I mentioned to him that when it's my turn, I'm going to pick chartreuse and apricot. He countered by saying he would pick "clear". This devolved into more ridiculous combos: slate, eggplant, stone, salmon.

"I know" he said, "everyone wear a red quilted vest over burnt umber pants with a skirt in the O'Malley family plaid." By now I was helpless with laughter, hoping no one would notice that I'd lost track of my senses without even liquor to blame it on. "I got it! Forget colors! Everyone dress like a rodeo clown." Tears streaming down my face, I try to hold it in but I have 2 weeks of sickness and stress pent up inside. I wonder if anyone will notice if I pee my pants or if I can leave gracefully before that happens. I try thinking of sad things: war, famine, the NY Islanders. It's no use. I'm weak with the silliness of it. It feels great. Bring on the monkeys.

One step at a time....

2009-02-23T09:09:00.009-05:00

So, I made it up all those damn stairs again. Yesterday I did the Hustle up the Hancock with my pal Steve from Revive Hope to raise money for the Respiratory Health Association of Metropolitan Chicago. Big, big Muchas Gracias to everyone who contributed to the fund raising. There's still time to send in a few bucks if you'd like to help out the cause.

Chicago is pretty cold but not much colder than NJ, which isn't really saying much. I woke up Saturday at 4am to catch an 8:40 flight out of JFK which was delayed for 40 minutes anyway. It has not been a weekend for sleep but that's ok. I did again meet the girls(and one guy) from Iowa.

Everyone in this picture is named Ryan

We got to the Hancock around 7am Sunday morning. The streets of Chicago are pretty quite at that hour, so it feels like you're getting there really early. Then you walk into the building and see this:

It's quite a melee

Gear check was especially painful. I got up to the front of the line and all I could see was a wall of plastic garbage bags with hands reaching out the grab people's stuff. Getting it back was no picnic either, but we managed.

I did also get to meet Melissa, a heart transplant recipient who blogs at revivehope with Steve. The neat thing about hanging out with Melissa and Steve, for me, and I hope this doesn't sound stupid, is that it's interesting to hear their stories, talk to them about what it's like to live with a transplant, how they got their organ, stories of their donor families, etc. EXCEPT that it's as a friend, not as a nurse and a patient. That's really nice for me.

I used to think, even when I was recovering organs, that I wouldn't want a transplant if, God forbid, I ever needed one. I mean, maybe if my kids were small, so I could stick around for them. I didn't really know any post transplant people and the regimen seemed so hard and it seemed like, to me, that maybe the cure was worse than the illness. Now that I'm on the other side of it, working with recipients, I see that that's not true. I have patients that have complications, a small few who died, but the majority of them are like Steve and Melissa-vibrant, healthy people who you'd never know had a transplant unless they told you. It is truly amazing how people get their lives back, or in some cases, get a better life than they ever had in the first place.

Of course I didn't get a picture of the three of us together. Because. I. Am. A. Doofus. (Smacks forehead). Well, we'll all just have to get together again next year.

Anyway, I think I did a few minutes better than last year, although my legs are tired today.

You take the stairs. I'll leap up to the top in a single bound.
Up, up and away!

Still time to give me your money!!

2009-02-17T17:04:00.002-05:00

Hey, y'all. As I mentioned in the last post, I am climbing the Hancock building (the stairs, not the outside) this Sunday with my friend Steve from Revive Hope. If you 'd like to contribute, click on the link at the right that says "Kari's Klimbers". Thanks and wish me luck! This year I'm skinnier and more in shape, so I should do it with only minor wheezing and moaning. Here's the post and pics from last year's climb, including a pic of me and my brother from anotha motha.

Also, I'm thinking of revamping the site and I'd like to hear your opinions of some of the other free or for-fee hosting sites. I'm leaning toward Wordpress. Anyone?

3 Day Weekend

2009-02-16T21:04:00.004-05:00

I got President's Day off. Ka-ching! I don't think I've ever had President's Day off, not since I was a bank teller (yes, a bank teller) and that was many years ago. Last week my office mate was off skiing, so I had the office to myself. Unfortunately, I had all the work to myself, also. To help, they gave me the new person on Monday, a nursing student on Tuesday and Wednesday and, the best of all, the pharmacist on Thursday. I say the best because, while she's perpetually stressed, she easily does the work of 3 people. While I put out fires and returned the 900 phone calls I had accumulated since Monday, she made all my post clinic phone calls AND called in Rx's. I love her.

I guess I'd write more about the job if there was more to write about. Seriously, I mostly make phone calls. I make rounds at 8am with the team, have clinic 2 days a week, eat lunch at my desk and make more phone calls. People who call in because they have a cold, because they only have 2 days left of prograf, because their urologist started them on a new drug and they want to know if it's ok to take. I have people who call me with their gynecologic and psychiatric problems. Remember how when you started nursing or med school, or possibly even veterinary school, and suddenly every relative you ever had would start asking you for medical advice for their various ailments? Multiply that by 600 patients and you have my job.

Saturday I was in a frantic state of I-can't-relax. I'd be playing with the Pooter and thinking of cleaning the house or what I needed at the store until my husband told me to cut it out. Actually, he said I need to stay in the moment more. Thanks, honey. We did start off the day with Valentine's "perprises" for everyone. Teen got flowers from a "Secret Admirer". Pooter got a Beauty and the Beast DVD and a Belle doll. I finally managed to surprise my husband-I got him a Johnny Cupcakes T-shirt. My surprise was that Friday night Hubby and I went out to dinner. At a nice restaurant. Alone. Oh, somebody pinch me.

Sunday, Pooter and I went to church, then visited the thrift shop where I bought a Columbia ski hat and 2 Berenstain Bears books, which both the Pooter and I have been enjoying. I recently discovered that the Bears are Baptist, but that's another post. Then Pooter comes over carrying an armful of stuffed Powerpuff Girls. You remember them-sure you do. So I bought Buttercup. She's the cranky one. (Insert your own joke here).Sunday evening Poot and I walked to the grocery store and when I returned I made a pork tenderloin stuffed with mushrooms, spinach and parmesan cheese and brussel sprout with bacon. Mmmm. Have I mentioned I've lost 12 pounds on my diet. Thank you, Mr. Atkins. Hubby introduced Pooter to the Powerpuff Girls on video.

It was a big hit. She's carried Buttercup around all weekend. Buttercup was even there WHEN SHE WENT ON THE POTTY FOR THE FIRST REAL TIME!! We called everyone with the good news and celebrated with marshmallows.

So today, my big day off, I was full of Monday energy and OFF! We took the bus to Gymboree. With Buttercup in toe. Buttercup shares her food, goes potty with her, helped us cook dinner and went into the bathtub. When we got to Gymboree, every one was SO SURPRISED to see Pooter's mother. Maybe they were hoping her dad was single. Anyhoo, during open gym she karate chopped her way over to a grown woman who was holding the Jimbo doll, grabbed it out of her hands and yelled, "I want to fight Jimbo! I want to fight Jimbo!" After I cleared up the fracas I looked at my husband and said that perhaps we should cut back on the Power Puff videos. He just laughed. "She's 30% feral." "Just 30%?" I asked back.

We managed to leave without casualties. Then we met my parents for dinner. All in all, a nice weekend. Even better, I have 2 days of work and I'm off for a week and a half! I'll be climbing the Hancock this weekend and will have more to post then, I'm sure.

2009-02-01T07:52:00.000-05:00

So, I didn't realize that you can't read the Nursing 2009 article unless you can log into google. I'll work on that if I have some time tonight. Maybe I'll just post the full article on here.

In the meantime, I'm working on a playlist of songs that have to do with donation for Nat'l Donate Life month in April (or maybe sooner). Does anyone have any suggestions? So far I've got Mariah Carey's Hero, You've got a friend by Carol King, Devotion by Indigo Girls, and a few others. Let me know your ideas and I'll see if I can find them on project playlist.

So, anyway....

2009-01-29T23:01:00.003-05:00

I haven't posted in some time, in case you didn't notice. I blame it on the winter. All I feel like doing is coming home, eating, snuggling the baby and going to sleep. Throw in the occassional vapid TV show. When I do go online, it's usually to surf Reddit and read my horoscopes-I am THAT apathetic. I certainly don't feel like writing. In fact, I feel like curling up under a blanket and not coming out until May. Love Monkey has said for the 987th time that we are MOVING TO ARIZONA, RIGHT NOW, I REALLY MEAN IT!

In my neglectful state, I have failed to mention that my friend Steve was on the Donate Life Float in the Tournament of Roses parade. He even video blogged (vlogged?) it for Revive Hope-just keep scrolling down, there's lots of pics and videos. Despite my silence, I've been showing them to everyone at work. Furthermore, Dear Husband has provided me with an airline tic to go out to Chicago in a few weeks and climb the Hancock with Steve again this year to raise money for the Respiratory Health Association of Metropolitan Chicago. If you'd like to help us raise $$ for this amazing event, go here.

If you'd like to see what I look like after climbing 1632 steps, go here. Scroll to the last pic, that's me with Steve-my brudda from anudda mudda.

Also on my mind has been the fact that I really want to do something different. Some of yall may be aware that I have 2 other blogs: P is for Pooter and Laughing Baby. I didn't mean to have THREE blogs, but I started Pooter to keep my family, especially the ones living in S. Korea, updated on the (then) new baby and Laughing is basically the monthly articles I write for the local food coop on parenting and anything that comes to mind. I always wanted to keep my politics and personal stuff out of the donorcycle blog because I didn't want to cloud any donation issues with my other, sometimes quite, opinionated stuff. Yet, it's a little schizophrenic and too much to keep up with and I still harbor the dream of having a $$-making blog. So I'm trying to come up with one blog to encapture all the various and amazing parts of my life while getting enough readership to allow me to put my daughters through college. The Universal Theory of blogs, as it were. If I expand on that dream, I think that I could eventually quit my job and work full time as a writer, working at home with occassional trips to exotic locales. Don't ever say I don' t dream big.

Finally, several folks have commented on old posts and I feel bad that I haven't replied in any way. One really nasty reply came in a few posts ago, and that, I glad to say, I haven't responded to, but I will say that some people only go by "Anonymous" because they don't want the world to know their name is Sissy McGirlypants. (And of course I mean that only for the person who left the ignorant post. Not the other 2 "Anonymouses" who left me really lovely comments. Thank you. )

Anonymous wanted to know about Horseshoe kidneys. Melissa'sleft me a lovely comment under There are no Coincidences. I have a special place in my heart for the little ones that need an organ and I'm glad your little one is doing well. You should go over the Falling Down is Also a Gift.

So, there you have it. Throw in a regime change at work(my old boss resigned), Christmas, trying to get the Teen into college and our car dying, that's been my last 8 weeks or so. As they said at that Ford Theater, "So other than that, Mrs. Lincoln, how did you like the play?"

I leave you with cuteness:

Out of hibernation

2009-01-23T19:25:00.003-05:00

So, I was going to wait until February 2nd to post. Then, if I saw my shadow, it'd be 6 more weeks of silence. Then this happened: the January '09 issue of Nursing 2009. I tried linking it-I can't. Then I remembered Google Documents. Thank you, Google. It's basically why this nurse now thinks organ donation is a bad thing. I'm composing a letter in retort. Here's the response from AOPO (Association of Organ Procurement Organizations).

Here is how you get in touch with Nursing 2009 magazine:

# Editorial office location: Nursing2009, 323 Norristown Rd., Suite 200, Ambler, PA 19002
# Editorial office phone: 1-800-346-7844
# Editorial office fax: 215-367-2155
# Editorial office e-mail: PE-Nursing@wolterskluwer.com

Ok, People of the Internets.... I think you know what to do.

There are no coincidences

2008-11-23T22:40:00.002-05:00

So LAST Sunday I spoke in church about organ donation. Pastor Seth said about 3 minutes. Hah! Somehow I managed to stop speaking before anyone started yawning. Seriously, a lot of people told me I did a good job speaking and that they were going to put "organ donor" on their driver's licenses and so on. Which is nice, because I never look a positive affirmation in the mouth.

What really floored me is that one woman, who I've sat near and chatted with on occasion, came over during coffee hour and told me that her son was an organ donor last year, in the very same PICU where I used to work. We probably talked for half an hour, at least. She told me how hard it is, but how sharing his organs has given her some meaning, a way to cope better with having her only child die. I can't even imagine-I think about it and it makes me want to ground my kids for life so nothing bad will happen to them.

For me, as a coordinator, it was nice to hear that donating has helped her and I told her so. I've only ever seen families when their grief is still raw and fresh, so it was a blessing for me to hear her say that donating his organs is helping her heal. I've said it before and I'll say it again, donation is a solace in a time of mourning.

This past week I met a friend for coffee who is now the hospital services manager of the hospital where that very same PICU resides. She's having resistance, of which I am familiar, to donation. Not that the staff is against organ donation, theoretically. It's just that PICU people tend to be very possessive of their little ones and don't take kindly to OPO staff "hovering around". I told her I'd be available to talk to them, if she wanted.

So now I'm in church again today and the woman who's a donor mom and I sit together. While talking I mention the above to her. She got quiet. I didn't want to ask for her help, because she already told me that she doesn't think she's ready to talk publicly about it. But I can see she's thinking. After services, she tells me that if I ever need anyone to talk to the PICU staff, I can call her. I told her I'd take her up on it.

Because no matter how good I can gab, she's the one they're going to listen to.

Giving

2008-11-23T21:11:00.005-05:00

My friend Ali works on a hospital ship docked at a port in Liberia. Recently, while visiting families out in the countryside, she joked to one woman that her baby was "so fine, I'm going to take him back to America." The woman untied the little one from her hip, handed her to Ali and walked into the bush without saying a word. When it was time for them to leave and she went to hand back the baby, the woman was sobbing.

Think for a moment what it could possibly be like to live in a time and place so hard that you would hand over your child to a stranger, like tossing a letter in a bottle out on the open sea. Was she thinking, as she handed over the child, that America was the promised land she'd never get to, but that her baby might have a better life there? Was she thinking that there would be one less mouth to feed? I don't know, I hope I never know.

It has made me think, as we enter the consumer frenzy we call the holidays, even more about what my values are and what my husband and I want to teach our daughter. The first Christmas she was here, all 2 1/2 months old, my husband announced that we would not pretend Santa Claus was real. Right from the get, he said, she would know he was make believe. I was appalled. No Santa? But, he's magical! Like fairies! Although the point may be moot (kids seem to have no dilemma with the paradox of make-believe being more real than reality), I think I'm starting to agree with him. I think I'm tired of the fairy tale Christmas.

I've long felt this way about weddings. Why would anyone spend tens of thousands of dollars, borrow it even, to live for one day in a way that is far above their lifestyle? Because it's the happiest day of your life? Well, if that's true, you marriage is going to be one long downhill of disappointment. But I digress. I don't feel a need to emulate the weddings of the British Royal Family and less and less I'm feeling a need to have a Currier & Ives Christmas. Especially when I remember that the reasons those Victorian Christmases were so lovely is at least in part because they had a lot of servants. Who worked on Christmas and didn't get to see their own families 'til the next day.

Bah humbug. So now I try and figure out what this season of peace and joy is supposed to mean to me. I spoke with hubby and said maybe we could take all the money we were going to spend on presents and send a big donation to a charity we believe in, like Habitat for Humanity or Heifer International. Wouldn't that be better than buying Aunt Carol another pair of slippers? But he likes buying and giving gifts for people. He loves it, in fact. It makes him act like a little boy and he tends to start buying early, like around Labor Day. He, once again, has the right point-it's about giving, stupid. While I ponder the moral quagmire, he's trying to figure out what he can get that will make someone else happy. So I'm starting with a small change. When the Pooter asks what Christmas is all about, we tell her it's about GIVING presents.

So, this year I'm trying to focus on what I can give. Not iPods and digital cameras, but what I can give of my time, my effort, my love. And if you want to know what to get me, I'd like every able-bodied adult to send $25 to a worthwhile, African charity AND spend 10 hours writing to your congressmen and senators why we should help the beleaguered continent. So no mother will have to choose between a life of poverty and handing her infant over to strangers. That's what I want for Christmas.

I'll probably get another sweater.

National Donor Sabbath

2008-11-11T22:45:00.002-05:00

This weekend marks the National Donor Sabbath, created to bring the topic of organ donation into houses of worship. One of the biggest misconceptions people have is that organ donation goes against their religion. In fact, all major religions support organ donation. Want to see what your religion has to say? Go here. It's okay, I'll wait. Unfortunately, most people don't think about organ donation until they're in a devastating situation. And that's the worst time to make a decision. Quite possibly, there's someone in your neighborhood, in your schools, your congregations, your work place, who need an organ and you may have no idea. Or maybe you think, I'm going out with everything I came in with-let someone else donate. Well, less than 1% of people die in a way that their organs can be donated. As Rabbi Hillel said, "And if I am only for myself, then what am I? If not now, when?"

So, if organ donation has touched your life, get up and say something in church this weekend.

I'll be speaking.

The not so best phone call

2008-11-07T18:54:00.005-05:00

We had wine with dinner, tonight, which is a very, very civilized way to end the week, even if all you're having is pepperoni pizza. ("Pepperoni?" My husband said, "You haven't ordered a pepperoni pizza in all the time I've known you." Well, that's my prerogative). Today started with a nasty gram from the boss: we all come in too late, leave too early and take too many frivolous breaks. For those (read: almost all) of us who come early, stay late and work through lunch 4 out of 5 days a week-we were pissed. Pissed enough to renew my BLS and see if the hospital down the street is hiring. Then by lunch time we were all friends again. Mostly.

Worst of all is that I had to write the "You better _____ by _____ or else" letters. Even though I deal with Post Transplant patients, we are all expected to pitch in with maintaining the wait list. Once you get on the wait list, for a kidney or panc, it may be years before you get an organ. In that time, the patients, depending on their health and needs, need to continue getting annual cardiac clearance, send routing labs in and come into clinic to be re-evaluated. Someone has to actually go through the list, figure out who needs what and when so that, when the time comes to transplant them, we don't suddenly realize that they need a pacemaker, ilio-femoral bypass or that their insurance has run out. So, driven by threats via email from teh boss, I had to scour a few charts and see why folks aren't keeping all their records up to date.

So here's the deal: folks get referred to us from their doctors when they need a transplant. Hopefully, they aren't on dialysis yet, maybe it's just looming large in their future. So they come in, meet with all sorts of professionals-surgeons, nephrologists, the financial coordinator, the social worker and last and most decidely least, the transplant coordinator. Then, once a week, we sit down as a group and decide who is eligible for an organ and who isn't. That's probably a whole 'nother post.

Once they're on the list, depending on age, health status and circumstances, they have to come in once a year or every other year for a re-eval. Annual retesting is also required, mostly cardiac testing. Folks who are on dialysis 3 times a week are getting reminded often when they need stuff and monthly blood samples are sent in, but the pancs are a different story-more on their own, so to speak. And, let me say, that the majority of people get things done in a timely fashion. For those that don't, we call doctor's offices for results, call the patient and remind them of what needs to be done and so on. I've been calling one woman for 5 months to get a stress test done or we can't call her in for a pancreas, should one become available. Remember, diabetes causes major heart problems. Another guy said he was going for a stress test in July. In August, his mother answered the phone and said he wasn't available. Now his numbers(all 3) have changed and I don't know how to get a hold of him, so I Fed-Ex'd a letter to his house, not sure if he still lives there.

I don't want to write the letter. You have 30 days to contact us or you're out. But, realistically, it does not speak well to his ability to take care of a donated organ (not that I'd be able to reach him I can't call him). The follow up is intense. We should have a slogan, "You get a new kidney, but your ass is ours!" Seriously, it's been 6 months and some of these people are like family, already.

ed note: started Atkins Monday, so that's the last pizza I'll see for a while. Pray for me.

It's still exciting to be on call....

2008-10-26T13:19:00.004-04:00

Despite the sleep deprivation. I no longer take broken people off helicopters or spend days in the ICU trying to mend them, but being on call when you get a kidney offer is still pretty exciting. Or maybe I just need to get out more.

So, Thursday night into Friday, I get a call around midnight for a kidney offer. The surgeon says we'll take it as long as the biopsy and anatomy are good. For you non-medical types, that means that when they recover the organs, they'll write down if there's any noticeable injuries or disease that might effect its function, along with the size of the kidney and the veins, arteries and ureter. Then they take a chunk (a little chunk) and send it to a lab to be looked at through a microscope by a pathologist, again to see how good the function is. If neither suck, we'll take it. The OR is scheduled for the a.m., so we won't know 'til then. Now I have to call our potential recipient and make him NPO (don't eat or drink).

Then I realize that I've left my on-call book, with the wait list that includes everyone's phone numbers, in my office. So after I tell the hubby, I head on out to the hospital, fortunately only 5 minutes away by car(no, I did NOT ride the bike). Anyway, on my way to the office, I get another offer, this one for a teenager. So I grab the book, leave the office and get another phone call. This time to tell me that the intended teenager recipient does not have a blood sample on file and will need to come in ASAP to give one so that cross matches can be run. They run a blood sample of the recipient against the blood sample from the donor to see if there is any cross reaction to certain antibodies. Folks that are on dialysis have a sample sent every month automatically from their center, but this kid's no on dialysis yet. Plus, there's a special form that needs to be filled out and sent with the specimen to the local OPO and it's only-you guessed it-in my office. Well, maybe there was a reason I had to come in, because I don't routinely have this paper on me(although it's probably not a bad idea). Even if I did, though, this family doesn't have a fax machine, so I'd only have to meet them here anyway.

So what I do instead is head up to the transplant unit, make all my phone calls. I wake up to sleepy and now very excited families and tell them that they may be getting a kidney, not to eat or drink anything from now on except meds with sips of water and I'll call back when I know anything. With the second family I make arrangements to have them come in a few hours from now to give a blood sample. Then I head down to the lab, explain my plight to the one of the techs and he takes all my papers, along with instructions and leaves it on the desk of the person who does those tests. I have written at the top: "Patient S______ is coming in to have a specimen drawn for (the OPO). There is an available kidney for them and it must be sent to (the OPO) ASAP. Thanks." With my name and number at the bottom. Then I head for home.

Except I can't sleep. And I don't feel like blogging. So I watch some Anthony Bourdain and read a little and then toss and turn until 6:15 when, if I don't get out of bed this instant, I'll have to wait for The Teen to get out of the shower and she takes slightly less than forever in there. So I haul my carcass out of bed, get washed and dressed in my most-comfortable-but-still-appropriate-for-work outfit and, this time, bike to work. On my way in I get a phone call from the teenage recipient's dad, saying the lab can't find the paperwork. I say to have them look on So-and-So's desk. They come back on and say they have it. Sometimes, just sometime's, things work out the way you need them to. I get to my office, have a quick coffee and it's time for rounds.

Well, it's been a week.

2008-10-12T16:04:00.002-04:00

Last night I was remembering with longing those heady days before the baby came, when I had scads of time to do whatever, whenever I wanted. Then I remember that I was the one who wanted a baby so bad. Then I also remember that when I had all that free time, I didn't really DO anything-I didn't write the Great American Novel or go back to school or even clean out the basement, so stop whining already.

Needless to say, I'm not getting on the internets so much, and when I do, mostly I just surf the news sites. Then I have to take an aspirin and lie down. You really shouldn't read the news-it's not worth it.

Work's been, well, it's a living. I'm vaguely happy that I get to totter around in my heels and long, white lab coat. I have a signed prescription pad in my pocket that I get to whip out when someone needs a test or a medication. Then I wonder when did I ever become so shallow that a lab coat and a little authority can make my day? That worked well 'til Friday, when we all got a nasty-gram from the boss for things that weren't our fault, that made me want to march in there and toss down my resignation and THEN I got a stern talking to from the chief surgeon about things that were my fault and it took all the wind out of my sails, which is probably just as well. Until I renew my BLS/ACLS and get a new car, there's no point in job shopping.

Aside from the soap opera, it's a pretty swell gig. I have a bunch of patients who I really like that have just reached their 90 day appointment and so I won't be seeing them until December. During the first 90 days after transplant the patients come in 2x a week for the first month, then 1x a week, then every other week, plus many, many phone calls, so you get pretty attached to some people. Then, like little, baby birds, they fly off back to their regular, hopefully improved, lives.

I feel like I've been seeing all these weird articles about transplantation, but I haven't had the wherewithal to come on and share them. First up, if you haven't already read about, is a story from April of this year. Appears a guy committed suicide, his wife donated his organs and then, years later, meets the heart recipient, ends up marrying him and then HE commits suicide. There's been bunches of stories circulating about cellular memory, as if the second guy somehow "caught" the suicide bug from him. If you read the story from the South Carolina paper, I think you'll agree that it was in fact 2 guys who had the bad luck to hook up with this woman. Anyway, if you want a bit of "As the World Turns" meets "King of the Hill" with a little bit of "Heartland" (remember that show?) thrown in, then read this.

Yes, Virginia, there's a new post coming...

2008-10-11T22:06:00.002-04:00

Recently, a commenter named Virginia asked if nursing was a good profession to go into.

Hell, yeah!

As long as you can get RN with an associate's degree, it remains a great bargain, as far as college goes. Two (well, more realistically three) years of school for $50,000 a year? At least in my neck of the woods. That's not too shabby. While I can see both sides of the argument for RN's having a minimum of a Bachelor's, for the time being it remains that you can make a pretty good living with not so much school.

Nursing school changed me. I learned how to prioritize, I learned how to focus my thinking. It gave me a lot of confidence. I never realized how smart I was until I went to nursing school. It also brought me out of my shell. I am pretty introverted. (Seriously, Steve, I am). In clinicals, you just have to hitch up your britches and march into the room, introduce yourself to the patient and get on with it. I learned how to make mistakes and learn from them-the first time I logrolled a real person, I pulled out their JP drain. The first time I made a medication error, I walked into my bosses office with my head down and we had a good long talk about how to avoid that in the future. I learned that I didn't know what I didn't know and that NOBODY, especially in medicine, knows everything and if someone thinks they do, don't let that person take care of you or your family. I learned that it's ok to ask questions and that the learning never ends.

I went to nursing school with someone who wanted only to go into research. She quit after the first few weeks of clinical-she just couldn't take wiping butts. It's a shame, really, because if you can make it through two years of clinicals and one year of med-surg nursing, you can really go anywhere. Get a few more years experience, some additional education and certifications and really, where can't a nurse go? There's nurse legal consultants and nurse educators and nurse lobbyists and if you really like school, you can even become Dr. Nurse. You can go into pediatrics, delivering babies, oncology, school nursing, travel nursing, dialysis, emergency room, ICU's, home health care, public health and if you get tired of patient care and don't want to look at another human being, there's infomatics.

Become a nurse and you'll always have a job. Those baby boomers aren't getting any younger. I've been reading these articles about how to recession/depression proof your job and they always have healthcare at the top of their lists of desirable positions. (My poor daughter is going into fashion, but I told her people will always need clothes, too).

You get to do really cool things as a nurse that most people just watch on TV: I've taken people off a helicopter while it was still running, I've had my hands in someone's abdomen up to the wrist ("That's his pancreas. Don't squeeze."). I've held someone's hand as they watched their mom die. I've put band-aids on boo-boos. I've handed out a lot of tissues. And yes, I have wiped a LOT of butts.

Nursing is flexible. You can work full time, part time, per diem, just weekends.

You can go to work in your pajamas. Or scrubs, which is almost the same thing.

Oh, yeah, and you get to help people in a really rewarding way and make a difference in their lives.

And one last thing. If you run into anyone who pooh-poohs this and says, "Nursing sucks! Don't be a nurse!" Please tell that person to get the heck out of the field, because their sorry ass attitude isn't helping anyone.

2008-10-06T04:30:00.001-04:00

Well, for those of you that go to Falling Down Is Also a Gift, you know that Anni is back on the liver list and pretty sick. Stop by and offer some words of encouragement and don't forget to keep Anni and her family in your prayers.

The pharmacist is your friend

2008-09-14T00:49:00.003-04:00

Have you ever watched "It's a Wonderful Life"? Of course you have. I'm a big Jimmy Stewart fan, myself and I've probably watched it dozens of times. I have my own copy, still in the original black and white, no thanks to Ted Turner. Cry every time, too, cause I'm a big mush. One of the big turning points in Ole George Bailey's life is when he keeps Mr. Gower from poisoning a patient because he's drunk and distraught over his son's untimely death. "It's poison, I'm telling you, it's poison! Please don't hit me again!"

What does that have to do with this post? Nothin'. I just like the movie. Plus, I've been talking to a LOT of pharmacists lately. I used to work in an ER with a dedicated pharmacy, which was oh, so handy and the PICU had a pharmacy too. Nowadays, I'm on the phone just about everyday with a pharmacy because someone needs a prior authorization or a refill on their prograf or something. And oy! The prior authorizations! What a pain in my tuchis! (spelling? You know what I mean). I don't understand why, if the insurance is going to give me the epogen anyway, I have to go through the trouble of calling some 800-number and explaining WHY we're giving the patient epogen. Do they think we just hand it out like party favors? Anyhow.....

I haven't yet met a pharmacist I don't like (Although one seriously tries my patience, no pun intended). But I do have to say that I'm starting to have a special place in my heart for the local, independant druggist. I'm sure that there are very good, capable and compassionate folk in the local big-chain drugstore. (Like Drugmonkey!) My goodness, though, is it refreshing to call Joe's Pharmacy instead. For instance, most of the time when I call in to a pharmacy, I'm greeted with the usual recording, "Thank you for calling Big Drugs. If you're calling from a doctor's office, blah, blah, press 8. If you'd like to call in a new prescription, press 2. If you'd like to talk to a person, hang up and find someone in your office, because we're all too busy to talk to you. Have a nice day."

When you call up Joe's, though, you get a human on the line, right away. 9 out of 10 times it's Joe, himself. I start in with my schpeil. "This is TC, from Dr. Kidney's office, I'm calling in a prescription for Doris Dontfeelsogood, her date of birth is..." At this point, Joe cuts me off, "Oh, I know Doris, what is it that you need? Ok, with 5 refills. Yes, I know your office number. Thank you." And there you have it. One time, our doctor gave a prescription for a med to the patient, and then changed his mind and I had to call the pharmacy and the patient to make sure the patient took the new med. And the patient only spoke Spanish. They said, "I'll just bring this new prescription over right now and make sure I get back the other one so they're not confused." I'm not making it up-they brought the new med to the person's house. Do you know what that says? It says, "Screw you, CVS and your fancy, new drive-through, we do house calls."

So there you have it-support your local Mom & Pop drugstore, they're a dying breed. As an added bonus, if it's an especially old establishment, take a look around and you may find neat stuff, like Bay Rum or castor oil soap wrapped in silver paper or greeting cards from 1978. And to show you that I put my money where my mouth is, our family uses the little pharmacy in our town, even though the cashier is a little loopy and always follows the baby around the store so she won't break anything.

Just tell 'em Clarence sent you.

Universal Theory

2008-08-25T21:18:00.003-04:00

The family's asleep. (Except for The Teen-she only sleeps during the day). I'm heady with the excitement of web-surfing without feeling guilty or being interrupted for the 88th time. I hardly know where to begin. I lie. Let's begin with my new favorite site: Pioneer Woman. She's my new heroine. Wife, Mom, Cowgirl-what's not to love? Mostly, I envy her ability to pull all areas of her life into one, cool, nifty, link-filled blog. For those in the know (all 3 of you), I have three blogs: this 'ere one, Laughing-Baby, (which is pretty much just my articles for the George St. Coop), and P is for Pooter, my baby blog. Which prompted Robin, from Nova Scotia, to say, "How many blogs do you HAVE, for cryin' out loud?" or something like that.

Anyhoo, I've been thinking for some time about tidying up my baggage, er, I mean bloggage. But I really like the whole donorcycle motif, ya' know? Also, I do get annoyed from time to time with Blogger's inability to say, space properly or upload a picture. So if any of you have mad web skillz, I'd love to talk with you about having my own site, with cool links and funky graphics that aren't stolen from Google images, etc. and that would be easy to maintain and (fingers crossed) maybe turned into a real, money making proposition. Make me an offer, I'm easy. (Shut up, all of you and get your minds out of the gutter.)

Guess what happens when you get a new kidney...

2008-08-25T19:37:00.004-04:00

YOU HAVE TO PEE!!

No, seriously. I have plenty of folks complaining about how often they have to go to the bathroom, now what with the new kidney and all. One guy is downright annoying about. I feel like telling him, "Good thing you didn't get a lung transplant, or else you'd be complaining about having to breathe."

In other news, my partner and I have a good system going. He talks to all the difficult patients and I talk to the crazy ones. (In all fairness, I should stress that 90% of our patients fall into neither category). But, also, crazy does love me. I really do seem to have a way with anyone mentally ill, drunk or anyone with more issues than the National Geographic. I could've been a social worker, but I'm not dysfunctional enough. Ba dum bump. Thank you, I'll be here all week. Eat the chicken.

Just so you don't think I'm completely snarky, a patient today told me that I have "sha-fi". Don't ask me how to spell it. Or even if I'm pronouncing it correctly. In his religion, it means I'm a healer. He told me he was blessed to have such people take care of him. The truth is, I'm blessed to do what I do.

2008-08-15T21:36:00.005-04:00

One summer apon a time, I used to do agency shifts in this little, rinky-dink, lousy ER near the neighborhood I grew up in. I don't think the equipment had been replaced since my mother worked there in the early 60's. So one night, I went out to the waiting room to discharge this homeless guy who had come in with some minor complaint. We used to get a fair share of homeless patients. I was a little apprehensive. I wasn't sure if maybe he had a psych history or rotten smelling feet or some other issue that would make me want to keep my distance. I shouldn't have worried. With a dignity that I've seldom seen on anyone, rich or poor, we discussed his care. When the discharge instructions were finished, I told him to come back if things got worse and to take care of himself. He looked straight at me and said, "I will and I shall." For a second it was like looking into the eyes of God. Then he shook my hand and left. If Jesus ever returns, you'll find him in an ER waiting room. I will and I shall. It echoes still in my mind.

I have a patient currently who is mentally ill. When she was still in hospital she became very paranoid, telling me that the nurses were keeping her in bed and wouldn't let her go to the bathroom, among other things. (Not true, I checked). Her discharge instructions included several interruptions by her boyfriend to argue with her, when he wasn't looking at me like I was a total waste of his time. I thought, "Hoo, boy, this one's going to have trouble with the follow up." I mean, our clinic schedule isn't rocket science, but it does take getting used to and there is a big onus on the patient to be responsible for frequent medication changes and repeat blood work and keeping track of their daily blood pressure, temperature and fluid intake and output. Trust me, it challenges those firing on all cylinders, as it were. I might even have projected that this one would be screaming at me on the phone every time her creatinine jumped or she had to adjust her prograf.

Instead, I find her to be one of our more pleasant patients. She keeps track, so far, of everything she's supposed to and shows up when she has to. If I think back now to how she was in the hospital, I think of how stressful it must have been to be helpless in a hospital bed, just recovering from major surgery, with lots of noise and little sleep or privacy. Now, she's taking all her meds, she's cut back to 2 cigarettes a day, one in the morning and one at night-which I think is a major accomplishment for her. Have we changed her whole life? I don't think so-she's still dating Mr. Douchebag and she still has whatever issues she had before the transplant. But she's doing well for her. Optimizing the patient's potential, or some such nursing theory stuff like that.

Just for the record, I don't really believe that Jesus is coming back to take the faithful up in a big rapture (although if he does, I am SO upgrading my car). But if you look for it, the Almighty Big-Whatever shows up from time to time in endless, little ways. The question is, how will you react to it?

This video is awesome!

2008-08-14T22:43:00.002-04:00

I found out about this from my friend Steve's site-Revive Hope. And I just had to pass it on:

Make your own, home dialysis machine

2008-08-05T23:13:00.003-04:00

A baby dying from kidney failure saved when her doctor designed and built her a dialysis machine from scratch in his garage.

That's not a headline you read everyday. Before I opened the link, I was supposing the story came out of Africa, or maybe the Australian Outback. Then I read that it happened in England. ENGLAND. I don't know much about the NHS, but I can't fathom a baby going into kidney failure and the family being told, "So sorry, but she's going to die."

I do know that hemodialysis is hard on the hemodynamics of a 6 pound baby. We had a baby born with kidney failure in the PICU, so he was started on peritoneal dialysis, which is also no picnic on a 6 pounder-their BP can still drop after they drain and although the machine can be reprogramed, it still alarms 80 times a shift because the dwell volumes are so low.

Anyway, back to the BBC. So this doc makes a hemodialysis machine, I suppose out of stuff he had lying around the garage. Goodness knows what I could make from the crap in my basement. A heart-lung machine, probably. How they got the hospital to use it is another wonder-I can't even use a different brand thermometer without a committee vote and a bioengineering seal of approval. And now the baby is a toddler and looking amazingly cute. Dr. McGuyver strikes again.

(Hmmm, when I think about it, the baby probably couldn't have PD because she had already had bowel surgery, so I guess HD was the only option.)

BTW, for all you facebook folks, (you know who you are), I'm on it, but I only visit once in a while, so I'm sorry if I don't return your flowers and zombie hugs and whatnot, but I barely have enough time these days to check my emails and put out the occassional post. So, you can keep sending me quizzes "What are your favorite felonies?" "What smell are you?" but it's unlikely that I'll answer.

Good news everyone!

2008-08-04T20:46:00.003-04:00

Remember I mentioned a while back about the Astellas Rose Bowl contest? Well, my friend Steve is one of the winners. Check out his winning essay at Revive Hope. I'm so proud. I can't wait til the parade, so I can point at the TV and shriek, "I know him! I know him!" and generally have my family look at me like I'm nuts, which may be true.

The dust is still settling at work after our recent inspection. I'm just trying to sit at my desk and schmooze with the patients and do my little job and go home like a good girl, for now. In the words of a trusted advisor, "KEEP YOUR MOUTH SHUT!" Hard for me, but I try. I am definitely the Queen of TMI. "Oh, did you not want to know that about me? Sorry, K THNX."

Other than that the summr is winding on. We will have no more vacation days til we straighten out the mess-glad I had that week off. K THNX.

I'm in a little funk today, the past week has brought up some old friends I haven't seen in a while and I ponder getting in touch with them. Well, one, anyway-my BFF from when the teenager was a wee girl. Haven't spoken to her in like 15 years at least. Well, we'll see.

Possibly adding to my pensive state is this video. If you haven't heard of Randy Pausch from under your rock, I highly advice you to take and hour and sixteen minutes and watch it. To that end, I started thinking about my childhood dreams......

To be Quincy. You know, the medical examiner? No, I did not want to be a crusty, old guy like Jack Klugman, but I did want to cut open dead bodies and solve crimes with a trusty sidekick, like Sam. I'm still bitter that nurses don't take Gross Anatomy.
I wanted to be an actress. Did well up until high school. Had the lead in Guys & Dolls, Dracula (the female lead, I was Lucy, not Dracula), and Bye, Bye Birdie and I was in West Side Story, too. But I was not really confident enough in college to pursue it, so most of my singing is saved for the Pooter.
To play the violin. I love the violin. But I play the clarinet. Because that's what we had in my house, my brother's used clarinet. My mother kept telling me that when I got good at it, she'd let me take violin lessons. I made it to first chair and still didn't get violin lessons. But it's not too late. And I am trying to learn piano, so I can accompany my singing. See #2.
To write a book.
To run a marathon.
To travel and live in far flung, exotic places.

Some, like the book, I'm still working on. What are your childhood dreams? Have any come true?

2008-07-29T20:32:00.003-04:00

Well, it's a little easier to write a post thanks to my husband. My laptop went on the fritz about a month ago. Wouldn't start up at all, just gave me an error message on a blue screen. Apparently, my cute, little laptop didn't come with enough memory to run a diagnostic and fix whatever problem it had, so my husband put in a few more gigabytes of memory. And erased my computer. Which was necessary, but still. Fortunately, the great American novel is still in my head and so wasn't effected.

Work is going ok-I still like the job. I have people thanking me for being their coordinator, which is nice. I have people asking me if they can switch over to me from the other coordinator (we split the alphabet) which is nicer. I can't help it if I'm nice and return phone calls ~~mostly~~ on time. Doggonit, I'm nice and people like me.

I did have one downer moment today. I received a call from an OPO last night, their donor family wanted an update on the recipient who was transplanted a few years ago. I'm only allowed to give basic info, like-they're still alive and the kidney's ok. So I called the person up and asked if they wanted to give any more info to the family. Apparently, they're having a hard time on the medications, they're not feeling well, they've developed side effects and probably "wouldn't recommend anyone to get a kidney." So no, they don't want to get in touch with the donor family. But they're thankful.

I can't imagine that it's worse than dialysis, but then I haven't gone through either. My biggest surgery was getting my appendix out and I balk at taking more than one fish oil tablet a day. One the other hand, I spoke with a person who'd been a living donor today, and she was so excited because for the first time in a long time her whole family was together, including her recipient. No surgery works out exactly the same for everyone and I guess transplant is no different. I like to hear the stories that people are going about enjoying their lives. It doesn't work out that way for everyone. Some have complications and I think for some it just wasn't what they were expecting.

I read somewhere that people given a chronic disease diagnosis usually find it easy to stick with their regimen for one year, then the compliance issues begin. I don't know if that's true, but I'd love to hear from you folks. I know it's hard also for kids to stay the course when they become teenagers. First, because hormones throw everything into turmoil and then add to that rebellion mixed with a bit of "it won't happen to me". I'd love to work with teenagers who need/have transplants.

On a side note, to all you F&F out there-Poot is asleep at this moment and I get to spend some quality alone time!! So I'm off to surf the innernets before she realizes I'm no longer sleeping next to her.

So that's how it is...

2008-07-22T18:09:00.002-04:00

I can write whole, big, informative posts and get nary of comment. But post one cute baby picture and y'all tripping over each other to comment. That's fine. I can take it. God knows, she's much cuter than I am.

And Ali, I hate to tell you, that picture was taken almost a year ago! The curls are longer, the dimples are deeper and she's prone to answer any request to stop doing what she's doing by saying,

"But Mama, I just doo-in!"

If you want to know what melts my icy heart, it's a cherubic little voice calling me Mama. It's been about 12 years since I last heard that. The other night I looked over and her and the teenager were snuggled on the futon eating noodles together. That just about did it, too.

p.s. Ali, I'm glad your cousin got her lungs! I'll keep her in my prayers as well as the brave family that made the decision that saved her life.

What gets me through my day...

2008-07-21T21:16:00.003-04:00

This is the picture on my desktop. Now you know why I can't wait to get home. Squee!

Oh, God, it's hot!

2008-07-19T23:07:00.002-04:00

I'm sweating, for no reason what so ever. It's not like I'm doing anything active. Just typin'.

Some weeks ago our main air conditioner died. Our landlord sent some guy over to look at it and, I don't know, make sure it's dead, I guess. He came on a day we told him we wouldn't be home. That's the last we've heard of him. At least we've got the AC in the bedroom. I feel like jumping into a vat of Pellegrino. Even my mouse is sweaty. Blech.

The good news is that I'm on vacation this week, so I can be as sweaty as I want to be and just lie around the house and moan about how hot it is. But work has air conditioning, you say. Yeah, and it also has WORK. Since I didn't win the Megamillions Friday night, I guess I'm going back Monday.

This has been my first vacation since maternity leave and since that involved something called "labor", I don't really consider it a vacation. It's been a nice week. The lil Pooter and I went to the zoo last Tuesday. Despite the fact that most of the animals were sleeping, it was tons of fun. They had a little train that went through the woods and along a lake. Everytime the horn went off, she grabbed my arm tight and put her head into my shoulder, but she was grinning from ear to ear. The carousel was another big hit, as were the monkeys. Another day we went to the farm and fed some piglets. I think Pooter loved this even more than the zoo, especially since they were up close and touchable. They had a ball in the pen, so we'd throw it and they'd chase after it. Someday, I might be called upon to explain where bacon comes from, but for the time being it was a blast. The big hightlight was when the enourmous mama pig pee'd on one of the piglets who didn't get out of the way fast enough. Pooter laughed until she squeaked.

We also inflated our kiddie pool and put it under our screened in tent for a ghetto fabulous resorty effect. This way mama can sit in the shade with a cool drink while the Poot splashes about.

Thursday was the big excursion. All four family members: Papa Bear, Mama Bear, Cranky Teenager Bear and little Baby Bear, all went to the Shore. As in "Down the Shore". My husband is from the shore area and he calls it "the beach", as in, "We're going to the beach, you Bennies." He won't say Down the Shore. Benny, if you're interested, stands for Bergen, Essex, Newark and New York. Some places call them Shoobies. In other words, loud, obnoxious persons with questionable driving habits who take over your town from May to September. Known to wear bermuda shorts with black socks and sandals. Since I myself once lived blocks from the beach, I don't think I should fall into that category but hubby begs to differ. Just because I never lit things on fire and then used a shotgun to put it out. And then blamed the whole thing on a black dog. Or something.

Anyhoo, Pooter also like the beach. Especially the SAND. Crashing waves, not so much, but the sand was a big hit. So big, that she brought several quarts of the stuff back in and upon her person that continue to be deposited on our bed and belongings no matter how many times we wash her. Her and Daddy made a big sand castle while Teen and I played in the waves. To insure we went against the BENNY grain, we arrived late and stayed til dusk, long after the lifeguards had gone and got to see a few people surfing in the full moon high tide. Then we had dinner at Wegmans and drove home. Pooter managed to fight sleep all the way home but was asleep minutes after her head hit the pillow. Just enough time to let me know how much fun the beach was.

And all week long I got to sleep without an alarm clock and be with my family every second of the day. I've got to figure out a way to make money without actually working. Legally, and without changing my name to Bush. Otherwise, it's back to work I go.

The best call I ever made

2008-07-17T23:49:00.002-04:00

I've been putting off posting in every way I can think of. Of course, my laptop is on the fritz, so that helps. It's so much harder to get on the family computer, what with the Counter Strike and the poker playing. At least the poker pays dividends. Then, when I do finally get a turn on the computer, I find endless, diverting stories on reddit or else I go shopping.

Mostly, though, I just haven't felt like putting myself out there. Work has been very stressful the last few weeks for reasons I don't think would be prudent to put on the internets. Let's just say I feel like an ant that some mean kid's been holding a magnifying glass over. And it rhymes with "EMS". Oops. Said too much.

Anyway, I am almost at the end of my 90 day probationary period. I have 10 more days to go back to the PICU, scot-free, no questions asked, according to our policy. And don't think I haven't thought about it. I'm used to a steep learning curve-I worked in a level I trauma center, for Christ's sake. But I am rather weary of asking people what I have to do in a given situation, being given vague instruction, asked for clarity, been told not to worry about it, and then being called on the carpet-sometimes from the same person I asked advice from-for messing it up. When I was younger, I'd just say to myself, "suck it up, buttercup" but I am too old for this crap. Then I start kicking myself, because at almost 40, I should be an expert, not a beginner again. I wanted an interesting life, and I've certainly got one, so there's no sense pouting about what I do and don't have.

"But what about the good bits?" I hear you ask. Well, I genuinely like the patients. About 98% of them, anyway. Over the 4th I was on call and we were pretty busy. I called a couple people for back up offers-meaning, someone was ahead of them on the list, but if it fell through for any reason, they'd get the kidney. So I called to make sure they were all healthy and available and whatnot. I mean, healthy aside from the kidney failure. You know what I mean-like I called one woman on her cell phone and she answered from her hospital bed. Not exactly up for major surgery. Anyway, I call this one guy for a backup offer and he gets all up in my grill. "What do you mean someone's ahead of me? I thought I was at the top of the list? What's going on?" I try and explain about how the list is really a pool and when certain tissue types match, a list is generated, but, if there's a perfect match somewhere in the country, they get first priority. I didn't get into paybacks and all that, please, I barely understand all that myself. Let's just say, thanks to the wonders of dialysis and insulin, that kidney and pancreas sharing is more complicated than with other organs. Remind me sometime, I'll explain in more detail.

Anyway, I calm this guy down, "listen, it's gonna happen, you're up there. I know it's frustrating to get called and then nothing happens, but hang in there and it's gonna happen."

A little while later I get another backup offer and I call another guy and he's pleased as punch, "a kidney, are you sure?" That offer turns into a primary offer and I call him back to tell him to not eat or drink and come into the hospital in a few hours. He can't believe it. Imagine, 3 1/2 years earlier you do all this stuff to get on the waiting list and then-you wait. Who knows when the call is gonna come? 3 1/2 years is a long time to hold your breath. So there he is, going about his daily business, doing whatever with the missus and BANG! Drop everything, pack your toothpaste and jammies-you're going to the hospital for a new kidney! And I get to be the person who tells him it's Christmas, your birthday and the 4th of July all rolled into one. It definitely makes up for the 4 people who I had to call back over the weekend and say, "sorry, not this time, but soon, I know it."

(As for Mr. In-my-grill, he got his kidney a few days later. The message-don't give up before the miracle happens.)

The new job is busy

2008-06-20T22:09:00.003-04:00

And, lo and behold, I really like it. I forgot that I like working with grown-up-people-patients too. Some are exceptionally nice, some are downright loony tunes. Some are exceptionally nice and loony tunes. Most are just normal folks, which may be why it surprises me how much I like working with them. I guess what I'm trying to say is that the last time I had adult patients was in the ER and that's not always a place to catch people at their best, she says diplomatically.

The people never cease to amaze me. I've met people who would wake up and be at dialysis at 5am(the am stands for Areya Mad!) 3 times a week and then go and work a full time job. And I whinged and moaned because I had to do a bowel prep once (seriously, by 9am I was like "how many more hours of clear liquids?" AND you can't eat red jello! Why do they even MAKE other flavors?!) I'm also the one who, after all my talk of natural childbirth, crawled out of the elevator and said, "Get the anesthesiologist, I want my epidural NOW!!!"

All this means that if I'm ever your patient, please just point to something shiny and hit me over the head with a large rock while my back is turned-because I am just that much of a pain in the ass when I'm sick.

And sick I've been. The third week of work the plague struck everyone and the office sounded like a consumption ward. I called out 2 whole days because of fever and general malaise and because I didn't think it was cool to cough on all the people on immunosuppresion. Then I was out for a day when Pooter had her surgery. Then, the VERY NEXT DAY, I woke up with-yes, that's right-fever and all-over ickyness and called out again. The next week I got a stern talking-to. Me. Whose husband yells that I go into work when I can't talk from laryngitis and I'm coughing up a lung. Who gives him a hard time if I have to stay home with a sick baby(that's why they make tylenol). I'm a rotten mother, but I show up for work, dammit. Now I'm working with people who never call out and eat lunch at their desk. Sigh.

Another reason for the long delay since my last post, beside being plague-ridden, is that I'm a little leary blogging about the J-O-B and I'm not sure what I'm going to do about it. If I thought the OPO would give me hard time, this place would definitely put the keebosh on it, so I'm wondering what my next move's going to be. And I would lerv to talk about work. There are some real characters, staff and patients alike. I really like everyone. Well, I really want to like everyone, and isn't it the thought that counts? Today, someone brought me 3 Twizzlers and left them on my desk. Isn't that nice?

I'm splitting up the post patients with another coordinator-and we do about 100 transplants a year, and the program's been around for a while, so it's like-a gazillion patients. 1/2 a gazillion for him and half a gazillion for me. Once I lose the water wings, we're going to split the alphabet. Hubby informs me that he read somewhere(probably reddit) that if you split the alphabet by last names, the first half is unfairly burdened. I suppose that's true. If I really wanted to (and had the time), I could go into the chart room and start counting, but I s'pose I'll just take my chances. So far, it does seem like A-M has more crazies, and if you see yourself or your family members in that statement, don't come complaining to me-I didn't pick your last name. For example, I know a guy whose last name is pronounced "Co" as in Codependant or Co-defendant, but it's written like a part of a man's anatomy that rhymes with rock. And he gets pissed off when people mispronounce it. For the love of Pete, I know it's your proud family name and all, but just change the spelling already. From now on I'm going to say his name is Rick-the "P" is silent.

But I digress. Mondays and Thursdays we have clinic from 8-12 noon. Folks sign in at the clinic, go down a floor to the lab to get their blood work done, then return to clinic, where they go over their medications with the TC (moi) and see one of the docs. First come, first served-somedays we see a few, but most days are nonstop patients for 4 hours. One TC starts the clinic, the other rounds with docs until about 8:30. At noon, I run for a bite to eat and return to my little office where we write down all the labs onto one overview sheet for the docs to review, then transcribe each person's labs into their chart, because our brand new fancy computer system cannot print out lab trends. Then, around 1:30 the prograf levels come back and we start scribbling again until the doc comes in. Chart by chart, we review the labs and meds and write down in each chart what changes need to be made. THEN, we call everybody with their changes, book biopsies and call in prescriptions until it's time to go home.

The other thing that amazes me is the time committment this takes for the patient. For the first three months following transplant, they come in for clinic and/or labs 2x a week for several weeks, then once a week and then finally every other week. And that's the minimum. If anything's out of whack, or they look like they're going into rejection, it's more frequent. Each visit takes at least 2-3 hours and some of them come from pretty far away. Most of them don't ever complain-"it beats going to dialysis" I've heard more than once, and that's the truth, I'm sure. By the end of 3 months we're like old friends. I've seen some of these people more than my own parents in the last couple of months.

The other days are filled up with filing, patient phone calls, reviewing blood work and tests sent in from outside facilities, the weekly staff meeting. It's a far cry from the office days at the OPO, where I'd arrive at a leisurely 10am, take an hour lunch and be out by 3 or 4pm. But then again, I don't have to jump up in the middle of the night and drive to Pennsyltucky any more, either. I like the 9-5, I like having weekends off and regardless of what my husband thinks, I come home at a reasonable hour and spend some time with my family before going to bed, which is nice, too.

Lucky

2008-06-06T05:01:00.003-04:00

Well, it's about 4:30am and I can't get back to bed. Late last night, after we got the baby to bed, I started coming down with yet another head cold. I try and think back to any infectious people I might have touched in the last 24 hours, but I can't. And, of course, yesterday I toughed it out and went to work when I just felt like staying home in bed and came home to baby crankasaurus, whose mouth is sore and my husband has no sympathy ("but my temp is 99.8!") And I got banished to the futon because a. I'm snoring and b. I'm on call and have 2 phones under my pillow threatening to go off at any time. Then I felt all good and sorry for myself and had a big 'ol pity party, population 1.

Fortunately, call's been-well, I don't really want to say-I still have 4 hours to go. And while I want each and every patient to get a kidney, if you could just keep those offers to yourself for 4 more hours, I'd be real appreciative.

As for the pity party, all it takes is a visit to Revive Hope and think about my friend Steve turning blue and coughing up a lung, or go over to Falling Down is Also a Gift and pray for little Anni who looks like she'll need that next liver transplant sooner, not later, or even over to 'Ole PJ with his gimpy leg to realize that I've got nothing to complain about.

Last night, after we got our little post-op patient settled in bed, my husband hugged me and said, "We're so lucky. Like 'win the lottery' lucky." And that is very, very true.

2008-06-05T20:24:00.003-04:00

My friend Steve wrote a touching post about paramedics and remembers the team from the University of Michigan who lost their lives last year in the service of organ donation.

They were:

Dr. David Ashburn
Richard Chenault II
Rick Lapensee
Dr. Martin Spoor
Dennis Hoyes
& Bill Serra.

You can see their bios on the Umich site here…

If you think being a patient is bad...

2008-06-03T20:54:00.006-04:00

try being a patient's mom. Or dad. Pooter had surgery on her teeth today. 2 1/2 hour surgery. Let me tell you, it is no fun at all to kiss your little one goodbye and send them off into the depths of the OR.

I'm also ashamed to say that Poot has bottle mouth caries. Or booby mouth caries, as the case may be. The dentist says the breastfeeding is to blame, although it would be more realistic to say that my practice of breastfeeding her to sleep is to blame, not breastfeeding in general. That's a habit that I never should have started. They start off wailing little wee ones and you think, "It's all right if I nurse her to sleep tonight." and the next thing you know you're paying more for dental work than I've spent on some of the cars I've owned. God forbid she should need braces-I've used up her dental allotment for the next decade, at least.

I've also got a good whopping dose of mommy guilt. Everything I had learned up til now made me think that breastfeeders were practically immune to cavities. Now research I've found says that while breastmilk alone is protective of teeth, breastmilk combined with sugars can be worse than either alone. If you're interested, I'll be posting an article on that over at Laughing Baby. It doesn't matter. I still feel like the worst mother ever. I called the dentist's office this afternoon to see if sucking would damage the caps and they said, "stop breastfeeding your toddler this instant, you freak." or words to that effect.

The other thing which I was unprepared for, but have since found out is common, is how rapid the progression is. We just saw the dentist 6 weeks ago and in that time it got a lot worse. We knew we had to have the work done in same day surgery because it was so extensive, but what was supposed to be a one hour case took more than twice that time. I was just glad that it was done in the hospital I work at-it has a children's hospital, pediatric anesthesiologists and, worse comes to worse, a great PICU (natch). I certainly didn't want to give her sedation in his office-I would have had everyone opening their wallet and showing me their PALS cards before they began.

Last week we went in to tour the pediatric same day area with a child life specialist. Pooter thought it was great fun-she was climbing on the stretchers and playing with everything she could get her hands on. This morning we arrived and she was right at home, driving the Little Tykes cars around and generally have a grand time. We got weighed and our vital signs taken-she even let them take her temperature in her ear which she never lets US do. I knew the anesthesiologist, so that was a great relief. Then they gave her a little liquid versed and before you know it, she was getting a little wobbly driving the car around and slurring her words. Before you could say, "Pull over, ma'am" she was snuggling into me and I settled her down onto the stretcher.

Daddy went in with her. He was a wreck the night before, but I knew I'd be ok until the moment came to say goodbye, so he went into the OR until she went to sleep and I headed upstairs to PICU to get hugs and mommy support from my friend Colleen. Then we met up and went to get some breakfast. After she had been in their about an hour, my husband said, "Ok, this has been fun, but I want my daughter back now." I agreed-I don't think she's been out of both our sights for 3 hours since-I don't know, I think we went on a date in 2005. At about that time my pastor came in to visit and we sat and chatted for a bit and so that passed another 1/2 hour talking about nothing, for which I was very grateful.

We got her back around 11:30. Recovery wasn't too bad-she was a little disoriented and crying, but consolable for about 20 minutes, then she woke up and drank 4 apple juices and announced, "I want to go home". So we did. They took out the IV and gave us an ice pop for the road and we went home and snuggled on the futon and watched Nemo and ate some pudding. Around dinner time she was feeling more herself and so we went in town to get some take out Thai and while we waited we went into the toy store and got her a present for being a brave little monkey.

As she was falling asleep, I asked her how her day was:
"We went to the doctor with daddy."
"That's right, we were at the hospital."
"Yeah, the obspittle."
"Was it fun?" I ask skeptically.
"Yeah, it was fun! I want to go to the obspittle 'gain." I'm grateful that she's not traumatically scarred by the experience. "Ok, we'll go to the hospital again." And I kiss her little head goodnight.

2008-06-03T20:54:00.001-04:00

Yeah, I know I haven't posted in a bit. The little one is having surgery tomorrow-nothing major, but you know, anesthesia and all that. Please keep her in your thoughts. Thanks.

Contest for Recipients

2008-05-27T22:37:00.003-04:00

Astellas Pharma-who need no free advertisement from me, but I thought you might be interested-have a yearly contest to help promote themselves and their website Transplant Experiences. They're looking for essays from transplant recipients and the winner gets to ride on their float in the 2009 Tournament of Roses parade.

If you go to the above site, there's a link called "The Ride of a Lifetime" that will give you all the info and includes winning essays from previous years to inspire you. The essay must be submitted by June 13, 2008 11:59 pm EDT, so if you're interested, get crackin' and good luck.

Starting Over

2008-05-24T21:16:00.005-04:00

I'm a newcomer, again. On a new job, with new people, not sure of what I'm doing or even where I'm supposed to be half the time. While my sense of adventure is still intact, it is a little bit tedious to be a newcomer at my age. I keep thinking that I should really be more settled by now. I tell myself that the many job changes (7 in 11 years? Eeks!) has enriched me with invaluable experience. As for enriching my retirement account, not so much. (Right now my retirement plan is to be nice to my children, so they'll take care of me when I'm old. That, and staying in shape, because I'll probably have to work 'til I'm 80).

Also strange is the transition to a desk job. I mean, occassionally as a procurement TC I'd be a desk jockey, but most of the work was in the field. When we all would get together in the office, it was usually riotous and no one could get any work done anyway. My new coworkers are "office people" though. There's a total of 5 of us, plus my boss. Three would (and do) gladly work for 8 hours straight at that desk making phone calls and sending faxes with the occassional potty break. They eat at their desk. The guy who's training me told me that he doesn't eat lunch. Yeah, ok. I can understand that there are days on the unit, when you have an unstable, vented patient who might not live to see the next shift and so you skip lunch. But in an office? Seriously, the phone calls can wait half an hour. Besides, sitting in that little office all day, you start rebreathing your own CO2 and the next thing you know, you're a little loopy-which I think has already happened to one of them.

The first 2 weeks I mostly watched people work, which I can't stand. I'm a doer, not a watcher. This week I managed to cut my chops on some actual work which involves calling people and telling them what to do, where to go and what meds to take. Twice a week, in the mornings, we have clinic. The newly transplanted come twice a week for several weeks, then they come twice a week alternating lab and clinic visits. Then they come every other week, with just a lab visit on the off weeks-all for the first three months when the risk of rejection is highest. Then we see them every three months for the first year, as long as everything's going ok. Then every six months and then once a year. After the first three months, their primary care gets turned back over to their nephrologist.

The patient's clinic day goes like this: they take all their meds in the morning except for their anti-rejection meds. We do a trough level every visit. They come into clinic, sign in and then go to the lab on another floor for bloodwork. Then they come back to clinic, take the anti-rejection pill and wait to be seen. When they first come in, the TC(me) goes over their meds to make sure they're taking the right things. Note to God, please don't ever let me become chronically ill, because I can't even remember to take my daily vitamin. How anybody manages to stuff so many pills down their gullet is a wonder to me. Basically, everybody is on the following: Prograf, cellcept, prednisone, multi-vitamin, iron, potassium and magnesium supplements, blood pressure pills and, of course, something to protect the ol' stomach from taking so many pills, like nexium or prevacid. This doesn't include the drugs for whatever other problems they have-insulin, water pills, more blood pressure pills, pills for gout, whatever. I'm trying to get used to all these "old people" drugs (no offense, but kids are usually on meds for breathing and reflux, period).

Clinic ends at noon and then we write down all the lab results in columns by patient for the docs to review, write them again in everyone's individual chart and together with the surgeon go over the labs for everyone who's been in the clinic and a few who have their labs faxed to us from outside labs. Then we write down the changes they want to make and THEN we spend the afternoon (and the following day) calling folks and telling them to increase their prograf or decrease their magnesium, etc. Anyone who looks like they're going into rejection gets scheduled for a biopsy and possibly comes to the hospital for 3 days for high dose steroids. It's not rocket science, but it's a lot to stay on top of. One good thing is that the docs are all super and my boss is pretty laid back as long as the work gets done.

You want me to take WHAT with a sip of water?

In other news, our recent bout with the plague of the week is dissapating. Everyone in the house is on antibiotics, except for the teenager, who's never home long enough to catch our germs. Possibly, if she did come in contact with one of our germs, she'd kill it with a withering glance.

Also, my friend and former coworker is working on a Mercy ship in Africa for a year and has a blog. Besides, being a better writer than me, she's also an amazing photographer and altogether more awesome human being than I could ever hope to be, plus she's muy modest, so she'll probably be pissed that I'm even mentioning it, but you should read her blog. It'll blow you away.

That's it for now. I'm off to enjoy me weekend, now that I have weekends to enjoy.

2008-05-14T23:23:00.002-04:00

Well, I started checking some of my links and found that Moreena's wasn't working, because I never updated it. Whenever I haven't been to her blog in a while and then I go there, she usually has something up that makes me cry. Then I wonder how come she hasn't written a freakin' book yet, because her writing talent makes me gnash my teeth in jealousy.

Then I watched the video and cried some more. A whole lot more. It's worth reading, but don't say I didn't warn you.

So long and thanks for all the fish

2008-05-14T22:06:00.001-04:00

Three weeks ago this Friday was my last day in PICU. Possibly my last day as a bedside nurse, ever. Mmmm, well, maybe. There's something to be said for taking care of the immediate needs of another human being. A long time ago, my friend John dated these two women (not at the same time). They could have been twins: they were both tall, blonde and bitchy. Well, there's something to be said for his taste in women but he was a fun guy to hang out with. Anyway, fast forward to 1997 and I run into girlfriend #1. She asks what I'm doing and I tell her I've become a nurse. She sneers and makes a remark about how co-dependant that is. (Remember co-dependancy? Or as I like to call, As Crazy as You Want Me to Be). I was brandy-new to nursing, at the time, so I just mumbled something about her not understanding and made my get-away, before I caught whatever it was she had. Another year goes by and I run into girlfriend #2. She also asks what I'm doing and again I say I'm a nurse. She ALSO says that that's soooo co-dependant. Now, I could have said that nursing is about caring, not co-dependancy. That it's about advocating for the sick, helping people when they're vulnerable, and healing folks who are wounded in their hearts, minds and bodies. It's about education and research and community outreach and technology and putting it all together in a multi-disciplinary, holistic package. But I didn't say any of those things.

Instead, I smiled and said, "How interesting, that's just what C-- said to me."

She just turned on her heel and walked away.

Without a doubt, some people think nurses are co-dependant. I know one or two doctors who think we're overpaid babysitters. (Oh, is the nurse talking? How cute).

For the past few weeks I've been doing another kind of nursing. So far I've mostly been making phone calls, or watching people make phone calls. I've done med reviews and taken histories and started to learn about the process of getting people on the waiting list for a kidney and then what to do with them after they get one. I will eventually wind up on the post-transplant side with another coordinator. People are constantly saying, "Oh, you're going to be working with him? Good luck." Love Monkey thinks this is a bad sign but I'm taking it as a challenge. I'll let you know how that all works out. For now, I'm not sure how much I'm going to be talking about my actual coworkers or patients because I've come to find out how non-anonymous the internet is and I've already been bitten in the butt making that mistake. I will say that the worst part of my week was telling someone that they're not a candidate for a transplant due to other health problems. Not fun. Think of taking away someone's puppy on Christmas and then telling them Santa's not real. It was worse.

And do I have to say that I'm sick again? Toddler germs. Just when I thought I'd caught every germ in the Mid-Atlantic states, I find a new one. Oh, well.

End of the Week Update:

2008-04-18T12:54:00.004-04:00

My last 2 days at worked sucked. Wed I was in a terrible mood and I had to take care of 2 depressing cases. One kid will never leave the hospital and the other is neurologically devastated and will be on a vent forever. I kept thinking that his case sounded familiar but I didn't work in the PICU when he was initially injured. At 3pm, the evening secretary came in and enlightened me-I had assessed him for organ donation a year and a half ago when he came in. Unfortunately or fortunately, depending on your point of view, he still has a little bit of brain stem left-just enough to give him clonus every so often.

Yesterday was worse and I had to stay late to catch up. My day was going swimmingly until I had to take a 2 hour road trip to specials AND got an admission, a fresh post-op, at the same time. And I pissed off the fellow, who's already pretty pissy if you ask me. Ah, well. I did get my starting date, finally, for the new job, April 28th. Then I guess I can start bitching to the anonymous innernets about that job.

Anyhoo, now that I've vented-thanks innernets!- We've got two carnivals this week:

Grand Rounds was Tuesday at Women's Health News. Next week it's at Dr. Val.

Also, this week, Change of Shift was up at Nurse Sean's.

Enjoy the reading...I'll be back at work all weekend.

Legacy

2008-04-10T22:10:00.004-04:00

I want to tell you a story. You may think you know the people involved, especially if you’ve been in health care for any period of time. Lately, I’ve been thinking about a lot of stories from my years as a nurse, mostly because I’ve been working with an awesome and funny agency nurse who keeps egging me on. Narcissist that I am, I happily oblige her. This, however, is one person’s story in particular.

It’s the story of an average girl, from an average family. By all accounts she was funny, even irreverent, smart, sassy and full of energy. She was opinionated. She had a lot of friends. If you were to look into her future, you might see college and a career, a family, some kids. Maybe she had something really big coming down the pike-like she’d write a famous novel or develop a cure for a major illness. At 17 years old, on the verge of womanhood, I’m sure she thought about her future a lot.

I’m not sure any of us understand why sometimes children die. I like to think that the children who come into our lives only to be taken away too soon come with a purpose. They teach us to love, they teach us to make every day count and most of all they teach us that to be human is an impermanent state, as fleeting as butterflies. Or perhaps that’s just my rational mind searching for meaning to a meaningless tragedy. In any event, on this day eight years ago, this 17 year old girl died.

I will never meet Kari. At best, I can get an idea of who she was and who she might have become through the people who knew her. Yet, this 17 year old, who died eight years ago today, has touched my life. She’s touched a lot of lives, people that she never knew in places she could never imagine. Think about it-if you died today, do you think that your life would have meaning to anyone beyond your circle of family and friends? So many of the things we do, as human beings, are done to insure that something- some part of us, will live on after we die: great works of art are created, books are written, children are born. You can take the poorest among us or the most powerful and all want to be remembered, to leave behind a legacy.

If Kari had lived her life exactly as she did, she would have left behind a legacy of love and happiness and that would have been enough. But Kari did one thing more. She had already told her parents that if she died, she wanted to be an organ donor. Sure, her parents probably thought, never thinking that they’d actually have to honor that request. But they did. When Kari died, someone had to approach that family and ask them, in the midst of their grief, to donate her organs and they, in the midst of their grief, said yes.

You would think that that would be an easy and straightforward decision. But her parents didn’t have to say yes. There’s also a possibility that her parents wouldn’t have been asked. The road to requesting organ donation is more complicated than most may realize. The hospital may not have called in the referral to the organ procurement organization. They may have said to the family-there’s nothing more to be done, let’s just pull the plug and let her go. The nurses may have thought-what’s the use, this patient is dead or going to die, and not been vigilant in maintaining her organ function. Instead, in those hours as Kari became brain dead, calls were made, support was provided, information was given and a whole host of people, some of whom will never realize it, made the organ donation happen. From many, to one, back to many, Kari’s donation became like a stone thrown in a lake, the ripples carrying the legacy of her life farther and farther from its original impact.

I know about Kari because her lungs now live in my friend Steve. I know I talk a lot about the fact that people shouldn’t have to be proven “worthy” in order to receive a transplant, but if there’s a person out there who’s more worthy of those lungs, I’ve yet to find him. In eight years Steve has become the head cheerleader of the “Keep Kari’s Memory Alive” team. I always knew he was filled with gratitude. Although he’s very vocal about how much his transplant has transformed his life, it was his unspoken actions that showed me the depth of his devotion: on his key ring is a little sandal with one word on it-Kari.

I don’t know how many people Steve has touched in his life, but if you walk the streets of Chicago with him, you’d think he was the mayor. Someone once told me that gratitude is an action word and watching him in action is a lesson in how to live life. When I get to feeling sorry for myself, I write to Steve and soon I’m wondering what the hell I’m moping around about. And Steve is one person. Kari donated several of her organs-each one touching a life, each life touching the people around them, and those around them until, until what? I don’t know, but if you want to know what love to the infinity squared looks like, think of Kari. That’s a legacy any of us would be proud to leave behind.

*photo by Howard Thompson

Starting the new job....someday soon?

2008-04-09T11:24:00.002-04:00

Well, I'm not sure when I'm starting the new job. It might be as soon as next Monday, but certainly no later than the end of the month. By hospital policy, I have to give my old job 4 weeks notice from the day I put in for a transfer. My old boss can ask for a couple more weeks saying it's a hardship and they need more time to replace me. Now the new boss and the old boss are "debating" it out with administration to see who needs me more. In my younger days it would have been thrilling to have two guys fight over me (hah, never happened), but this may be more satisfying.

Last Friday I did attent an education day for the transplant department and I got all excited about starting the new job. So excited that I went shopping. Because in this job, I get to wear CLOTHES! (As opposed to scrubs, you know what I mean). With summer coming up, new shoes may be in my future, also. No, seriously, Love Monkey, I got rid of TONS of shoes last year and I have hardly any in my closet. I desperately need some summer sandals.

In tranplant news, this blog is allegedly about transplantation, my friend PJ has a coupla posts on recent organ donation cases. I'll leave it to him to fill you in this week on actual blog content, while I go back to thinking about shoes.

Oh, yeah, I had another blog I wanted to link to: my friend Ramona at Suture for a Living had a post on the first full face transplant in France recently. Last year at the AOPO conference I went to a lecture on face transplant. Full of graphic color photos, I'm just glad it wasn't a "lunch and learn." I used to think that I would draw the line on donating my face, but when you see what type of deformities these people have, well, I'd want to be able to give them a somewhat normal life if I could. Face transplants would be for people who have severe burns or deformites or trauma to the face, things like missing lips and noses. I think I remember hearing about one woman who hadn't seen her own grandchildren in years because they were so afraid of her. Interesting topic, they're looking for the right opportunity to do it here, but as you can imagine, people aren't exactly lining up to donate their face. It's hard enough to get people to donate the non-visible parts of them.

Anyways, I'll let you know when I start the new job.

2008-03-27T21:15:00.003-04:00

There are no coincidences. Today I had a busy day at work. One little guy was very emotionally needy and the other little guy was very physically needy. I called my husband at 6pm and said, don't bother picking me up at 7:30, I'll call you when I'm done.

I finally finished charting around 8p, called him to pick me up and went down to the lobby to wait. I started reading a paper that someone had left. Halfway through, I got up and went to wait outside. He called back and said he was just leaving the house. I sighed and went back inside and picked up another section of the paper. I read the comics, my horoscope("stay in bed today") and a couple other things before I got to the obituaries. I always read the obituaries, because, well, you never know. And I saw that a little precious baby I had taken care of a few times had died yesterday.

I knew from the first time I took care of her that she was going to die. At six months old, she was diagnosed with a disease that would rapidly waste away her muscles until eventually she would stop breathing. I think it was on that admission that her parents decided that when the time came, they wouldn't intubate her but would just put her on comfort care and let her go.

Now, I would think of her time and again, knowing that eventually by the end of her first year on earth she'd be gone. But I like read the newspaper, I don't know, maybe once a month. Today I just happened to be late, then my husband happened to be later and somebody happened to leave a paper lying around for me to pick up. I'm sure I would have heard the news eventually, but I'm glad that I got to read about it right away and while I'm sad for her and her parents, I'm glad that her suffering is over. No more chest PT, little girl, no more coughalator.

What a baby, she was, too. A tiny little thing with a smile that could light up the room. I don't know why children are born into this world just to die, but it's a blessing to take care of them, every one.

Oh, the Peep-manity!

2008-03-24T22:27:00.002-04:00

Remember when I said the Pooter didn't eat any Peeps. Well, she proved me wrong:

The Great Peep Massacre of '08

She bit the heads off of every Peep she could get her little hands on. Like the Easter Bunny meets Ozzy Osbourne. It was terrible. Then we let her loose on daycare. After I brushed her teeth 3 times.

She's still smart as hell, though.

Evidence of The Pooter's exceptional intelligence

2008-03-24T10:04:00.005-04:00

Pooter and I woke up this morning to find her big sister still in bed. Apparently there was a delayed opening today. Spring holiday isn't until Passover week, which makes Teenager happy, as the weather will be warmer. Anyway, first thing Pooter did was steal some Peeps from Teen's room and run gleefully down the hall.

I expecter to find her stuffing her mouth full of Peeps and thought, "What the hell, Easter only comes once a year." We like to practice a laid-back style of parenting here at Chez TC. Instead, she had them arranged on the rug like action figures and was playing with them. I knew she was a super genius. Even the l'il Pooter knows that Peeps aren't a REAL food.

So I worked on Easter, which was not too bad. Pooter doesn't know her days of the week yet, so we can do Easter baskets and dye eggs any day of the week, it's all the same to her. And it gives me a reason to avoid my extended family. Plus, working on a holiday guarantees that someone will bring in food, especially if you work with Filipinos. Unfortunately, I didn't get any ponsit or turon (spelling?) but somebody did make some kicking stuffed shells and there were enough cookies to stretch around the unit 3 times.

We had one little kid who was really too well to be in the PICU, so once he was up and bouncing around we made him an Easter basket out of an old gauze box and colored tape and filled it up with the candy we had at the nurses' station. He was a super sweet kid, very smart but a little too respectful, as in every time a family member raised their voice, he flinched. Not surprisingly he had an open DYFS file. That's when I start wishing I'd win the lottery so I could take home every stray kid I can get my hands on and love them to pieces. And another reason to miss the PICU. The law of Hospital Karma says that in the next few weeks I'm bound to have plenty of experiences that will tug at my heart strings and make me regret my decision to leave. That's the same law that guarantees that the last shift before you leave a place will be hellish. Sorry, coworkers, you've been warned.

Sorry the blogging has been so splotchy. I'm hoping that will change with the new job and I'll have more time. I'm only writing today because I have a deadline for my monthly newsletter article that I'm in deep denial about. One more threatening email from the editor and I'll get right on it. But first I gotta eat some more Peeps.

** And if you didn't get enough Peeps yesterday, here's a little Peeps poem from The Original What's for Lunch blog.

The Kids are All Right

2008-03-22T21:56:00.003-04:00

Well, all right, enough suspense. The news is:I'm back in the transplant game. I was waiting to break the news to my boss and officially decide before I said anything to anyone. I'm taking a job as a kidney/pancreas transplant coordinator starting next month.

It was a toss up. The new job is Monday thru Friday, flexible hours as long as I show up for clinic and meetings. Call is from home-I only have to take calls, I don't have to go anywhere in the middle of the night. No weekends or holidays.

The flip side is that I'm giving up bedside nursing, which I do like and I'm giving up taking care of the little ones, which I love. I'm also giving up doctors who role their eyes at the nurses suggestions, giving up working every other weekend and giving up getting a talking to when I'm 5 minutes late. No more 12 hours shifts. I can come home and do something more than gobble down dinner and go to bed with the baby. Pay's the same, benefits are comparable, one more week of vacation. The group of TC's in the office all seem pretty cool and they seem to get along with one another and the boss. I'll be doing post transplant, following up with the patients after they're transplanted, going over their meds and educating them on everything they need to know about their transplant. I'll be in clinic twice a week. It's new-very different from the organ recovery biz. I think I'm going to like it. Wish me luck.

But first, a word from our sponsors!

2008-03-19T16:24:00.006-04:00

This is NOT the big news. It's more like some housekeeping tasks.

Let's start off with a commercial:

Up til now I've been a bit like Madonna. Like a virgin. Not actually a virgin, you understand, just like one. But NO MORE! I've tossed aside my amateur standing and have officially become a Professional Blogger. According to the fine print in my Adsense contract, I'm not even supposed to hint that they exist on this site, so I won't. However, just below all that you may have noticed an ad for scrubshopper.com. In the interest of full disclosure, I haven't shopped there yet, but I'm going to. Good news for you, Lucky Reader, is that Scrub Shopper is giving donorcycle readers a 10% discount! To get the 10% discount enter promotional code SSBLOG10. Thanks, Scrub Shopper!

Let's see, what else. Like so many people I know, I'm going back to school. Over at the Nursing Online Education Database is a new article, 101 Little Known Nursing Scholarships for Nurses.

What else? I haven't kept up with Grand Rounds or Change of Shift in ages, sorry. That could all change soon cause there is BIG. NEWS. COMING. Ohhh. I can't wait. What could it be. I'm not pregnant, I didn't win the lottery and I didn't run into Brad Pitt. Nor am I having Brad Pitt's baby after winning the lottery, but I can dream, can't I?

Watch This Space...

2008-03-18T19:57:00.001-04:00

Big news coming, I'm just firming up the details. So keep watching and I'll let you know in a day or two. :)

1632

2008-02-24T15:21:00.008-05:00

That's how many steps it is to the top of the Hancock Building. At least according to my stairmates. 94 stories. As promised, there were firemen, but I managed to make it to the top under my own steam.

The firemen, some of them, anyway, wore full gear for the climb. And if that's not challenging enough, I'm told that they will take turns carrying each other up the stairs. Show offs.

No, really, I love fire fighters. That's what it takes to make them strong enough to carry my ass out of a burning building. There were a gazillion people there and it seems like most of them climbed for Team Kari. 85 folks were on the team. Everyone knew Steve. If you came in late and want to know why we're doing this, check out Revive Hope which has a link to Kari's story on the Mid-Iowa news website.

I also got to meet a lot of great folks. Laura, for one, Steve's lovely wife, and their neighbors, Joan and MJ. Steve's sisters Karen and Nancy and his mom, Debbie. My peeps, Jenn from Loyola and Eve from Iowa Donor Network. And, let's see, Dave and his wife and kids AND, last but not least, the girls from Iowa, Kari's friends and teammates from her volleyball team who are still laughing and telling tales about Kari like she still lives down the street. It's a sure bet that when Kari told her family she wanted to be an organ donor, she had no idea of how many people would come to know her name and her story. Like ripples in a stream, her story has spread to so many people and has helped, not just the people who received her organs, but untold numbers who continue to be inspired by it. That is a legacy to be proud of.

And now some pictures:

You're going where? For how long?

WTF, Momma, WTF?

Some of the girls from Iowa

Steve, workin' the media

We did it!

I'm leaving, on a jet plane

2008-02-24T15:20:00.000-05:00

Well, I got a late start but I’m in the air. I was on the plane to the train and had just gotten on the second train when Love Monkey called and said come home. I thought the worst at first, of course. I thought something had happened to one of the kids or my parents, but no. It turns out that there was some weather or something at the airport. So I got off train #2, got back onto train #1 and went home. It was the quickest trip to the city ever.

On the flip side, I got to see Pooter (she was sleeping when I left) and we had lunch and took a nap together, so that was nice. Got up around 5ish, checked the airport website and decided it was safe to venture out again. It turns out I had to take the train to the train to the airtrain to a security checkpoint to a shuttle bus to the plane. Sheesh. Then I had a snack.

As for airport security, everytime I go through, I wonder why people put up with this. I saw some guy, who looked like my dad, get frisked-and I mean frisky, lets-see-what-you’re-hiding-under-your-testicles frisked, right in front of me. Because he forgot to remove his belt. Fortunately for me, I left my TSA-Totally Sucks Ass shirt at home or else they’d be tasering me still.

Anyway, now that I got the conservatives all riled up and sending me emails, I totally missed pizza and beer due to the delay. Ah, well. The delay also gave my flying phobia several more hours to marinate. Seriously, I’m totally scared to fly. I’ve tried Xanax, alcohol, meditation, prayer and hypnosis. The hypnosis worked. Now, I’m only mildly terrified. Actually, it’s really only the takeoff that gets me. It’s so, unnatural, getting all that weight off the ground. Once we’re at cruising altitude I’m ok and I figure I’ll take my chances on the landing. I take my seat, say a prayer, do a little guided imagery and tell myself that it’s ok, I’ve live a good life. I’ve learned a little, loved a lot and laughed often. Then, prepared to go into the great beyond, I buckle in. The great thing about Jetblue is that the TV stays on during takeoff. I got to watch Chris Rock make fun of white people. I figured if I died, at least I’d die laughing.

Arrived at O’Hare a little before 11pm. Steve not only picked my up but let me sleep on his couch. Muchas Gracias to him and Laura for their hospitality and the comfiest couch ever.

I'm off!

2008-02-22T12:16:00.004-05:00

Tomorrow at this time I'll be awaiting my flight to Chicago. Hopefully, I'll make it to the top, but I hear there's going to be firefighters, so maybe if my legs give out, one will carry me the rest of the way. I can dream, can't I?

I can't thank all those who donated enough. I didn't think anyone would give money, truthfully, certainly not my "imaginary" internet friends. Certainly not my wonderful niece and nephew-in-law all the way in Korea. Thank you, thank you, thank you. Check back next week for pics of the grand event.

Today I gotta get it all together in order to be at JFK on time. I think the train to JFK is actually longer than the flight itself. I could have left from Newark, but it would have meant a layover in, I think, Kuala Lumpur. I can't spend that much time in an airport, I get hives. Also, I have to make sure my travel bag is devoid of such stuff as nail clippers and unmarked containers, lest I get tasered by the TSA. (Sorry, I really love the TSA. Please don't put me on the no-fly list.)

Anyhoo, after all that train to the plane to the train to my destination, there's a promise of deep dish pizza and beer. I can't wait.

Oh, yeah...Change of Shift is up!!! Now with video!!

a whole week off

2008-02-19T23:04:00.005-05:00

I don't even know what to do with myself. Hmmmm.

Well, not exactly, but I will be doing this:

and this:

And BTW, I can't thank all of you enough for donating to my Hustle up the Hancock. You know who you are and this week I'll even have time to thank you all individually.

Tonight was my last day at work for 7 days, oh glory be! I'm not sure when I last had 7 whole days off in a row. Also, I broke my streak in which my last day before a break means some disaster happens. Like a bunch of hemophiliacs in a glass bus crashes into a nun convention. Or something. Anyway, quiet day at work. Took care of one awefully cute lil baby and even got to rock her and feed her and possibly sing to her, real low so no one would hear. Possibly the 2nd cutest baby on the planet, but much smaller than the Pooter. Like, 75% smaller. Cute little nugget.

Anyway, I'll be spending the next few days cleaning and spending quality time with the family before I jets off to sunny Chicago. (It's sunny this time of year? Right, Steve?) And I promise to have lots of pictures to post and maybe some actual writing content when I get back. Wish me and my quadricepts luck. We're going to need it.

Thursday Reading

2008-02-07T11:11:00.001-05:00

Change of Shift is up at Nursing Voices, a forum for nurses from around the world.

Tuesday, if you missed it, Grand Rounds was done by Amy at Diabetes Mine. As I know from experience, hosting Grand Rounds is no picnic. Great job, Amy.

If you want to read something shorter, I was inspired to write this by David Bale at Very Short Novels. Hope you like it.

Our Boy

Your room was starting to have a well-lived in look; Pictures on the wall, stuffed animals, snacks, balloons. There was a huge, shaggy blanket that your mom brought in for you but usually she wrapped it around herself, just for the comfort in it. Then, the week before Super Bowl Sunday, your favorite nurse had brought in Giant’s pennants to put up around your room, because she knew it was your favorite team. Whether you even knew if what Super Bowl, or January for that matter, was besides the point. That was the same Sunday they brought the priest in to have you confirmed.

I didn’t really know you at all, sometimes when I saw your dad in the elevator, I’d ask him, “How’s our boy doing?” and he’d give me an encouraging nod. Meanwhile, your body just became smaller and thinner, until you were just a bump under the blankets. Your parents had been hopefully waiting for you to recover. Then they made you a DNR and a different kind of waiting was started.

I came back after three days off and the significance of the empty room didn’t hit me immediately, but in the lounge I saw a bag full of blue and red Giant’s gear with a piece of tape, “for Nurse Dawn.” That’s when I knew. The room had been swept bare and there wasn’t a sign left of the Giant’s or anything else that was yours. Even your specialty air mattress bed was gone.

A few hours later, the room had a new occupant, an annoyed looking teenager getting a respiratory treatment. She had no idea that you had ever been there.

Let the fun-draising begin!!

2008-02-05T21:51:00.000-05:00

I already made $25 bucks-donated by my awesome niece and soon to be nephew-in-law, Annie and Doug, all the way from South Korea! Thanks guys! That's like 2 whole galbi dinners and a bottle of soju.

Also, my friend Tennessee Don from Underdog put up a post about my efforts, so the pressure's on. I must climb that tower or let down every democrat in the 9th district! Thanks, Don!

I'll be Climbin' for Kari!

2008-02-04T21:44:00.001-05:00

Somehow, someway, some time ago, I decided that I was going to Chicago this February to

Meet my friend Steve

Climb the Hancock Tower

Did I mention I'm going there in February. Because I've been to Chicago when it's been sunny and warm, but February? Who goes there deep inna heart of Winter. Me, of course.

Also, so as not to confuse y'all, like I confused my mom, I'll be climbing the stairs(as opposed to climbing the outside with ropes and carrabiners and such, which is waaay beyond my super powers). All 96ish stories of stairs. How bad can that be. After all, Katie Holmes ran the damn NY Marathon and was later seen sporting heels. I'm a hell of a lot tougher than Katie Holmes, I'll tell you right now. I could totally take her in a fight.

Anyhoo, I'll be in the, umm, what do they call Chicago, anyway? The Big Breezy? The Big Cheesey? Well, I'll be there February 23-25, for climbin' and all kinds of socialness, that I have to go half-way across the country to get, because my friends in NJ(The Big Stinky) can't even CALL ME! (and you know who you are, too).

But enough about me. Why am I doing it? Because of Steve, of course, the one man hurricane who started Kari's Climbers in honor of his lung donor Kari. Steve has a beautiful page all about how he came to know and meet Kari's family and friends, many of whom climb with him every year. Read all about it here and bring the tissues. Steve also writes for Revive Hope, an awesome blog with inspirational stories about how organ donation touches people's lives. If you haven't already, check it out, if only for the adorable picture of wittle Stevie.

Did I mention that this is a fundraiser? Give, give, give people. Give til it hurts. See how many seconds you can hold your breath and than give that many dollars! Than thank the deity of your choice that you have healthy, pink, shiny lungs that breath on their own without any help from oxygen and machines and such. For your added convenience, GIVE HERE. Look at my lonely, little thermometer: it's at zero. Please help it out, won't you?

Meanwhile, in anticipation of the climb, I'll be putting a StairMaster in a walk-in freezer for training purposes.

If you're in the Chi-town area and want to see TC in the huffing, wheezing flesh, email me. If you're strong enough, maybe you can carry me to the airport Monday when my legs no longer work.

Chimera? What's a Chimera?

2008-01-30T12:24:00.000-05:00

The Chimera is a mythical creature, as described by Homer in the Iliad, as "a thing of immortal make, not human, lion-fronted and snake behind, a goat in the middle, and snorting out the breath of the terrible flame of bright fire".

Chimerism in scientific terms is when an animal has two or more different populations of genetically distinct cells that originated in different zygotes; if the different cells emerged from the same zygote, it is called a mosaicism. (From Wikipedia, see here for the whole article). A male tortoiseshell cat is a chimera.

Microchimerism is the presence of a small number of cells, genetically distinct from those of the host individual(also from Wiki). In some cases, fetal cells can find there way into the mother's circulation and remain there for as long as decades. This has also been found in some severely immunocompromised trauma patients who have received blood transfusions.

Even more startling is the case of a woman who was found to have two sets of genetically distinct cells. It was discovered when she and her family went for tissue typing because she needed a kidney transplant. From the New Scientist, November, 2003, this is a really interesting story on it, and explains it very well. As researchers have looked into it, genetic material can be transferred from mother to children and vice versa, or between twins in the womb. There is even speculation that a mother can receive cells from her fetus, carry them in her circulation for years and pass them on to future children that she carries, all without anyone having a reaction to what should be seen as a foreign invader by the body. Could they be blast cells? Like a stem cell transfusion? Even more perplexing is why this should happen.

I'd be lying if I said I really understood this. Chimerism first came to my attention this past fall when I was doing research on transplantation. I had never heard of it while working as a TC, but immediately it was clear to me why transplant researchers would be so intrigued by this. One of the biggest, (the biggest?) problem with transplant is rejection. The recipient's immune system sees the new tissue as an invader and tries to destroy it. Not only is it a problem with the life of the organ and the life expectancy of the patient, but also the the cost of the antirejection drugs, which can be $50,000 a year, are a big factor in people's financial ability to pay for a transplant. Imagine not having to take antirejection drugs. Imagine being able to extend the viability of a tranplanted organ. Some centers, like Northwestern Memorial in Chicago, among others, have been transplanting stem cells from living kidney donors into the recipients. The logistics of both stem cell and organ transplantation make this currently unfeasible for cadaveric organ donation.

Just when things can't get any weirder, comes this story from Down Undah. 15 year old Demi-Lee Brennan received a liver transplant. Nine months later, her doctors discovered that her blood type had changed to that of her donor's. More importantly, they found that stem cells from the donor liver had penetrated her bone marrow, changing her immune system and allowing her to come off anti rejection drugs. While transplant surgeons have known about stem cells "floating about" in the recipient's body, this is the first time anyone has, in effect, received a stem cell transplant and changed their immune system. If they can find a way to replicate this, it could change the field of organ donation.

Imagine taking on your donor's DNA. Makes that new Jessica Alba movie seem downright tame.

Winter of My Discontent**

2008-01-21T16:44:00.000-05:00

Can you believe we're halfway through January? December, according to my horoscope, was supposed to be a banner month for me:Jupiter was in Sagitarrius or Venus was trining with Mercury or some such. Mostly, though, it felt like my head was in Myanus. Work continues on. RSV season started early and the hallways are cluttered with yellow isolation carts. Let me tell you, there's nothing like spending 12 hours in a blue hefty bag to make a girl smell, well, less than fresh.

It seems everytime I turn around, there's a new job opening for a transplant coordinator. Not on the procurement side, even I'm not that masochistic, but on the recipient side. The hours are usually good, 9-5 Monday to Friday. Call consists of making phone calls from home. Not too shabby, but I like the PICU. I like the work, I like my bosses and coworkers and I like 99% of the doctors. If one of these jobs had been available when I left the OPO, I would have gone for it. So, do I stay with the what's close and comfortable or do I search for greener pastures?

As for that 1%. There is one doctor who I have a problem with. Initially, I liked her. She's very bubbly and friendly and confident. Then, during rounds, I started hearing her tell the residents things that were just wrong. Like dopamine doesn't make your heart rate go up. That Levo only effects beta, not alpha receptors(or was it alpha and not beta? Either way-it effects both). That a person can't have an O2 saturation of 90% and a PO2 in the 50's. Recently, my patient was an organ donor. She mentioned to the resident that the family can bring up a religious objection to brain death at any time (my state says that people can reject a diagnosis of brain death based on a religious objection, in which case the person would stay on the vent until they cardiac arrest). I respectfully told her that the law says that the objection must be brought up by the family at the beginning of the process. She countered and gave an example of some family somewhere who sued the hospital. I said that anyone can sue at anytime, but it doesn't mean they're going to win. She did not like that I challenged her wisdom, in front of a resident no less. Ever since she's been quick to find fault with me, usually during rounds when she has an audience. Then I spoke with another attending, I found out that many people have been having a problem with her, attendings, residents and nurses alike. I'm trying to just stay on my toes, cover by butt and otherwise keep my big mouth shut-not easy for me.

So I've christened her Doctor Betty. Just like Renee Zellweger, whose Nurse Betty gets bonked on the head and thinks she's a nurse, so I believe that this woman was bonked on the head while watching Grey's Anatomy and now she thinks she's an intensivist. Don't mess with me, sweetheart, I've got a blog and I'm not afraid to use it.

So, a couple other things happened with Dr. Betty during the organ donor. First, we were waiting for rounds, the TC and I, because we had some management concerns. The team passes by to the next room. I ask them if they're going to round on our donor and she says, in the hallway, VERY LOUDLY, "we don't round on dead people." Now, next door is another young girl with a brain injury and her mother is very, very aware of the organ donation going on next door. She's standing in the hallway when the Dr. Betty says this.

Secondly, she says, again to the resident, that the bronchoscopy we need can't be done until the patient is pronounced because it's unethical. In truth it's because the OR only has 2 bronch carts and they're both in use until later in the day. But now my hackles up, because this chick wouldn't know ethical if it bit her in her not-so-small posterior. (See-my hackles are raised just thinking about it.)

So that got me thinking about the whole donor process and what's ethical. There are a couple of ways to break down the process-before death and after death, before consent and after consent. Here's the referral process in a nutshell: hospital staff identify potential organ donors based on neurologic criteria. These neurologic triggers were proposed by the HRSA collaborative based on what worked at hospitals with high consent rates. Patients with a Glasgow Coma Score of 5 or less and or loss of 2 or more cranial nerve reflexes meet the triggers to be referred to the hospital's OPO. The family is not told of this referral. Why? Because at this point, a bunch of things can happen. Very often, the call is made and the person is ruled out over the phone; they're too old, they have cancer, AIDS, multisystem organ failure, etc. For some reason, these referrals always seem to come in at 3am. You can almost hear the nurses, "Hey, has anyone called this guy in yet?" "No, we'll let the night nurse call it in when she has a chance."

Or, the person is not brain dead and may not be close to being brain dead. They may still be sedated and/or paralyzed. Then, why are we called so early? Because it is hard to know how slow or fast a brain injured patient will deteriorate. They may never become brain dead. They may be brain dead tomorrow. We've followed patients for weeks only to finally tell the hospital to re-refer them if they get worse. Sometimes they get better, sometimes they stay in that suspended state of not dead but not waking up either. That's a post for another day.

Should families in the above situations be told that the patient is being referred for an organ donor evaluation? Like so many of the controversies surrounding donation, it's complicated because of people's emotions. If a patient possibly needed to be trached, an ENT would be consulted. The family would be told. Maybe the patient would wind up with a trach, maybe not. Maybe the family wouldn't consent or maybe they'd want more time to see if the patient improved.

The same thing when a referral is made for a potential organ donor, when the OPO is consulted about whether the patient could be an organ donor. More than likely, they won't fit the criteria. Only 1% of all deaths are medically suitable to be organ donors. From my experience, if you tell the family at this stage, one of two things will happen:they will really want the person to be a donor and their hopes will be crushed if they're ruled out or they will get upset that anyone is talking about organ donation from their still-alive loved one. All right, add a third reaction-they don't get upset, but they say no, and then they OPO will look like they're hounding the family if they keep asking the family.

But does that make it right, not to tell? Families should be kept informed of what's going on regardless of what their perceived reaction will be. It boils down to having a different approach because organs are a limited resource. I'm sure ethicists have a word for this. In order to be an organ donor, even if you meet the requirements, a lot of variables have to be taken into consideration to get the best possible outcome in a short time period. If organs were plentiful, we could just do whatever and not worry about the family's reaction, because another donor will come along. If we had all the time in the world to let families think about it and not ask them to make a tough decision at the most stressful time, it would be easier to get consent. But we don't. Even if every medically suitable, brain dead patient's family consented, there still wouldn't be enough organs for everyone on the list. And the timing is short-families must make this decision while they are still realing from the death of a loved one.

Am I making sense? It's hard to make a cohesive argument when I have to start and stop every paragraph, being pressed into mommy duty. Anyway.

It's similiar to when I would introduce myself to families. I say, "Hi, I'm a nurse who works with the families of brain injured patients. I'm here to help you with some end of life decisions." Or words to that effect. Not a lie, but concealing the truth. In order to spend time with the family, see what their needs are and how best to approach them. This is generally how the TC's in my OPO do it-other OPO's may vary. Friends of mine have quit over stuff like this-they feel it's too misleading. I still go back and forth with it, but in order to be a successful TC, I did have to make my peace with it early on. I wonder if it would just be better to be introduced at the family meeting and say right from the onset who we are. This way, we're trying to develop a rapport with the family. One one hand, this is good:the family gets some usually well needed emotional support and someone who can act as a laison between them and the hospital. Some hospitals already have a person like this in place(social worker, patient rep, etc), some don't.

The problem with the rapport approach, that I have, is that at times it feels like you're a used car salesman. Here, let me get you information, keep you updated on the patient's progress, get you tissues, etc. All so that when it comes down the request, you'll say yes because, doggonit, you like me. I suppose that could be considered condescending to the families I've talked to. I'd like to think that each and every one make the right decision for them. Again, it's an emotional time and how something is presented can have a big impact on what decision they're going to make. I guess, though, when it gets right down to it, I don't ever remember feeling like I twisted someone's arm to donate. And the people who aren't there, with the families, can say how it's such an important cause and we're just trying to do the right thing and be advocates for the people on the waiting list. But when you're right there in that room with the family who's grieving and looking to you for guidance, it can feel like a mighty fine line.

**Now is the winter of our discontent

New Music-yes! New Posts? Workin' on it

2008-01-18T22:56:00.000-05:00

New Music for the New Year. Which was 2 weeks ago, I know. Toddler. That's all I'm saying. A really tall, extremely smart toddler with a long reach. Anyway, I've got three new posts in the shute, all at various stages of completion, all about organ donation. Love Monkey promises me some time to myself this weekend to write, so stay tuned and enjoy the tunes.

Guess what I got for Christmas??

2007-12-27T21:20:00.000-05:00

No, it wasn't coal.

When I left the OPO, sadly I also had to leave my laptop. 14" IBM Thinkpad, mostly indestructible. It was basic black, addressed all my needs, wasn't too heavy. It didn't have a disc drive, cause they didn't want us installing programs, I'm sure, but other than that, I loved it and vowed to never have a desktop again.

Husband told me he was going to me a gift that would change my life. Several things came to mind-a trip to India to spend a week with the Dalai Lama? Hmmm, too expensive and he's probably busy. A winning lottery ticket? A chance to meet Johnnie Depp? (that wouldn't change my life, but it would totally rock!) No, none of those.

He got me my own laptop. This is me, typing away on my brandy new acer, with CD/DVD burner and a webcam. Maybe I could do podcasts!? After I lose 20 pounds and get a makeover, of course.

This past week at work was a doozy. I worked Sat, Sun and Mon with the same sick, intubated kid. Nobody was really sure what was wrong with him, but originally they thought he had croup. Last week, I took care of him and he was doing something really weird-for a couple of hours his CVP would be high-19 to 22 and his urine output would drop. Then, without any intervention, his CVP would return to normal and his UO would increase. I told the intensivist on that day and then never heard anything else about it. I was wondering if he had a coarctation of the aorta, but his pressure was low, not high, and I really thought someone would have picked up on it(he's an older child). Turns out, he has a collateral artery wrapped around his aorta and it's not respiratory at all. Always go with your gut.

So New Year's Eve I was asleep by 10pm. Then the next 2 days I was off and basically did NOT ONE THING. So much for time management, but it's been a long time since I've taken a nap without a kid attached and I'm not apologizing for it.

On the organ front, I've been reading about this girl, Nataline Sarkisyan, who was denied a liver transplant by CIGNA. I was pretty appalled but hadn't written about it because I didn't really have time to delve into it. And if there's one thing we pride ourselves (myself) on here at donorcycle, it's avoiding easy answers and half-truths. So today in my emailbox was a surprisingly in depth article on the case from Maggie Mahar at Health Beat. I did think at the time that it was surprising that doctors would transplant an organ into a person with cancer. Except in certain cases, cancer patients don't usually get transplanted because the immunosuppression drugs already put a person at risk for cancer and there's a high risk of coming out of remission with the same or another cancer. But I thought, well, maybe Nataline was cured by the bone marrow transplant from her brother. Now, reading the article, it says that her doctors gave her 6 months to live WITH the transplant.

Of course, if it was our own child we'd take those odds, but here's the thing-there aren't enough livers to go around. So who should get it? The 17 year old who will probably die anyway, or someone else who will live another 5,10, 20 years? It's a hard choice and I'm trying to come up with an analogy but I can't think of anything that involves such a restricted resource with such emotional appeal. Then, too, the hospital asked the family for $75,000 if insurance wasn't going to pay. I guess some have argued that the hospital could have eaten the cost. I'm not sure if that figure was for the surgery and hospitalization. I do know, that for self paying recipients, the hospital wants to see if they have the resources to pay for the first year of anti-rejection meds, which runs around $50-60,000. Again, this sounds really harsh, but the meds are needed or else the organ will be useless. It's the same reason why people are counseled to see if they are up to all the follow up treatment that comes with receiving an organ. Again, I'm not really sure why that gave that dollar amount to the family, who couldn't come up with the money of course, and the doctors are no longer talking.

I don't know where the answer lies. I'm reasonably sure that if the docs at UCLA felt the transplant was worth it, then CIGNA should have covered it. On the flip side, Maher points out that CIGNA approves 90% of all tranplants. And I do agree with her on this point, by reconsidering their position when it was essentially too late, CIGNA now looks like a horse's ass(My words, not hers).

The one thing I am sure of is that this sort of thing happens because organs are scarce. If you could get one just as easily as you could go the pharmacy for a presciption, no one would have to make these choices. I do hope, if nothing else comes out of this, that all those who fought for Nataline will sign their organ donor cards.

Well, it's Christmas Eve

2007-12-24T09:07:00.000-05:00

And we're all sick, except for the dog. I think we must have the most virulent head cold ever seen...it's now over a week and my head still feels 2 sizes to big. Tomorrow I have to work, which is making me feel very Grinch-like. We are all making tons of food, so hopefully it'll be a slow day, no one will die and I'll get to pig out. I've given my teenager the option of waiting til I get home to open presents, or getting up with me at 5am to open them. She just huffed.

Just like in Hooville, Christmas come whether there's presents and a tree or not, so I'm diligently buying presents at the last minute. We were going to have Christmas morning THIS morning, but last night we made the discovery that we didn't have wrapping paper. We do have a tree and it's up but still a little bare. There's lights and garland, but so far no ornaments and the dog keeps eating the candy canes off the tree. Pooter has added to her reportoir with some Christmas words: Woo-woof(Rudolph), Santa Claus, candy cane and sssssssssnowman (the S-N combo is still a trial for her). We have watched the original Burl Ives "Rudolph" a record 823 times over the last week. Every time I watch it I can't help thinking that in real life, Rudolph, the dental elf and Cornelius would all run away to the East Village, where the elf and Cornelius would finally proclaim their love for one another (he is a total BEAR, after all) and Rudy would be panhandling on St. Mark's Place.

In other news, this happy article was posted in a local paper. I've had the pleasure of working with Dr. Laskow and it's true, he is a class act.

Last week I was the primary nurse for an organ donor. My good friend "Hector" got to come out an be the TC and boss me around with 8 gazillion orders and, as usual, the OR was delayed until almost midnight. But this time I got to go home at 7:30pm. His poor orientee was like, "I have to stay HOW long?" I assured her that in no time, she'll be able to stay awake 30 hours straight on 5 hours sleep and then drive home. It's funny that my first job was 8 hour overnights and I could barely stay awake through it. The down side is that if I get woken up in the middle of the night, say by someone snoring(ahem), I'm awake for the duration. I might as well just get up and get a cup of coffee cause they'll be no more sleep for me.

Having a 17 year old donor was sad. I didn't know her at all, having been off the first few days of her admission. When I saw the OPO staff on the unit, at first I was afraid it was for a girl I've been taking care of, on and off, since Thanksgiving. I'm now on a first name basis with mom, dad, younger sister, best friend and several teachers from school. She's been touch and go for weeks and if she doesn't make it I'll be really upset, but I haven't given up hope yet. That's the thing about critical care, some patients are there for so long, you really get attached. We did have one Christmas miracle-a little bugger who's been in the ICU or in subacute care since he was born 10 months ago finally went home. Mom carried him around the unit so we could all say good bye to him.

Well, as you can see, I still have stuff to talk about, so I guess I'll still be blogging for now.

Merry Christmas.

SurgExperiences

2007-12-22T15:14:00.001-05:00

Check out SurgExperiences over at Buckeye Surgeon. Now I have to get back to Christmas shopping.

If You Give a Surgeon a Scalpel

2007-12-20T21:30:00.000-05:00

(with apologies to Laurie Numeroff)

If you give a surgeon a scalpel, he’s going to want a pick-up.
But wait! He’ll remember that he always operates better with some music.
“Nurse! Can you put on the radio please?”
“Certainly, Doctor. Do you want Rock?”
“No.”
“Classical?”
“No.”
“Country?”
“No.”
“Easy Listening?”
“Oh, God, no.”

Then he’ll remember that he has a Frank Sinatra CD in his car. He’ll want you to page the tech and ask him to run down and get it.
While you’re waiting, he’ll hum a few bars and show off a few dance moves to the scrub nurse. “Yes sir! I used to really cut the rug in my day.” He’ll say.

While he’s dancing, he’ll remember that he’s parked illegally. He’ll have you page the tech and see if he can move his car while he’s down there.
Suddenly, the resident will comment that he’s hungry. A spirited discussion will ensue on where’s the best place for lunch.
“Chinese?”
“No.”
“Thai?”
“No.”
“Italian?”
“No, I had pizza yesterday. Sandwiches?”

The surgeon will remember that a great, new Mediterranean place opened up. You’ll page the tech again while he talks about the great hummus and baba ghanoush. “Wait! I want brownies, too! Tell him to get brownies!”
To fill in the time, he’ll tell a story about the time he vacationed in Greece and lost the keys to the rental car on the beach and they had to walk 10 miles back to their hotel room and his wife didn’t speak to him for 3 days.

Finally, the tech comes back with 5 Frank Sinatra CD’s, the keys to his car, now washed and polished, one pint each of hummus and baba ghanoush, 6 gyros, a 2 liter bottle of soda(it was a special), extra pita, two types of brownies and baklava.
“Hmmm. Now what was I going to do?”
The anesthesiologist looks out from behind his paper and coughs, “Ahem”.
“Oh, yes. I was going to ask for a scalpel.”

To all my favorite surgeons and everyone else:

Happy Holidays and all the best in 2008!!

2007-12-09T18:52:00.000-05:00

As most of you know, I quit the TC business in August to spend more time with my family. I'm not really sure where I want to go with this blog. I certainly haven't been spending the time on it that it needs. So I'm taking a hiatus until after the New Year to see where, if anywhere, it's going to go. Thanks,

Susan

Dah Na Na Na Nah Nah Na Na

2007-12-07T11:08:00.000-05:00

It's my birthday! Enjoy the tunes.

Yes Virginia, The Saga Continues

2007-11-21T13:13:00.000-05:00

Dear Editor—
I am 8 years old. Some of my little friends say there is no Santa Claus. Papa says, "If you see it in The Sun, it’s so." Please tell me the truth, is there a Santa Claus?
Virginia O’Hanlon

So starts the famous editorial written by Francis P. Church 110 years ago this month. He goes on to say that little Virginia's friends are wrong. "They have been affected by the skepticism of a skeptical age." It gives one pause to think what Mr. Church's reaction to the 21st century might be, were he here to see it. Is Santa Claus still real? Well, Newsweek hasn't yet proclaimed, "Santa is Dead", so I guess there's hope.

In my house, the controversy continues. My husband, a man of much romance but not an ounce of sentimentality, has decided to tell our daughter the truth about the Santa "myth",as he puts it. "There are plenty of other, more meaningful myths I want to raise her with," he proclaimed, although so far substitutions are not forthcoming. It should be noted that when Mr. Higgins learned the truth about Santa it was a traumatic event (insert your own instant analysis here). My own fact-finding about Santa was not only NOT traumatic, but is actually remembered fondly-a product of a childhood that is not known for many fond memories. In a nutshell, I read the truth about Santa in a fictional story in one of my mom's magazines. A young boy finds out about Santa, is disappointed but then learns about the true meaning of Christmas and responds by playing Santa himself. It wasn't award winning fiction and I can't really convey what it was that had such an impact on me. Perhaps it was the realization that my parents would go through such hard work to make me so happy and not take any credit for it. Especially since my siblings were so much older and I'm sure were threatened with their lives not to tell me. Whatever it was, the magic of Christmas never left me. Perhaps it's my fertile imagination. In 3rd grade, I wholeheartedly believed in Santa, gnomes and my parent's omniscience.What didn't I believe in? The Easter Bunny, Original Sin and my parent's veracity.

Somewhere in the Santa story is the essence of Christmas for me. Yeah, I know, it's a Christian holiday. It should be about the baby Jesus and all that. But if you read Church's entire response about Santa(and you should, it's a classic for a reason), it goes beyond Christmas and religion to the heart of what makes us human. "I still believe in the good of man" said Anne Frank. Sometimes, that seems as fanciful as Santa and his elves. Yet at work today, I saw a bunch of kids, who have access to the internet, Bratz dolls, Dr. Phil, and Youtube, in a word-kids who should know better-light up when they saw Santa. Santa the Biker came to our hospital this week and the kids went gaga. "It's a miracle!" one girl said, "Santa came in November!"

I think it's more than just the free toys. Most kids I know like the giving of Christmas, as well as the getting. When my eldest daughter was young, her school would have a day where the kids could go and buy cheap presents for their families. I'd give her $20 and you would have thought she was the luckiest girl in the world, able to buy presents all on her own without any parental input. And homemade presents? "I made it!" they shout proudly. If you've never been the recipient of small lump of clay decorated with garish stones and feathers and presented to you as a "paperweight", you are poor indeed.

I don't know where this leaves us with Santa at our house. My husband is still convinced that most people are disillusioned when they learn the truth about Santa. I'd love to hear your stories. I'd also like to win an argument in my house for once. So, if you want to tell your own Santa story, please leave it in the comments section. As for my little one, if she's anything like her parents, I have a feeling she's going to believe in whatever she wants to believe in.

I know what I know

2007-11-20T21:30:00.000-05:00

I really haven't been on the internets in over a week, except for quick scans of my email. I did, however, pass PALS (pediatric advanced life support). I think it's the 3rd time I've taken it and it seems to get easier and easier, which is not a good thing. In fact, I think there was too much of the fancy videos and not enough content. I didn't have a problem, but I felt sorry for the people who were taking it for the 1st time, including one respiratory therapist I know who I thought was going to have a breakdown when they gave her the "baby in asystole" megacode. There's no real end to that code, except to call it, but who wants to have a dead baby. It's broken tougher participants than her, to be sure.

So in addition to realizing that I know more about PALS than I thought I did, I also learned in the past week:

I know what to do when someone faints, or almost faints, or is just having a culturally diverse grieving response. Help them to the ground(extra points for avoiding back strain) or a chair. She was up and about before I could bring back water and a cool washcloth. Code purple avoided. (Code Purple is medical jargon for, "help, someone received bad news and fell out!")

I learned how to use the peritoneal dialysis cycler. Than I became the point person for the rest of the floor, because, really, when do we ever use that? On someone who weighs 6 kilos, no less? 4 more kilos and he'll be ready for transplant! Go, little baby, go!

I went to conference on nursing research and learned that if I ever want to get a PhD, I can kiss my family goodbye for 4-6 years. Sigh.

I learned that I have completely fallen in love with a little imp who is probably going to die within the next year. I can't help it...she wormed her way into my heart and that's where she'll stay.

I know (from years in the ER) that when you smell diesel coming through the vent system it's because someone hasn't turned off their truck(or ambulance), which is highly annoying for staff and possibly dangerous for your respiratory patients.

I know that sometimes when people appear unresponsive it's because they don't speak English, are hard of hearing, are just plain scared or all three. Maybe you should check on that before you write them off.

And finally, that like being a Catholic or riding a bike, nursing is something that you never forget, no matter how much time you've been away from the bedside.

I am so not bitter

2007-11-08T21:35:00.000-05:00

Can someone please explain to me why amalah is up for a weblog award? Excuse me, but I bitch about my loved ones, I show cute photos of my kids, I have snarky DOWN PAT, for goodness sakes. And I also talk about a little thing called ORGAN DONATION! But do I get nominated? I've been complaining about it all week to the fambly to no avail-they haven't given me an ounce of sympathy.

And the comments!! I'd rather have 2 little 'ol commenters than 167 versions of "OMG! Me too! You're so awesome!"

All right, it's not all about me. But what about the other great mom blogs out there? Like my friend Moreena-top notch writing if I ever read some. (Unlike my perpetually unfortunate grammar-I speak English good, don't I?)

Anyway, I'm voting for Notes from the Trenches out of spite. Not that I'm bitter or anything.

This goddess is NOT bitter

And the word of the day is:

2007-11-08T01:30:00.000-05:00

hu·bris /ˈhyubrɪs, ˈhu-/ Pronunciation Key - Show Spelled Pronunciation[hyoo-bris, hoo-] Pronunciation Key - Show IPA Pronunciation
–noun
excessive pride or self-confidence; arrogance.

You may recall a few posts ago where I said I was reasonable sure that the baby didn't have pneumonia. Silly mommy. Last Friday, after spiking a temp of 103.6, her parents(both nurses, thank you very much), decided that maybe medical intervention was called for. Of course, my FP was not on call, so I called the guy covering for him. After telling him the medical history in a nutshell-basically, 5 weeks of being sick, one ear infection, countless sniffles, bronchitis, a lacey rash and now more fevers-he tells us to get our butts to the ER as a CXR is probably in order.

So there you have it, bad parenting example #567. At least it's not as bad as the time MY mom thought I was faking sick to get away from the dinner table and then realized during my bath that I had chicken pox. And she's a nurse, too. So, anyway, Daddy nursed(not literally) the baby over the weekend while I took care of other people's sick kids. Sunday, she was a little better, but then Monday she spiked a temp again and looked really listless, so we were back to the doctor's. She was mildly dehydrated, and the augmentin wasn't working, so he changed her over to zithromax and said to give her more fluids. Hurray for the power of breast milk, since it's the only thing she wanted, except for sips of water. Tuesday, she felt well enough to be cranky and we managed to feed her some bread soaked up with potato-leek soup. Today she was definitely on the mend, enough so that I will only feel a little guilty about leaving her cranky-clingyness to go to PALS manana.

Other than that, we've been forced to watch Signing Times DVDs for hours on end. Pooter calls it "babies". I will say this, it's better than Thomas the Train, "choo choo", which is like kiddie valium. We also watch the "woo-woof", which is a Little Einstein DVD that features, you guessed it, dogs. Thank God the signing ones are good, although I now know every song by heart, including The Silly Pizza Song which I can sing AND do in sign.

All that signing, though, and the Pooter still says something that sounds like "budday" when she wants water. She can sign dog and cat and eat and sun and cookie and a myriad other things, but for life nourishing fluids, she cries and says, "mauw budday?" We're starting to get the hang of it, but it's hard to remember on little sleep.

Speaking of PALS, Good Lord, I haven't been to PALS in almost 3 years. Now, there's homework I have to do beforehand. And they changed all that CPR stuff, too. 30 compressions in 23 minutes, etc. What do I know, everybody I code is intubated and we just pump and bag, pump and bag. Uh-oh, hubris again. Now I've gone and jinxed myself-I'll probably witness somebody collapse on my way to class tomorrow.

Work is, well, scarier in some respects, because being away from the bedside for 3 years has dulled my nursing 6th sense. But I did have a good laugh because they floated a NICU nurse down to us last week and gave her a 17 year old boy. Who needed to be straight cathed every 6 hours. Poor girl wasn't used to wee-wees that big. I helped her through it and hopefully she'll say nice things about me to the NICU nurses so they'll return the favor when I'm floated upstairs to take of some little mouse that doesn't even weigh a pound.

I have managed to make nice with one of the pediatric nephrologists after telling her I used to be a TC. Now she's nice to me, but apparently a little cold to some of my coworkers. My specialty, winning over the difficult people. Just one of my many super powers-sorry, they can only be used for good and not evil. Oh, wait, I think that's hubris again. Sigh.

You want fries with that?

2007-11-01T20:06:00.000-04:00

Hospitals continue experimenting with ways to improve customer service, usually at the expense of employee morale. I've had my own experience with that. When I worked in a busy ER, the three biggest complaints were 1)wait time to be seen 2)wait time to be treated and 3)wait time to get upstairs to a room. Almost always, the Press-Gaineys had nice things to say about the employees. Then some big, upstairs Wahoo comes down and tries to teach the nurses how to say "Please" and "Thank You" and THAT leads to cranky nurses. Boy, you do not want your nurses cranky. In fact, right now, go to your nearest nurse and give her some chocolate. THANK YOU.

Working with donor families has given me a whole new perspective on meeting people's needs. When you've spent 8 hours trying to find out if it's possible to recover sperm from a brain dead husband, suddenly getting a cup of tea and a box of tissues doesn't seem so hard. (Please don't ask how they get the sperm-you really don't want to know). Granted, that's an extreme example, but I was taught that you do whatever you can for the donor family, if at all possible. They're giving a tremendous gift. In return, if they need information, a parking voucher, a cup of coffee or a shoulder to cry on, you give it.

I returned to the unit carrying this credo in my back pocket, I guess, without really thinking about it. So I was surprised to hear people grumbling about, of all things, guest trays for patients' parents. "They just came in and now they want to eat? Why didn't they eat at home?" My first thought is, "Why do you care?" It's not extra work, because dietary brings up the tray. It's not impinging on my Christmas bonus, because the patient is billed. I think there's just a certain type of person who is suspicious that someone, somewhere, is getting away with something. They're not bad people. My dad is one. Just don't kick the ball into their yard.

I have to say, also, that I like being nice. I don't enjoy being in a bad mood(no comments from family members, please). Sometimes, I am so cranky I can't stand myself. Last week I had a woman tell me about her four year old daughter, " I don't know where her attitude problem comes from. Life has made me bitter, what's her excuse?" I'm pretty sure that mom can't stand herself, either. And I think I know where her daughter's attitude problem comes from, too. Believe me when I tell you I am not a perky person. The last time I checked, sunshine and rainbows didn't come out of any of my orifices. I like being a pessimest because I would rather be pleasantly surprised than always disappointed. Still, I have found, more often than not, that when you are kind to people they respond with kindness.

So what's the solution? Can you train "niceness" into people? I recently attended a customer service seminar. Well, it was really only an hour, so I guess that makes it a lecture. A message that says, "We want customer service to be a priority, but not so much that we'll spend $50,000 for the famous motivational speaker. Instead, view his motivational video and then motivate yourselves." (Friendly hint, don't motivate yourselves too much or you'll go blind). Anyway, the lecture instructed us to introduce ourselves, explain to the patient what was going to happen and about how long it would take and then thank the patient. Wha? I think this falls under the category of either you already do it or you can't be taught it. I mean, do they really think there are people sitting there going, "Tell the patient who I am? I had no idea! Up 'til know I've just been going into the room, reaching under their gown and asking them to cough."

I think a lot of crankiness stems from burnout, personally. I was floated to the nursery a few weeks ago and they had that one nurse who just seems to infect the rest of the unit with her bad attitude. You know just what I'm talking about if you've ever worked with this person. She bitchd about everything and everyone, including the babies, who she considered "bad." How can a newborn be bad? Makes me glad that my husband went to the nursery with the baby instead of staying with me. Anyway, I was charting and I looked out the window and all you could see was the roof. Vents and smokestacks and gravel and pigeons. I said, to no one in particular, "Wow, your view sucks." Nurse Cranky asked me to repeat myself. "Your view, out the window. It sure is awful." "Oh," she said, "I thought you were talking about my personal point of view."

Now, if you recognize yourself in that example, it is time for a massage. And a job change. Because, really, working in the nursery is NOT hard. (I'm probably going to get lots of comments from nursery RN's telling me how challenging it is to feed, diaper and rotate the little hamsters. Bring it, is all I got to say).

Somewhere in all this is a point. I suppose if we all had jobs we loved and got paid what we were worth and were able to leave our personal issues at home, we'd all be much nicer to the patients. Then we can tackle peace in the Middle East and world hunger. So here's my 2 cents: Be good to yourself and be good to the people around you. If you start to view the world through crap-colored glasses, take a break, get some perspective and lighten up. And if your friends at work start getting obnoxious, say something to them. Then, we can go to as many customer service seminars as they want, knowing we're still providing the same great care we always gave. And if the hospital wants to take credit for our "pleases" and "thank yous", let 'em.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Oh, yeah. Change of Shift is up at Nurse Ratched's Place. See ya there.

House of Plague

2007-10-31T16:09:00.001-04:00

We almost cancelled Halloween at our house this year. Half the family is sick, including La Baby who, if she lived with normal folks, would be in the ER right now. But my children know that unless I'm getting paid $45 dollars an hour, the only thing that warrants a trip to the ER is bleeding from the eyeballs or viscera. Poor Pooter. I'm pretty sure it's not pneumonia, but I've spent the last few days with kids whose parents said, "If only I'd brought them to the ER sooner, maybe they wouldn't have quadruple pneumonia."

I also was hoping that Pooter would be able to wear her first real Halloween costume to daycare today, but she's got a fever. She was going to be a bee. Well, she still can be a bee any day of the week, just not for Halloween. We bought the outfit last week at Claire's in the mall and then she wore it at the mall playground and was the delight and envy of all the other l'il childrens. I do have great footage of her bouncing around with bee wings, if I can figure out how to get it off my phone. Once again, Susan 0, Technology 274.

Love Monkey is also sick. I'm pretty certain he no longer has any internal organs from the diaphragm down but as my attending said this week, "Green, black or red is all the description I need." So Teen and I are set to (wo)man the door as she announced she is officially too old to treat or treat. And the cat is going as a chihuaha.

Yo quiero candy, bitches.

Must Read

2007-10-27T08:21:00.001-04:00

Well, once again Moreena puts into words all I wish I could say and more. This week, she wrote about the anniversary of her daughter's first transplant. Please go read it. Forever more, when I am confronted with an unknowable question, not unlike Douglas Adam's "42", my answer may well be 3.

Her post brought to mind this poem I wrote down years ago in my poetry notebook. Yes, my poetry notebook. Because TC is really very sensitive inside, with a crusty exterior-like a scooter pie, sort of.

Mama's Promise-Marilyn Nelson Wanick

I have no answer to the blank inequity
of a four-year-old dying of cancer.
I saw her on t.v. and wept
with my mouth full of meatloaf.

I constantly flash on disaster now;
red lights shout Warning. Danger.
everywhere I look
I buckle him in, but what if a car
with a grille like a sharkbite
roared up out of the road?
I feed him square meals
but what if the fist of his heart
should simply fall open?
I carried him safely,
as long as I could,
but now he's a runaway
on the dangerous highway.
Warning. Danger.
I've started to pray.

But the dangerous highway
curves through blue evenings
when I hold his yielding hand
and snip his miniscule nails
with my vicious-looking scissors.
I carry him around
like an egg in a spoon,
and I remember a porcelain fawn,
a best friend's trust,
my broken faith in myself.
It's not my grace that keeps me erect
as the sidewalk clatters downhill
under my rollerskate wheels.

Sometimes I lie awake
troubled by this thought:
It's not so simple to give a child birth;
you also have to give it death,
the jealous fairy's christening gift.

I've always pictured my own death
as a closed door,
a black room,
a breathless leap from the mountain top
with time to throw out my arms, lift my head,
and see, in the instant my heart stops,
a whole galaxy of blue.

I imagined I'd forget,
in the cessation of feeling,
while the guilt of my lifetime floated away
like a nylon nightgown,
and that I'd fall into clean, fresh forgiveness.

Ah, but the death I've given away
is more mine than the one I've kept:
from my hand the poisoned apple,
from my bow the mistletoe dart.

Then I think of Mama,
her bountiful breasts,
when I was a child, I really swear,
Mama's kisses could heal.
I remember her promise,
and whisper it over my sweet son's sleep:

When you float to the bottom, child,
like a mote down a sunbeam,
you'll see me from a trillion miles away;
my eyes looking up to you,
my arms outstretched for you like night.

TGIF

2007-10-26T20:33:00.000-04:00

Have you ever been around so many insane people that when you meet some normal folks you just want to kiss them? No. Well, I have had some crazy parents in the past few weeks. Today's little patient had parents who were normal, not fighting with each other and full of common sense. It restored my faith in humanity for another day.

Yesterday was the opposite. I complained so long and hard about some folks that I felt guilty about it and yet still needed to vent. Finally, Love Monkey said, "Susan, let it go." The hard part is when it seems so clear to you what the problem is, but the person experiencing it is just clueless(at least to you). I'm sure I can be just as dense when it comes to my own issues. The hard part was that they were just, so, demanding. I can give people a lot of slack, especially when they're dealing with stressful stuff, but don't think for a second that I'm your bitch. That really pisses me off and then my compassion flies out the window. I guess maybe I'm a little fried lately because I usually have more patience. Ah, well.

Anyway, I'm off for the weekend. Time to recharge. Maybe catch up on writing?

I told you so

2007-10-25T05:04:00.000-04:00

Well, word is out. Dumbledore is gay. In case you've forgotten, you heard it here first. That's right, I called it. Now pay up, suckas. Actually, I didn't bet anyone, but if you'd like to lose retroactively and send me some cash, I'd be ok with that. If you've got the time and would like to know where the "gay-ness" shows up in the books, the LA Times will tell you all about it.

Well, I've been spending a lot of my internet time on Facebook. What little free time I have, that is. I've now discovered zombie hugs, tattoos and quizes about my sex life. Hoo, boy, and if you think I don't have a lot of time for the internet...Anyhoo. Now, I know I'm a grownup and all, but seriously, my niece and nephew and their respective sig others are all teaching this year in South Korea and you know the kids today, they're all on Facebook. Even my teenager, who just discovered that I'm on it, much to her mortification. Want your kid to spend less time on teh interwebs, join Facebook. It's much less cooler when your MOM uses it. Tee Hee.

This week, I've actually had a little time to peruse the weekly Grand Rounds. My friend Susan over at Improbable Optimisms has the first spot with a great read on hope. Check it out.

And under the "Better late, if ever" category: The latest Change of Shift over at Kim's.

Meanwhile, Love Monkey and I spent a night at Atlantic City this week. With teh baby, of course. All paid for by his poker habit. Gotta love the comps. It was nice, we spent some time at the beach, but it's no Vegas. In fact, it's a lot like Keansburg with shiny skyscrapers. Ah well. And could someone please tell me why you can't get a decent, cheap meal in A.C.? I mean, you can mortgage your house and go to Ruth's Chris Steak House, but want breakfast for less than $12? Forget it. In Vegas you can get a steak for $1.99, but in AC, 2 eggs, toast and some freezer burned sausages will set you back 8 bucks. Other than the eating, though, we had a good time.

In organ donation news (oh, yeah, this blog is about organ donation), Scientists in the UK are doing studies on giving CO2 after transplant surgery to dilate vessels and improve blood flow to the organs. Now, the funny thing is, the picture in this article is the SAME picture the BBC uses for EVERY organ donation article. I'm thinking, if you're the BBC, you could spare a photographer once in a while to go and get a new shot of something else related to organ donation. Or maybe the Brits are just very frugal. Anyway, I'm off to work, where there's no internet. Very sad.

Ray of Hope

2007-10-17T04:34:00.000-04:00

From ESPN, this is the story of the North Carolina mascot who was struck by a car last year and became a donor. Buy more Kleenex and pass this on to everyone you know. If you didn't believe that love conquers death, you do now.

Tuesday!

2007-10-16T05:15:00.000-04:00

Holy Crap! I'm up early enough to read Grand Rounds! Version 4.4 is up at NY Emergency Medicine.

Memorial Day

2007-10-16T04:30:00.000-04:00

October must be the month for memorial services. I had my pick of two this past weekend, one for the children's hospital and one for The Sharing Network. I picked the later, because I was hoping to see some of the families I've worked with in the past year. And the free food, of course. Then I notice some other folks had their memorial services this past weekend, also.

Sunday, after the service, I had this fine post practically writing itself in my head. Now, in my younger days, I could carry a half-finished poem around in my head for a week and work on it, finally writing it down in almost completed form when I got around to it. Ha! Like I really knew what busy was when I was 20. Anyway, the baby was up sick all night and I had work at 7am Monday and by Monday night it was gone, gone, gone-appropriate lead-in lyrics and all. I'll miss my brain when it's gone.

Anyway, I'm glad I went and I did, in fact, see one of my donor moms. She had driven all the way from Pennsyltucky with her sister and they were glad to see me too. The staff always does a nice job on the service. We(they? See, still doing it) offer folks the option of making a quilt square in honor of their loved one and then my old boss' wife and her friends sew them up into big quilts that hang in the office and get shown at events and donor drives and stuff. I brought one to my daughter's Career Day one year.

They also did a photo tribute at one point. It was amazing to see pictures of all the donors alive and smiling. Especially because I tend to remember them as I first saw them-intubated in an ICU. If you work in a hospital you probably know the feeling. You take care of this patient for so many days that you can forget they're a person. I remember one donor, whose family showed me a picture of her, in better days. "She's beautiful!" I said, because it's hard to visualize what a person really looks like when they're lying flat in bed, with their hair matted down and their face all puffy and their body bruised and there's five miles of tubes and wires coming out of every available body part.

It's nice, even if your patient is just sick, and not an organ donor, to see their picture. It makes them real, you know? Then they're more than just the splenic lac in 18 or whatever. It certainly is easier to do this in PICU, because kids are, well, kids and you'd have to be a cold-hearted snake to not fall in love with them, but it's still nice to see pictures of them taped up in the room.

I don't like to think that people who work with the donors forget their "human-ness" often. I mean, you spend an awful lot of time with the families, crying with them, talking about their loved ones. But it can be tempting, when sleep is a dim memory and you've been sitting around a hospital for too many days to count, waiting for something, anything to happen, to just think of the donor and not the person. How many organs can be recovered, what time can we get to the OR. It's in the language-"I got consent". No, you didn't GET anything. The family GAVE you consent. Maybe it's just me, or maybe I shouldn't blog at 5am when I can't sleep. The people in the business are some of the most caring, compassionate people I've ever met and they don't take donors for granted. As long as you can still see the forest for the trees, is all.

Anyway, I also got to see my peeps, who were (mostly) glad to see me. The highlight may have been the 4 year old kidney recipient and his parents who were on hand to thank the donor families. It's nice to see the living, kicking, cranky, I-want-to-play-I-don't-care-why-these-people-are-here-to-see-me results of your work once in a while. Also, I got to see my friend Pammy-cakes invite the Imam back to her house for drinks. That certainly was worth the price of admission right there.

Well, I've gotten my verbal catharsis and I still can't sleep. Time to clean.

Also for Wednesday

2007-10-10T12:09:00.000-04:00

Team Annika needs your help! Moreena, from The Wait and the Wonder is in charge of the American Liver Foundation walk in her area. Help her meet her goal, so she won't have to do anything desperate AND you'll help find a cure for liver disease. Send in what you'd normally spend on beer and wine in a week and it'll be good for everyone's liver!

Meanwhile, over at Nurse Ratched's, there's Grand Rounds with an armed forces theme.

Better Send Flowers

2007-10-10T08:47:00.000-04:00

I went to the wake of a friend's father last night. I'm always at a loss for what to say at funerals. I didn't really know anyone there, other then my friend, so I just people watched for a while. Then, I checked out the flowers. He was holding wooden rosary beads. A rosary made out of those tiny roses is nice too, but do you any idea how much that costs? The flowers made me think of my great-uncle's wake. Similiar families, although my friend's "out-Italians" my family by a magnitude of 10. Anyway, when Uncle Micky died, my siblings and I decided to pool our resources and send flowers. Then my sister suggests, since flowers die, wouldn't it be nice if we sent a plant arrangement instead? I left the details to her and ponied up my money.

The thing about my uncle, he was a terrible alcoholic. Later, as an adult, I heard some stories, but as a kid I only knew that he was perpetually cranky and I was a little afraid of him. A year before he died, he went into our community hospital with some ailment and wound up coding, being resuscitated, coding again, another resuscitation and then getting a million complications, including infections. When my aunt didn't make him a DNR, we thought she was crazy. I mean, the man had abused his body for decades, we didn't think he'd survive another code. Just to prove how stubborn he could be, he not only recovered, he made it home. My aunt recalls that the next year with him was a really good year. He certainly was nicer and funnier than I'd ever seen. Goes to show, you can play the odds in medicine but you never really know what's going to happen.

My aunt and uncle have four sons. They're my family's version of the Marx Brothers. Remember them? I think their names were Groucho, Harpo, Marco and, uh, Squiggy. Anyway, these four had an act they could take on the road. They're still the funniest guys I know. Nothing is sacred with them. If you take yourself too seriously, they'll skewer you, but they're hysterical. Anyway, we're at the wake and I look around for our "plant arrangement" amidst the enormous and lavish flower pieces. Then I see this, I don't know, some sort of tropical vine in the corner with a big bow on it. One of my cousins spots me. "Hey, thanks for the vine. I thought it was one of the funeral home's plants, then I realized you guys sent it." His brothers join in for the kill. I think there are jokes about jungles and Tarzan, I'm not really paying attention as I scan the room for my sister. She spent 75 bucks on that?

We do, all, eventually have a good laugh. We try and imagine what Uncle Micky would have said about it, which leads to reminiscing about him. Cranky, and alcoholic, that he was, he was a character and soon his sons have us laughing. Which is, if the person was old and lived a good, long life, a fine way to go about waking someone. I hope I'm enough of a character that I have folks cracking up at my funeral. If you know the person, this is always a good thing to talk about with the family-remembering them, remembering the good times you had.

What not to say? Well, I would caution you to never, ever say "I understand" unless you have been through something very similiar. My friend's dad was home with hospice care for the weeks before he died. My grandmother also died pretty quickly and was at my mom's home under hospice care. My mom and I took turns staying up at night with her. It was hard on everyone, hard to watch her dying, but worth it, knowing she died surrounded by her family.

I wouldn't offer platitudes, either. "Well, he's in a better place" or "God must have needed him more than we did" or whatever people try to come up with to rationalize the person's death. The best bet is sincerity. Say you're sorry for their loss. I like to say to people at funerals that I'm there if they need me, but I think there's too much going on at that moment. If you know of something you can do in the days around the funeral, then make a concrete offer. Can you take their kids for a while so they can make arrangements? Drop off food, run some errands for them. One nice thing to do, after the funeral is over and everyone stops dropping by is to not forget them. Like send them a card and some flowers on the next holiday or on the anniversary of their loved one's death to let them know that someone else remembers, too. Not everyone grieves, right away, either. My sister in law lost her younger brother a few years ago and I remember, almost a year later, she broke down at a family picnic crying. She just needed someone to listen to her.

Meanwhile, my aunt still has that plant. She told me it takes up most of her sewing room, it's grown so big. I'm haunted with the thought that everytime she waters the thing, she thinks about her husband's death, but she seems to have a good sense of humor about it. A trait she has passed on to her children, evidentally. I think she's even going to name it.

But in the future, I'm going to stick with flowers.

My Big Day Off

2007-10-05T11:26:00.001-04:00

It's Friday. I've worked 8 hours of overtime last week and 4 this week, the l'il Pooter's still sick and my house looks like who done it and ran. Then working all weekend. While I'm figuring out what to do with my big day off, I'll probably read the latest Change of Shift at Madness:Tales of an ER Nurse. I've been promised some writing time today, but you know I'll probably just clean. God forbid I need an ambulance for any reason, I'll have to tell them my house's been ransacked to save face.

2007-10-02T08:37:00.000-04:00

When Everson Walls donated one of his kidneys to Ron Springs earlier this year, it made news. Now it's making legislation. Rep William Lacy Clay (D-MO) is sponsoring a bill named after both players. The Everson Walls and Ron Springs Gift for Life Act of 2007 (HR 3635) hopes to fund a national resource center and grants for organ transplant needs. Walls and Springs together have started a foundation to promote organ donation.

For your weekly carnival update, the new SurgExperiences is up at Suture for a Living, one of my new, favorite blogs. Also, Grand Rounds is up at Musings of a Distractible Mind(note the new blog address). Great Dr. Seuss theme this week, rhymes included!

Happy Reading.

A Tale of Two Jobs

2007-09-29T11:24:00.000-04:00

Yes, I love the new job, as my aforewritten post shows. I love the babies, I love taking care of sick kids. I even love(well, maybe like a whole lot) taking care of stupid teenagers who ingest too much beer and fall off car roofs. No, really. I think it's because you can talk to teenagers in a way that you can't talk to other patients. "Dude! What the hell were you thinking?" and they just shrug and look sheepish. Plus, you can get away with the occassional curse word in front of teenagers, as long as their parents aren't around, like when you're hip deep in a dressing change and you drop your last piece of Telfa and now you have to stop everything and walk clear across the unit to get another one and so, without thinking, you mutter, "Mother-f*#ker!"

Sorry, but TC can curse like a sailor. In several languages, including Tagalog. It's a gift.

Anyway, I have had a series of patients in the last 4 shifts, mostly because I am low on the totem pole and so don't get continuity with my patients because some other, more senior, nurse, wants to take care of "her" baby. Whatever. The past couple of days we've had a potential organ donor on the unit and my former colleagues have been present. In was nice, in that I got to exchange some juicy gossip and catch up on the happenings around the office. It also shows me that, just like being Catholic, you never stop being a TC. I still say "us" and "we" when talking about the OPO. Actually, I instinctively typed "my" OPO. See what I mean.

So, even though it's probably good that I got out of that handbasket before it bursts into flames, I have to say-I MISS IT! I miss my old job. Or at least I miss the work, if you know what I mean. I miss the thrill of waiting by the phone and finally getting called out. I miss sitting around ICU's all day waiting for the doctors to finally start clinicals and listen to them whisper about you at the nurse's station. I miss the nervousness when it's finally time to ask the family and then the rush that comes when you know they're going to be a donor and you have 8 million things that need to be done all at once. I miss crying with the families and hugging them and listening to them talk about their loved ones. I miss knowing that you're getting one more person off the waiting list.

Also, I miss the free time I had, when waiting, to write as much as I pleased with no interuptions. I do have more free time now, but it's all spent at home and there are lots of distractions, including one who can crawl all over the desk and say, "Eat dat! Have dat! Want dat!" Right now, as we speak, I have a 2000 word essay in the works, that requires actual research and critical thinking as opposed to my usual snarky ramblings. My fingers are itching to type it, although I hear there's a cream for that now. In former days, I could pass the time in an ICU, tucked into an inconspicous corner, surfing and typing away on the best technology a non-profit could buy, while waiting for a doctor to decide if 96 degrees is too cold to start brain death and is it ethical to start pitressin on a patient who's peeing a gallon a minute if the organ donation people are in the same hospital.

Ahh, well. Maybe when the little distraction is older I'll go back.

Speaking of which:

I Cn Haz Cupcake!

** Sorry bout the run on sentences, I'm trying to finish before "The Big Comfy Couch" is over.

One more reason to be a nurse

2007-09-26T11:46:00.000-04:00

If I were a better woman, I'd do my job without regard for accolades and thank you's.

But sometimes Thank You's are nice, too.

Sunday night reading

2007-09-23T20:30:00.000-04:00

I've worked all weekend and my feet feel like they weigh 20lbs each. Riding the bike to work is really nice, but that last hill on the way home is a doozy. Tonight I walked the bike up it.

Anyway, I'm overdue for my monthly coop article, so tomorrow will be spent busily thinking up a topic and then writing on it. Better late, if ever, is my motto. In the mean time, if you haven't read it already, Change of Shift is up at Kim's. I have a new post in the works, so check back in a day or two.

LPS(longer post soon)

2007-09-19T23:33:00.000-04:00

Well, we all survived the weekend.

And I have to say, Sixteen-odd years and two kids later, I finally feel like a "real" mom. Mainly because I managed(with ample help from Love Monkey) 8 teenagers and one baby for 2 days and there were no injuries, no fights, nobody got lost and everybody got fed(if burnt weenies and ice cream cake count).

The weekend turned out to be nice. Around 9am the rain stopped and the sun came out, even if it was a little windy. Even the old folks came out-Auntie and my mom and dad. I had the most awesome video on my phone of this parade snaking its way out to beach, led by Auntie, with her walker, going full steam ahead, followed by the Teenager holding a huge Jolly Roger flag and various kids carrying all our crap out to the beach and the grandparents bringing up the rear-my mom with her cane and dad carrying the beach chairs. I was even going to post the vid for your delight and edification. But I didn't press record. Because I am tekniklee challenged! Auugh!

We had a nice fire on the beach. We did some swimming until the park ranger yelled at us. We roasted weenies and marshmellows and generally had a great time, including Pooter, who chased every "duckie" (read:sea gull) she could find. It was so great that I want to do the same for my 40th next year, except maybe not in December, unless it's a beach party in Jamaica-hint, hint.

Monday and Tuesday were 12 hour days for me, which I was looking to with dread as I'm still kinda sick. I feel loads better but I have this bronchitic cough that makes me sound like the illegitimate spawn of Betty Davis and Harvey Fierstein. Just what you want in a nurse taking care of your small children. I sound like I have the consumption, but REALLY-I FEEL SWELL!

Anyway, miracle of miracles, our census was low Tuesday, so they let me go 3 hours early! Huzzah! Then, later that night, the Pooter got sick and was up all night miserable. She still a little fragile today, but several doses of motrin and tylenol and some soup have made her happier. So, longer, more relevant posts to come. I'm going back to sleep.

Weekend Report

2007-09-14T20:56:00.000-04:00

I've spent the last three days desperately ill, the last two days working and now, at 9pm on a Friday night, I'm leaving for a weekend at the shore with a dozen teenagers.

Please pray to the deity of your choice that:

a. It doesn't rain, and

b. I don't kill anyone.

DT(dear teen) has just called to ask me to bring her hairdryer down. HAIRDRYER. At the beach.

Cough.

This just in....

2007-09-12T20:44:00.000-04:00

Donorcycle's official fact checker and stats keeper has just informed me that 100-47 does indeed equal 53, not 63. Thanks, PJ, and keep up the good work. And for the record, you try writing with a toddler climbing all over you. Oh, wait, she was in daycare today....I'll have to come up with some better excuse.