The new job is busy

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

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.

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...

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.

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

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

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.

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

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:

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

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?

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.

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!

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

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

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!

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

Let's start off with a commercial:

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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...

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

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

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.