There are no coincidences

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

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

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

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....

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.

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...

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.

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

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

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...

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.

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!

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

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!

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......

1. 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.
   
2. 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.
3. 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.
   
4. To write a book.
   
5. To run a marathon.
   
6. 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?

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...

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...

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

Oh, God, it's hot!

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

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.)