We need more monkeys!

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....

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!!

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

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.

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....

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

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

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: