I couldn't stand it anymore....

So I went ahead and started a blog on typepad.

I intend to continue blogging, but only on typepad and will eventually move my entries on blogger over to some archives on typepad. It'll be awhile though.

In the meantime, the link to go to now is here

http://www.tameworld.typepad.com/

September 11, 2006 -- Five years later...

And I still remember with crystal clarity, where I was and what I was doing when I first heard about what was happening....

Five years ago, I was a second year resident on the eleventh day of my general surgery rotation and I was dog tired.

Five years ago, I was up at 4:30am CDT and at the hospital starting rounds at 5:30 am. My partner-in-crime Leila (fellow 2nd year on the same rotation) hadn't gotten there yet. The day before we'd split the patient list and I took the NICU with 18 or so babies all with surgical issues to manage. Leila took the rest of the hospital but only had about 12 or so to see, so she was coming a bit later.

Five years ago at 7:45am CDT, I was standing in the NICU, at the bedside of baby #14, who was on a ventilator, had drains & lines coming out of more places than you can imagine, and I was trying to calculate how much fluid had been pumped in and if his kidneys had made enough urine to keep the fluid balance even.

Five years ago at 7:50am CDT, my pager went off with some weird extension someplace on the 4th floor. Wasn't a known number so I didn't just drop everything to answer the page.

Five years ago at 7:55am CDT, I called the extension, since I'd gotten another page to the same weird number, and it was Leila. Her voice was not right, and it took a few repetitions of what she was saying before I got the point that I needed to get up to the 4th floor STAT. Didn't know why, but since it was a post-op floor, I thought she wanted help with a kid who was about to code. Since the gulf coast has hurricanes, the NICU was on the 3rd floor & shared the floor with the generators. So there was not stair access from 3 to 4. I had to wait for the elevators and the entire time I had my ears peeled waiting for the "Code Call" over the PA. The adrenaline was starting to pound and no matter how fast I said "Hail Mary's" the elevator took forever to go up one floor.

Five years ago at 8:00am CDT, I found Leila in an empty patient room on the 4th floor, staring at a TV watching the replay video of the first plane hitting the first tower and that tower collapsing.

Five years ago at 8:03am CDT, Leila and I watched the second tower go down. Stunned, shocked, horrified, scared, and already on adrenaline overload, all I could do was think of my family. This was the second of the 5 occasions that I've just dropped everything at work to focus on my family. Called Michael to make sure he had a TV on and knew what was happening. He did and his worksite was already starting disaster drills, not knowing what was happening. Called my Mom since I was sick with fear that my Dad was traveling and possibly on the East Coast for work. He wasn't; he was at his usual office. But Mom hadn't put the TV on yet. Called my brother, and the military base he was on was going to high alert as we spoke. So my core family was OK and I got back to work.

My residency hospital was in a military town so there were some pretty fast reactions. The CEO of our hospital had been at a conference and was trapped in Houston since all flights were grounded. He'd called in and by 8:30am our hospital was in disaster mode. All non-essential surgeries were cancelled. That lightened up the load of paperwork for Leila & I, since we didn't end up being in pre-op doing tons of last minute history & physicals. The residents on duty at that time were informed that we wouldn't be going home until we were dismissed. Made me glad I was keeping a call bag in the car every day instead of just for call nights.

By about 9:20am CDT Leila and I had mostly finished seeing all the kids on the surgery service. We were busy discharging everyone who could go home, so that we could clear beds if they were needed. We'd actually decided that now was a good time to take a break and grab breakfast before the cafeteria closed at 9:30am. And that's where our two surgeons found us, and our day went into a tail-spin.

A little background: this children's hospital was the tertiary care center for a 33 county area in South Texas that covered 31,000 square miles of territory. It was not unusual to have families that would travel 3 hours to get to us, rather than see the local E.R. It also wasn't unusual for us to "inherit" bizarre, strange, indescribable patients from the valley and from Northern Mexico. And when this happened, it usually involved a crisis of some sort and always involved a very sick kid, usually hovering on the verge of death. So we had a crackerjack transport team. They could do ambulance, fixed wing aircraft, helicopter, small jet. You name it, they'd take it, to go get a kid. As a matter of pride they would go to extraordinary measures to try to make sure the kid was in the same shape or slightly better by the time they arrived.

So I was in mid-bacon & egg sandwich when Dr. S found us to let us know we had a sick, sick kid in the Valley whom we'd suddenly been given responsibility for. He was in end-stage kidney failure, dialysis was failing, and of all times, he had a donor kidney become available. Only problem was, he was over 150 miles away, and his kidney was another 75 miles north in San Antonio. The surgeons in San Antonio, couldn't get to the valley because all flights were grounded, so they'd called us, since we were closer, to see if we could help get the kid to San Antonio. And by-the-way, the clock for that new kidney, had started counting down about an hour ago. So we only had about 8 hours at best, 12 hours at most to try to work a miracle.

I'd like to think that I had some heroic role to play at this point. The reality of it was, I was so low on the totem pole that I wasn't going to accomplish anything directly for this kid. Instead, Leila & I did the only thing that we could do, and that was we took over everything we could on the surgery service that day. Between the two of us, we became the pediatric surgeons. We tried to run interference to give Dr. S and Dr. H the time to help that kid. We carried their pagers, answered all their calls, did consults and saw patients for them. Eventually, Dr. H and Dr. S managed to work their way through the local chain of command at the nearby Air Force Base and got through to a compassionate commanding officer.

So long story short, they made arrangements for our transport jet, to fly accompanied by armed fighters down to the valley. The plan was to pick up this kid, fly to a base in San Antonio, where ground transport would take him to the surgeons there, and then our jet would fly home accompanied by the fighters still. Our transport team and pilot were advised in no uncertain terms that if they veered off the flight plan by more than a degree, they would be shot down. No questions asked. Dr. S. ended up being the medical control doctor for the flight and was in radio contact with the team almost the entire time. The kid made the trip ok to San Antonio and got there before the 12 hour mark. I never did learn if his kidney transplant succeeded or not.

And on the homeward bound leg, the transport team was able to radio back. Even though they were scared the entire time by the armed guns pointed at them, they had successfully completed their mission on a day, at a time, when all the other planes in the country were grounded.

So on a day that was overflowing with tragedy, that was my small, local miracle....

edited 09-12-06 at 8:28am -- I have been trying to post this entry since late last night. I had a photograph I took on Sept 11, 2006 that I wanted to add to this entry. I kid you not, I have tried to upload that photo 2 dozen times without success. In the interest of getting this posted I'll forgo the photo for now. This experience however is just adding to my frustration with blogger.... Stay tuned, the channel may be changing....

This week in pictures....

First off, Monday the 4th, was the first anniversary of my cousin Andrea & her husband Kraig. I thought about you two on Monday, and then Tabitha went tearing by yelling something, and I was forever sidetracked. In the past 5 months, I discovered that "Mommy-Brain" is in fact very real, and I count myself fortunate that I don't have the clumsy type, only the very limited short-term memory type. I realize that makes me late, but really Congratulations!! You have now officially past the newlywed phase and you both lived! I'm very proud of you two. I don't have a current picture, but this is one of my favorites from their wedding. Aren't they just cute!?!

I also didn't mention that our sweet Tessa has reached that feline milestone of 12 years old as of August 23rd. Only about 84 years in people years - not bad. She still has her kitten moments, but mostly she has staked out the kitchen counter as her territory and her life is mostly sleep, be brushed & adored and a little bit of eating. Last year we were fairly certain we were going to lose her any day after a span of two weeks of bilious vomiting. Our vets found a shadow on x-ray that appears to be a tumor originating off the lower part of her spine. Apparently it waxes and wanes. Some days she feels pretty good, other days not so much. About every 4-6 months she starts acting like she's got a partial bowel obstruction and after 10-14 days she perks right back up. So we just look at this situation as she's had a pretty good life and when she's tired of being with us, she'll let us know. Otherwise, everyday with her is pretty much a gift. So here is one of my favorite portraits I took and then on Monday, she found the crockpot cooking dinner and made friends....

Wednesday morning I did grab the camera & caught a picture of Miss Tab with wheels on the way to school. Since then I've mostly been just trying to stay caught up. Our school has unfortunately not gotten the bugs out of the crossing guard schedule, so she has to stop & wait for me before she crosses the street in front of the school. The sarcastic exasperation from her is nearly "overwhelming". And Yes, she is sticking her tongue out at me. Just 110% sass right now....

Wednesday also saw me sign and return my contract for my new job. A very happy moment actually. Then I met Michael for lunch. Turns out that this will be the first time in 12 years that I'll be working close enough to him that we can meet for lunch! Since I've heard non-stop about all the fabulous restaurants around him for the past 3 years, I'm looking forward to some good lunches! So here's a peek at the building that my office will be in....

Today I planned ahead and had the camera for some ballet class photos. And she was just hamming it up, let me tell you. She had oreos (and learned their name) for her afternoon snack today and apparently the sugar hadn't worn off yet when we got to ballet. At any rate, these make it look like she knowns what she's doing. The reality is that you can take the gymnast out of the gym, but you can't really make her dance! I'm sorry, but when she keeps demonstrating her cartwheels & handstands to her ballet classmates, something is lost in translation....

This week I have just been struggling with blogger. Trying to post and especially upload pictures has just been a tedious trial of re-send, re-send, re-send, save, re-send, etc. So aggravating that I am serious considering switching to typepad, even though that one has a monthly charge.... Don't know, more research is needed and I'll have to get back to you. If anyone has any experience with typepad, leave me a comment. I'd really appreciate it.

I'm not the only one with frustration issues. Tab has had a rocky week at school. A note got sent home Wednesday that she'd poured water on some kid's head when they were supposed to be in line. Then there seems to be a disconnect between what she's capable of doing and what her teachers are expecting her to do. For instance one note said that she was having lots of problems with the addition/subtraction facts. But when I really looked at the worksheets she was bringing home, there's been a subtle shift in the vocabulary from "add", "subtract", "plus", "minus" to "sum", "difference", "addend", "subtractend". When I sent a note back pointing this out, and that if they used words that Tab knew, then she could answer the questions, and she'd stay interested and engaged in learning. Well, the response I got made it seem like I just discovered the secret formula to win the lotto. Suddenly, "Tabitha got it!" Sorry folks, it's not brain surgery. The kid has been here for 5 months, and only speaking English for 3. So to quote my Dad, "Use the K.I.S.S. principle." (I'll allow you to fill in your favorite version of what that stands for....) But the take home point is, if you want her to do the work, use words she knows and keep it simple.

Oy vey! So now we've got a parent-teacher conference scheduled for next week to make sure that we're all in agreement on what the expectations are for her. Every night this week has been an exercise in frustration & patience for both of us to get her homework done. I'd like to think that after next week's meeting things will go better, but I suspect it's going to be worse for awhile before it gets better. Thank God she can ride that bike & stay up about 98% of the time, so that something's going well right now!

Last night, in that brutally honest way that 8 year olds have, she told me "Mamma, you worry too much!" When I explained that that was part of my job, she thought about it and repeated herself. I offered to let her do some of the worrying, but she didn't want to. She also decided that Dad didn't really want to, and that none of the cats really knew how to worry. So basically she decided, it really was my job to worry, since no one else wanted to.... How's that for philosopy studies at 8 years??

In other goings on, I have been studying like a fiend for the Pedi Boards on Oct 23 & 24. Covered 178 pages in the past 4 days, over about 8 hours of reading time. Just got another case review book that arrived yesterday. I ordered it on Wednesday and paid for 2 day UPS and it arrived in less than 24 hours. Scared me to death since I hadn't expected anyone at the front door when the doorbell rang! Tucker and Pixel have become my serious study buddies and they sprawl out on the kitchen table and shed profusely while I've got all the books out. I may start posting a daily log of time & pages, just to keep me honest....

Today I hit the Hemetology/Oncology chapter and it is just sheer, painful slogging though the material. Today I finally figured out why this topic is so terrifically hard for me and it boils down to being scarred by residency. Over the course of 3 years, I helped to take care of nearly 100 kids with various forms of childhood cancers. Over three years, I had more than my fair share of kids die. I unfortunately became the resident expert on codes and pronouncing death. So some of the kids I already knew the outcomes. But there were always ones I wondered about, so my last year, on one of my last rotations, I had the opportunity to sit down with my Oncology attending, whom I really liked, and I asked her "What happened to so & so?" I was able to list off about 20 names of kids whom I had all gotten attatched to, or had made an impression on me. They all had a variety of cancers, were a variety of ages, a variety of ethnicities, and all characters in one way or another. These were kids whom I had really hit it off with. And know what? Every single one of them, died. Not a single one had pulled through. Even some of the ones with pretty fair prognoses. As a person, as a physician, I can't even being to describe how gut-wrenchingly crushing that was. And at that point I started to feel a deep seated hatred for childhood cancer, what it does to the kids and what it does to the people who love them. So now, when I have to study this stuff and memorize mind-numbing minutiae, all of those negative feelings, and experiences, and losses come rushing back and I have a really hard time focusing. So, I guess, I'm just going to have to figure this one out and get my act together, even though this has historically been one of the hardest parts of the exam for me. But this year, I am determined that I am passing this d*** test. So I gotta' do, what I gotta' do

And on a final note, Tab's school has sent home the forms for the annual fund-raiser. This year the kids are selling cookie dough. And not just any cookie dough. This is good stuff! Michael & I bought some a few years ago and it bakes up into really tasty cookies. So, if you're so inclined, I have a little girl who really wants to sell some cookie dough (48 cookies to the box). The choices are:

• Chocolate chunk $13
• Peanut butter $13
• Snickerdoodle $13
• Oatmeal raisin$13
• Sugar cookies $13
• M&M cookies $15
• White chunk macadamia nut$15
• Heath chunk $15
• and my personal favorite Chocolate chunk pecan$15

Seriously, if you're interested, leave me a comment & we'll make arrangements!

So this morning....

Miss Tab did ride her bike to school for the first time. Helmet, no elbow or knee pads . Followed directions well enough and no crashes on the way there or on the way home.

She was just so dog-gone pleased with herself, that she was like a soda can all shook up and barely containing the fizz....

This is however, the reality of learning to ride her bike in 5 days....

Disclaimer: I did not beat my child -- she did this all by herself....

It has been a very busy past three days....

So much so, that the weekend review in pictures is the best way to summarize....

Saturday, Tabitha went to her first friend's "invitation-only" birthday party. Swam for almost 3 hours. Had a great time even though she was an 8 year old hanging out with the 10 yo set.

Earlier Saturday had involved a trip to Walmart to look for a "mid-sized" bike that would be easier to pedal and easier to stop. Tab didn't like the aesthetic choices, i.e. if it's not pink, it's not coming home. So instead, she ended up with a basic silver Razor scooter like the one that the new girls next door have. She also convinced Dad that she needed the $4 Cinderella wig for Halloween, but she needed it now to practice her princess skills. This is a stretch to imagine, but she wants to be a princess for Halloween.... We just didn't see that one coming.... {sarcastic snickering inserted here....}

She also played with my camera for a bit and got this unusal perspective of Tucker.

Sunday she was still zonked so I went to church by myself. That was a nice change. Got home and found this.

Safe to say.... It is Official....

I Live With SLOBS!!!

For self-torture only, I added it up last week and on average I spend 35-45 minutes a day, every day picking up after Tabitha & Michael. All six cats take less work....

Miss E. from next door adopted us this weekend since her mom was out-of-town on work. So she took part in Tabitha's first batch of chocolate chip cookies. Yum! Want some right now actually. The girls were in fact, thrilled with themselves. And Michael cleaned up most of the mess....

After the cookies were done we headed to our friend Ellen's home for some holiday R&R. Took Miss E. with us, since otherwise Tab would be the only "child-sized" kid there. All of us had a blast. The girls had fun swimming in the pool and diving from a real authentic diving board. But the favorite was all the arcade games that Ellen & Kenny have collected. No quarters required. 'Nuff said. I even got in on the action and set the new high score on the vintage pinball machine. Who knew I was so talented with the flipper bar? (185,580 points by-the-way!)

Once we got home, both girls campaigned for a sleep-over, so next thing I knew, we'd adopted Miss E. for the night. The girls had fun. Played on Michael's flight simulator for a bit. Watched Project Runway with me for a while. Then they camped out in the media room and binged on three movies in a row. Apparently they fell asleep at 02:30am and were up at 9. Our block lost power from about 8:30 to almost 11am. So once the girls were fed & cleaned up, Em went home. Tab was a whiney tired crank-monster all day. The kittens were non-existent all day too. They'd apparently stayed up with the girls to check out all the goings-on, and such a late night really put a crimp in their usual 18 hours of sleep!

Tab was determined though. She had one more day of bike practice to meet my requirements to ride her bike to school on Tuesday morning. So in spite of 8+ hours of rain, she got out there and practiced. Hard! See here for the beginnings of the bike saga. She has made some good progress in only about 5 days. Controls the 16"wheels well. Can ride with one hand, stops on a dime - with the brakes instead with feet, turns tight corners and still maintains her balance. So this was Labor Day, biking in the rain....

To quote Tabitha....

"Oh, my Goodness!"

It has been quite the day! We've just finished getting to know our new next door neighbors who are moving in this weekend. They've got two girls around Tabitha's age, and with E. next door - we have the "girl squad" for our block lined up!

I'm sure that as intro's go, we all meant for this to be a quick meet & greet, but the parents & the kids were having such a good visit that time got away from us and two hours later we, the adults, realized that they, the kids, really really needed to be headed to bed.

I think good times are definitely in the forecast....

Otherwise today was calmer in that I didn't drive through three counties and the cost of gas was a delightful$2.49/gal. Still hectic in that I was on a schedule of places to be and things to do.

Had part two of my thyroid scan today. Yup, I went "nuclear" yesterday and started on a 24 hour thyroid scan which involves swallowing a radioactively tagged iodine capsule & 24 hours later taking pictures/scans of where the iodine goes. Yesterday was only the 5th time in 10 years that I've used the "doctor card" to get something done, but on an already stressful day I was getting jerked around and I needed it to stop. The radiology place had set up the scan 6 weeks ago, because I had to stop taking any thyroid medication then in order for it to have time to clear to get accurate scans today (very long half-life for you physics / pharmacology folks.) So they scheduled the scan after they'd gotten faxed orders from my doc's office. On Aug 30th, his office called the radiology folks to check if they needed orders or not. The radiology people said "yes" but no new orders got sent. So at 9am yesterday, with the nuclear iodine on a countdown timer, the radiology people called the doc's office 4 times asking for new orders (because the others had "expired".) At one point the radiology dude jokingly suggested that I just write my own orders but then said that that wasn't really ethical. So after waiting 1.5 hours, I called my doc's office. Found out they were at office #2. Got told he had the day off. And I went "boing". In a very nice, yet firm "don't-screw-with-me" voice I let them know that I wanted their charge nurse on the phone, that there was a problem, and that at that point I had 15 minutes left before the iodine would have to be wasted because it had decayed too much to use, and that "By God, those orders better get faxed over here now, because you do not want me showing up in your office today because this test needs to be rescheduled." (it's not like the radiologist keeps radioactive iodine just laying around - it gets ordered on an "as needed" basis and there weren't any spares....) Apparently that got through, because the fax machine miraculously spit out an order sheet & I was called back less than 5 minutes later. Signed a bunch of consent forms and then swallowed this very innocent looking green & white capsule.

Today compared to yesterday was a cake-walk. The hardest thing was holding still for 25 minutes with my head bent backwards for the scanner to really get a good "look" at the radiation coming off my neck. Just as I was starting to fall asleep - I was done. So hope to hear something by the end of next week -- holiday weekends always throw off getting results.

Met Dad for lunch, talked to Mom on the phone, and spent a deliriously happy 2 hours wandering around Recollections looking at the newest stuff. Wanted to get a bunch, but didn't. Since I already have enough projects going at home right now, I need to finish some before I start more.. Got Tab to ballet, and realized I forgot the camera! Arggg! Michael & I visited the new winestore by the dance studio. This will be the last time I try wine samples at 4:30pm on an empty stomach! I'd had a migraine brewing for 24 hours, but the wine pushed me over the edge. So not barfing in the car on the ride home was priority #1. (Erin I feel your pain!) Glad Michael was there to drive. (Of course, if I'd been by myself, I wouldn't have been in the wine store anyway....) And then this evening has progressed in a domestic blur....

What's wrong with this picture????

It takes 5+ months to obtain hospital privileges....

But less than five minutes to give them back.

Oy! That was the theme of the day today. It was a bittersweet sort of day. It felt good to lose the hospital responsibilities, but it was sad to know that I really was not going to be working with some really quality people anymore. This baby-doctoring has been what I've done for the past 3 years; it's what I am. At these hospitals, the nurses & staff, these women have become my family away from home and I will miss them. Kirsten, it has been fun. On days that we wanted to cry, we made each other laugh! Glad we got in one last lunch and there will still be more to come. Rhonda & Casandra, thanks for always keeping an eye on me and keeping me on the "straight & narrow". There are so many nurses and techs who have kept an eye out for me over the years, keeping me honest & focused, that I wouldn't try to name them all. My special favorites know who they are, and I will think of you all often. (Wish I hadn't forgotten my camera the last week as I would have loved to get some pictures while I was there.)

On the sweet side, I picked up my contract for my new job. No real surprises there, but I'll read through it more thoroughly over the weekend. I've been given the gift of time, and won't be starting until Sept 18th. Which I'm a bit surprised about, but I plan to use this as good time for some serious studying for the Pedi boards in October. Not to fear, I will get some scrapbooking done too!
All things in moderation....

And so another chapter begins....