Thursday, October 16, 2014


"I hereby declare, on oath,

I want to tell you a story.  It is an entirely true story.

 that I absolutely and entirely renounce and abjure all allegiance and fidelity to any foreign prince,

Once, many years ago, I awoke from a very vivid dream of a little girl with curly hair.  Somehow, I knew that she was my little girl.

potentate, state, or sovereignty,

I already had a lovely little girl, but I knew that there was another one out there.  So I started looking for her.

of whom or which I have heretofore been a subject or citizen;

I looked in India.  She wasn't there.

that I will support and defend the Constitution and laws of the United States of America

I looked here at home.  She wasn't here.

 against all enemies, foreign and domestic;

I looked for a LONG time. 

that I will bear true faith and allegiance to the same;

An adoption agency sent me a picture of a little Colombian girl with a lollipop, and a long, sad medical history.  If the story was true, she was going to die whether she came home to me or not.  So, heavy hearted, I said, "No."

that I will bear arms on behalf of the United States when required by the law;

But that little girl DID have a curl on top her head...and she didn't look like she matched the long, sad history.  So I suggested some extra medical tests.  And I went back to looking.

 that I will perform noncombatant service in the Armed Forces of the United States when required by the law;

And a few months later, the agency called me back.  Those tests are all do you think?

that I will perform work of national importance under civilian direction when required by the law;

I think she needs to come home. 

and that I take this obligation freely,

And yesterday, with her little boy on my lap, I watched her take her Naturalization Oath of Allegiance to the United States of America and prove she is a US Citizen.

without any mental reservation or purpose of evasion;

And all the way home my heart was squeezed tight full of gratitude to God for the gift of my beloved Curlygirl.

so help me God."


Saturday, October 11, 2014

Itty Bitty Blessings....

A few weeks ago I notice that the heat in the car wasn't working.  The AC was fine, but there was no way to take the chill off in the morning.  But, hey, it was summer, so most of the time I just forgot it was a problem. 

Getting up at 5 AM to go to the gym in October, however, would be more pleasant with heat in the car.  Seat heaters are awesome, but they don't defog the windshields, right? 

Friday morning I scraped frost off my windshield and discovered that my 'defroster' was adding layers of frost to the inside of the window, making it difficult to forget that I had a problem, so I took it straight to the car doc.  At the end of the day, they called me.

"Good news!  Your car has heat!" 

Good news indeed.  "What's that going to cost me?"

"Hope you're sitting down." 




Apparently some wire was bent.  He bent it back. 

Give the man credit.  He could just as well have told me that he had to replace the hunkafundkle and the solenoidal sinus and charged me $322.50 and I've been none the wiser.  So praise be to God for an honest mechanic and an affordable car repair.


PS Babygirl and I both had a rare day of excellent brain function.  She commented on it almost as if it seemed impossible.

Wednesday, October 8, 2014

Miserable Migraine....

I've had a couple of days this week where I feel  like somebody beat the crap out of me.  Muscles I didn't know I have have been cold and crampy and achy and tired.  I worked Monday and called in sick yesterday with a combination of headache and muscle pain.  I went to bed at eight last night and got up and went to the gym this morning.

(Aside story:  If you swim regularly, you kill bathing suits, especially since the people who make a plus-size suit apparently assume you will wear it for 10 minutes at a time once a year rather than actually exercise in it.  At this time of year, the only place to get a suit is online.  I ordered two, and one of the new ones seemed rather generously sized on the bottom and snug on top, opposite to the usual fat girl sizing.  It wasn't bad, but I discovered that breathing and swimming at the same time were not compatible activities in this suit.  The good news is that the ocean will NEVER be able to remove this suit, so it will go to the beach next time.)

I went to work, and toward the end of my first patient's visit, I got that telltale ache at the base of my skull on the right side (I nearly typed 'left'.  When I get these things it's almost always the right side and I almost always say left.  I don't know why).  It was followed by the sensation that the back of my scalp was wrinkling, with a crawling sensation (one of my least favorite auras).  I immediately took my migraine medications and moved on to my next patient.  I had barely finished when the side effects of the meds and the migraine hit together along with a massive wave of nausea, and I was done.  Nurses move fast when you say, "I'm going to throw up."

They had to walk me to a dark room where I watched the light show behind my eyelids and kept my ears covered against all the noise.  They shot me up with anti-emetics and called Hubby from work to come and get me.  He bought me a cup of full-strength coffee, and I went to bed and slept until three PM. 

My tongue is still tingling.  My head is still sensitive and noises are still a little much.  Time keeps jumping around.  Last time I looked it was four, and now it's six.  Babygirl has her own headache and s laying low.  Hubby is ordering pizza because it's the least noisy thing to make. 

I see the doc in the morning.


Tuesday, October 7, 2014

Coming Back...

Yesterday's lab reports represented an improvement:  Creatinine is down from 1.3 to 1.1 with her baseline being 0.8 (and normal for age 0.6 or less).  Potassium back to normal at 4.3 (but we had a better phlebotomist - our man Frank was there and he doesn't fool around.  The girl the other day did a lot of the vein-patting delay-tactic stuff that can cause an artificial rise in potassium due to trauma).  She still has too much acid, but that's better also.

The good news is that they aren't immediately calling us to Philly. There was a grumble about the fact that our next appointment isn't until the end of November, so after the team chats this morning, that might get shifted.

Babygirl wasn't up to school but she was very productive with the math tutor (the poor young lady whose first experience was to watch her cry the other day).  She says Babygirl covered four days of math.  Yippee, I say. Now she's only TWO weeks behind in one class, and three weeks behind in eight others, but who's counting?  TutorGirl was a bit startled by this take on reality, and she's not in charge of the big picture, but he sent a text to Babygirl's advisor outlining my ongoing concerns about ALL of her classes. 

Meanwhile, I'm on day three of some kind of crud that makes me feel like someone ran me over with a truck, and I just cannot get warm.  Who gets goosebumps on just one half of the body? I swear they are rolling up and down from my right ankle to my shoulder.


Sunday, October 5, 2014

Day Of Rest.....

Babygirl has spent today recovering.  Headaches and tummy aches off and on with the sniffles that mark the end of the cold that's been riding in the background of the past two weeks.  She ate dinner and we're watching some TV, waiting for bedtime. 

I spent my day curled up with a book.  I couldn't get warm, so I finally got out the heating pad and plugged it in underneath myself while I read.  I've been too tired to read, which is very unusual, so I've been stuck on the same page for weeks.  It was a relief to finally finish something - an almost overwhelming sense of accomplishment.

I reset my brain with a handful of Sudoku puzzles. 

I stopped crying.

It's not much.  But it's the best I can do. 

I think I'm ready to face the week.


Saturday, October 4, 2014

Grateful Relief....

On the way into work on Thursday morning I was in a dark place - exhausted, discouraged, sad and hopeless.  An optimist by nature, this is a hard place to get to, and I'm so rarely there that I don't have a lot of plans for getting back OUT.  I climbed out of my car into a pile of bright yellow leaves and even THAT didn't make me smile.  On the way into the building I struggled to find something, ANYthing, I could sincerely and without a trace of snark tell God I was thankful for. 

As I contemplated the number of patients I knew were loaded into my schedule against the amount of paperwork backed up on my desk, I rewound the weeks' workload and realized....very few of my scheduled patients had actually kept their appointments. 

"No Shows" are a chronic problem in our office.  Our patients are poor, mentally ill, careless, overstressed, and overbooked.  They run out of minutes, pay their rent ahead of their phones, don't get reminder calls and take extra work hours when they are offered.  And sometimes the 'no shows' come in clusters.  The only reason I'd been able to manage all Babygirl's phone calls to the school and all her docs was because my patients weren't there.

So I stopped, and said a 'thank you' for the no shows. It wasn't much, but it was, honestly, the best I could do. 

Babygirl's neurologist called, concerned about the medications and the kidney.  The bottom line is that he doesn't want to be responsible for wiping out her kidney function.  He's not.  But he's freaked, a little.  Nephrology didn't call.  The school called.  I told them not to send a tutor.  Babygirl's still just too sick.

Friday morning, after 24 hours without the lisinopril, Babygirl awakens with a small tummyache and a small headache, overall, an improvement.  I asked her if she could handle a tutor and she said yes, so the school sent one over for a couple of hours after school.  Nephrology called and said they want the kidney retested Monday, so we won't know if the kidney damage is permanent or temporary until then.

Last night we went out for dinner.  Babygirl ate a salad and part of a bowl of soup, the most I've seen her get down at one sitting in over a week.  We went to Barnes and Nobles and she bought a Manga, getting into an animated conversation with the sales clerk about his 6-month stay in Japan.  It was beautiful, heartbreakingly beautiful, to see.

Crawling up out of any hole takes time.  Each battering we take lays open scars laid down by the last one and revives fears barely buried.  We keep walking.  Falling.  Crawling. 

Lord, give us the strength to get back up. Again.  And again.  As many times as it takes.



Thursday, October 2, 2014


Babygirl is on the fourth (fifth? it's been such a crappy month that it's beginning to run together) day of this ongoing episode of inexplicable abdominal pain.  No fever, no urinary symptoms, one day of vomiting for a couple of hours, some nausea, some weight loss.  Just total, ongoing misery. 

Recapping her school attendance:  Three weeks ago she missed Wednesday through Friday with a severe headache. The week before last she missed Tuesday and Thursday with headache. Last Monday she called Hubby for  ride home from school with a headache and stayed home Tuesday through Thursday with more of them, and Friday with a cold. She began having the belly pain Sunday and hasn't been to school all week.  We haven't seen a home teacher through all of this.

Yesterday I called the school and spoke to the head of the health office and explained where we were.  It was reassuring to hear her utter exasperation when I told her that there was some confusion about how to meet her 504 plan.  I think that she will be clearing that up. 

I heard from Babygirl's advisor that a tutor was available for the evening, so would I bring her to school for tutoring?  Um, no.  The kid is sick.  Get the tutor to our house, okay?  Okay.

I called Nephrology. They reviewed things, heard the story, looked at the dose of the new headache prevention medication (which, at 15 mg twice daily is under the 40 mg/day adult maximum but is more than they usually use in children.  Keep in mind, however, that Babygirl is 15 and adult-sized).  They ordered STAT blood work (at 4:30 PM, with a tutor scheduled to arrive at the house at 5:30 and me still at work and Bible study scheduled at 6). It turns out that among the rare side effects of this medication (rare indeed since I prescribe this drug all the time for over 25 years and have NEVER seen it)  is abdominal pain.  Seriously?

Keep in mind that I haven't seen Babygirl for more than the 30 seconds that it took to wake her up and see that she was too sick to go to school at 7 AM, so I really don't know how she is feeling right this minute, right?

I hover over the fax machine, call AGAIN when the fax doesn't come, grab the papers and run.  I hustle poor Babygirl to the lab and get her home in time for the tutor to arrive.  This lovely young lady has never met Babygirl.  She is expecting that Babygirl has some books, or texts, or papers, or SOMETHING for her to start working on.  I was told that she was going to be given a packet of work for a couple of Babygirl's elective classes to work on.  She had no idea what I was talking about. 

She started to see if Babygirl had any grasp of in this year's math - her most difficult subject.  She was patient and kind, and in less than ten minutes Babygirl had put her head down and was sobbing.  Sometimes you are just too sick to deal with anything, you know?  In all of the time we've had tutors, I think this may have been the third time we've had to send one home because she just couldn't manage.

On a happier note, Citygirl wanted me to come and listen to a band that she was thinking of hiring for a party she's planning.  I collected myself, got in the car, settled into some very relaxing music with a fruity drink and......

The on-call Nephrologist called.  Babygirl's kidney is most unhappy.  Her creatinine is up to 1.34 from 0.8 only two weeks ago.  Her potassium is high and her bicarbonate is low (lots of acid that the kidney is not getting rid of).  Her advice:  Stop the new medication, and stop it NOW.  I check the time - it's 5 minutes to medication time.  I call hubby's phone.  No answer.  Home phone - same.  Babygirl's phone - same.  Repeat all four or five times.  Finally Babygirl answers, and I tell her, "Dad has to change your medicine. Go tell him to call me."  He calls, I tell him, and he says, "But she just took it!"

There is not enough rum and pineapple juice in this world to cope with this, just not enough. 

Screw it.  There's nothing more I can do about it tonight.  I had an appetizer, called it dinner, and enjoyed Citygirl's company and the music, and came home and resorted all the pills.

This morning they will call with a plan. 

All of this is overwhelming enough, right?  But this is the script that runs in the background of my life.  In front of this, I go to work, to the gym, clean my house, spend time with the grandkids, do the grocery shopping, take care of my mom, go to church.  Most of the time I don't feel sorry for myself, but last night I just wanted to turn the clock back somehow - but to where?  There is no point on that timeline that doesn't bring us back to here, since there is no choice I wouldn't make that would exclude any one of my kids from my life.  There really is no 'might have been.'  There is only THIS.  It's just that watching her suffer is So. Damned. Hard.

Citygirl prayed for us all last night.  Something to the effect of, "We know You're taking care of us, but we'd kinda like to see some proof of that...."  I'm sure she was more respectful than that.  And I'm sure He got the point.  And I'm sure I agree.