Thursday, July 6, 2017

Enjoying the Journey....

Since trips to the doctor are an inevitible part of our lives, we try to keep it interesting when possible. The quarterly trip fell near to Independence day, and the annual picnic and parade with the family, so I scheduled off for the 5th as well as the 6th and took a three day "weekend" in the middle of the week. 

The picnic and parade in Glenside were amazing, as always.  Bolivian dancers and wine.  Who could ask for more?

The next day we took my neice back to The Pratt Institute in Brooklyn.  Famous for art and architecture, it has some very interesting art installations.  This one was apparently by Wile E. Coyote.

My neice's school ID entitled her to two free passes at the Brooklyn Botanic Gardens, so we went. They were having difficulty with their credit card reader, so they let the rest of us in for free as well!  


We returned to Philly to enjoy dinner and a campfire with Uncle Ricky.  He'd never had a s'more, and we had to teach him what to do with the marshmallows.....

Closer, dude.

Today we went to CHOP in the early AM. I was a bad mommy and completely forgot to have any blood work done, so we'll have it done on Saturday.  We DID have labs done locally six weeks ago, so we thought we'd talk about that, but for some reason THOSE had never arrived at CHOP, so they are going to track those down and call us later.  She is otherwise doing well.

After CHOP, we had several hours to kill before we had to leave for Nemours.  I had randomly picked up $2 off coupons for the Liberty Museum (never heard of it) in the Philadelphia Historic District, so I looked it up online and we decided to go.  We walk half a mile to the subway, take the train for 10 minutes and, voila, we are there.  $2 off the price of admission meant that our total charge (for BOTH of us) was $5, the best deal ever no matter how good or bad the place might be, but I have to say it was a completely wonderful little museum.  It was themed around the concept that individuals are what make liberty possible.  There was a movie about the Congressional Medal of Honor, areas dedicated to women's rights, important religious figures, Nobel prize winners and ordinary people of extraordinary courage (individuals who hid Jewish families during the Holocaust, for example).  The displays were interactive and gripping.  They used original art and humor in many ways throughout to promote personal responsibility and peace:

"Truce: Rock, Scissors, Paper"

Lunch at The Bourse, a carriage ride through history, train/walk back to CHOP, and now we are at Nemours waiting for doctor #2.  After this we drive home, and we'll have earned our dinner at Perkins since we hit 10,000 steps on our FitBits a while ago.


Saturday, June 24, 2017

Mourning With Those Who Mourn.....

At the very end of the year last year Citygirl's hubby lost his grandmother. She was at their wedding, and they won the "Longest Married Couple" dance quite proudly. This loss has been devastating to their family, the more so because it occurred a long way from the family home. So this week, almost six months later, a formal funeral was held in their hometown. Hubby and I decided to come out to New Hampshire to celebrate her life with them.

A close as we are to New England, neither of us had ever been through Vermont or New Hampshire. The drive was absolutely breathtaking and was only about five hours long. We saw dozens of intriguing places we would love to have spent hours exploring!

We arrived in time for the service. Babygirl and Hubby had never seen a Catholic funeral, so the up-and-down kneeling was new to them, as well as the incense and the music. Their cantor had the voice of an angel: "An He will raise you up on eagles' wings, bear you on the breath of dawn; make you to shine like the the sun, and hold you in the palm of His hand." Goosebumps.

At the graveside, her children told stories of the kind of woman she was, and read poems she had written. Her grandchildren grieved.  And I mourned with them, remembering afresh the loss of my own mother and grandmother.

This is, I am sure, the purpose of a funeral.  It gives families a place to put their grief:  A place to remember, to share, to mourn in solidarity with each other and with friends.  A place to laugh over happy memories and cry for the loss of them:  A place to let go.

The next day we joined the family for a "Nana" tradition:  A game of mini golf with all of the grandchildren.  It was silly, sunny, happy, and rediculous - perhaps the best sort of memorial a grandmother could ask for.


Monday, May 29, 2017

Surviving the Bug....

I've been a bit under the weather this week.  I tend to be pretty tough from an immune standpoint, but this past year has hit me with more than a few bugs.  Not surprising, really:  It's a well-known fact that having people you love die has a negative impact on your immune system for a year or so, and I've been stacking up losses left and right.

That being said, it is extremely rare for anything to hit my GI system.  Even my migraines tend to leave my gut alone.  But this....THING...that Squeaker brought home from school..... Dang.

I had an eye exam Thursday morning.  They tend to trigger migraines, so I really tend to put them off.  This one was more than a year overdue, but everything was good, no change in prescription, all is well, except that two hours later when I went to work I looked like some sort of crazed junky with my right eye about normal and my left fully dialated (which, by-the-by, stayed that way for about another four hours).

So when I started feeling anxious and queasy in the mid-afternoon, I thought for sure I was going to be hit with a migraine.  In fact, my last patient of the day was being seen for migraines, and I joked with her about not worrying if I suddenly had to leave to puke.  She laughed - we migraine people find that sort of thing funny in a sad sort of way.

Once she was done, I found I was totallly unable to finish any more computer work.  I shut down and went home.

On my schedule for Friday morning were four house calls with a resident.


By morning I had gotten rid of Thursday's lunch, breakfast, rehydration attempts, and, I am pretty sure, Wednesday's dinner as well.  I actually didn't feel TOO horrible, so when the resident arrived at my house, we headed out.  First patient?  No problem. Second?  Not bad but I handed off the keys and had her drive after that and let my manager know I was a no-go for afternoon clinic.  Third?  I think I was okay, but my Tylenol had worn off, everything hurt and I was grateful for a sensible second set of eyes.  Fourth?  Well, I perked up a bit and made it through but was grateful indeed to escape in the end.

Last night was the first time I ate a solid meal since.

I'm the last to have it.  Squeaker gave it to his mom, and they were both ill for two days and recovering for one.  Babygirl had it, ill for two days and recovering for three or four.  Me?  Ill for 12 hours and recovering for 2 days.  Nasty sucker.  Hubby's in the recovery phase now and he's been the least sick.

Why. Does. Sickness. Come. On. Weekends?

If this weren't a holiday I'd be going back to work today, dammit.


Sunday, April 23, 2017

This Month's Disaster.....

We all know that Larry has a....delicate gut.  Our experience with last years' 4th of July fireworks aftermath (Sure Fire Paint Remover...) was just one example:  It took two weeks to get his tummy settled.  He can't eat people food, and we have to be careful not to switch up his dog food either.  And he's REALLY not the guy you want on a long road trip. So when he stopped eating for a day early last week, we didn't really think too much of it.

The second day, he ate some.  And then he didn't.  And then a little, and then...not.  And then came the poops.  We came home to a house that smelled like a cross between dog doodoo and death. We spent some time trying to imagine WHAT he could have gotten into and came up with nothing. He's either in the house or on a leash all the time.  The second day of this horror, he hit a bathmat.  I rinsed this out in the toilet and realized that I was seeing a LOT of blood.

Needless to say this was on a Friday evening.  Our vet has no weekend hours.  Over Friday night to Saturday he began throwing up as well, and by Saturday morning it was clear that he wouldn't make it to Monday without some professional help.

What is it with kids and dogs?  Do they all absolutely know for SURE when the doc's/vet's office closes??

There's a lovely animal walk-in not far from here.  When Simon had a tummy bug a couple of years ago they fixed him up, but they made it clear then that he was at the outer edges of what they could do on site there.  Larry was clearly a few steps over that line, so I called the Vet Hospital emergency line and they invited us on over, after informing us that there was a minimum $150 fee for weekend emergencies.

(I checked the place out online before going. Our other option would have been Cornell Vet center, an hour away, and they also ask for you to pay up front.  The reviews were either "They did a great job," or "They were great but expensive," or "What kind of bastards won't even care for your dog if you can't pay??" Personally, I understand your pain if your pet is suffering and you can't afford a vet, but dissing someone because you expect them to work for free seems unreasonable to me.)

The initial evaluation was reassuring, but the differential diagnosis somewhat alarming, as I expected.  The tests to rule out the ugly stuff was what set us back the most.  IV fluids, antiemetics, antibiotics were given and he looked like a new man when we walked out the door.  He's a bit tired today still but eating and walking, and no more of the runs.  We have a couple weeks of special diet, medications and probiotics for him. We will see our (much more affordable) regular vet in a couple of weeks for follow up.

Hemorrhagic gastroenteritis.

It usually hits little dogs, and tends to be related more to stress than infection. Untreated, it can be fatal in a matter of days. They asked about stressors, and I really couldn't think of anything in particular.

But as I was walking this morning I pictured Easter from HIS point of view:  Five extremely excited children ramming through the house at high speed screaming about baskets and eggs and CANDY and baskets and EGGS and eight or ten extra adults crammed into his space talking and laughing and eating and maybe some goodies being dropped on the floor for doggie cleanup and.....

Who knows.  He's a good boy.  He's had Thanksgiving and Christmas under his belt already, with the same people and chaos, more or less.  This might have just been one too many.  We might have to make sure he's upstairs and quiet for the next family gathering.

At our house we joke about the $1000-disaster-of-the-month.  This will do for April.


Sunday, April 16, 2017

Odd Things....

Easter Sunday is always wonderful. Crazy busy, but wonderful. Today was blue-sky sunny and 75.  Eggs were hidden outdoors, so the one we inevitably didn't find didn't matter. Dinner was perfected by that one daughter who stepped up and said, "What can I bring?" and doubled down with three choices on the veggies. Dinner is early on Easter, so there is plenty of time to sit, relax, and let the mind wander.

It's been an odd couple of weeks.

Babygirl's recent doctors visits were not bad. Her labs were drawn a week ahead, and she happened to be ill, so we had to redo them because they were a bit off, but the repeats were fine.  Her Botox injections finally appear to be paying off, and she's had more headache-free time than she has in a very, very long time.
Meanwhile, our insurance insists that the last Botox injections were experimental therapy and won't pay for them.  They DID pay for the ones before that, and the ones before THAT, and so on.  In fact, they covered the first two sets without argument and I've had to fight for each one since.  W. T. H.

My thumb has been healing slowly with no recurrence of infection.  My wrist and my shoulder, oddly, still bother me, because I tweaked them all over the place trying not to use my thumb.

I am dealing with a patient in my office who believes he was bitten by a pit viper while visiting Daytona Beach.  Given the nature of his story, I'm guessing that I might be exploring my first involuntary commitment if his leg isn't getting better.

My washer died Thursday. I discovered it when I went to move Thursday's was to the dryer and put in Friday's load.  There was some kind of error code flashing, so I just opted to try to restart it.  It pumped out all the water and then just kept pumping. And pumping. And pumping.  Since this was clearly not helpful, I pulled the plug and waited for the 'door locked' light to fade out.  The door remained locked.  I plugged it back in, hoping it had forgotten whatever it was on about, but NO, the endless pumping resumed.  I unplugged it for several hours.  Rinse. Repeat.  It's stuck on trying to empty when it's already empty, and permanently locked.  This would be less of a problem if nearly every bra I own wasn't in there, sopping wet, and, I imagine, getting fairly nasty.  I'd go shopping for more, but it's Easter Sunday and, ewww, Walmart bras?  Besides....

I found a killer mother-of-the-bride dress yesterday.  Bella is getting married in the fall, and although she didn't stay with us as long as her sister JuJuBee did, she asked me to be Mom for the wedding.  (In other news:  I saw a picture of myself from this morning and I didn't look.....bad.  Sometimes I forget how much weight I've lost.)  So although the dress was reasonably priced, hosting Easter dinner, putting together Easter baskets, and buying a fabulous dress doesn't leave a budget for new lingerie, especially if I need a new washer.  Hopefully our repair guy will be able to liberate them tomorrow and I can used Curlygirl's washer to finish washing them.

We are considering a fence for the yard.  Capone is just that crazy. And the grandkids are just to little to trust with the doors.

It's our second Easter without Mom.  Maybe SHE took the missing egg. It was always her before.


Tuesday, April 4, 2017

Fiscal Year 2016....

I am, as always, behind on paperwork.  Our tax lady doesn't even bother scheduling us until April, and as always I put everything off until I have no choice.  It's a genuine pain in the hiney to do our taxes. Sorting the medical crap alone can take HOURS.'s done.

Historically, our worst year was transplant year, 2012, with a total of $19,157 in out-of-pocket medical expenses (and 14,701 miles traveled for medical purposes!), and our best since then was 2014 with $5,500 out of pocket and 2015 with only 2,261 miles of travel.

2016 had some interesting challenges.

Our insurance has changed the way things are reimbursed and we didn't figure this out until bills started rolling in after Babygirl's February blood tests.  Our home hospital and her new neurology center are "Level One" providers. Our deductible for the family using these providers is $4400/year.  The hospital where Hubby gets his pain management, and Children's Hospital of Philadelphia (where Babygirl gets all of her transplant-related care) are Level Two providers.  Our family deductible there is $8800/year.  Hubby's pain management sends tests to a Level Three lab, which is not covered AT ALL.

Babygirl's first set of blood tests at CHOP in February came to just over $10,000.  We ended up owing about $3500 for those visits (I negotiated $1500 of her neurology visit down to $200, just settled: The insurance said her treatment was "experimental" even though they had paid for the SAME treatment three months earlier) but the rest was lab costs, and I had to set up a payment plan.  I learned that if I had had the labs drawn at home, it would have cost half as much, so all further labs were done here to decrease our portion of the costs.  Hubby's Level Three lab cost is still under appeal.


Pharmacy costs:  $3,415.90.  That includes two $300 co-payments for Botox.

Medical copayments and deductibles: $7,302.

Mileage: 3,040 (worth $.19/mile for tax purposes, $577.60)

Tolls and parking: $157.27

Grand total out-of-pocket:  $11,834.77.


Add an additional pre-tax $215 for our part of health/dental/vision that comes out of my paycheck, sight unseen.

We'll do a bit better this year.  All Babygirl's labs will be drawn locally.  We're considering whether switching Hubby to our hospital's pain management program is reasonable. Babygirl has been taken off of some medications, and there are no copayments for Botox at her new neurologist's. But this is the second year in a row our costs have come up, and with the loss of Hubby's income last year the hit was especially onerous.


Meeting a Donor's Mom....

During my recent hospital stay, the discharge planner asked the usual questions:  Are you safe at home?  Do you have any trouble getting and taking your medications?  Do you have any mobility issues inside your house?  But there were two rather interesting questions.

"If you needed a caretaker, who would that be?"

Well.  When my headaches were kicking my butt, hubby stepped up and did the muscle work: Shopping, cleaning, parenting, whatever I couldn't manage at any given moment.  He's in no shape for that right now.  My response?  "That just can't happen."  She looked a little nonplussed, but I suspected it wasn't the first time she'd heard something similar.  Then:

"Do you have any concerns about how you'll pay for this hospital stay?"

I actually laughed out loud.  She went somewhere beyond nonplussed.

"I have a child who had a kidney transplant five years ago.  Medical expenses are $1000/month line item in our budget. I'm just taking the hit for team this year and meeting our deductible."

Her eyebrows hit her hairline.  So we chatted about the realities of the expenses of it all.  And then we chatted about her reality:  Three years ago, her twenty year old son died and became an organ donor.  She'd not met an organ recipient, although she had letters from some of her son's.  I asked if she had written them, and she said, "I haven't gotten to that place yet."  We talked about Jorge, and his parents, and Babygirl, and suffering.

"I have to look at it this way:  I got to be his mom for 20 years, and it was the most amazing thing that ever happened to me."

I feel the same about each and every one of my kids.  They are, collectively and individually, the best part of my life and heart.  I've never had to say good-bye to any of them, and I hope I never, ever have to.  But if I do, I hope I do it with the grace and courage this woman has.


Friday, March 24, 2017


Yesterday morning gave an update on the thumb injury.  It didn't quite carry it far enough, apparently.

Each workday since the injury, I've had the same nurse unwind the ACE wrap, pull of the gauze and really LOOK at the boo-boo with me.  Monday - okay, not bad - and a whale of a lot better than the massive Sunday morning swelling that I had before my dose of Godzillamycin.

Tuesday, same.

Wednesday?  That drainage looks a little....yellow.  And what do you think? Is it more red? No?

Thursday I start work late.  So after I did yesterday's post, I got the bandage off.  Hmmm... That's DEFINITELY more red. And more swelling.  And doesn't this area feel a little mushy to you?  So, naturally, since I had a million patients scheduled, I kept working and went to the walk-in after work. (To give me credit, I did call my doc.  He was off work. HIS little girl was home with influenza and a fever.)

The walk in doc heard the story and basically said, "So what do you want ME to do about it?" and sent me to the ER.  The ER called in the troops and had me admitted.  So I've been on IV antibiotics for over 24 hours, and the thumb is looking better. Orthopedics have me in a bigger brace. Infectious disease ordered an MRI and won't let me go home without a second look tomorrow.

MRI with AND without contrast.  Thirty minutes of lying on my back with my broken thumb jacked up in an awkward position while IV fluids continue to fill my bladder.  Yoga practice to the rescue!  I was the longest, noisiest shivasana EVER, but I actually fell asleep for a couple of minutes.


I tell my kids all of the time that intelligent people are NEVER bored.  It's true. But sometimes we ARE at a loss for things to do. I should have grabbed my Sudoku book.


Thursday, March 23, 2017


It's been 5 days since I put a drill through my thumb.

For those of you who didn't hear the details.....

I was working with the mission team at about 9:30 AM Saturday, making Christmas ornaments out of wood to sell as a fundraiser.  As I was drilling through one piece, the 3 mm drill bit snapped.  I had quite a bit of downward pressure on the drill, so when it bucked sideways, it went into my left thumb.  Since there wasn't much left of the bit, I avoided impaling myself to the table, but you can see; looking at the side opposite the entry wound, just how close I came to having an EXIT wound.

There was a 3 mm entry wound and a good bit of bleeding.  My tetanus shot was up-to-date, so I had a teammate bandage it up, mopped up the bloody floor and continued working.  It was just my left hand, after all.  I changed the bandage about 5 times over the course of the day as the wound continued to bleed (a good thing for a deep puncture - you want it to wash itself out, really).  At our 11 PM bedtime, I took the bandage off for a final cleaning and fresh dressing and realized it was throbbing a bit.  And....there were some red streaks headed up past my wrist into the forearm.

Well.  That's not good.

So I did what any sensible person would do. I went online and checked out the ER wait time.  It was a little over 2 hours.

I did the math.  Two hour wait, 4 hour treatment time.  Added up that equalled no sleep, and I'm on call tomorrow.  Yeah, nope.

I took three Advil and went to bed.

When I got up in the morning it didn't look any worse (nor any better, truth be told) so I checked the ER times again. Twenty minutes?  Hallelujah!  I preregistered and was assigned and arrival time in 45 minutes, time enough to eat breakfast (NEVER go to a hospital on an empty stomach, never ever ever) and pack my gear.  I arrived ahead of schedule.

X-rays showed that there were no drill fragments in the thumb, BUT!  I had managed to knock some bone fragments off the edge of the joint with the drill bit.  I done broke it.  It really didn't feel that bad, honest!

The ER doc had an out-loud mental discussion about what antibiotic to use given my list of allergies and recent bout of C. diff, and opted to give me a dose of IV Godzillamycin while I was there to jump-start the treatment.  He also scolded me for waiting.  I'm not thinking that what amounted to a 5 hour delay in starting that antibiotic really mattered a lot, but time will tell I suppose.

I was back at church before the service was over.  Early Sunday morning IS the time to be in the ER.

So.  It really doesn't hurt much.

But you can't button your jeans with only one thumb.

You can't hold a dog food can and fork out the food with only one thumb.

You can't cut meat like an adult with only one thumb.

You can't open ziplock bags with only one thumb.

And for absolutely sure you CANNOT remove a 4-hook bra at the end of a long day with only one thumb.


Tuesday, March 14, 2017

A Homey Blizzard...

I grew up south of Buffalo.  OMG BUFFALO! People say! SO much SNOW!!

Well, the honest truth about the city of Buffalo is that it is generally sunny, fairly windy, and not too snowy. (Think about it.  If it got 10 feet of snow at a time ALL the time, would it make the news when it did?  I mean, who ever reports on a snowstorm in Syracuse?? In 'Cuse, a snowstorm is just SSDD, right? In Buffalo, it's an Event.) In fact, if you listen to weather reports in the area, you generally hear things like, "In the city we expect 2 - 4 inches of snow overnight. But in squall areas south of the city we can expect up to 18 inches."

"Squall areas."  "The Snow Belt south of the toll booths."  "South of Rich Stadium."

Call it what you will.  It was my Dad's driveway.

It wasn't at all unusual for us to get 6, 8, 10 inches and go to school in the morning with the snow still coming down. We used to speculate the the superintendant of schools had a bright sun and blue sky painted on the inside of his window shades.  When the snowfall got above a foot, there was one area where the buses just couldn't get to, so those few kids down in the valley simply didn't make it to school.  It had to approach nearly 18 inches in one snowfall to make them close the schools. Snow commonly started in October. We were frequently ice skating on ponds at the end of November.

Our town was Prepared. They started running plows when the first flakes flew.  Our town had SIDEWALK PLOWS.  Seriously. Sidewalk plows.  I miss those babies. Especially today.

We've had 30 inches of snow since midnight.  They cancelled school preemptively.  I've shoveled the sidewalk three times and my FitBit says I've done 15,000 steps even though the dogs only got walked a mile. I've helped dig out about 8 cars.

I'm sitting here with hot tea, getting ready to assemble some goulash and put a pumpkin custard in the oven. I'm supremely grateful for a large number of things:

Central heat.
A gas stove.
Neighbors who help you dig your car out (and who get excited when they get paid in organic Farmer's Market beer).
Neighbors who can't dig themselves out, and the strength in my own arms to help.
Fleece blankets.
Warm socks.
Snuggly dogs.
Well-stocked cupboards.
Childhood memories.
Memories of my children's childhoods.

No matter what our day-to-day struggles, having that odd event that makes us completely switch up our lives and schedules can trigger gratitude and reset our hearts back to a quieter, more elemental time.  Snow.  The smell, the beauty, the challenge.


Friday, March 10, 2017

Stick a Needle...

On Thursdays I take Capone to doggy daycare.  He's just two years old, and a complete lunatic, and he picks fights with the big dogs at the dog park so I can't let him run off steam there. I have a friend who trains dogs and keeps our pups when we are on vacation, and she has 'small dog day' at her place once a week.  Since it's around the corner from my office, I walk him there on my way to work.  Her big fenced yard is perfect for him, and he's exhausted by the end of the day.

Yesterday, just as I was dropping him off, I got something in my eye.  It felt like an eyelash, under the edge of the upper lid, but I just COULDN'T get it out.  It wasn't terrible, but SO annoying.  My next stop was to get a haircut, so I figured sitting still with my eyes closed (and watering!) would wash it out and I'd be fine.


From there I walked to work and asked my partner to see if she could get it out.  She couldn't even see it, and was unable to flip the upper lid inside out to get a good look.  We just don't have the right tools.

The staff cancelled my patients and the nurses set me up with an ophthalmologist.

A couple hours later I was meeting what appeared to be a 19 year old girl with a black ponytail.  She put drops in my eye, flipped the eyelid, scraped off some 'debris', yanked a couple of eyelashes and sent me home with $25 eye drops.  It will be interesting to see the bill for that.

This morning I am off work to finally repair the root canal that caused all the trouble last summer.

The really sad part of all this?

My computer at work has been acting up, fading out as often as twice per patient.  Yes, IT has looked at it. Yes, they replaced it with a new laptop and it still has the same problem. No, no one else is having this problem. NO, we have not yet performed an exorcism.  It has made work so stressfull that I've had more headaches in the last three weeks than I have in the last year.

I am looking forward to a revision of a ROOT CANAL as a fun alternative to going to work.  And the possibiity of someone sticking a needle in my eye yesterday didn't seem so bad either if I got to go home.

THAT's how bad work has sucked for the last month.


Wednesday, March 8, 2017

Too Many Shoes....

Our church has always done Wednesday night dinners in Lent, with a short Bible study and communion.  I like them, always have:  Informal, friendly gatherings, usually including at least a couple of people I don't know extremely well.  It's nice.

Babygirl and I went together tonight and enjoyed the discussion, and spoke of gratitude (and the lack thereof) on the way home, one of the more subtle themes of the evening.

And when we got home, we caugh up on a Lenten discipline designed as a fun way to raise money for UMCOR (the United Methodist Comittee on Relief), given to us at dinner.

March 2: "We waste food while others live without. Pay $.01 for each disposable cup and plate in your home."

March 3: "Most people in the world walk to get around.  Pay $.50 for each vehicle you own."

March 4: "Heat is an expensive luxury. Pay $1 for your warm home."

March 6:  " "I cried because I had no shoes until I met a man who had no feet." Pay $.05 for each pair of shoes.

March 7:  "Do something fun with friends or family and give $.10 as a thank offering for each one."

March 8: "Many have no bed or inadequate bedding. Give $.50 if you slept in a warm bed last night."

Well, we didn't have to sacrifice much on the paper plates and cups (although some friends had just stocked up and ended up ponying up $12 LOL). But I got nailed on the shoes.  I was a little surprised, actually.  I don't feel like I have a ton of shoes, but it turns out I have nearly 30 pairs!  Like, how...???

I'm a walker, so I have two pairs of sneakers and two pairs of 'snow sneakers.'  A pair of work boots for mission trips and a pair of 'apre ski' boots. Oh, and actual ski boots.  Three pairs of flip flops, two pairs of hiking sandals, a pair of waterdogs,  Eight pairs of cute flats in a variety of colors, mostly leftover from all of last years' wedding parties. One pair of dancing heels, also wedding shoes. And the rest are 'work shoes', nice enough to wear to work and comfortable enough to survive the day in.  With the exception of one pair of sneakers and two new pair of work shoes, none are less that a year old and most are more than 4 years old. Several are hand-me-downs that Citygirl got tired of. There is a small crowd of shoes under my desk at work.

I grew up at the bottom of middle class, or at the top of poor depending on whether my dad was laid off or not at the moment.  I had a pair of sneakers for gym and a pair of shoes for school.  The first year I had a job and could buy myself two pairs of shoes for school stands out in my mind:  I could CHOOSE which shoes I wanted to wear!

I'm generally not a hoarder, and not a collector.  But today's Lenten discipline uncovered that memory.  I didn't really 'go without' as a child, but I frequently had less than my friends did.  I can fit nearly my entire work wardrobe into one large laundry basket, and I have a small dresser and the world's smallest closet.  But apparently I have made up for some childhood insecurities with my shoe collection.  I'm no Imelda Marcos, but hey, it's a start.


PS Our total for UMCOR so far is $7.05.

Saturday, February 25, 2017

Mountain Climbing.....

Yoga class.  I started with some trepidation, but it's become a pretty regular part of my life. Babygirl and  I make it to two to three classes weekly, and are the better for it.  (Babygirl noted today, as she bent down with a dustpan, that it's easier to do chores like that one now that she does yoga regularly.)  Since I had no idea what one did in a yoga class, I've learned a few things.

I've learned that I CAN stand on one leg, reach one arm out in front of me and reach back with my other arm and grab my foot.  You know, the one that ISN'T still on the ground.  I've learned that I'm not the only person who can only do this pose on one side, but not the other.  I've learned that I'll never figure out why they name poses after awkward animals. No pigeon I ever saw ever looked like anything that I or anyone else in the room is attempting to do.  And, like Citygirl, there is a part of me that giggles everytime I imagine rooms full of adult people all over the world lying on their backs hanging onto their feet for dear life in the Happy Baby pose.

But I digress.

While yoga itself is not a religion, it is a meditative practice, at least at our studio.  Each class begins with setting an intention:  What are you focusing on tonight?  It can be as simple as peace, or self acceptance, or a more complicated thought.

The other day, the instructor gave us this quote:

"These mountains that you are carrying, you were only supposed to climb." *

My brain literally stopped.

In one sentence:  This is what we are doing wrong.  This. Is. What. I. Am. Doing. Wrong.

This quote has been bouncing around my head for three weeks now.

Ash Wednesday is this week.  It's time to contemplate Lenten discipline. The last few years it's been about giving back, being kind.  This year?  Well, how do you figure out how to let go of the mountains?  To put them down and not pick them up again?  How do you just climb?

Time to re-route the journey a bit somehow.  Stopping my brain was an excellent starting point.


*quote attribution: Najwa Zebian

Tuesday, February 7, 2017

The Road Less Traveled....

A friend at work showed me pictures of her son the other day.  He's about Babygirl's age, and he's a wonderful boy. He's kind, generous (he's the one who passed on his 'guys' to LittleMan so many years ago because he knew we only had 'girl toys' at our house!) and well-mannered.  He's a natural athelete who once actually managed to make a hole-in-one at a PGA golf course.

The pictures were ordinary enough:  Handsome young man, suit and tie, lovely young lady, formal dress, all decked out for a school dance.

It tore my heart.

Citygirl was a social butterfly and attended so many formal dances at so many different schools that I cut her off budgetarily in terms of new formal dresses. She learned to shop on the internet and switch up with friends and I have a million pictures of her in the most astonishing dresses, surrounded by beautiful girlfriends all trying (in my humble opinion, of course!) to look as lovely as she.

JuJuBee had no real interest in such goings-on.  She and her beloved were once voted prom King and Queen on a mission trip, and they nearly died of embarrassment.  It was typical of her quiet personality that this was NOT as funny to her as it was to those of us who had stuffed the ballot box.

Curlygirl went to her Senior Prom, and because it was almost the only dance she'd ever wanted to go to we went all-out on the dress.  She was lovely.


She is walking, and not by choice, the road less traveled.  Before her illness she was not an extremely outgoing child, but she would go with Youth Group and have sleepovers and invite friends in. She wasn't a 'girly girl' who paid a lot of attention to fashion or makeup, but she was only 11 when she got sick. Who knows, if illness had not intervened, what type of social life would have developed for her?

She is attending school online.  If asked, she says that she is happy with her social life.


I've seen her dressed up for her sister's wedding, dancing and having a wonderful time.  I think it's not likely, however, that I'm going to see her in a prom dress with an updo going to a school dance.  And if it were her choice, like JuJu's, not to go, I'd be fine with that.  It just tears me to think that the choice has been taken from her.


Saturday, February 4, 2017


Let's face it:  This past year has been a stinker.  2016 is a year that is generally best laid to rest.

We lost my Mom a year ago this month.

Matt had the surgery which, while un-paralyzing his leg, put paid to his ability to work (so we did without his paycheck for the last 7 months of the year while his disability application got sorted.  Good times).

Curlygirl and SqueakersDaddy separated, and she is struggling.

We put our beloved Maybelle down.

My work accidentally put me on medical leave, leaving me with no paycheck for the last three weeks before Christmas, which means NO ONE in the house got paid before Christmas.  (I got paid before New Year's but it took until yesterday to get a physical copy of that final paystub for tax purposes!)

And Babygirl has continued to fight the headaches.  My heart sinks thinking about it.

On the flip side, though, 2016 has had some sweet gifts.

BamBam was born a year ago today, just in time to bring us joy in the midst of our mourning.

I've been in contact with a lost cousin.  I like what I see - I really really really want to meet her in person.

My wonderful son-in-law has been accepted to and started at Cornell University, and I'm so proud to have another Ivy League kid in the family!

Citygirl's promotion at the CIA makes her the youngest executive there ever, and the fastest promoted.

JuJuBee has applied for LPN school, looking for ways to make things better for her growing family.  I'm incredibly proud of her toughness and drive.  I'm incredibly proud of her pride.

If you had asked me, back in the beginning of 2011, what I pictured for the future in six years, I might have mentioned a second home in the south, plans for retirement, Babygirl's upcoming high school graduation. None of those things are happening anytime soon or on the expected timeline.   Life does what it does, and goes where it goes, and we have learned the cold hard truth:  Control over our lives is an illusion.  We can only hang on, and our choices lie in whether we laugh or cry.

I suppose it's anyone's guess whether Babygirl would have had such severe migraines without the transplant. But there is no question of how unendurable her suffering was on dialysis, and she'd be quick to say she wouldn't go back for any money.  Since it's her life, and her pain, my maternal gut-twist over all of this takes second place to the fact that she remains steadfastly and absolutely grateful for her transplant.

And therefore, so am I.

So happy first birthday to BamBam, and happy 5th anniversary to Babygirl's and Jorge's kidney!  Long and happy may they all live!


Friday, February 3, 2017

Five Solid Years.....

We got a letter from the family of Babygirl's kidney donor, Jorge, last month.  They said they're sorry they don't write more.  They admit that they are still very sad, and said that they are going to go home to Mexico for a while.  Lordy.  I'm impressed that they have the strength to write at all.  I'd be curled up in a little ball forever, I think.

I think of them often, pray for them, and am grateful for them.  I mourn with them this day.  Every. Single. Year.  Probably for as long as I live.


Saturday, January 14, 2017

Art Museums.....

Thursday was a medical travel day.  Nephrology finally got word to us (at the extreme last minute) that they were fitting us in at 8:30 AM. Since Neurology was at 3:30, it left us a big gap.  The trip between hospitals can take an hour in tough traffic, but even taking that into account, we had 9:30 - 2:30 to do as we pleased with.

We've had the Philadelphia Museum of Art on our list for a long time.  Babygirl loves museums of all kinds, and I'm game for just about anything, really.  The weather in Philly yesterday was amazing for mid-January, a balmy 60 degrees.  We took a look at all our transportation options (subway, bus, taxi), checked a map, asked the locals and opted to walk.

Philly has a lovely riverwalk up the Schuykill river.  The hospital is only a couple of blocks from the river, so we crossed over and hiked the two miles to the museum.  We watched dozens of people try to sprint up the stairs and then take photos a la "Rocky."  We chatted about how, in some ways, the view down Ben Franklin Ave felt a little bit like Paris (side note:  The steps up the museum are in 5 rounds of 13 steps.  Since that number is considered unlucky you almost never see steps set to that number if it can be avoided, and it certainly could have been on an outdoor flight.  There has to be some bizarre Masonic historical context there).

Admission to the museum was more affordable than to the museum at U. Penn, surprisingly.  I asked the desk whether the museum had a Van Gogh on display, and was delighted to find out that they had several.  I've never really seen one.  He was surprised when I (shamelessly name-dropping LOL) told him that the Louvre doesn't have any, nor any Monet/Manet paintings - they are all in a separate set of museums that we never got to.

Babygirl had no specific interest in those artists, however, and on learning there was to be a guided tour of the South Asian art section decided that we should go with the tour.  It was admittedly fascinating.

"A soul outside the cycle of time." My mind is still a bit boggled.

The ever-popular lay-on-the-floor-to-get-the-ceiling shot:

The tour thankfully left us enough time to swing through the impressionists wing as well.  Seeing great art in person is completely different than seeing a photo.  Brushstrokes, layers, lighting, movement.  Amazing.

This is one I had never even seen a photograph of, called "Rain" by VanGogh.  Sorry for the odd sizing.


This gives a pretty extreme closeup of one of the sunflower series - it ALMOST does the brushstrokes justice.....

And then there is this oddity, by Toulouse-Latrec, a portrait of his dog painted on a random piece of cardboard (seriously, I suppose there is only so much Moulin Rouge to paint...):

The locals had recommended downloading the Uber app and catching a ride if we needed one.  I was truly surprised at how easy and affordable that was.

The ride from Philly to Wilmington was complicated by a handful of accidents on I-95 south (one apparently involving a truck full of carpets?), and Google rerouted us through an urban neighborhood where we saw a man come out of his rowhouse with a white german shepherd and a pig.   Not a little Vietnamese potbelly, a 400 pound white pig.  Sideshow, as it were.

Medically all is well.  The kidney is happy, Botox is helping the headaches at least for half of the time it is supposed to and we have marching orders for the next few weeks.


Wednesday, January 11, 2017

Things Unforgotten.....

While taking down the Christmas tree on Saturday, I reflected (as I always do) on the origen of each ornament.  Some I can't recall, some are a bit generic ("I bought that box to go on my first tree after medical school") but many more than you'd imagine have specific memories associated with them.

Most of my grandmother's have been broken or gone missing, but there are real pinecones with glitter that were maybe hers? Or Mom made them because they were like hers?  There are at least a dozen made by hand by my children over the years. There are gifts from college friends, long gone from my life but not my heart. There are ornaments that move me from far past to present, each a memory of love and caring:  Gifts like gentle voices from Christmas past.

There is one that always makes me pause each year, both in placing it on the tree and removing it.  It's a sweet little gray tiger china cat, sitting on a real satin pillow - odd for a Christmas ornament, really.  It was given to me by a patient more than 25 years ago.  He was the first of my patients to die entirely in my care.

Robert had suffered from severe depression his entire life in the era before Prozac. Treatments were limited to medications so sedating that people sometimes drooled; or to electroshock therapy.  Long-term hospitalizations were common.  He had done these things, and survived them all.

I asked him how he managed.  His answer remains one of the most haunting I have ever heard.

"Well, Doc:  Every morning, the first thing I do is decide whether or not today is the day I am going to kill myself.  When I decide it isn't, I put it out of my mind and get on with my day."

Every. Morning.

What kind of courage is required to look yourself in the eyeball every single day of your life and make a conscious decision to keep fighting a lifetime of accumulated despair?

He died at home only a few days after a cardiac workup.  I'll never know if I failed to find the problem that was causing his symptoms, or if his having symptoms gave me a way to put 'natural causes' on his death certificate for his family when he maybe made a different choice.  Those who found him found no reason to suspect that he had taken his own life.  I know he was intelligent enough to not leave evidence behind.

I've given it more thought as years have gone by than I did at the time.  This is very complicated:  Am I uncomfortable because I might have missed a treatable cardiac problem (I certainly was at the time!)?  Or because I think I could have helped more with his depression?  Or because I might be happier thinking he harmed himself than that I might have missed something?

Uncomfortable thoughts indeed, for a young doctor.  No less uncomfortable for time passed.

Doctors in general are realists.  We know that things happen, we know that we have the barest illusion of control, we know that our patients' lifestyles matter more than what we do much of the time.  I am good at compartmentalizing:  Separating home from work, head from heart.

But Robert thought well enough of me to give me a gift.  So each Christmas I spare a thought and a prayer for my many patients like Robert, who make the choice daily to live against the forces of despair.  And I remember those who haven't survived my care but whose courage lives on in my heart, inspiring me to always, always try my best for the rest.


Thursday, January 5, 2017


Generally speaking, I am a full-fledged grownup.  I am the one who manages Babygirl's medical appointments, medications and day-to-day needs.  I am the one who organizes vacations, family gatherings, big meals. I am the family CFO, paying (or juggling, as needs must) the bills. I am the one who manages the household stock of toilet paper.  You know, The Grownup.

Babygirl needs to see her specialists every three months, and have blood work every six weeks.  Her last appointments were in October.  We saw nephrology first, and then rolled out of Philly to go to Delaware to see the neurologists.  Since I didn't know when we would be following up with neurology, and they are harder to get appointments with, I told nephrology I would give them a jingle when I had more information about when I was coming back.  They gave me orders for blood work in six weeks and I sashayed out the door.

When I flipped the calendar to 2017, I realized two things:  1)  I had failed to take Babygirl for her six week blood work, and 2) I had never scheduled a nephrology appointment to go with the neurology appointment, which is upcoming on a Thursday. 


Adulting is hard sometimes.

Since the nephrology clinic is booked full on the day we are going to Delaware (and the day before AND the day after!), this means that I am going to have to make two separate four-hundred-mile round trips this month to the Philly area. 



Monday, January 2, 2017

Start the New Year: Clash of the Titans.....

Yesterday morning, despite a no-alcohol New Year's Eve, I was a little fuzzy in the morning.  We have three dogs, and I let them out in shifts, since Larry really can't focus on getting his business done with Capone's hyperactive intrusions into

Curlygirl and her roomate live in the apartment next door, and they each have a dog.  Capone (well-named little criminal that he is) doesn't want to make friends with Titan (a Pit/Boxer sweetheart) and Opie (a demon-possessed poodle/chihuahua mix), so we have to really watch the back doors to avoid conflict.  To add to this, Titan has been known to slip his collar on occasion and take himself for a stroll.

So when I opened the door to let Larry in, and a biggish Pit Bull hopped in through the door, jumped up on my chest and gave me a Titanic kiss, all I wondered was how the HELL he'd gotten out AGAIN and WHY is wearing a bandana instead of his collar??

I let him into Curlygirl's apartment, and let Larry in our side and put Capone out.

A couple of minutes later....some sleeping section of my brain got a hit of caffeine and thought, "Wait, what?  Titan isn't quite tall enough to kiss my cheek, is he?  And what color was that dog??"

I slipped into Curlygirl's appartment to find THREE dogs happily playing.  Oddly, Opie did not object to the extra Pitty, and Titan never objects to anything.  Yeah, it was a BIG dog, gray, not brown and white.

That explains the bandana vs collar thing.

Curlygirl was asleep on the couch through this entire thing, mind you.  Gray Doggie gave her a good sniff and a tail wag.  Lucky for her he didn't jump up and join her - I'm guessing he was a solid 50 pounds of muscle.

I snagged the bandana and gently led him to the front door, figuring that he could just walk himself back to wherever he came from, right?  As I opened the door, I spotted a neighbor with a leash and collar headed for my back yard (where Capone was raising a mighty ruckus), calling "Blue!  Blue?"  Good name for a gray dog I guess.  She was dogsitting for her son and Blue had snuck out. She was happy to see him, if somewhat puzzled by his indoor visit with us.

Oh. My. Goodness.  Thank God he was a peaceful dog.