My office is one the last in our organization to switch to fully electronic medical records. I've been hearing the complaints and moans of my colleagues for the past two years as the change has been implemented. I've taken my Mom to her doctor and watched him carrying her 20-pound paper chart on his little mobile computer desk. It's easily three times heavier than his laptop. I haven't seen him open it for any reason - I think it's just a security-blanket kind of thing. And even he has begun to admit that once you get the hang of it, it's a good idea.
We've begun. For the last month all of our prescription renewals have been handled online. It's lead to some interesting mistakes, none thus far harmful. Prescriptions meant for local pharmacies have gone mail-order and vice versa. Medications whose doses have been adjusted but not recorded in the medication list have come back to haunt us. I've been frustrated to be partially trained. I can renew a prescription, add a problem to the problem list (the computer insists that I should have an actual REASON to be writing a prescription, imagine that!) but I can't check to see when I last saw the patient or view their most recent lab reports.
This week we "go live". I have a ton of training time, and based on the experience of other offices they've cut our patient load from 5/hour to two. I expect the learning curve to be steep and ugly, and the Bad Words are already flying.
In the long run it will be a very good thing. It will increase accuracy, decrease the number of times I write a prescription only to discover that the patient's insurance won't cover it. It will tell me immediately if a procedure requires prior authorization. And each 'chart' will be completed before I even leave the patient's side - no more waiting for transcriptions. And I'll bet the spellcheck will let me use the word 'colonoscopy' without suggesting that I really meant 'kaleidoscope'.
I've seen how the electronic medical record makes things simpler for Babygirl when we go to CHOP. They know her medications, her pharmacy, her history - it's all at their fingertips. I've watched them create graphs of lab values to follow trends (something I've had to do by hand for my patients). I've seen how her kidney doctors know, less than 20 minutes after we've seen him, what her neurologist is planning to do.
Here's what makes me sure I'll make it:
If my mom's doctor, ten years my senior and firmly convinced that Barack Obama himself personally looted his retirement fund, can figure this out and make it look like a good idea, anybody can. I can handle this.
Just remind me to wash my mouth out with soap before you talk to me in church on Sunday.
DeeDee
Tuesday, October 15, 2013
Sunday, October 13, 2013
Little Discouraging Things.....
My housekeeper did not show up yesterday morning.
Seriously, that was all it took for me to pull out my personal broomstick and ride it through the universe. Well, that and only 3 hours of sleep.
I haven't had a cleaning helper all that long, but it is amazing how much can get done by two people in four hours compared to one person in any amount of time. I tried calling and discovered that his number is one of several that my new phone just re-assigned a new number to, so if he doesn't get in touch I won't be able to find him (I already checked the phone book - he has a unique name. He's not there). It's most likely due to the not-next-week-the-week-after stuff that happens here all the time, so I have to make sure someone is here at 7 AM next Saturday in case he comes, and look for someone new if he doesn't.
So....the kitchen is clean (thanks, JuJuBee) and the upstairs bath (thanks, Hubby) and the downstairs bath, sort of (um, thanks, JuJu) and Mom's bath (me). And I did what I'd planned: Hands-and-knees scrub of the living room floor with a full closet cleanout.
What didn't get done? The dining room floor, and all of the sweep-and-mop of Mom's side of the house. This would matter less if we'd cleaned last week (wedding trumps cleaning!) or if we weren't accepting houseguests, who will have to stay on her side of the house, in just six days.
I have to say I slept well. I also have to admit that my triceps are not happy and I still have another floor to scrub.
It amazes me sometimes that I handle some of the big stuff with less hysteria than some of the little stuff.
DeeDee
Seriously, that was all it took for me to pull out my personal broomstick and ride it through the universe. Well, that and only 3 hours of sleep.
I haven't had a cleaning helper all that long, but it is amazing how much can get done by two people in four hours compared to one person in any amount of time. I tried calling and discovered that his number is one of several that my new phone just re-assigned a new number to, so if he doesn't get in touch I won't be able to find him (I already checked the phone book - he has a unique name. He's not there). It's most likely due to the not-next-week-the-week-after stuff that happens here all the time, so I have to make sure someone is here at 7 AM next Saturday in case he comes, and look for someone new if he doesn't.
So....the kitchen is clean (thanks, JuJuBee) and the upstairs bath (thanks, Hubby) and the downstairs bath, sort of (um, thanks, JuJu) and Mom's bath (me). And I did what I'd planned: Hands-and-knees scrub of the living room floor with a full closet cleanout.
What didn't get done? The dining room floor, and all of the sweep-and-mop of Mom's side of the house. This would matter less if we'd cleaned last week (wedding trumps cleaning!) or if we weren't accepting houseguests, who will have to stay on her side of the house, in just six days.
I have to say I slept well. I also have to admit that my triceps are not happy and I still have another floor to scrub.
It amazes me sometimes that I handle some of the big stuff with less hysteria than some of the little stuff.
DeeDee
Friday, October 11, 2013
Year Three, Week 26 - Preparing for a Crowd.....
Conversation with Mom, every night this week:
"Is your Dad coming here?"
Yes.
"When?"
Next Saturday.
"Did you say Aunt Squirrely is coming too?"
Yup.
"How is she getting here?"
She's flying.
"Is she coming alone?"
Nope, H is coming with her to help.
"Who's H?"
Squirrely's granddaughter.
Add random questions about who/what/where/when/why and variations on that. It's exhausting, absolutely brain-wearing, to answer the Same. Exact. Questions. Over and over and over again.
But likely not as exhausting as it will be to have two frail, elderly houseguests and an unknown fourteen year old first cousin once removed (my first cousin's kid - that makes H Babygirl's second cousin? I think?) for two weeks.
I'm not sure how this happened, exactly. But dang, I need to clean. And buy wine. LOTS of wine.
DeeDee
"Is your Dad coming here?"
Yes.
"When?"
Next Saturday.
"Did you say Aunt Squirrely is coming too?"
Yup.
"How is she getting here?"
She's flying.
"Is she coming alone?"
Nope, H is coming with her to help.
"Who's H?"
Squirrely's granddaughter.
Add random questions about who/what/where/when/why and variations on that. It's exhausting, absolutely brain-wearing, to answer the Same. Exact. Questions. Over and over and over again.
But likely not as exhausting as it will be to have two frail, elderly houseguests and an unknown fourteen year old first cousin once removed (my first cousin's kid - that makes H Babygirl's second cousin? I think?) for two weeks.
I'm not sure how this happened, exactly. But dang, I need to clean. And buy wine. LOTS of wine.
DeeDee
Sunday Rambles.....
Sunday began with another morning breakfast at the lakeside. We packed all of our gear, and loaded the truck (in the traditional downpour that opening the truck cover engenders). We checked out of the KOA with plans to come back someday, and headed for church.
The church our friends were married in is pastored by our former pastor, so it was wonderful to worship there with him and his wife and most of the people from our own church who had attended the wedding. After church, the pastor and his wife took us to tour the new building their congregation is moving into in a few weeks - amazing, amazing space! Seven of us had lunch together, giving the mother-of-the-groom a much needed opportunity to decompress all of her wedding stress. It's always entertaining to hear the behind-the-scenes drama. Who knew the cake had almost fallen over?
On the way to the wedding we had passed an outlet mall, and on the way home decided to check it out. We spent more than a few hours shopping - clothes, shoes, kitchen gear, food - it was all great fun, and the heavens did NOT open every time we loaded a couple of bags into the back of the truck. Perhaps that is reserved for a full load-up.
We got home without getting lost, unpacked without getting soaked, and slept like babies in our own beds.
It's hard to say what the best part of the day was. Worship. Lakeside. Bargain-hunting. Two hours of laughter and love with old friends. Enjoying the whole package with Hubby and Babygirl.
Yeah. That last thing. The whole package. We have a very good life.
DeeDee
The church our friends were married in is pastored by our former pastor, so it was wonderful to worship there with him and his wife and most of the people from our own church who had attended the wedding. After church, the pastor and his wife took us to tour the new building their congregation is moving into in a few weeks - amazing, amazing space! Seven of us had lunch together, giving the mother-of-the-groom a much needed opportunity to decompress all of her wedding stress. It's always entertaining to hear the behind-the-scenes drama. Who knew the cake had almost fallen over?
On the way to the wedding we had passed an outlet mall, and on the way home decided to check it out. We spent more than a few hours shopping - clothes, shoes, kitchen gear, food - it was all great fun, and the heavens did NOT open every time we loaded a couple of bags into the back of the truck. Perhaps that is reserved for a full load-up.
We got home without getting lost, unpacked without getting soaked, and slept like babies in our own beds.
It's hard to say what the best part of the day was. Worship. Lakeside. Bargain-hunting. Two hours of laughter and love with old friends. Enjoying the whole package with Hubby and Babygirl.
Yeah. That last thing. The whole package. We have a very good life.
DeeDee
Thursday, October 10, 2013
Dance Like No One Is Watching.....
We woke up on Saturday to a gloomy day. I had my coffee and toast out on our little covered porch, admired the trees and watched the fish jump in the lake. Despite the cloud cover it was unseasonably warm for October - I didn't even need a sweater.
When everybody was up, we debated what to do with our free time before the wedding a 2. We piled into the truck and drove half an hour through the rain to Point Breeze on Lake Ontario. Babygirl has done a lot of travel through Pennsylvania because of her kidney transplant, but she hasn't seen much of New York State!
The lighthouse was open (thank God it wasn't a federal park!), so we got to climb to the top and admire the view. It was eye-opening for Babygirl to see a body of water so ocean-like, so big that we couldn't see the other side. We walked out to the end of the harbor jetty in the rain, wind lashing and waves splashing over the rocks. Between the spray and rain we were soaked to the skin, but the simple adventure of it was SO worth it! Babygirl came to understand the purpose of the jetties when she saw how calm the river mouth was compared to the open lake.
We drove back to camp, enjoying the scenery. We crossed the Erie Canal several times on several different types of bridges - some that were high enough to allow for the boats, some drawbridges, and one swivel bridge. The Erie Canal song is still stuck in my head ("I got an old mule and her name is Sal, fifteen miles on the Erie Canal.....Low bridge! Everybody down! Low bridge, for we're comin' to a town..."). Yes, I know the whole song. There's a lot of music in my cerebral MP3 player.
We bought produce from local farm markets, defying the 'never eat anything larger than your own head' rule. We shopped for shoes - odd, yes, I know. And naturally, we were running late when we got back to camp.
But one of the advantages of being in a camp is that there are camp showers. Hubby took the cabin bath over and Babygirl and I hiked (about 30 feet I think LOL) to the camp showers, and we were all ready on time.
The wedding was lovely, the bride and her maids beautiful, the groom and his men handsome, the flower girls sweet as angels (good disguise, by the way) and the ring bearer adorable and entertaining.
The reception was awesome. Good food, good friends, good music. All the old dances were played - the Macarena, the Electric Slide, and so on. Hubby and I got to dance some slow ones, and Babygirl danced and danced and danced. And danced some more. It was hysterical to watch Babygirl and Hubby do the Harlem Shake and Gangnum Style.
We came to our Kabin laughing and exhausted, Hubby and I knowing we were going to be a bit stiff in the morning. But it was worth it all to see Babygirl so happy and free and energetic. She's pretty self-contained and reserved, but we all let go and danced as if no one else was watching.
These are the moments that make memories. The moments where you are fully present, fully engaged, and fully joyous in the celebration of the birth of a new family.
Congrats, Ryan. Congrats, Jess. "May all your troubles be little ones."
DeeDee
When everybody was up, we debated what to do with our free time before the wedding a 2. We piled into the truck and drove half an hour through the rain to Point Breeze on Lake Ontario. Babygirl has done a lot of travel through Pennsylvania because of her kidney transplant, but she hasn't seen much of New York State!
The lighthouse was open (thank God it wasn't a federal park!), so we got to climb to the top and admire the view. It was eye-opening for Babygirl to see a body of water so ocean-like, so big that we couldn't see the other side. We walked out to the end of the harbor jetty in the rain, wind lashing and waves splashing over the rocks. Between the spray and rain we were soaked to the skin, but the simple adventure of it was SO worth it! Babygirl came to understand the purpose of the jetties when she saw how calm the river mouth was compared to the open lake.
We drove back to camp, enjoying the scenery. We crossed the Erie Canal several times on several different types of bridges - some that were high enough to allow for the boats, some drawbridges, and one swivel bridge. The Erie Canal song is still stuck in my head ("I got an old mule and her name is Sal, fifteen miles on the Erie Canal.....Low bridge! Everybody down! Low bridge, for we're comin' to a town..."). Yes, I know the whole song. There's a lot of music in my cerebral MP3 player.
We bought produce from local farm markets, defying the 'never eat anything larger than your own head' rule. We shopped for shoes - odd, yes, I know. And naturally, we were running late when we got back to camp.
But one of the advantages of being in a camp is that there are camp showers. Hubby took the cabin bath over and Babygirl and I hiked (about 30 feet I think LOL) to the camp showers, and we were all ready on time.
The wedding was lovely, the bride and her maids beautiful, the groom and his men handsome, the flower girls sweet as angels (good disguise, by the way) and the ring bearer adorable and entertaining.
The reception was awesome. Good food, good friends, good music. All the old dances were played - the Macarena, the Electric Slide, and so on. Hubby and I got to dance some slow ones, and Babygirl danced and danced and danced. And danced some more. It was hysterical to watch Babygirl and Hubby do the Harlem Shake and Gangnum Style.
We came to our Kabin laughing and exhausted, Hubby and I knowing we were going to be a bit stiff in the morning. But it was worth it all to see Babygirl so happy and free and energetic. She's pretty self-contained and reserved, but we all let go and danced as if no one else was watching.
These are the moments that make memories. The moments where you are fully present, fully engaged, and fully joyous in the celebration of the birth of a new family.
Congrats, Ryan. Congrats, Jess. "May all your troubles be little ones."
DeeDee
Tuesday, October 8, 2013
Year Three, Week 25 - Out of Town....
We were blessed to be invited to the wedding of some good friends. It was over three hours away from home, so we needed to plan ahead. So naturally, we didn't, really.
About 3 weeks ago I started looking for somewhere to stay. Now, this wedding was happening in a REALLY small town, and there wasn't much in the way of accommodation. The local motel had internet ratings approaching zero stars and comments like, "The owner is too old to clean. Don't stay here unless you like the smell of mold." Well.
Most of our travel with Babygirl since her transplant was to family's homes, or to our (always clean on our arrival) beach house. I hadn't really considered the implications of cheap motel hygiene.
But we are nothing if not flexible, so I looked at alternatives. And one really excellent alternative is KOA Kampgrounds.
Now, camping in the northeast in October is almost guaranteed to be a nightmare. If it isn't raining, it's cold. Tonight, for example, is lovely with a frost warning.
But KOA Kampgrounds have Kabins. (Yes. They spell EVERYTHING possible with a 'K'.) We've used the Kabins before. They are Kute. And Kozy. Which, literally translated, means 'impossibly small.' The last time we used them, we had narrow bunks, a double bed, and a porch. But hey, it's just three of us, and we have Kamping gear, so as long as we have heat and power we're cool. Sorry, Kool.
So I Googled KOA, found the one nearest the wedding and discovered that they have some awesome Kabins that sleep up to 8 people and include a full bath and partial kitchen! We opted for one that sleeps 4 (a small bunk room and a queen-sized bed in the room with the kitchen/table). It had a covered porch about 15 feet from the edge of a beautiful small lake, surrounded by changing leaves. It was 5 miles from the church and 10 miles from the reception. Perfect.
We put the address in our GPS and drove off into the rainy dark (by the way, if you are in need of rain, give us a call. We'll stop by and open up the back of the truck to load/unload and the heavens will open, guaranteed). Now, you need to understand something about me. I am NEVER bored. And this is because, like a toddler, I am willing to fiddle with just about any damned thing.
So, I played with the GPS. I pushed every button. I changed the voice from Jan (who gives detailed instructions) to Michelle (who just announces, 'Turn right HERE!') to Yeti (who grunts when the turns are coming and gives an exasperated growl when you miss it). I watched us change altitude, direction, speed and icon type (Hubby likes the one with the dog hanging his head out the window). I discovered that we can get audiobooks on the GPS and listen while.......holy crap, we missed our exit 20 miles ago!
Ooooppppsss. That's when I discovered the little red button turns off Jan. Or Michelle, or Yeti or whoever. We re-entered our destination and traveled down unlighted country roads in a dark so dense it looked like we were riding in a videogame. We arrived only a few minutes after our scheduled time, checked into our Kozy little Kabin and crashed. Krashed.
And despite the detour, we had an excellent time on the ride.
DeeDee
About 3 weeks ago I started looking for somewhere to stay. Now, this wedding was happening in a REALLY small town, and there wasn't much in the way of accommodation. The local motel had internet ratings approaching zero stars and comments like, "The owner is too old to clean. Don't stay here unless you like the smell of mold." Well.
Most of our travel with Babygirl since her transplant was to family's homes, or to our (always clean on our arrival) beach house. I hadn't really considered the implications of cheap motel hygiene.
But we are nothing if not flexible, so I looked at alternatives. And one really excellent alternative is KOA Kampgrounds.
Now, camping in the northeast in October is almost guaranteed to be a nightmare. If it isn't raining, it's cold. Tonight, for example, is lovely with a frost warning.
But KOA Kampgrounds have Kabins. (Yes. They spell EVERYTHING possible with a 'K'.) We've used the Kabins before. They are Kute. And Kozy. Which, literally translated, means 'impossibly small.' The last time we used them, we had narrow bunks, a double bed, and a porch. But hey, it's just three of us, and we have Kamping gear, so as long as we have heat and power we're cool. Sorry, Kool.
So I Googled KOA, found the one nearest the wedding and discovered that they have some awesome Kabins that sleep up to 8 people and include a full bath and partial kitchen! We opted for one that sleeps 4 (a small bunk room and a queen-sized bed in the room with the kitchen/table). It had a covered porch about 15 feet from the edge of a beautiful small lake, surrounded by changing leaves. It was 5 miles from the church and 10 miles from the reception. Perfect.
We put the address in our GPS and drove off into the rainy dark (by the way, if you are in need of rain, give us a call. We'll stop by and open up the back of the truck to load/unload and the heavens will open, guaranteed). Now, you need to understand something about me. I am NEVER bored. And this is because, like a toddler, I am willing to fiddle with just about any damned thing.
So, I played with the GPS. I pushed every button. I changed the voice from Jan (who gives detailed instructions) to Michelle (who just announces, 'Turn right HERE!') to Yeti (who grunts when the turns are coming and gives an exasperated growl when you miss it). I watched us change altitude, direction, speed and icon type (Hubby likes the one with the dog hanging his head out the window). I discovered that we can get audiobooks on the GPS and listen while.......holy crap, we missed our exit 20 miles ago!
Ooooppppsss. That's when I discovered the little red button turns off Jan. Or Michelle, or Yeti or whoever. We re-entered our destination and traveled down unlighted country roads in a dark so dense it looked like we were riding in a videogame. We arrived only a few minutes after our scheduled time, checked into our Kozy little Kabin and crashed. Krashed.
And despite the detour, we had an excellent time on the ride.
DeeDee
Wednesday, October 2, 2013
Year Three, Week 24 - Courage to Admit It...
Babygirl grumbled and complained about missing another day of school to go to Philly. She's generally pretty good about the crap that goes with being sick a lot, but this one just made her angry somehow. We got to our home-away-from-home Sunday, and were both hit with a big batch of I-Can't-Sleep. Since we share a room there, we had some slumber party style conversation. If kids at slumber parties talk about being chronically ill, or insomnia, or hating to miss school and stuff like that.
I find Babygirl's anger to be a good thing. It means she' thinking for herself, looking for her own path and coping with her feelings - finally admitting out loud how strong those feelings are. She as much as said that she doesn't feel like anything is actually different with her life, or it wouldn't be - if she were allowed to just live it.
She has a point.
So we drove to the city and saw the docs and got the results of the tests and drove home and went back to living our lives.
And I contemplated what I've learned this week about courage.
Babygirl's, in accepting all that's happened and still carrying on with her life. Her courage is letting the anger out but not letting it stop or change her.
Her doctors', in being willing to say when they don't completely understand what is causing a problem and being willing to let things evolve without intervening in ways that could make things worse.
Mine, for not jumping in and demanding an answer - for being able to come to grips with the fact that we'll never in this life have the answer to most of our questions anyway. Loving Babygirl is a gift beyond all price, and there is no amount of sickness or sorrow that can make that gift less. Living our lives to the fullest possible measure within the context of the limitations we've been given appears to me to be the only possible path to Joy. Living in denial of reality is not an option.
Admitting the limits of our strength and knowledge is infinitely preferable to playing make-believe. Carrying on despite those gaps, in the knowledge and full acceptance of those limits seems to me to be a better choice that building our lives on false hopes and fake sunshine.
The solid foundation of my faith is built on Truth. The foundation of my hope is Love. The reality of our lives does not alter either of these things in any way.
DeeDee
I find Babygirl's anger to be a good thing. It means she' thinking for herself, looking for her own path and coping with her feelings - finally admitting out loud how strong those feelings are. She as much as said that she doesn't feel like anything is actually different with her life, or it wouldn't be - if she were allowed to just live it.
She has a point.
So we drove to the city and saw the docs and got the results of the tests and drove home and went back to living our lives.
And I contemplated what I've learned this week about courage.
Babygirl's, in accepting all that's happened and still carrying on with her life. Her courage is letting the anger out but not letting it stop or change her.
Her doctors', in being willing to say when they don't completely understand what is causing a problem and being willing to let things evolve without intervening in ways that could make things worse.
Mine, for not jumping in and demanding an answer - for being able to come to grips with the fact that we'll never in this life have the answer to most of our questions anyway. Loving Babygirl is a gift beyond all price, and there is no amount of sickness or sorrow that can make that gift less. Living our lives to the fullest possible measure within the context of the limitations we've been given appears to me to be the only possible path to Joy. Living in denial of reality is not an option.
Admitting the limits of our strength and knowledge is infinitely preferable to playing make-believe. Carrying on despite those gaps, in the knowledge and full acceptance of those limits seems to me to be a better choice that building our lives on false hopes and fake sunshine.
The solid foundation of my faith is built on Truth. The foundation of my hope is Love. The reality of our lives does not alter either of these things in any way.
DeeDee
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