The article is a bit long, but I found it a very good read, definitely something worth spending a few moments on.

Annals of Medicine: The checklist

- Byrd

In addition to the viral yuck and potential for major illness, I have been having issues with one of my native kidneys. Two weeks ago I started having the burning pain I normally associate with a kidney stone. I have had kidney stones in the past, and this seemed much like those episodes. This time however the pain did not get to an intolerable level and then resolve itself quickly upon passage of the stone. So a few days after the onset of the discomfort I called one of my docs to let him know about the problem. After establishing through testing that I had an infection, I began a round of Levaquin. It has now been nearly a week since completion of antibiotic therapy, and I am still having back discomfort, particularly in the evenings.

Last week I went in for a visit to the GI doc because the symptoms did not resolve, the discomfort in my back and side are still there and I am really tired, plus I began having some minor chest pains. He decided to do a sonogram of the offending kidney. Lo and behold I have four kidney stones in my left native kidney, one of which is nearly the size of a dime. Ick!! How the heck does one get rid of a kidney stone that large! Now I must say here that I have a significant lower than normal perfusion through both of my native kidneys, which is why I tend to hang on to stones for a while and not be bothered by them. However, this latest offender is bothering me.

So I am now worried about the potential ugliness of a major viral event, and very worried about what can be done if anything about the monster that is currently inhabiting my left kidney. I’m trying to stay positive, but this is a trying time for me. I am really tired, and even school has not been the saving grace for me that is normally has been. Although, I must say that AP helped me to have a really nice V-Day, he did good, and I had at least a few good moments this past week. So I keep moving, and studying, hoping that I can get enough brain cells working so that I can do well in school, even though I am having a hard time finding the energy to concentrate.

But, all in all, I feel great about actually accomplishing something today.  I have one foot…ok, maybe a toe…on the road to being healthy again.  This time I have to remind myself that even though school starts next week, I still need to exercise.  It is going to be tough, because I’m still worried that it might put too much stress on my body.  And after last semester spending two weeks in the hospital with viruses (that intestinal virus really knocked me for a loop!), and another week at home with respiratory problems, I’m feeling a bit skittish about doing anything that might tax my system.  But this semester’s classes shouldn’t be too terrible, I’m only taking two courses, Physics 2 and Genetics.  So I’m hoping that finding time, and the strength to exercise won’t be too much of a problem.

So my fingers are crossed, and I’ve said my prayers, and so maybe I can actually get myself healthier.  It’s at least worth a try:)

- Byrd

Every day 39,000 units of blood are needed in hospitals and other care facilities nationwide. Every two seconds someone in this country needs the “gift of life” that donated blood provides. I have been a recipient of a blood donation on multiple occasions, and it has saved my life. I hate to think that anyone would be deprived of a much needed infusion of blood products because there was a shortage due to not enough supply.

In order to be able to donate, you must be at least 17 years of age, weigh more than 110 lbs., and be in good health. If you aren’t sure you would be eligible, please contact someone at your local blood donation facility. Approximately 60% of the population is eligible to donate, but unfortunately only 5% of those eligible actually do. And if you are able to donate, please remember that you are allowed to donate blood again after 56 days.

One donation can potentially save up to three lives. It is such an easy thing to do, and it usually takes less than one hour total (the actual donation itself takes around 15 minutes). Isn’t saving a life worth an hour of your time?

- Byrd

(image courtesy of AABB)

So moving on…after I get to my first class late because I had to lay back down again for a few minutes before I left the house, I discovered that there was only one seat available off to the side, by itself, and in the front of the room…great:(

Then in my next class, the lab section to the first class, the instructor would not let us take notes. Hello?! She wanted us all to be looking at her! Huh? Then, when I felt that I absolutely had to write something down, she stopped class, pointed at me and told me to stop writing! WTF! This is college lady, not high school or elementary school, if I want to take notes then I should be allowed to take notes.

My evening class tonight went good. I actually understood everything, which is an unusual occurrence for me in a chemistry class. Although, it is only the first day, and compared to the Biochemistry class I’m taking at the other school, it likely just seems easy for now but will probably kick my behind later.

Speaking of Biochemistry, I have a quiz in the morning. Yuck! He sent us a review sheet, and I knew absolutely nothing on it…great, yet again. Looks like I’m going to get to know a chemistry tutor really well this semester:(

Oh well, on to Wednesday…with a smile…even if it is a forced one:) And my throat still hurts…but I’m smiling:)

Four Jobs that I have had -

1. Nutrition Support Dietitian
2. Diet Technician
3. Medical Office Receptionist
4. Concession Stand at a baseball park

Four places that I have lived -

1. McKinney, Texas
2. Denton, Texas
3. Bedford, Texas
4. North Richland Hills, Texas

Yep, I’m strictly a Texas girl!

Four of my favorite types of food -

1. Tex-Mex
2. Italian
3. Southern-style home cooking
4. Anything fresh from the garden, Yum!

Four places that I’d rather be -

1. Omaha, Nebraska
2. Colorado
3. Somewhere with my favorite “mad scientist”
4. Snuggled up with my favorite “mad scientist” and my cat Remi

Four movies that I watch over and over -

1. GI Jane (one seriously tough chick)
2. Apollo 13 (with number 4 above)
3. Serenity (again, with number 4 above)
4. Outbreak

Four of my favorite TV shows -

1. The Closer (another tough chick)
2. Criminal Minds
3. Bones
4. Anything medical on Discovery Health channel

Four websites I visit daily -

1. Astroprof’s page
2. Star-Telegram.com
3. Omaha.com
4. OR-Live.com

Four computers I have owned -

1. an old HP
2. Toshiba laptop
3. a Frankenstein sort of thing that my best friends husband made me
4. I have only had three computers

Four people to tag -

I’m new to this blogging thing, so I only know one, and he tagged me:)

Anatomy & Physiology is difficult enough during the regular session, and during the summer it is three times as fast. My study time averaged three to four hours per day (more on the weekends), in addition to the two hours of class each day and four hours of lab twice a week. I would have liked to have been able to do more studying, but my brain was too tired for me to truly retain the material. I think taking this class on the heels of a long semester with physics, statistics, and Organic chemistry was a little much for me. Keep in mind it has been awhile since I have been in class, and it is taking a while for me to get back into the whole thinking thing again.

Another thing about taking this during the summer is that I’m not sure anyone has the time to truly “learn” the material. I think that because it all went so fast, I only temporarily learned most of the material in order to get through it. I truly would have liked to have spent more time and really delve into the material a bit more than I had the time for.

If any of you who read this are educators, I would love to know what you think about teaching the majors science courses over the short summer sessions.

Later in the episode we see why there are rules in the use of narcotics when the Mom pulls the IV out of her daughter’s arm, changes the flow rate, and then attempts to shove the IV in her own arm to supposedly commit suicide so that her daughter can have her heart. Hello again technical writers, they haven’t used stiff metal IV needles in YEARS. Even the one they were using on the show was obviously white, meaning it was the normal flimsy poly/rubber type. For those of you who haven’t had the misfortune of having an IV stuck in you lately, the IV needle itself is removed after establishing a patent line in the vein, the part remaining is a sleeve of very flimsy poly material plus a hub that remains on the outside of the skin.

At about ten minutes into the show, I have to force myself to continue watching, thinking that this has to get better. But, I really need to study (two tests this week in A&P). Still, I make myself continue to watch, hoping that there is something good to come of this show. After all, it might make some more open to organ donation, right? Well, if it doesn’t scare everyone off first maybe.

It is then that I hear the main character in the show, a Dr. Grant, say that if a donor heart came available that night, that he would “make it work” for the little girl. Hmmm…here we go again technical writers…did no one bother to contact UNOS and research the rules on how transplanted organs are allocated. First of all, when an organ becomes available for transplantation the hospital informs UNOS (United Network for Organ Sharing) of the donor’s blood type, age, body size, etc., as well as its geographical location. UNOS then goes to their list and chooses the recipient candidates from the top of a list that has all of the potential candidates ranked according to need, geographic location, etc., and then informs the recipient’s hospital of a potential donor. It is really more complicated than this, but you get the idea. So basically, it is not the Dr.’s choice as to who gets a donated organ, unlike the idea portrayed by this TV show.

Also, you can’t “make an organ work” for someone, it either matches or it doesn’t. There are many things to take into consideration when matching donor to recipient. I won’t get into the technical scientific evaluations here, primarily because I don’t really know them well myself, but there is much more to it than just simple blood type matching. Think about this for a moment, say that the mother of this child were successful in committing suicide (yes, I know this scenario won’t work for many reasons, just go with me on this OK), the difference in body proportion isn’t just external. The mother’s heart is the appropriate size needed to pump the blood in an adult body, the little girl needs a heart that will pump the blood in her much smaller body. There isn’t much extra space in the cardiac cavity (or any body cavity for that matter), so the mother’s heart likely would not have fit. But then you also need to have a good tissue match. There are little protein molecules embedded into each of our body cells, and these proteins are in different arrangements in each of us. It’s God’s little way of making us unique. Our bodies recognize when there is something inside of us that does not match in these protein arrangements, and will then mount an immune response. So it is important to get as many of these little protein units to match as possible between the donor organ and the recipient so that there is a lesser chance of the recipient losing the new organ to rejection.

As for the rest of the show, I had to make myself ignore the technical inaccuracies and try to enjoy the show purely for the dramatic effect. Unfortunately, I did not derive much enjoyment out of dramatic aspects either. The relationship between the Dr. and his ex-wife/organ donation coordinator did not grab my attention, neither did their little “spat” they had in regards to his infidelity while they were on the plane on route to an organ allocation. I don’t see professionals such as those who are portrayed here, having an argument about this subject in front of their colleagues.

I think what we have here is a good idea gone wrong by the influence of TV producers who feel that they need to change facts in order to sensationalize an already sensational story. I think that this story would still go over well if they had kept with the actual facts and rules that govern how organ transplants occur. The subject in and of itself is sensational, there is no need to change things in order to make it so. My fear is that this show will give people the wrong impression about organ donation. Unfortunately, not much of anything in the media is completely real, including the news. So much of what they broadcast is sensationalized because they think it will make people watch. Plus, they get many of the actual facts wrong as astroprof points out in his blog on science and the media http://astroprofspage.com/archives/998.

I for one will be interested to see if this show continues, and if it does will it continue in the path that it started on, or will we see any changes that might reflect a more accurate portrayal of organ donation/transplantation. It is my hope that it does continue, but only with real-life accuracy.

The first issue is cost. Most people are aware that these types of medications are expensive, but just how expensive are they? Upon checking a few websites that give medication cost comparisons, I have found that my daily expense is approximately $70. (I don’t actually know what my pharmacy charges because I am never billed.) I take a combination of Prograf and Rapamune. There are, of course, other medications that I must take on a daily basis (two of which are specifically meant to counteract the side effects of the immunosuppressants), however their expense seems quite small in comparison (roughly about $5 a day in total). Thankfully, I qualify for social security disability and Texas Medicaid so all of my health care costs are paid. I don’t know what I would do if I had to try to pay my own expenses.

The second issue is the side effects. Although I am deeply grateful that these medications exist, the effects can make daily life difficult. The most irritating aspect for me is that my brain never stops. It feels like I am constantly caffeinated, like I’ve drank about a dozen espresso’s. If my body could keep up, it might not be such a bad thing, but my body gets tired and I want to sleep, but I can’t because my brain won’t stop. So very irritating! However, the good thing is that I can now think about many different things at the same time, which is helpful for studying. I seem to be better able to remember the things now as opposed to before the transplant.

Another side effect is associated with the increased brain activity. The higher the level of medication in my blood stream, the more I shake. If I keep my blood levels at where my doctors would like for it to be, I would shake like I had actually drank all those espresso’s! If I had a penny for every time someone asked me if I was nervous, I would be rich (but then I wouldn’t qualify for medicaid so that would be bad). Like the increased brain activity, the shaking never stops. I remember back to the days immediately after the transplant when they had my immunosuppressant levels very high to ensure my new organs would stay with me. I shook so much that my entire bed would actually travel across the room (with the wheels locked) and need to be moved back every few hours. It isn’t quite that bad now, but I do have the occasional day where I can’t hold a pen well and my handwriting is illegible. I can actually follow how well I absorb my medications and how high my levels are by looking at the notes I have taken in class.

There are other side effects, but as yet they don’t seem to interfere with my daily life, although, they are important to note. One side effect is elevated cholesterol, fortunately mine is still within normal range. The other potentially dangerous effect is that one of the medications causes a kind of toxicity to the kidney’s. Not good considering I only have one that truly works, and it is transplanted. So I watch my kidney functions closely.

Even with all of the multiple issues that go along with having had an organ transplant, I am still very grateful for this life. I am still amazed each morning that I have lived to see another day:)