it's hard ...

it's hard not to think of the toddler that i took care of often when i started, who just came back in b/c he relapsed.  

it's hard not to think of the 10-year-old who vomited all night and was in excruciating pain b/c his liver is 3x the size it should be and they can't figure out why he's having continual fevers.

it's hard to watch a baby go through transplant for the 3rd time in a last attempt to save his life.

it's hard to watch kids get horrible mucositis and GVH.

it's hard to watch the the girl my own age spend months in a hospital and tell me all she wants is to find a guy and have babies.

it's hard to watch a guy spend his 18th birthday in the hospital and beg the docs to let him go to prom for his senior year (that he missed most of).

it's hard to watch the parents of a dying child grieve and to hold that girl's hand 2 hours before she dies.

it's very very hard to go home and not think about all the kids i have grown to love sitting in that hospital bed or crib fighting for their life.

sometimes my job is just hard.

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(just a side note - i'm not trying to be depressing or get anyone down or something.  it just helps to get out my feelings somehow and write about stuff i see all the time.  i'm sorry if it makes you sad; despite all this, good stuff does happen where i work!  i'm just not writing about that in this post.)

at work

in the midst of my busy night at work last night, i got to do one of my favorite things.  at 4 am i got to spend an hour rocking a sweet baby boy back to sleep.  i'll get paid to do that any day.

gladly  :)

i've been waiting for this ... :)

pray for this baby

please pray for my little friend and patient B tomorrow.  he's 4 months old, and he will be having his bone marrow transplant tomorrow around noon.  this is his chance at life.  without it he will die.  his cancer markers have increased lately despite heavy doses of chemo.  this transplant is coming just in time.  thank God for his selfless donor - someone who has never even met this sweet baby.  so please pray for B tomorrow.  thank you.

if you are interested in become a donor - visit www.marrow.org

all it takes is a swab of your cheek and the willingness to possibly get the chance to help save a stranger's life.

happy earth day!

my hubby rocks!

so yesterday brandon gave me the biggest surprise for my birthday.  i opened the box and it had an apple in it w/ a piece of paper that said i was the proud new owner of ... a new mac book!  what?!  i had no clue, but was obviously thrilled!  it's supposed to be here tomorrow - yay!  he's been saving up for a new guitar, but aparently that guitar was code name for mac book!  i have the best husband ever.  so sorry - he's taken ladies :)

my birthday :)

it is an absolutely gorgeous day here in cincinnati, and it's my 22nd birthday!  i am still like a kid on birthdays.  i think they are fun - i'm not going to lie :)

i woke up to this from my awesome hubby.  some beautiful flowers, a very sweet card and a hannah montana balloon.  :)  he's so thoughtful.  he's going to take me out tonight.  i'm not sure yet where we're going, but i'm sure it will be fun.

last night at our staff game night, farrah made me a cake (my favorite - confetti cake!), and everyone was so sweet to remember.  i have already gotten calls from my sweet cousins, my parents and my brother and his girlfriend this morning.  love you guys!  (and miss you!)

i am reminded of how blessed i am to have so many people that love me.  i've gotten lots of cards and little gifts from family and friends.  thank you to everyone who has sent me b-day wishes today; it truly means so much to me and i love you all very much!  thanks for making my b-day special!

i prefer the calm

there are some nurses that love emergency situations.  they love hearing a code called and running to see what they can do.  i am not one of those nurses. 

i prefer to catch signs of pending danger before they turn into emergencies and i would rather my patients keep on breathing.  but in all reality, sometimes things happen and there is nothing you could have done to prevent it.  you just have to jump in the chaos and do what you can.  so that's what i did.

tuesday was one of those days for me.  i was in the room helping my patient get back to the bed from the bathroom when she looked at me in alarm and said, "my arm is going numb!".  a split second later she went down.  i caught her and first thought she had passed out, but then she started seizing.  i pulled the staff emergency button while trying to keep her from falling.  she was the same age as me, so it was hard for me to hold her up, but i did.

luckily every single doctor (NPs all the way up to the attending) on our unit was down the hall rounding on another patient and came running in.  they helped me get her back in bed and she slowly came out of it after some oxygen and dilantin.  my heart was pounding and my hands were shaking when it was all over.  she ended up being okay, but after many tests, they still don't know what caused the seizure.  it was one of the scariest things i have ever seen.  seriously.

i am just thankful she was okay and i didn't fail to recognize something.  i try so hard to be as attentive as possible when i work and to the best job i can to take care of the kids.  some days are easier than others.  that was not an easy day.

not to mention i didn't end up getting home until 10 pm (after leaving at 6 am that morning), and i got to get up wednesday to do it all over again!  lol.  at least it was a much better day :)

i want a pair of tom's shoes

these are so cool!  and they go for a great cause.  

my birthday is coming up in a few days ... :)

easter

we had a great service at river's crossing this morning.  we sang some of my favorite songs, and i was completely taken with worshiping my God.  at the end brandon and the band did the song, "true love" by phil wickham with scenes from "the passion of the Christ" playing on the screen.  i was broken in thankfulness for what Jesus did that day for us.  i wish i had a video of the service this morning, but here's a video of the song in case you haven't heard it before.

i hate that i need reminding, but today i was reminded of how amazingly blessed i am to be called His daughter.  to be loved enough that the God of the entire universe would give up His only beloved son to die a horrible death on a cross for me and all humanity.  it is truly unbelievable.  thank you Jesus for loving me!  thank you for rising from the dead 2000 years ago!  thank you for being alive and real and moving today!  i am so totally amazed by You.

updates

so this is an update post.  sorry :)

• the little girl i wrote about in my previous post ended up going to the PICU on thursday.  i thought she might.  thankfully she had gone to OR for an NJ placement and went from there, because she couldn't maintain her airway.
• brandon and i finally joined the Y.  we've been wanting to for a while, but you know how life gets - busy.  it's been so good to get back in the habit of working out.  
• yesterday brandon and i went to the mall for the first time in like 5 or 6 months.  we were anticipating finding all kinds of fun things, but guess what?  we left without buying anything!  nada.  
• but then we went to target and found all kinds of things to buy ... of course, lol.
• we also ate at cracker barrel (one of b's favorite places).  we just happened to be there at 5:15 and were by far the youngest people in the building.  it was quite humorous.
• today was spent working out, cleaning house, doing laundry and just being sort of lazy.  that's what saturdays are for right?
• on days i don't work, i usually end up sleeping in.  brandon thinks it's kind of wasting my day, but i figure this is the only time in my life i can.  once we have kids, i have a feeling i won't get to sleep in too many days.  am i right?
• we're going to a birthday party tonight.  should be good food involved i hear.  also good friends, so it should be fun.
• i am so excited about church tomorrow.  i have missed being in the service so much.  i've missed 8 sundays in a row!  i worked day shift, we were out of town the next, then i had to do the 3s class at church for the month of march (5 sundays!) and then i worked day shift again.  needless to say, i have missed it and am pumped!  to top it off, it's easter sunday.  it's going to be amazing at river's crossing tomorrow.  can't wait.

my day ...

• up at 0520 am
• leave house at 0600 and drive 45 min. downtown
• arrive at work and sit through a painfully boring/repetitive staff meeting that lasted entirely too long
• wear an ugly plastic yellow gown, gloves and mask all day every time i go into one of my kid's rooms
• walk into my 2-yr-old patient's room and think she's going to have to go to the PICU soon
• politely demand the doctor come look at my patient b/c i'm worried about her (her mouth/tongue/airway is dangerously swollen from a nasty virus), to which he does and proceeds to tell me i should be worried about her...
• draw lots of labs and give lots of medicines and run some tests to see if she'll get better
• discharge my other sweet 5-yr-old home; yay :)
• get my other sick baby stable (she doesn't have to go to the PICU)
• give a very long infusion (rituximab) that the docs don't decide to order unti 1530
• rock my sick baby to sleep (she ended up being okay for today, whew)
• give report, sign off orders, and check the PCA syringe
• drive 45 min. home
• shower
• watch american idol and eat a grilled cheese with my hubby at 2130
• blog this
• off to sleep so i can rest and do it all over again tomorrow!

the cost of medicine ...

every kid on my unit (blood and marrow transplant) is on tons of meds.  one drug we give often is a drug called IVIG (intravenous immune globulin).  most kids get it 2-3 times per week.  it's used to prevent graft-vs-host disease and immune deficiencies, and the dosage is based on the kid's weight.  you usually get a gram of IVIG per kilo, so say a kid weighs 60 kg (132 lbs.).  they would get 60 grams of IVIG.  the average cost is $125 per gram.  so do the math ...

60 x $125 = $7,500/dose

for 1 dose of this medicine!  most of our kids get this 2-3 times per week.

that's $15,000-22,500 per week for this ONE medicine.

and to think i handle this medicine every day like it's tylenol or something ... that is craziness.

no april fools

i feel like i've had  a block when it comes to blogging lately.  i just can't think of much to say.  i've just been working a lot it seems like.  speaking of work, yesterday i discharged a patient i've taken care of a lot lately.  it was the first discharge i've done since being at children's, because we don't discharge people very often.  they are usually there for weeks or months.  

she's 22, had a transplant last fall, and this was her 2nd hospitalization since then.  she knows how the discharge process goes.  she had tons of different specialties that had to come by and see her all day.  i had to give her platelets and an infusion of cidofovir before leaving.  anyway, it was a long day of her sitting and waiting to leave.  finally everything is done and i go to get her discharge papers for her to sign.  when i get back she and her mom were gone.  um ...  

they just left.  so i call her mom's cell phone number that's still written on her dry erase board in the room, and they have pulled out of the parking garage already!  i had to go down to the main entrance of the hospital, do her discharge teaching through the window of her car and get her to sign this special paper.  i seriously thought she was playing an april fool's joke on me.  no joke.  i've never had to chase down a patient in the parking lot to do discharge teaching.  good grief.