Friday, January 21, 2022

Pancytokeratin and Purple Balloons

     The supply chain is compromised, and you never know what's going to be in short supply. You know if you've been to the grocery store - it's not pretty. Random things are depleted. Rick from histology called me in the middle of the week. We are having trouble getting pancytokeratin. What do you want me to do. Pancytokeratin? That's a staple in my world. We have never been out of that. Just run a low molecular weight Ck and a high molecular weight ck. They did, and it worked, and luckily the next day we had our supplies replenished. 

    Laurie's birthday is this week, and she reserved the private room at Sauced tomorrow night and invited a select few. I'm excited. Laurie had a rough year a few years back, and she is finally becoming herself again. She said no gifts on the Evite, but she didn't know who she was dealing with. Melody wanted us all to go in on a gift. Jessica told her she was longing for a classy understated string of pearls. Melody found one, and we all chipped in. I got a bunch of charms from Rad Girl Creations - I was introduced to them last week in Pathology Mom's Group on FB. The stickers and charms are edgy and pathology related and super cool. Emptied them onto my floor this week, shut the door, and invited Jessica over to help me pick out some for Shelby and Savannah and Laurie and Bob and Joe. 

    Laurie's favorite color is purple, I've known this since even before my time at PLA. Jessica and I ordered some purple decorations off of Amazon (I know, shouldn't support Bezos, but it's so fast) and I told her I would get balloons from Party City, which is right across the street. Turns out they are out of everything purple. Balloons, decorations, and candy. WTF. Planning to stop into Fresh Market tomorrow after work to try to find something festive and purple. 

    Cecelia called me last night and asked if she and her friend Blakely could spend the night tomorrow night. Hell yes! I was so excited I bought Boulevard pimento and cookies. Mike and Rachel are going to host a brunch on Sunday morning. Can I wear my pajamas? I asked Rach in text. What can I bring? Something fruit tray related. Easy. Done. They are coming to support their friend and go to the mom's funeral at 2pm at Wildwood. I had only suggested she live stream it I didn't want to stress her out but I still remember seeing Marcie Lewis' face at my grandfather's funeral in high school and feeling so supported so I am super proud they are making the trek back here. She's going through a lot, I told C, but she will remember this for the rest of her life. I'm so proud of you for making the effort.

    I've had two 7am meetings back to back this week - CARTI general tumor board (Joe Beck is a hoot) and BHEC QC (Bob Searcy is even more of a hoot). Long story short Admin cuts off their nose to spite their face. The head nurse waxed eloquent about division support and market analyses to try to determine why we were losing money all of a sudden. Keep up with the times. Pay the senior staff better so we don't lose them. Travel nurses have no investment into long term care, and they are more expensive. Bob was like speak English to me. Give me a name, not a nameless department. I'll give my recommendations. 

    Problem is, Admin has blown up over 300% since the mid-seventies. And they are making money decisions that don't bear fruit. I'm not trying to alienate myself from the powers that be. I want to influence them - I'm Chief now - and I have my first med exec committee next Monday. I saw a statistic that there are now ten admins for every doctor. And they make helluva lot more than we do. But we are on the frontlines, and there is a shortage of medical workers, so we are as much in a state of disarray as the rest of the world. 

    I was problem solving a health issue Lucy was having last week - hadn't talked to her in months. She's one of a kind. She told me a few months ago that astrologists have been looking at this time for hundreds of years. We are not close to being out of the dark, she said. It's going to be a few years of hell. Five, maybe more. So take a breath and get ready. That calms me, when I get stressed. My GI issues are thankfully abating. I'm having more energy to work out - also catching up on QA I have let linger for the past year. But when you open the news and read about all the voting and abortion restrictions it's hard to have hope.

    Easy peasy call week so far Jess and I were marveling this afternoon. It's so quiet, we had better not talk about it too much or we will jinx ourselves. Oh the hand! I forgot to talk about the hand. I got a hand today, five digits really. Amputated for wet gangrene, which I embarrassingly had to google today bc we only see the dried mummified version of gangrene on the feet. Since we so rarely get hands, I deep dived into the chart.

    Patient on ECMO. Got Covid in November. Vaccination status unknown. Supportive family. Wet gangrene is the kind with active bacterial infection. So pus, wounds, blisters, chance for sepsis. I had a little PTSD reading the charts, bc I remember when my dad was on ECMO. The machine doesn't take care of you as well as your heart, so the extremeties get cold and blue. We had around the clock family care - my little bro took the night shifts, because you really need a patient advocate no matter who you are. We constantly asked for heating pads - they have the fancy twist activated ones but if you aren't in attendance they will fall off and no CVICU nurse, as amazing as they all were, will watch out for your hands and feet as well as someone who loves you. Thanks to us, dad still has all of his digits. My next plane flight is to see them in February and their new house. Can't wait.

    Happy Friday. Much love, Elizabeth

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