Sunday, July 12, 2009

Sunday at the Beach

Today I took the longest walk since my surgery almost three weeks ago. I am at my home in Florida spending what I expect is my last week of recuperation. I am spending the week on the beach at Seagrove Beach.

I walked all the way to the next warning flag. These flags are place on the beach about a half mile apart to warn swimmers of the water conditions. It uses a simple red, yellow, green system. Today's flags were yellow and my walk was about a mile round trip.

In the winter when I come here, I can make this same walk and see no more than a handful of people. Mostly, they are locals walking or fishing. But today is Sunday, July 12 - the height of vacation season - and the beach is packed. There is not a ten yard stretch that doesn't have people on it. I used to be annoyed by this invasion of people driving cars with tags from Alabama, Tennessee and Georgia, but I have come to accept it. Sometimes, like today, I actually enjoy it.

The beach sounds were like music. The waves keeping the beat with children laughing and squealing with delight. And everywhere the beautiful Southern drawl. Smiling families were taking pictures that will no doubt be on this year's Christmas card. Many appeared to be baby's first trip to the beach pictures as well. Oh my goodness, bikinis are still itsy-bitsy.

On the walk back, I counted nearly 50 children (and a couple of adults) building sand castles. Two kids were being buried alive. (With five brothers and sisters, I remember this activity well. We also made hundreds of "frog houses" constructed by covering your feet in a mound of sand and then pulling your feet out without it collapsing. It was more like an igloo and there were no frogs around, but it entertained us for many lazy hours.) The sand castles today ranged from the primitive to the sophisticated. I saw the dry sand method, the damp sand method and the sand-water drizzle method. Most castles had the requisite moat. I noticed that some kids build the moat first and others wait until the castle is finished. The younger kids just dig a giant hole, sit in it and build a wall around themselves. Others seemed to be trying to dig to China. I didn't want to burst their bubble by telling them that I had tried that unsuccessfully for years.

It appeared to be the first day of vacation for many of the families on the beach today. I had a few hints that it was their first day. First hint, most vacation rentals here are Saturday to Saturday with Sunday being their first full day on the beach. Second, no sunburns! People always underestimate the intensity of the Florida sun off this white sand. Even with all the warnings to reapply sunscreen, many will pay the price tomorrow. I also noticed that all the readers were on the first few pages of their new books. And, my last hint, little brothers were still playing with and listening to their older sisters. I only heard one boy say to a slightly taller girl with the same color eyes and hair, "You aren't my boss!"

So I enjoyed my long walk today and I look forward to returning tomorrow. No matter how long I live away, this will always be home to me. Tomorrow, the sand castles will all be swept away ready to be built again. Cheeks and shoulders will be red. And the sugar white sand and the emerald green water will be here to welcome us all back.

Friday, July 10, 2009

My Kidney Lives and Pees in St. Louis

My kidney lives and pees in St. Louis. Yes, that is my quote that was picked up by TV and newspapers at the press conference last week. Of all the great information shared that day, that was the sound bite the press was waiting for. Later, as VP of HR, I thought I might have to issue a reprimand to myself for saying "pee" in public. But then I remembered that I had just written a blog about my bowel movements. I guess I will let this transgression pass as well.

The press conference was held at Johns Hopkins to announce the historic eight way domino kidney swap, the largest every done. The star was Dr. Montgomery along with Mr. and Ms. Brinkman, newlyweds who were recipient and donor, respectively, in the swap. I also had the privilege to be one of the eight donors who gave our kidneys to eight recipients over a three week period at four hospitals in four states. Until the last pair of surgeries was complete this week, we were asked not to talk about it.

Now, I can shout to the rooftops. MY KIDNEY LIVES AND PEES IN ST. LOUIS!! My kidney was flown from Baltimore to St. Louis and transplanted into an energetic 60 year old woman. Her daughter in turn donated her kidney as the last donation in the amazing chain. This last kidney went to the still anonymous recipient who was the person in the chain who had no live donor and who would have died without this transplant.

When I started this process, I planned to donate my kidney to my co-worker, Robert. I never imagined that I would be a part of something so large and remarkable.

I was donor #7. The chain was made up of ten women and six men. Seven of the people were in need of a transplant and they each had someone willing to donate a kidney to them. However, all seven pairs were incompatible due to blood or tissue type. Donor #1 is the key to it all. Donor #1 was Thomas Koontz, a Virginia gentleman who wanted to give back something to honor his daughter's cure from brain cancer. He willingly gave his kidney to anyone who needed it. I am in awe of the generosity of such an altruistic gift.

He had no idea how big his gift would become. Like me, I suspect he thought that one person would benefit from his gift. Instead,Mr. Koontz's kidney went to Ms. Wolstenholme; Ms. Wolstenholme's sister gave her kidney to Mr. Brinkman; Mr. Brinkman's wife gave her kidney to Mr. Bruce; Mr. Bruce's wife sent her kidney to Detroit to Ms. Johanson; (Are you confused yet? We are only half way through.) Ms. Johanson's friend sent his kidney to Oklahoma City to an anonymous recipient; the anonymous donor there sent a kidney back to Baltimore for my co-worker Robert; my kidney went to St. Louis for Ms. Leffler; Ms. Leffler's daughter then gave her kidney for the final recipient who had no donor. This ended the chain.

Brilliant! Simply brilliant!

However, the complexity of the logistics is mind-boggling. Just figuring out the mix and match of donors and recipients, then coordinating sixteen surgeries in four hospitals is hard to imagine. Not to mention there were kidneys flying all over the place. Dr. Montgomery said, " The airspace around Baltimore was full of kidneys."

At the press conference that day, I wore a Hopkins blue dress and an organ donation green scarf. No one saw the symbolism, but it was meant only for me anyway. I have never been more proud to be a part of Johns Hopkins Medicine than I was that day.

While most of the sixteen people involved do not know each other and may never meet, we are forever linked by this amazing event. When I wake each morning I will smile knowing that Robert and seven others have new kidneys, but I will laugh out loud at the sheer wonder that my kidney lives and pees in St. Louis.

Monday, July 6, 2009

The Post-surgical Therapeutic Value of Pajamas

Today is D-Day +14. I donated my kidney to a co-worker two weeks ago today and I feel fantastic. I sit around all day resting, reading and visiting with friends. I take regular short walks and longer walks a couple times a day. Until today, I have been out of my pajamas exactly 3 times - to go to my follow-up appointment, a celebratory dinner with friends, and to visit my co-worker/recipient who is still in the hospital. I would have worn them to the dinner, but I didn't want to embarrass my friends.

I have often heard people talk about the beauty of leisurely days spent in their PJs. One friend says that she has one weekend day every couple of weeks when she makes herself stay in her PJs until at least noon. They use the time to read and talk, but mostly to quietly and slowly do nothing. They say that it is restorative.

I have never appreciated the true value of a comfortable pair of pajamas. I am one of those people who pops out of bed and gets dressed ready for the day. I am no good at sitting around and never in PJs. So when Sharon, the discharge nurse, told me that I would be in the hospital for a couple of days and then ordered me to rest at home for a couple of weeks, I headed to Target. I selected a couple pair of snazzy cotton drawstring pants (expecting a tender belly) and a couple sleep shirts in complementary colors. My best girlfriends brought me a couple of very hip sets from Anthropologie.

I think I did pretty well in my selections for a PJ novice. After I was home a couple of days, I apologized to a friend who was taking me for a walk that I looked so sloppy. He said, "I think you look adorable in your tie-dyed baggy pants." Adorable? I haven't been adorable since the second grade at Lula J. Edge Elementary School in Niceville, Florida. I few days later, a genius designer (truly genius) was sitting with me and said, "Did that top and bottom come together or did you do that?" I looked at my orange and yellow plaid bottoms and my turquoise top, stuck out my chin and said, "I put them together myself." "Hmmm..." he said, "I wouldn't have thought of that combination, but somehow it works."

So here it is 14 days after surgery and I am still in my pajamas. Day in and day out, I wear my PJs. I have stopped thinking about regular clothes. My best doctor friend, Kristy, dared me to go to the local ice cream shop in my PJs. Don't ever dare me. I had the peanut butter cup delight. I have friends who come everyday to take long walks with me - I call them my dog-walkers - we walk all over the Canton waterfront in my pajamas. It is shocking.

A few days ago I got up and decided it was time to get back to real clothes. I was greeted by my niece, Katherine, who is living with me. She is a fourth year medical student at the University of Miami spending a year here getting a Masters of Public Health from Hopkins. She asked me why I was putting on clothes and I said I felt like I was committing one of the seven deadly sins - sloth. She said, "Aunt Pam, don't you know that pajamas have a post-surgical therapeutic value. Clothes restrict your belly and will put pressure on your incisions. I recommend you put back on your pajamas." Eureka! Bingo! Jackpot! Permission from an almost-doctor to stay in my PJs!

After 14 days, I now understand the allure of staying in your PJs all day. PJs send a message to your brain that you are in relax mode. No need to run errands or clean the closet or vacuum the floor. Just sit down and read or talk or write a letter. It is restorative.

I am going to suggest that the transplant center modify their discharge instructions. If they seriously want donors to rest and recuperate, the instructions could state: WEAR YOUR MOST COMFORTABLE PAJAMAS ALL DAY UNTIL YOU ARE READY TO RESUME NORMAL ACTIVITIES.

I guess I should start weaning myself off my PJs starting tomorrow.