Two in Less than a Week...

Last night's episode of House M.D. - some guy dying of some mysterious disease, we get it.

His kidney's fail (this happens quite regularly on House MD, or at least the 'threat' of total kidney failure). Well crud, we have to find the guy a working kidney ASAP so we can keep him alive long enought to find out what's wrong with him!

So what do these brilliant doctors do? Ask his 13/14 year old daughter to pony up an organ.

'Scuse me?

The show treats the situation as if it's as simple as the parent/guardian signing the release form and the minor child can be wheeled into into surgery and relieved of her left kidney. Considering it's the parent that needs the kidney, don't you think that's a conflict of interest???

First off, a potential donor is put through GOBS of tests before they are 'cleared' for surgery. No way and no how can the process be expedited that quickly.

Secondly, and more importantly, a minor CANNOT donate an organ. Under no circumstances. For no reason whatsoever.

Do I make myself clear? A living donor must, Must, MUST be at least 21 years old. No expections.

As a friend of mine pointed out, these shows are called 'fiction'. However, there is suspension of disbelief for entertainment's sake and then there is disinformation with the potential to be harmful and dangerous. Perpetrating the idea that a 13/14 year old can be a living donor (and under the stressful, immediate circumstances of her father, her only living parent, dying) falls under the latter category.

G- D- it, I hate when people get the words wrong

I'm paraphrasing a great line from "bull durham" where Crash Davis interrupts Eddie "nuke" LaLouche's butchered rendition of "Try a Little Tenderness".

In this case, I'm referring to the writers of the latest "Grey's Anatomy".

Last night's episode revolved around a six-way kidney swap, chock full of drama and ridiculousness as viewers have come to expect from the prime-time soap. But as anyone in my writing group knows, I'm a stickler for continuity, consistency and realism (yes, even in stories about Lizard people from Planet 32A97), and that extends to television programs that puport to show the inner workings of a hospital. So let me set the record straight:

1. The odds of all members of this six-way kidney swap being in the same locale and the same hospital are quite slim. Not saying it hasn't/can't/won't happen, but to find six donors and six recipients with coordinating blood types and HLA matching in a small geographic region is incredible, to say the least. Detached kidneys are viable for 48 to 72 hours, so it's much more likely they'd fly the organ to its destination.

2. One of the donors turned out to the be mistress of one of the recipients. Everyone (except the woman's lover) believed she just decided to cough up a kidney to a total stranger for no reason. Yes it happens; I'm not so cynical as to discount this possibility. However, every donor is put through a psych eval of sorts. Granted, mine was pretty minimal and for the most part, they're looking to weed out martyrs and the uncertain, but I'd like to think someone would've picked up on her ulterior motive, especially considering how quickly she cracked under the pressure.

3.Dr. Bailey and her 'pep talk'. Sure, the writers paid lip service to the fact donors should not be coerced in any way to relinquish a body part, but it happened anyway. Where the hell was the transplant coordinator? How about sending a mental health professional in to LISTEN to this poor woman who just discovered her husband was A. having an extramarital relationship with B. someone much younger and C. the person in question was there to donate a kidney!!

4. The biggie - KIDNEY IN A JAR. First off, unless the kidney is cancerous or otherwise malevolent, they do NOT remove a recipient's natural kidney during a transplant. They simply insert the new organ lower in the pelvic region. That's right, a transplant recipient usually walks out of the hospital with three kidneys.

On a personal level, I'm really disgusted by the idea of 'kidney in a jar'. This is a person's vital organ, someone who put their trust in you as a medical professional, to treat them and heal them, and you're coveting their body parts for decor accessories? Disrespectful doesn't begin to cover it.

And finally, of six recipients, at the end of the episode, one wasn't doing so well. His son was part of the kidney swap and there was the obligatory tearful scene between them, but where was the actual donor. You know, the person whose kidney actually went into this guy's body? Granted, everyone in this circle was donating to help 'their' loved one, but they also knew exactly who was getting their kidney.

Guess the writers didn't think the donor was all the important.


(P.S. Happy Birthday Vi....)

Living Donor Denied For Lack of Follow-Up Care

http://www.lvrj.com/news/32802344.html

The Mayo Clinic refuses to allow Randy Warner to donate a kidney to his friend Tom Roe because Warner is a 'recluse' with no family or friends to care for him after his hospital discharge.

Roe's family offered to look after Warner, but unfortunately UNOS has very strict rules governing anything they deem 'compensation' to a donor for an organ. The recipient's family caring for a non-related donor makes The Mayo Clinic squirm with possible impropriety.

Secondly, for 30 days post-surgery, Roe's insurance covers the cost of any health services Warner may need, and The Mayo Clinic will be responsible for providing them. Regardless of public perception, some donors do experience complications, and if Warner has no caregiver, he may not seek assistance as soon as he should, if at all. I suspect the Mayo Clinic is protecting themselves from any liability if something detrimental should occur to Mr. Warner under these circumstances.

Thirdly, according to the article, The Mayo Clinic refuses to give Mr. Warner copies of his pre-transplant tests so he can and Mr. Roe can seek out another transplant center for the procedure. Obviously they can still solicit another center, but Mr. Warner will have to endure the diagnostic tests for a second time.

While I can't speak about Arizona's laws, Ohio's stipulate that medical records are NOT the property of the patient, but of the provider (physician, clinic, hospital). A patient can obtain copies of these records, but for a price.

Personally, I think this law is ridiculous and yet another way for the medical community to take advantage of consumers. The consumer pays for the service, yet they are allowed no records of it? Do mechanics horde the documentation of work done on your car? Plus, this extra fee hampers lower income people who tend to visit different clinics or providers. They simply can't afford this extra fee, which prevents their current physician from knowing their medical history, and consequently thwarts patients from receiving the continuity of care so important to good health.

And let's not forget that Mr. Roe's insurance company forked over approximately $10,000 for the pleasure of testing Mr. Warner, and it looks like they'll be doing it again. While The Mayo Clinic is doing nothing illegal in refusing to give Mr. Warner his test results, I wonder if a sternly worded letter from Mr Roe's insurance company might change their mind?

Hair Metal Lives...

My latest foster pooch is named Poison. He doesn't look Poison or act like Poison (except when he lifts his leg on things he shouldn't) but such is the life of a racing greyhound. My hope is that his new family will change it to a more fitting moniker.

But in the spirit of the season, I gathered with other retired racers and their families for a little celebration. My boy was - what else? - a heavy metal rocker.



What you can barely see through all the curls is an Ozzy Osbourne tee and a red bandana tied around his front leg. He was quite popular with the ladies :-)

Locks of Love

I relinquished nearly a foot of hair today at the salon. It wasn't a premeditated act, more like a spontaneous urge for change. I'll submit photos soon...

Let's Hear it for Artistic Interpretation

Thanks to Suzanne for this little gem...

Sick Girl by Amy Silverstein book review

When she was 24 years old, Amy Silverstein was diagnosed with an irreparably failing heart. She celebrated her 25th birthday in the hospital and a short time later underwent a heart transplant. Since then she’s practiced law, gotten married and adopted a son (plus published a book), AND she’s still kicking almost 20 years later with the same heart beating in her chest.

Pretty amazing story, right?
Not if you ask her.

Public perception about post-transplant life is mostly rainbows and lollipops. In reality, a transplant recipient’s day to day existence becomes about multiple medications, a suppressed immune system, opportunistic infections, and the looming awareness that your happy ending has a very time-limited warranty. There is a serious misconception out there - a transplant is not a cure; it is merely a treatment.

This is why Amy’s story is valuable to the conversation. She doesn’t just scoff at all those warm-fuzzy, inspirational, second-chance essays, speeches and articles; she grinds them to bits under the sole of her Jimmy Choo shoe. Despite the amazing results of her surgery, Amy is still down-right pissed.

That’s part of what makes reading “Sick Girl” so difficult.

Amy’s unrelenting anger, while understandable, never seems to abate. She mistreats all of her doctors and specialists, and even her descriptions of the social workers and psychologists charged with supporting her are condescending and uncharitable. The only person she seems to have a kind opinion about is her boyfriend-fiance-and-eventual-husband Scott, and she manages to dehumanize him in the other direction, referring to him as “her angel” repeatedly. While I think we can all agree that a loving and supportive spouse is irreplaceable, no one is infallible. By categorizing him and their marriage this way, Amy manages to distance it and her experience from her readers.

Some of the complaints about “Sick Girl” as reported by Amazon.com users focused on the author’s socio-economic status. On the surface, this seems shallow and possibly jealous. Is Ms. Silverstein supposed to hide her upbringing, her education and her standard of living so she doesn’t potentially offend anyone? Of course not. The problem lies in her inability to recognize how fortuitous her situation is. To have “the number one internist in New York”, and be whisked away to a “private hospital” for tests is perceived by the average reader as privilege. They can’t help but think that if they were the ones with the failing heart, they would be long dead before they would be able to locate the entrance to the building where her specialists practice.

Many of the author’s flaws could be overlooked if she expressed any sort of self-awareness. After all, nearly twenty years have passed since her transplant; by all calculations, she should’ve learned a thing or two. Yet near the end of her memoir she whines (I’m reluctant to use that particular word, but it is accurate) that only one person in her life, aside from her family, knew her when she was “healthy”, as if the person she’s been for the past seventeen years isn’t her “real” self.

Despite her age, formal education and by all appearances, above average intelligence, Ms. Silverstein completely refuses to accept her condition. No one, least of all me, is saying she should be happy her life was radically altered at such a young age, but her shock toward her husband’s insistent “You have a transplanted heart!” borders on delusional. It is as if she views the whole ‘sick girl’ persona as a hiatus from the life she envisions for herself, an unrealistic perception that will simply never come true.
A friend of mine asked me why, if the book contains so many deficiencies, did I continue to read it. Aside from simple curiosity, I hung in with Ms Silverstein because some of her observations deserve attention. How quickly she learned to hide her condition from her law school friends because reminding them of her imperfect health made them uncomfortable, for example. And the realization that doctors, no matter how well-reputed, are human and painfully imperfect, which means that a patient must, must, must take responsibility for their own well-being by researching and asking questions, even to the point of making demands. Finally, Amy exposes the reality of living with a transplanted organ, which is a truth the media and popular culture continue to deny.

You might find the messenger behind “Sick Girl” abrasive, but it doesn’t negate the truth of her words. In a world as complex as organ transplantation, it’s what she has to say that is the most important.

Anyone Still Think That Bailout Was a Good Idea?

After Bailout, AIG Execs Lounged At Resort

"Less than a week after the federal government had to bail out American International Group Inc., the company sent executives on a $440,000 retreat to a posh California resort."

"The tab included $23,380 worth of spa treatments..."

While we're on the topic of AIG executives:

"Lawmakers also upbraided Sullivan, who ran the firm from 2005 until June of this year, for urging AIG's board of directors to waive pay guidelines to win a $5 million bonus for 2007 - even as the company lost $5 billion in the 4th quarter of that year"

(For the record, in case my prior posts didn't clue you in, I was totally and completely and wholly opposed to this bailout. This B.S. is exactly why.)

Scene from a Dentist's Office

Hygenist: Any change in your health since your last visit?

Me: I lost a kidney. (pause) Well, I donated it. I didn't misplace it.

Disadvantages...

To Being Visually Impaired: You don't realize how dirty your shower is because you never have your glasses on when you're in the dang thing.

To Living in the Land of Many Trees: Really, literally overnight spiders can spin themselves cozy, brand-new homes.

America's Financial Crisis 101

Say you have $10. You give it to someone. After a week, they give you $12 in return.

Welcome to lending.

Now, say you are the person who borrowed that original $10. What if you could give it to someone else and they'd pay you $14?

Welcome to the US Banking System. The Federal Reserve loans the money to the banks, who then loan it to the American people.

Before WW2, banks didn't offer credit to the average American. Afterward, beginning with the GI Bill, lenders opened their coffers, provoking a rise in home ownership, as well general consumerism.

By allowing people to pay for items over time, they were able to afford more expensive purchases, and they had more disposable income. Consequently, demand for goods rose, and everyone made money.

In the past 20 plus years, 'real' wages have remained static while the cost of living has increased - a lot. Also, the top 5% of wage earners have gotten increasingly richer while the rest of America has stagnated or slid backward. This is not my opinion; this is fact.(consult the census data)

In summary: prices increase and wages don't, so in order to maintain the same standard of living, more debt must be incurred.

In its most simple form, the financial crisis was created because borrowers can't repay their loans, specifically mortgages.

Why does this effect the entire financial community, and ultimately, American citizens? Because banks got the brilliant idea to take the loans they've given to Americans, and instead of waiting for them to be repaid, they sell them to companies like AIG. This gave banks immediate money to loan out, while Lehman-Brothers,etc benefited from that $10=$12 equation I mentioned earlier.

The problem is that they bought the loans with our 401K or IRA money.

The other problem is that the investment companies assumed the loans were 'good', but in truth, banks gave loans to people they really shouldn't have. They didn't care if the loans would be repaid, because they were being reimbursed by companies like Merrill Lynch. And frankly, the executives at AIG/Lehman Bros et. al. didn't look too closely at these loans because it wasn't THEIR money at stake, it was ours.

Sounds like I'm making an argument for that $700B bailout, doesn't it? Quite the contrary.

These companies are hurting because they need money. They need money because borrowers are not making their loan (house, car, credit card, student loan) payments. Will giving AIG etc. money - OUR money, TAXPAYER money - change that?

Will they lower the interest they charge on their loans to help people make their payments?

Will they convert variable loans to fixed loans rates so people can make their payments?

Will they 'forgive' any amount of unpaid debt?

Big fat NO.

I can just hear the chorus of "But, but, but...."

But nothing.

Give the money back to the American people. Not in the form of some bullshit 'tax refund' or blank check (like they want to offer the mega-corps), but in the form of debt relief.

Paying off a $20,000 car loan frees up over $300 a month. The lender (whether it's the bank or an AIG-controlled mutual fund) gets their money AND the consumer has that cash to recirculate into the economy.

Extrapolate that to a $200,000 house.

Win. Win.

The only losers in this scenario are the greedy corporations who whine that instead of getting $12, they're only receiving $11.

Last time I checked, $11 is still greater than $0.

Do the math.

This is How We Save the World, part 2

In my attempts to procure support for living donors, I found a site whose url promised just that - with an .org extension even. Upon rudimentary examination however, the site was bland, non-descript and painfully out of date.

I sent the following email, which has yet to acknowledged in any way:

To: info [at] livingorgandonor [dot] org
Date: August 21, 2008.

It is unfortunate that after months of research on living donors and kidney transplants, I only now run into your site. While I didn't exhaust the information contained there, I was dismayed to find your statistical information ends at 1999. Have you stopped updating in lieu of other pursuits?

While your site seems to give a cursory overview of what it means to be a living donor, there is much information omitted. New surgical procedures, legal issues that differ by state, and most importantly, addressing the emotional and psychological well-being of the living donor. Your site, like every other site I've encountered, treats the living donor post-transplant as an afterthought.

95% of today's transplants (grafts) survive the first year, but what of the other 5%? With over 6000 living donor transplants performed in 2007, that leaves approximately 300 living donors grieving and struggling to understand the tragedy befallen them and their intended recipient. Yet this phenomenon warrants nothing more than a single sentence on your site, with no suggestions on how to come to terms with the understandable anger, sadness and self-recrimination that follows such an event. Transplant clinics themselves lack the support system to deal with these unforgotten heroes, and the national organizations behave as if they don't exist out of fear that acknowledging their pain might dissuade some people from donating.

If you have no further interest in the issue of living donors, please pass the torch on to someone who will keep the site relevant and updated. Otherwise, do all past and future living donors a great service and keep the site as thorough and current as possible.

Thank you,
Cristy