Thursday, May 10, 2012

Liver Transplant Dance

Today was my clinical exchange day with the Liver Transplant team.  I was super excited about this one b/c liver kids are my favorite in the PICU!!!  I was looking forward to seeing what life is like for those kiddos once we send them out of the PICU.

The first part of our morning was in post-transplant clinic.  We saw a bunch of now healthy, non-yellow super cute kids.  And it was fun.

And then we went in to see a patient who was in the PICU for about 7 weeks, waiting for, and then receiving her liver.  While she is 11 years old, she acts like she's about 5 sometimes and can be (as her mom puts it so eloquently) quite the drama queen.

If something hurts a little bit, she screams and yells a lot.  If something hurts a lot, well you can hear her outside the building.

So when we realized that it was 2 weeks post transplant, and time to take out her staples, we knew we were in for it.

And sure enough, the liver transplant APN and I walked in, with staple remover in hand, and she freaked out!  Screaming, flailing all over the exam table, and telling us there was NO WAY we were getting close to her with "those things!"

After much soothing, and working on breathing techniques, and then some distraction techniques (helpful to have a child life specialist in the room!) we started to take out the 39 staples.  Oh what fun those 39 were.

About every 5 or so, we'd take a break from removing the staples and put steristrips onto the incision.  This is where we told her she had to catch her breath, calm down, and get ready for 5 or so more.

Towards the end, with about 14 to go, she was so worked up she was sweating...which she screamed out "OH MY GOODNESS I'M SO SWEATY! This is HORRIBLE!"  To which the liver APN taking out the staples laughed and I looked over and she too was sweating!  And so was her mom.  It was one big sweaty hot mess in there!

But with 14 staples to go, Liver APN started singing a song about each staple.  And as each one came out, she sang and counted backwards.  So naturally, I started dancing.  I mean if someones gonna be singing I might as well be dancing!

After a steristrip break, the APN leaned over to take another staple, and the patient screamed "NOOOOOO!!!!! You CAN'T do this without the dancing! You HAVE TO DANCE!!"  And this was no joke!  Her face was beat red she was so passionate about this request.

So we finished the rest of the staples one by one, each getting easier as we counted backwards and I did my silly little dance.  And after the last one was out, we had a major dance party.  It was awesome.

The patient was able to sit up, wipe her eyes, catch her breath, and say "That was a good song!  And that was a cool dance!"

That, my friends, is the Liver Transplant Dance!  And that is the only way that this APN remove staples from here on out!