Tag Disability

Step 1 Again…The Donor Perspective

Michael 12 Comments

Now that I’ve been added to the kidney transplant waiting list the hard work begins. Finding a donor. On one hand you can sit around, stay healthy, make sure the transplant center has your current contact information, and just wait. On the other hand, you can try to find a living donor and go through all new sorts of levels of stress.

My immediate family has dwindled to a pair of sisters and a daughter. That would not be a good hand to hold in poker. But all three have expressed interest in donating and that closes the odds. They decided they would go through the donor evaluation process before we would ask if we should look to others. All three are currently in the process but at different stages. Two have been determined to be acceptable matches, one still awaits those results, and none is anywhere near completing the battery of tests donor candidates face.

You remember all the examinations and tests I had to go through? If you don’t, type “kidney transplant” in the site search bar and refresh your memory. We’ll wait. … Ok, ready? Well, as the saying goes, you ain’t seen nothing yet!

Like mine, their first appointment was a phone interview, a few basic questions designed to screen for obvious exclusions like diabetes, untreated high blood pressure, or various cancers. Also like mine, their first on site appointment meant lots of tubes of blood, a chest x-ray, an EKG, and face to face interviews with a nephrologist, surgeon, nurse, social worker, and transplant coordinator. Unlike mine, theirs also includes a donor advocate who is also a previous donor.

Like my first appointment at the hospital they left with a handful of appointments for follow up tests. Unlike mine, theirs were unlike mine. Where mine were targeted to make certain I could sustain the rigors of the operation and maintain the required follow up to prevent rejection, potential donors are tested to make as certain as possible that they are as healthy as possible and will be able to withstand the rigors of life with a single kidney.

Potential organ donors must be at least 18 and not more than 70 years old. That’s quite a range and obviously an 18 year old is going to be and is going to expect a different level of health than a 70 year old. My potential donors are just shy of 29 and a little over 67 years old. The one in between just turned 56. Three different stages of life, three different batteries of tests. Any single test can exclude the person or become the focus of a follow-up test. Surprisingly the youngest has the biggest list of baseline tests. As she explained it, the reviewing nephrologist said a 48 year old who is healthy today has a pretty good chance of still being healthy in 20 years. He has already passed the age when chronic illnesses would have taken hold even if they aren’t obviously obvious. Being healthy today means less to the 28 year old and how she will be at 68, 58, or even 48 so her testing will be more in depth and her expected results more stringent to mitigate missing sign of problems that might develop in the future.

In all cases they are going to get the best physical they’ve ever received. And if they pass all the physical exams they even get to have a go with a psychiatrist.

That’s just in case you thought you were nuts giving away part of your body.

——

If you’d like to re-read all the posts in this thread as well as other related posts, I’ve put links to all of them on one page. Go here, to join the journey.

Related posts

First Steps (Feb. 15, 2018)
The Next Step (March 15, 2018)
The Journey Continues (April 16, 2018)
More Steps (May 31, 2018)
Step 4: The List (July 12, 2018)

 

Step 4: The List

Michael 12 Comments

We are making progress. Tuesday afternoon I received a call from the transplant center at the hospital that the test results are in, the clearances have been reviewed, the committee has met, and I can now say I am officially sick enough to need a new kidney if one can be found for me. Have a seat, pour your favorite beverage, and I’ll tell you the next chapter of this story.

Saying I am sick enough for a transplant is really not accurate and was not the point of three months of testing. We knew the level of my sickness of those organs the first time they stuck a pair of needles into my arm, attached the other ends to a dialysis machine, and said it will get easier over time. They were, they still are, and it hasn’t yet so it probably won’t. It won’t.

The point of the tests, the examinations, and the reviews was to see if I am healthy and strong enough to withstand the surgery, recovery and follow-up to replace those pieces of mine that zipped right on passed middle age outpacing the rest of me to done for. And we discovered and now have documentation that I am. Er, healthy and strong (sort of), not yet done for.

Now we just have to find a replacement for those pesky, unproductive pods. Unlike other parts of me that have been unceremoniously replaced, there aren’t any replacements for a kidney other than another kidney. That means finding somebody who is done using his or hers or someone who is ready to part with one of the two that come as standard equipment in homo sapiens.

And now we come to the point of Step 4. The List. People, including me (well, I’m people too), refer to The List. There really is no single, all encompassing, first to last list. If you want to think of a list, it would more appropriate to think of each donated organ having its own list. When a person is accepted into the program and begins waiting for an organ, his or her matching criteria is placed into a database. When an organ becomes available, the organ’s criteria is compared to the database and all those people whose needs match the offered organ are retrieved. With some exceptions they are retrieved in the order they were entered into the system. Thus, The List for that organ.

There are exceptions to being positioned on the list from the order a person entered the system. Neonatal and pediatric patients are given some preference and people in need of a transplant who had earlier in their lives donated an organ receive placement preference.

When my blood was drawn in April at that first test in the transplant center, there were already over 114,000 people waiting for an organ transplant in the United States. When I became approved on Tuesday, 143 other people joined me being added to The List. About 95 transplants were performed that day and 20 people died waiting. The List grew by about 3,600 since April.

A recent poll revealed that 95% of people support organ donation but only 54% have ever signed up to be a donor. Unfortunately, only 3% of deaths result in actual available organs appropriate for transplantation. And so, the list grows. I could wait for 3 to 5 years until I make it to the top of an organ’s list.

There is a way off the list without dying or becoming too sick that a transplant’s benefits no longer outweigh the risks. The living donor. Kidneys and portions of livers can be donated by live individuals directed for a specific recipient. (Some people actually make altruistic donations that enter the general pool and are designated to a recipient as a deceased donor organ would be.) Under very rare circumstances, lung, pancreas and intestine live donations may be possible. Living uterus donations are undergoing clinical trials.

Living donors account for about a third of kidneys transplanted in the United States. Kidneys from live donors not only mean a faster transplant for the recipient but a more successful transplant.

Already four people have stepped forward and asked about making a living donation of a kidney for me. Their evaluations will begin next month and can take two to six months to complete. I’ll take you along that side trip as we make this stop on my journey. That way you’ll know what a potential living organ has to go through.

Just in case.

——

Related posts

First Steps (Feb. 15, 2018)
The Next Step (March 15, 2018)
The Journey Continues (April 16, 2018)
More Steps (May 31, 2018)

 

Step 3B – More Tests

Michael 15 Comments

It’s been a while since I brought you a transplant update so I thought I should get at that knowing that without one soon, your days just wouldn’t be the same.

I haven’t done an update for a while because I’m still in the midst of the tests. You’ll recall the evaluation process started with a series of exams and some “simple” diagnostics – labs, x-rays, EKG, and sonogram. Those were all done in a single visit to the transplant unit at the hospital. More in depth testing was ordered and those are a previously alluded to cardiac stress test, an echocardiogram, a CT scan of the abdomen and pelvis, and a colonoscopy. They should have all been completed by now but the physician doing the colonoscopy had to postpone so that is now scheduled next week. After that I have to secure a medical clearance from my urologist to go with the clearances already secured from the dermatologist and rheumatologist.

You might ask why they need all these tests and clearances and that’s why I’m here. At least for this post. The initial tests determined suitability to undergo the actual operation. For any surgery, a patient will be ordered an initial exam and basic labs, chest x-ray, and EKG. Usually those labs include chemistries and blood studies to see how the body is processing, and the exam is done by the surgeon or a PCP to get an idea of the patient’s general health.

The initial transplant lab tests included the basics but added blood and tissue typing to determine what to look for in a donor organ and some specific tests to exclude the possible or potential exposure to hepatitis, pneumonia, tuberculosis, or cytomegalovirus. These would not exclude a patient from transplant but might indicate additional tests or precautions, or possible vaccines or treatments, may be required.

The more in-depth testing of the echocardiogram and stress test are necessary not only to determine if the patient will be able to withstand the rigors of major surgery but also the aftercare which will be complicated by a drug regimen including immunosuppressants and corticosteroids. The colonoscopy is necessary to detect the presence of any cancers not noted by other tests or reviews which might exclude a patient from consideration.

The medical clearances are specific to each patient’s history. The initial referral must come from a nephrologist or kidney specialist. Nephrology is the specialty involved with the patients already ongoing dialysis treatments so that physician is most able to tell if there would be a possible benefit to considering a transplant and the urgency if so considered.

Every potential transplant patient is also required to have a dermatology clearance. This seemingly unrelated specialty clearance might sound an odd requirement. The immunosuppressive drugs used for life after transplant are associated with the possible development of skin cancers. The dermatologist can establish if the patient already is at risk or has melanoma activity and can further establish a baseline survey to be used as a control for future annual examinations. In my case the dermatology consult was of more significance because I am already being treated with immunosuppressants for the Wegener’s Granulomatosis (now called Granulomatosis with Polyangiitis (GPA) (and we already talked about my feelings on that bit of nomenclature)) that is the apparent cause of my renal failure.

Wegener’s is also responsible for my requirement to have a rheumatology clearance. As a vasculitis, rheumatologists are the most common specialists to be consulted on Wegener’s as are many other autoimmune diseases such as Lupus or Crohn’s Disease. A target organ of Wegener’s is the kidney, especially true in my particular case, so the clearance is required to establish that the disease is not in an active state that would place the donated organ at the same risk of failure as the present. Other organs affected by Wegener’s include lungs, sinuses, and the general vascular system, so active disease would impact the surgery and aftercare even in the absence of kidney involvement.

A urology clearance is also specific to my case because of my medical history having had bladder cancer. That was treated by the removal and subsequent replacement of my natural bladder. I was diagnosed with bladder cancer in 2012. After several attempts of excision of the tumors which all resulted in recurrence we made the decision to remove the bladder completely. This would mean some artificial means of holding liquid waste that typically is done by that unsung organ.  Because I was quite young at the time (only 57, and yes, that is young!) we elected to have a new bladder created, appropriately called a neobladder in the medical world, which the urologist fashioned out of a piece of my ileum. That is the final part of the small intestines that connects the small and large intestines. Long story short, it required a very extensive operation and a lot of “re-plumbing.” The urology clearance will confirm there has been no recurrence of the cancer and that all the pieces are still functioning as they should be and are in the places where they should be and the most appropriate locations for the placement and connection for a donor kidney. The specific requirement for my abdominal/pelvic CT scan will aid him in his part of the evaluation.

And that, in not too brief but actually quite brief discussion is why I am still going through all my evaluation tests. I know, your next question is doesn’t that seem to be too long and too involved for a transplant? And right on the heels of that you might ask but aren’t transplants life and death type operations, why such a long wait for these people?

To the first if those I agree it’s taking a while but no, I don’t think it is too long. Certainly you want to be thorough in evaluating the ability of the patient (remember, that’s me) to get through the operation and that you don’t end up with a successful operation but a dead patient (again, me). So I don’t mind everybody taking their time and getting things right.

And to the question aren’t transplants life and death and you don’t want to take forever with this, I say yes and no. In the case of a kidney transplant there is an alternative treatment to End Stage Renal Disease (ESRD). That is dialysis. Of course a transplant will result in a more natural and often longer life, but dialysis, for all its flaws (enough flaws to keep an entire blog running for a good long while) will keep a kidney patient alive. Like a patient waiting for a heart transplant, if I don’t get a transplant I will probably eventually die from my disease. Unlike a waiting heart transplant patient, I can’t mark that inevitability on my calendar. All transplants can mean the difference between life and death but when you consider sustainable alternatives, for some like a heart, liver, or lung patient, a transplant is more urgent than others like maybe the waiting kidney or pancreas transplant patient.

And so the journey continues, albeit slowly. And my thanks to you for coming along also continues. So please, stay tuned.

Related posts

First Steps (Feb. 15, 2018)
The Next Step (March 15, 2018)
The Journey Continues (April 16, 2018)

Figuring It Out

Michael 2 Comments

You haven’t read anything from me since early last week. It’s not because I got sick and ended up I the hospital or anything dramatic like that. I just haven’t been feeling me lately. I’ve not had a bad week but I’ve not had a great one. Sometimes that happens. To look at me you’d probably not notice much, if any difference. Most of the time I look neither disabled nor chronically ill, yet both of those I am.

Neither of those necessarily has anything to do with the other of those. I, you, or anyone else can be one, the other, both, or neither, and it would all be perfectly normal. Except for those who are not perfectly normal.

If I had to pick which to be I’d go with the neither option. Being chronically ill is a little easier in society. There are lots of support groups for almost any chronic illness you can name, from “basic” high blood pressure to the more exotic diseases and conditions of which two have taken residence in me. Most chronic illnesses do not result in a disability but the ones that do quite make up for that vast silent majority of those that don’t. Even those leave most people looking like there is little, if any wrong goings on under an otherwise fairly healthy looking skin.

Being disabled is also no picnic. I’m lucky that I still have most of my abilities available. I might be able to imagine a world where I am dependent on others for daily functions that you take for granted like washing behind your ears or making a cup of tea. But I can’t imagine what it’s like to be dependent on people’s foresight and planning to permit me to do those other things you take for granted like opening a door or stepping up onto a curb.

Whether overtly disabled, like a paraplegic in a wheelchair, or with a hidden disability that doesn’t affect mobility until you’ve taking the first 30 steps then can go no farther, there isn’t a whole lot of acceptance and accommodation going on out there. Wearing ribbons and outlining parking spaces in blue just don’t add that much to my quality of life. Sorry.

If you don’t read “Help Codi Heal” you should. Codi is a young wife and mother of three who was living her life when she was injured in a fall two years ago and now is living her life in a wheelchair. Because she is seen differently now, in a recent post she wondered how she would teach her children to accept life’s differences. Her dilemma came as she wondered how you teach acceptance of differences without pointing out the differences. Her not quite 4 year old taught her children don’t have to be taught acceptance. They are naturally accepting. So then, the new dilemma is how do you get them to stay that way?

NoHPaccessI think the answer is, you don’t. Leave it alone and let the children grow into being accepting adults organically. They won’t turn out to be ogres. I’m certain the amount of non-acceptance is directly proportional to a society’s extent of sensitivity training. The more we try to “teach” acceptance, diversity, inclusion, and affirmation, the more we turn away, divide, exclude, and deny.

Our attempts at equal rights for anything have never really succeeded. We manage to call so much attention to the inequalities and attempting to right past wrongs we never get around to actually addressing the actions that made the thing wrong.

Let me tell you a true story. In 1972, I applied for a summer job at the local steel mill. That was when many companies were feeling pressure from regulators to comply with what was then called affirmative action, ten years after the regulations went into effect. I went through all the necessary applications and tests and was in an interview with the personnel manager who told me that he’d love to hire me but he really needed “a black or female student to even things up” for that summer. No discussion of my ability or inability to do the job, just what he needed to do to “even things up.” That phrase stayed with me and at every job I ever applied for in the next 40 years I heard it in my head. I always wondered if I’d be competing against any minorities and would I be unfairly dismissed because I wasn’t one. Real or no, that was a perception that stayed with me for a lifetime.

Forty years later when I was the hiring manager, I was required to give each applicant a form to voluntarily complete after the interview. It asked the applicant’s sex (male, female, other), race (optional), ethnic background (of a select handful), and veteran status. This was sealed and sent to a third party to tabulate to determine if we were interviewing from a pool of applicants representative of our local population. No question of the job we were interviewing for, education or experiential requirements for the job, or if the applicants who responded were representative of the population. Real or no, pressure was felt every time I had to make a decision among applicants of diverse backgrounds, even if their professional backgrounds were also quite diverse.

How do we address the elephant in the room? If you ask a roomful of 3 year olds they would probably say, “Look, an elephant! Let’s play.” How do we get the three year old grow up to be 23 with that same innocence and acceptance? Just leave them alone.

They’ll figure it out.

 

Step 3a…The Journey Continues

Michael 16 Comments

We stepped off the elevator and I was sure we turned the wrong way in the garage. I read the directions off to my daughter and we were both certain that we had selected the correct garage entrance and floor and entered the building at the door indicated on those directions. It was a little difficult with the construction going on in the parking structure. Much of the signage was obscured and it lent enough of an air of uncertainty that the only thing I was certain of was that I wasn’t certain. When we went from the brightly lit elevator into the dim hallway I thought this wasn’t going to be my day. That’s when the neighboring elevator pinged and a young lady rushed out, saw us and said, “I am so sorry. I’m late. Let me get this opened up and check you in.” I breathed a sigh of relief that I hadn’t gone completely crazy. Yet.

Welcome to the continuing story of As the Kidney Turns. Last week I finally had my in person evaluation appointment and initial round of tests for a potential kidney transplant. I’m calling this Step 3a because there are more tests to come before we get to Step 4, the (hopefully) acceptance.

Step 3 Day started early. Apparently too early. I’ve never been one to be fashionably late. If told to be somewhere at 8, I show up at 7:45 so when I was told to be somewhere at 7:45…well. But I used to worked right down the street from where we were and I knew that if the stars weren’t lined up just right, and the traffic lights were working against you, it could take 20 minutes to go 3 blocks in that part of town. My daughter was with me for the appointment and we didn’t have to be concerned that we were a couple minutes late getting started. We would end up spending the next 7 hours there.

The day started like any doctor appointment. Height, weight, and insurance. Not necessarily in that order. I was checked in which amounted to verifying insurance and demographics, signing various authorizations and releases, and being led to a combination office/exam room. Then things got different in a hurry. There we spent the next four hours meeting with an insurance specialist, two doctors, a pharmacist, a social worker, and my personal transplant coordinator who would be my contact throughout the process all the way to the surgery if that would be the (again hopefully) ultimate end. (I then would be transferred to a post-transplant coordinator who would stay with me presumably until my ultimate end.)

We talked about the actual procedure, that a my own kidneys are not removed but a new location is prepared for the transplanted organ and the how the blood, nerve and fluid connections are made, where that space might be, and the physical recovery from the operation. Most people recover in the hospital for 5 to 7 days then at home for another month or so before resuming regular activities.

We talked how with a transplant the recovery process never really ends. The initial follow-up requires twice weekly visits to the transplant center for 4 to 6 weeks, then weekly visits, then twice a month, then monthly, and so on until I would stabilize at life time annual visits. Post-transplant specific medications are used for life to lessen the chance of rejection and infection.

We talked how if accepted into the program while awaiting a transplant there will be the need for ongoing tests and examinations to continually affirm my suitability. In the absence of a living donor that wait could be 4 to 5 years. Those tests include specific blood tests drawn every month and because I have Wegener’s Granulomatosis which is treated with an immunosuppressant, I would have to be re-cleared by those physicians every 6 months confirming I have no exacerbation of that disease or confounding effects of the drugs used to treat it.

We discussed the differences in recovery and results between living and deceased donated kidneys. If you’re wondering, kidneys from living donors tend to begin working shortly after implantation and can last for 15 years or longer. Those from deceased donors may take several days to begin working and can be expected to keep on working for 8 to 10 years. Also, again if you’re wondering and because I always had, a living donor who should someday need his or her own kidney transplant will receive priority in their own journey.

We also talked about what all this means to me and my family. Pre-transplant for me means continuing with dialysis and some more frequent doctor visits to insure I remain suitable for the procedure (if it’s determined that I am to begin with). The additional blood test can be drawn at the dialysis clinic so that would be one less trip I’d have to make each week. Speaking of trips, if I feel like taking one I’d have to notify my coordinator where and for how long I’d be. Because I live alone, after transplant for those first few weeks I’d need someone to stay with me or I to stay with someone. I would also need assistance getting around initially and getting around would be necessary having to make the trips into town for those checkups at the clinic. Fortunately, those will be short trips. Family gets involved right away. One of the requirements is attending a patient and family education class that goes over in more detail all that was discussed at last week’s appointment.

After all the meetings with all the people and a physical exam from both doctors (there were two doctors because one was the medical specialist and one the surgeon), I was set loose in the hospital for various tests. Those included to the lab for blood test (17 tubes, yikes!) and a urine sample (only one, thankfully), to cardiology for an EKG, and to xray for chest xrays and a sonogram of the kidney and one of what I have been given to replace the bladder. Still to come are a stress test, an echocardiogram, a cystogram, and (my favorite) (yeah, right), a colonoscopy.

Early returns seem to indicate I might be able to pull this off. Nothing came up at the initial exams that would have immediately disqualified me and the test results that have come back are more or less normal, for me. The remaining tests are scheduled over the next several weeks and I hope to have a definite answer by June. Then we can start thinking about possible donors and a whole new step.

DLAAgain, thank you for staying on the journey with me. Coincidence continues. This month my transplant evaluation coincides with National Donate Life Month. Every April, Donate Life America celebrates National Donate Life Month, focusing national attention on every individual’s power to make life possible by registering as an organ, eye, and tissue donor, and learning more about living donation. Many years ago I registered to be a donor. That was long before I ever suspected I would someday be looking at transplants from a recipient’s perspective. If you’d like to explore becoming an organ or tissue donor, check with your local transplant center, your personal physician or the Donate Life America website, or register at RegisterMe.org.

Related posts

First Steps (Feb. 15, 2018)
The Next Step (March 15, 2018)

 

 

 

The Next Step

Michael 12 Comments

Welcome to another episode of As the Kidney Turns. When we last left our hero he had just been referred to the local transplant team for evaluation for a potential transplant. Yesterday he got the call to schedule that appointment.

Yes, I got the call Wednesday afternoon for a phone review and to schedule the first kidney transplant evaluation appointment! Even though I spent my career in health care and even participated in post-transplant processes (more on that in another post coming soon), this is going to be a new experience for me. I said I’d keep you in the loop with the process and we start here if you’re still interested in coming along for the ride.

The telephone interview ran a little over a half hour and included a review of systems (current health status and medical conditions, medical history, past surgeries, recent tests, and physical abilities and limitations), and a brief description of what to expect from the evaluation appointment.

The first contact with every new provider always starts with the review of demographic information – height, weight, date of birth, and those sorts of etcetera. One of the questions posed was actually the second time I was asked it this week and the first time was by Tax Guy. You remember him from the last post as one of the stops on my whirlwind appointment tour on Monday. What could a tax return preparing team and a kidney transplant evaluation team have in common? It was “are you working?” It was actually a two parter. First “are you working” and that was easy to answer. No. The follow up was more difficult. “Why?”

It wasn’t put so bluntly by either, but both had to put something down on their forms. The US tax return includes a space for “occupation” that must be filled. Since I am not working I have three choices: unemployed, retired, disabled. I’m sort of all three. I am not being employed to anyone’s good use.  I am old enough that I could retire but not so old that I can draw on pension benefits. And I am not working due to the loss of function that was required to perform my job. Since my income is from disability benefits rather than pension benefits I am disabled rather than retired for the purpose of paying taxes. So that satisfied the accounting world.

The transplant evaluation people need to know if I am physically able to withstand the rigors of the operation and recovery. Being disabled affects not only the need for the potential transplant but the response to the transplant and it’s after effects. A kidney transplant is different from a heart, lung, or liver transplant in that for most potential kidney transplant recipients, if one does not receive the transplant there is still another option to maintain life. Dialysis. It’s not a perfect alternative but for the patient who cannot tolerate the surgery or recovery associated with a transplant it is a means of replacing not the kidney but what the kidney does. Knowing that, it is in the patient’s best interest to not subject him or her to a major surgery that poses significant and severe risks if those will be more harmful than not having the transplant.

So, to make a long story short (which I almost always cannot and once again I fear I have not), in the medical world there are basic functions that I cannot perform on my own including walking and standing without assistance, the loss of my bladder and associated parts requiring me to rely on self-catheterization for what the bladder and other parts usually do, and the ongoing and chronic progression of Wegener’s Granulomatosis and its effects. In the medical world, I am also disabled. But enough of me is still functional enough and strong enough to, on paper, appear to be able to withstand the rigors of transplant surgery and recovery, I can now progress to the evaluation stage to determine if the theoretical transfers positively to the practical.

NationalKidneyMonth

Source: National Kidney Foundation

I’d be very happy and honored if you’d stick with me for that progression. Hopefully this will be the only time that you have to make such a journey. March is World and National Kidney Month. Even though my appointment isn’t until April I’m going to take it as a good omen that I got my call this month. You can make my journey yours and not have to make one on your own, if you remember to, in the words of the National Kidney Foundation, “heart your kidneys.”

Related Post:
First Steps (Feb. 15, 2018)

 

Working It Out

Michael 5 Comments

Every now and then I get it into my mind that I should go back to work. Most of the time that happens when I’m asleep in the form of a dream (or nightmare if you will). Some of the time it happens when my every so often disability recertification comes in the mail. In the past few days both of those things happened. And then I thought, if I had to, what would I do?

I couldn’t do what I used to do or I’d be doing it. Whatever it would be it should be something that I don’t have to think much while I’m doing it. I had a lifetime of thinking. I’d want something mostly brainless.

It shouldn’t be anything that requires a lot of sitting. I spend so much time sitting during dialysis (so I can “live a normal life” while I’m not on dialysis) and after dialysis (so I can recover from dialysis) that standing is actually refreshing. But it couldn’t be anything where I had to stand for more than a half hour at a time. I’m good on my feet in one place for around 30 minutes and then I fall over. Sometimes it’s a little more, sometimes a little less, but 30 minutes is a good starting point. Or more appropriately, stopping point. Limited standing would be good.

The local dollar store had a sign up for a part time cashier. I love dollar stores and it would be a financial plus for them since my little salary would certainly turn into dollars spent there. But I’m certain they don’t have half hour shifts and I’m just as certain they wouldn’t take kindly to me teetering, tottering, then toppling a few times each day, ADA regs notwithstanding.

HelpWantedA great standing job would be TV weather person. They only stand in front of the big screen for 2 or 3 minutes then it’s back to checking the weather app on the phone to prepare for the next segment. I can do that. I even already have the app on my phone. Two actually. The one that I wanted and downloaded myself and the one that magically showed up the last time my phone automatically updated itself from wherever it automatically updates itself. If I would be willing to move I can probably do it without either of those apps. I’m certain that in San Diego I can go on air and say “tomorrow will be warm and sunny,” and be right 362 days of the year, 363 on leap years.

A short period standing job would be good but would more likely still have to invented. What else is out there to do? Driving. I like to drive and I know my way around town. I could drive something, but not for a cab company, or worse, an app based ride hailing service. I wouldn’t even pick up a hitchhiker back in the last century when thumbing on the open road was right between VW bus and Greyhound as the most popular means of interstate travel. Depending on the kindness of strangers is not my idea of gainful employment.

Limo driver might work. Oh the people who climb into the back of a limousine are just as strange as those crawling into the back of a taxi and then they aren’t nearly as strange as those crawling into the back of a taxi. You can tell that by the way even though some limos have glass partitions between driver and passages they are rarely bullet proof. Car lot courtesy van driver is another stranger driver job I can get along with. Again, they are still strangers but the people I would be working for are holding the strangers’ cars hostage. The problem is that sometimes those drivers double as lot attendants and that means clearing cars of ice and snow in the winter and washing them year round. That makes it all much too much like a job.

What else? I thought I’d find out and check some ads. I was still interested in possible jobs but not that interested that I wanted to open up a browser and check a real job site. I discovered that there are still want ads in the paper. A lot of them are for security guards. That wouldn’t work for all kinds of reasons. Security guards either sit a lot (see above), stand a lot (see above), or walk a lot (not even considered enough to be included above). No to guarding.

But I found a job in the paper that seemed ideal. It was titled “staffing assistant” and the responsibilities included “reviewing and recommending job applicants, and making staffing recommendations.” I figured I could review my background, recommend they hire me, then further recommend my job to be home based and with no additional responsibilities.”

Now we’re talking dream. No nightmares need apply.