My husband, J had a liver transplant in 2009 at Broward General Hospital. On the day after the doctor informed us that, according to J's lab values, he had only about 5 days left to live, my husband received his liver transplant. Despite many setbacks - rejection, an obstructed bile duct, no circulation in the hepatic artery, to name a few, here we are - 9 years later, enjoying our retirements, children, and grandchildren. There are never any words to express the kind of gratitude we feel every day to each and every member of the transplant team.
J and I have been "snowbirds" for approximately 15 years, spending the winters in Florida and the remaining months in New Jersey. Being away from the comfort and easy accessibility to the transplant team, while in New Jersey, initially caused us some anxiety, but over the years we have had absolutely no difficulty getting transplant needs met when not in Florida.
Elaine Juliano has been our saving grace many times. She immediately responds to any questions or requests we have regarding transplant issues. Elaine is always prompt in regards to medication refills, lab prescriptions (which must be updated every 6 months), and reporting J's monthly lab results (done monthly while we are in New Jersey.)
I would like to address two recent significant issues Elaine has dealt with great professional, ethically responsible and personal care and consideration.
In August, Elaine was relentless in obtaining insurance authorization for J's absolutely necessary immunosuppressant medication, Prograf. J had never previously ever had a problem filling his Prograf prescription until his health insurance through the State of New Jersey was changed to a new insurance company. After many attempts by us to obtain authorization, we turned the problem over to Elaine. She met the same barriers with the new insurance company, but battled on, finally finding an independent pharmacy in Miami who accepted the new insurance and mailed the Prograf to us in New Jersey. We couldn't thank Elaine enough for her persistence!
The second, most recent situation Elaine took control of in regard to J's health, was nothing short of life-saving. This is the incident I most want to bring your attention to, which demonstrates just how efficiently organized and extremely competent, but most of all, personally caring and concerned Elaine is in regards to each and every aspect of her transplant patients' lives. It also clearly demonstrates her depth of knowledge, education, and experience, only the very best of nurses possess.
As always, Elaine promptly every month reviews J's labwork when she receives it and reports the results to us. Actually, I handle J's health care and Elaine understands the need to reach out to me with any issues, either by phone or email. I personally find this to be an act of respect shown toward me. I do touch base with Elaine when J has medical problems, even if they are not transplant-related because she truly knows how important it is to treat "the whole patient." Over the past few years, I have kept Elaine updated on J's cardiac arrhythmias (afib, atrial flutter, and SVT) and the recommended treatment by the cardiologist here in New Jersey. J was scheduled to have a cardioversion this summer. One day before the cardioversion, I received an urgent email from Elaine. She had just received J's most recent routine lab work and she not only explained the abnormal lab results (very elevated BUN and creatinine levels) as being indicative of renal failure but also instructed us to go directly to our nearest emergency room. Knowing J's cardiac status, she further instructed us to make sure J was not hydrated with too much IV fluid and to call the cardiologist. I immediately took J to the ER, where Elaine's nursing diagnosis was confirmed. J was indeed in renal failure and unbeknownst to us, also had pneumonia. The cardiologist promptly canceled the cardioversion scheduled for the next day. Elaine received great praise from the ER doctor and nurse practitioner for her quick action and astute attention to J's labwork. The cardiologist also said that Elaine had most likely averted a life-threatening crisis, had he gone ahead with the cardioversion, as planned.
Elaine Juliano has always shown us genuine care, concern, and compassion, as well as her depth of knowledge. However, in this case, Elaine most likely saved my husband's life. Please extend our deepest gratitude to Elaine. A nurse this special should be recognized and admired and held up as an example to all nurses, especially transplant nurses.