Memories, Lessons, & Dreams

I should come here more often.  I'm sitting in the library.  It's quiet.  It's thought provoking.  It's peaceful.  That's not exactly the same description of the house I left a few minutes ago.  I left a screaming, fit-throwing 2 year-old and his clingy, crying, little brother.  Don't worry, I left them in the hands of my capable husband who already had his getaway time this morning to the gym.  My introverted personality needs this quiet to recharge.  To think.  To learn.  To reminisce.  To dream.

Ahhh.  Quiet.  deep sigh...

I find it fitting that I'm in the library to write this last piece for the year.  Can you believe that another year is gone.  In a few weeks I'll be starting my LAST year of residency.  Wow, <enter cheesy cliche here>!  Here are a few thoughts from the year  past and the year ahead now that I actually have the quiet to let my brain go there:

MEMORIES:

• I'll always remember meeting B.C. and her daughter in the ER.  We got her diabetes and pain under control, then started to care for her daughter's pregnancy, and then diagnosed her son with cancer.  Talk about highs and lows.  They are still always smiling, and I'm always happy to see any of them on my schedule.  It's an easy reminder of why I love Family Medicine.
• Who could forget those terrible call nights.  The post I've had the most comments about has been: "10 Reasons to Not Call your Doctor at 2AM."  It's my least favorite part of the job, but it does make for the best stories.
• Cemented in my brain is the lunch time meeting in Dr. Fruehling's office when he officially dropped the bomb that the clinic wouldn't be recruiting me for the sake of salvaging the residency program.  Even though nothing he said that day was "news" to me, it still left a wound that I'm still trying to figure out how to heal.
 

LESSONS:

• God answers prayers.  He is faithful and good.  When I need a little reminder I still go back and read My Little Firecracker and 619 Arthur.
• Believe it or not, I've also learned that I canNOT actually do it all.  I will never be Martha Stewart + Rachael Ray + Beth Moore + Dr. Oz + Michael Phelps.  There are only 24 hours in a day.  An hour of studying is an hour I'm not swimming.  A morning reading my Bible is a morning I'm not at the hospital rounding.  A weekend with Jason is a weekend I'm not with the boys.  I used to think that I could sleep less and schedule more.  Now I've come to terms with sacrifice.  I'm not willing to sacrifice time with my boys for time with my hobbies, so this summer may be my last triathlon for a while.  I'm not willing to sacrifice my marriage for my career, so I've come to terms that I'll probably be the doctor referring patients to specialists for issues because I didn't stay on top of the latest and greatest treatments.  I just can't do it all.  And that's okay.
   

DREAMS:

• I'm still working on my 30 by 30.  I've gotten some accomplished already, and I'm working on a few of the bigger ones.  For example, we did pay for some one's dinner at the "pancake store" (aka Perkins), we took the boys camping, and I'm on track to finish the Bible in the next year.
• We intend to have my student loans (all $112,704-ish) paid off, in full, by Jason's 30th birthday: May 14, 2014.  Feel free to keep us accountable and ask how we're doing.  Actually, please do.
• I dream less tangibly, too.  In the next year, I hope to have a job that will be fulfilling yet yielding to the rest of my life.  I hope to start planning for the next little Newman.  I hope to read more and write more because I actually really do enjoy it.  I hope to see the success of my husband in his career.  I hope to have happy, healthy, (and well-behaved) boys.

Well, I'm not very good at ending things.  And I'm usually the one saying "good-bye" twice when I end a phone conversation.  I end all of my emails with "Thanks!" even if it isn't really relevant to the conversation.  And I still haven't figured out when to hug vs. shake hands vs. walk away when I leave some one's house.  So, I apologize for ending this awkwardly, too.

P.S.  I really should come to the library more often.  :)

Camping

I guess you could say that we are always up for a challenge.  Last weekend was the Zlomke family campout, and we didn't want to miss it... again.  So we hauled a car load of stuff, our two boys, and a tent to Fort Kearney for the weekend.

We may be up for a challenge, but we aren't totally nuts.  Instead of the Thursday through Sunday extravaganza for some, we came just for the Saturday and Sunday.  Trust me, that was plenty.  We had a blast, but we were EXHAUSTED by Sunday afternoon.  So exhausted that we ALL took a 4 hour nap when we got home!

G waking up bright and early in the tent.

Here are some highlights from the trip:

• Staying up most of Friday night to make Grandma's cinnamon rolls to take for breakfast.  Thankfully, Jason talked me into making a double batch because one whole pan burned.  We still had plenty.
• Jogging with my dad Sunday morning.
• Watching 83-ish year old Papa throw Owen up in the air.  I'm pretty sure one more toss and they both would have ended up in the ER.  One with a broken arm, and the other a broken hip.
• Griffin having a blow-out diaper in the pack-n-play during dinner.  That's what I get for pushing the apple juice (even if it was watered down) to keep him hydrated.
• Dad's awesome pork chops and Jaekeun's Korean food.
• Walking to the Platte River.
• The plethora of bean side dishes at the Litchfield potluck dinner.
• Driving around Saturday afternoon, just so the boys could have some sort of a nap (and so I could get out of an hour reading historical markers at the actual Fort Kearney).
• Griffin finally realizing that swimming is fun.
• The boys each taking a shower in Dad's camper.  If you've ever been in a camper bathroom, imagine it with me, Jason, Owen, and Griffin with a lot of crying and a lot of soap.  At least they were clean in the end.  And Owen was proud to have taken a "shower" instead of a bath.
• Owen's huge eyes when he went to bed in the tent repeatedly saying "I not scared."
• Penny the puppy.

Under the Knife

Health insurance was made for babies like Griffin.  Not quite a year old and he has surpassed Owen's trips to the hospital and medical bills a few times over.  (And don't forget, Owen did "break his foot" when he was 12 months old, so he's not completely naive to the whole thing either.)

Last week, Griffin went under the knife.  I was going to spare you the details of why, but if you're like me curiosity would drive you nuts.  And I don't want anyone[else] going nuts.  So... my all-boy little "G" was born with an undescended testicle.  One nut.  Uni-ball.  Solo.  I know, it's not too glamorous, and he will be totally embarrassed in 15 years if he knew you knew, but that's it. 

After waiting 6 months for it to come down on its own, which obviously it didn't, a trip to the surgeon was next on the agenda.  (Getting that scheduled is another whole story.)  With no sight of it by exam or by ultrasound the planned operation was for exploration of his abdomen.  If they could find it they would do the first of a 2 or 3 part surgery to free up and lengthen the blood supply so in the future it could pulled back to where it belongs.  The other possibility was that it never developed properly in the first place, and they would just need to take it out so it wouldn't become a problem down the round.  I was convinced, for no particular reason, the latter was the case for Griffin.

The surgery was scheduled for two hours on May 29th.  I was thankful that the ball (no pun intended) was rolling, but of course I was nervous for the possible complications.  Of which, the complications I made up in my mind were much worse than what was realistic.  Enter Philippians 4:4-7.

The day came, and Griffin was blissfully unaware of what was awaiting him.  Jason and I planned for a long day starting with a morning with a cranky, fasting baby, an afternoon with nerves and a slow clock, and an evening with a groggy, uncomfortable boy.  After checking in and getting settled in the room, we headed down for an ultrasound.  It was going to be the same as the one he had a few months ago, and I figured the outcome would be the same too.  It seriously never crossed my mind that they would see what they saw.  They found it!  And it was already down near where it needed to be.

It didn't take long for the word to spread to our surgeon.  About the time we made it up from Radiology the Urology resident met us and the surgeon was not far behind.  Surgery plans had changed.  No exploratory surgery needed.  Instead they planned to do the final stage of the surgery: "orchiopexy" is the cool, official name along with a hernia repair.  In an unrelated event, our O.R. time had been moved up half an hour.

The rest of the day went just as smoothly.  They couldn't quite get it exactly where they wanted, but they anticipate it coming the rest of the way on it's own and doubt he'll need anymore surgery.  And not only did we not have to stay the night, we were out of there by 3:30.  Talk about answered prayers!

It has been just a few days, and he is back to his usual self.  If it weren't for some bruising and being unable to take a bath, go swimming, or "straddle" any toys (which, for whatever reason, Jason found really funny), you wouldn't even know he just had surgery.

Despite having a few health hurdles, we know they have been minor compared to what some parents go through.  We are so thankful to be blessed with healthy children who happen to have a few little quirks and blessed to have health insurance.

The Future

We are not idle.  Something is always happening.  There are some big - I mean huge - fun things in the near future that we are working toward.  Some are lofty goals.  Others well earned achievements.  And, of course, some are just the exciting stuff of life.  It gives me anxious butterflies in my stomach thinking about the next few years.  Not the anxiety that comes out of fear but out of anticipation instead.  I feel like a kid on Christmas Eve, or like I'm climbing a mountain and the summit is just ahead.  I can't wait to unwrap the gift.  I can't wait to see the view.

In a little over a year I will finish residency.  Just a year.  That might seem like a while to some, but after being in school essentially my entire life a year is like a breath away.  In the last few months I've been looking at jobs and negotiating contracts.  It's seems surreal.  Soon enough my professional life will be wide open - free for me to shape and fulfill.  I'm looking forward to a clinic schedule filled with my own patients, delivering siblings and eventually grandchildren, going to bed at night knowing that I made a difference, and of course a 4 day work week.  Ooohh, it's coming.

Jason is also in an exciting point of his career.  He recently got a teaching position at a middle school in Grand Island, and, in case you missed it, he just graduated with his masters in Education Administration this spring.  If you know my husband, you know that it won't be long before he has climbed the ladder and is a principal, athletic director, or superintendent.  And he'll be great!

Nearly 20 years of combined post-high school education wasn't cheap.  Our lofty goal for the next two years is to be debt free.  In two years from yesterday, when Jason turns 30, we hope to mail our last student loan payment.  Forever.  It's a lofty goal for sure, so feel free to keep us accountable.  Actually, please do.  Even with a few sacrifices in the next two years, we are super excited for the view at the top of debt free mountain.

Lastly, with negotiating contracts that include (or don't include) maternity leave and watching Griffin grow from a helpless baby to a curious toddler, we can't help but think about what the future holds for our family.  Now before rumors fly, we are not pregnant nor are we trying.  But with my 2 or 3 or 5 year glasses on, I might be able to see another Baby Newman crawling around (and maybe in pink).

Isn't it exciting?!  I hope you can be excited with us.  We haven't been idle because we have so much to look forward to.  The work is worth it.  The process has been enjoyable.  The journey, rewarding.  Now the push for the finish.

Hoarders

By now, we've all seen the terribly uncomfortable, sometimes nauseating shows that give us a small glimpse into the life of a hoarder.  If you are like me, you get some comfort from the fact that my unkempt living room is far from the collections of crap and mountains of mess belonging to "those" people.  However, recently I heard something that has stuck with me.  It's a simple definition of hoarding:

hoard-ing: v, having without using

Having without using!  Let that settle for a moment.

 If you're like me your mind may be drawn to the stack of boxes in the basement that you moved, and then moved, and then moved.  Those boxes that you first packed 7 years ago and have yet to open again.  You know, the one that has the third set of kitchen utensils from your bridal shower you might need someday.  The one with the glass vase you can't use while there are kids (or just clumsy you) in the house.  How about the heavy one with all of those books from college that the bookstore wouldn't buy back.  Do you have a few of those?

 

"Hoarding" is the word for this generation.  "Pack-rat" might ring your bell instead.  Regardless, "foolish" is what the Bible calls it.  To soften the blow, I'll avoid the three letter "s" word that ends with "-in."

 

This definition has been tumbling around my head bumping into the greed, pride and insecurity that's in there, too.  Talk about a headache.  Therefore, I decided to do something about it.  It's called a garage sale!  (I know, it's pretty redneck.)

Can you believe all of that "stuff!"  That's just a fraction of what we were selling and an even smaller fraction of what is probably still left sitting around our house.  And if you've known Jason and I for any amount of our married life you know the size of the places we've called home - 400 square feet to 800 then 900 now about 1200 square feet (woohoo for a basement and a garage that somehow are already full).  Where?  How?

 

After a few days of hard work, it's over.  It feels good to have some junk out of our lives and a little extra cash in our hands, and it really didn't even hurt to watch stuff leave that I once thought I "needed."  Good riddance!

10 Reasons to NOT Call Your Doctor at 2 AM:

The disclaimer: These may, or may not, be based on actual events.  If you think one was you or someone you know, it wasn't.  I promise.  Actually, they are all overly dramatized... for the most part, and I really do like my job... for the most part.

10.  Because you can't breath.

Calling for breathing problems is generally very appropriate, and you should usually call any time day or night.  However, if you literally CANNOT breath, please do not waste your time calling our office; having the call center page me; to have me roll out of bed, turn on the lamp, find my glasses, find my pager, find my phone, then return the page to them; to finally get your name, date of birth, and phone number; to call you; to hear you say: "I ... (gasp) ... am ... (gasp) ... short ... (gasp) ... of ... (gasp) ... breath ... (gasp, gasp)"  Call 9-1-1!  I'll see you at 4AM when the ER calls me to admit you to the I.C.U..

9.  Because your dentist told you to.

If you are a dentist, I respect the work you do, and I probably would like you as a person.  But I have to confess there have been a few times that I have cursed your profession under my breath.  There are a rare few dentists out there creating a bad taste in my mouth just as I'm sure there are a few Family Physicians out there doing the same.  Regardless, it is never fun to get the call from a patient that had dental work the previous day, now their pain is uncontrolled and they were told to call their family doctor if that happened outside of their dentist's regular office hours.  Please manage your own complications.

8.  Because your 8 year old has had a cold for 3 days, it is getting better, they don't have a fever, and they have been normally eating, drinking, peeing, pooping, playing, and currently are sleeping comfortably.

And what is your question?  You need a note to keep them out of school tomorrow?  Really?  Sure there have been plenty of times I've sent parents to the ER at 2AM for kids with fevers, coughs, vomiting, etc...  It's totally appropriate to call if you're wondering if you should go to the ER.  But I can promise you I won't be inviting you to swing my my house at 2:30AM to pick up a note for school.

7.  To see if your regular doctor has open appointments in the morning.

Enough said.

6.  Because you have diarrhea and you're supposed to have a colonoscopy in the morning.

Can you say "colon prep."  I've sat through a few pre-colonoscopy appointments, and I've yet to be at one where they forget to mention this small side effect.  On the off chance they forget to tell you when you go in for yours, here's your warning: You. Will. Have. Diarrhea.

5.  To ask if the doctor who sent you home from the hospital 2 weeks ago wanted you to take a baby or full dose aspirin.

First question, it was two weeks ago and you're just thinking of this now?  Second, maybe that's a question you should ask that doctor?  Third, who takes aspirin at 2AM?

4.  To discuss your genital warts.

It may be surprising, but this is not all that uncommon.  It may not be as surprising that I have yet to see a genital wart emergency.  Who knows... maybe some day.

3.  Because you're in the ER waiting room, and you've been waiting too long.

Picture this with me.  You are sitting in a hospital ER waiting area.  The chairs really aren't that comfortable.  You are surrounded by several other people patiently waiting for their name to be called.  Some bleeding.  Others coughing.  Babies crying.  Through the large, somewhat-bullet-proof glass window looking into the nurse's station you can see nurses, doctors, phlebotomists, and X-ray staff hurriedly running around as efficiently as they can to get people in and out.  You suddenly realize you have been waiting 20 minutes and that guy next to you with chest pain got in after waiting for 2.  What do you do?  Option 1: Go up to the desk, and see why you haven't been called; Option 2: Continue to wait patiently and know that next time "stubbed toe" won't get you very high on the list; or Option 3: Call and wake me up to complain and find out that I actually won't "pull some strings" to get you in.  Hmmm...

2.  Narcotics.  Narcotics.  Narcotics.

They call it pain meds, pain pills, the-only-thing-that-works, narcotics, what-your-other-doctor-promised, or that medicine that starts with a "P".  Even if your kid flushed it, your dog ate it, some stranger broke into your house and stole it, or if it was lost in your luggage when you flew back from the funeral of your great aunt twice removed in Arkansas, I won't refill it.

1.  Because you can't sleep.

And now I can't either.  Thanks!

Hospitality

"Cheerfully share your home with those who need a meal or a place to stay." I Peter 4:9

"Need" might be a stretch, but it was my pleasure to share my home this weekend.

If you would have seen the piles of laundry, the smell of our garbage can, and the hair that had collected on our bathroom floor at the end of last week you would likely not have guessed that we were the host for Easter dinner this year.

Thankfully, it didn't take too long to get things presentable and food prepared.  We even had plenty of time to enjoy an Easter egg hunt on Saturday and an awesome church service Sunday morning.

Mom, Phil, Alicia, their three kids, and my grandparents came over for Easter dinner.  It was so much fun - such a pleasure to be surrounded by aged wisdom and youthful energy in the same dining room.  Dinner was followed by an egg hunt, more food, a couple of rounds of cards, more food, and then a pitful showing (on my part) of Acquire.

I enjoyed every minute of it.

If you've ever hesitated to open up your home, forget your excuses.  It's worth it.  We have a small house, a tiny kitchen, a toaster oven, no dishwasher, and no time.  And we hosted!  We did it, and we'll do it again!

Brothers on Easter!

Cynic

There is what seems to be a right of passage in my profession.  One that isn't glamorous.  One that most people aren't aware of.  Heck, I didn't even really know it existed until I was well on my way to becoming it with my feet sprinting down the road of cynicism.  Becoming jaded.  Losing my innocence and naivety.  I even felt a little pride when my staff physician last year laughed and said, "Wow, Susan, you're already jaded."  It felt like I was joining their club.  I was a "real" doctor.  So mature.  Now the cynic in me has taken over and trying to pull back the reigns to let some compassion creep in is more difficult than it should be.

Unfortunately, it isn't just the "Dr. Newman" side of me that is a cynic.  It has rubbed off and left muddy fingerprints on the "Susan" side of the rest of my life, too.  My ability to doubt, mock, and judge is quick, sharp, and effortless.  Sickening.

Some day I hope to find the balance between naivety and cynicism.  Wisdom.

James & Dave

Despite the fullness of my schedule with all that is residency, the time set aside for two non-medical, yet equally educational, studies has been so amazing in the past couple of months.  It's incredible how much of an impact a few hours a week can have.  When my eyes open in the morning my mind begins to ruminate on what I'm learning in these groups, and it can't help but spill out into the rest of my day.  I know the intent of any study is to learn something new and hopefully to have a lasting impact, but it is so beautiful when it works.  As I'm in clinic, driving around, delivering babies, or making supper little one-liners pop into my head and once in a while even fall out of my tongue.  "Don't show favortism" even when it's an uninsured, city-call patient.  "What would Dave say if you went out to eat... again?"  I'm so excited to share what I'm learning.

The first is a financial study Jason and I are going through with group of a few other young couples we've been getting together with on Sunday nights.  It. Is. Good!  If you're interested it is called Financial Peace University (or call it "FPU" if you want to sound cool) by the blunt Dave Ramsey.  Jason and I have always been in agreement to be "responsible" with our money, and we've listened to Dave on his radio show for years.  However, this has forced us to take it to the next level, fight about where each dollar is going, and, literally, put our money where our mouth is when it comes to our goals and priorities.  If tithing is a priority, how did we "forget" last month?  If being debt free is more important than a tan, why are we planning a cruise?  It's like exercise: time-consuming, uncomfortable, and slow; but worth it.

The other is a group of women I'm starting to meet on Monday nights for Bible study.  Right now we are going through the book of James (as taught by Beth Moore).  If you think Dave Ramsey is blunt, to the point, and in your face, put on your thick skin for James!  I'm being rocked by his teachings, but I'm also remembering how cool this whole entire book is!  Genesis to Revelation.  It has given me boat load of humility (which I need), but also a renewed awe and hunger for real wisdom.  It's that wierd paradigm in which you fill a void, but at the same time realize that the void is bigger than you thought.  One answer leads to ten more questions.  Like when I eat ice-cream it makes me want to eat more ice-cream.  I get full and more hungry at the same time.

Now that I'm off topic and craving chocolate chip cookie dough, my point was going to be to introduce you to my two new friends: James and Dave.

How I Do It

Easily, the question I am most often asked is: "How do you do it, Susan?"  I usually have a less than adequate answer such as "I don't know, I just do."  I know that's not the thoughtful answer they might have been expecting, but the other answer is long and complicated and most of the time I don't even know.  Also, the truth is, that even though I do it (whatever it is), I don't always do it well.  This morning, however, I feel like all the balls in the juggling act of my life are still in the air so it's as good of a time to figure out an answer.  Without further procrastination, here are a few pieces of my strategy.

#1.  Have a plan.  Some people would call this discipline.  Others would call it being anal.  Regardless, I find the only way for me to get things done is to map it out.  I live and breath by my calendar.  Actually, my calendars.  I know where I'm going and where I need to be.  I used to know what we were going to eat for the week, now we know what we're going to eat for the whole month.  So much time is saved when all I have to do is look at the menu hanging on the refrigerator door and say, "Jambalaya tonight," instead of hum-and-hawing in front of an empty fridge for 15 minutes, then opting to eat out which takes another 30 minutes to decide, 10 minutes to drive there, and over an hour later to enjoy.  Thanks to Dave Ramsey, we also have planned out how we are going to spend every cent for the rest of the month, too.  In my opinion having a plan is freeing.

#2.  Accept help.  This was (honestly, still is) a difficult pill for me to swallow.  If you haven't gotten the picture that I tend to enjoy being in control just reread #1.  However, there is 0% chance I could be where I am, or do what I do, without the army around me.  Right now, streaming through my mind like a slide show are the faces of people who make my life possible.  From the nurses at work to my better half at home they are the reason I can get out of bed in the morning.  Even right now, my mom has my sick little boys for the morning so I could get some things done.  (I'm not sure blogging was what she had in mind.)  But truthfully, this should be bold and in 72-point font because it is that big of a necessity!

#3.  Prioritize.  There is a list of "correct" priorities I could spout off, and then there's the list of "true" priorities obvious by the choices I make every day.  What do I spend my time on?  Where does my money go?  What do I think about?  This is where the rubber meets the road.  This is where I admittedly fail over and over again.  I'm finally back in Bible study and am realizing how starved for it I've been.  My job already consumes most of me, and forcing myself to say "no" to the extra stuff is painful but oh-so needed.  Thankfully, it's getting easier for me to turn the t.v. off, but that hasn't always been the case.  And trying not to replace it with the computer takes some heavy duty conscious effort.  Also, there are still things on my list that haven't made it into the game yet (exercising being one).  Therefore, I still have a lot of work to do, and accountability to have.

#4.  The big picture.  It's no mistake that God has me reading the book of James at the moment.  He reminds me that my life is a mist.  A vapor.  Here today, gone tomorrow.  I can plan, prioritize, and do all I want only if it's His will.  Ouch.  Feel the sting.  I'm not in control, and thankfully, I'm not.  He is.  I get up in the morning thankful for the blessings I have and content that I'm a very small piece of a much bigger plan.

Well, maybe that answers the question a little better than "I don't know" although I feel like it still isn't adequate.  In summary, as Paul says, "I have learned [or, in my case, am learning] to be content whatever the circumstance... I can do everything through him who gives me strength [and who gives me two of the sweetest little boys, too!]"

Job Hunted

Oh man.  Where should we start.  It feels like I'm sitting down for coffee with an old friend who I haven't seen in far too long.  There are a thousand things to say, but it's so jumbled in my brain I don't even know if I can put together an intelligent sentence. 

And although, I could pick any one of those thousand things to talk about, I guess I'll start with what is arguably the biggest.  The elephant in the room.  The thing that keeps me up at night and distracted during the day.  That pesky thing is that I've started the daunting task of... job hunting!  Gasp.  That sounds so professional and so strange coming out of this mouth that has been a student for the last 24 years.  It's scary crazy to be job hunting.  Although, truthfully, "hunting" really isn't the right word anyway.  I, actually, kind of have felt like the prey.

Primary care doctors are such an endangered species, that it puts me in a strange, kind of awkward, situation.  I almost would prefer to be in competition.  At least then, I would know who really wants to hire me.  Me for me.  Not just because I'm a body with an M.D. who can fill their desperately empty hole.  Me because I'm the best out there, not because I'm the only thing they can get.  I want to feel chosen.  Selected.  Desired.  I remember the feeling of getting the internship in high school, the scholarships in college, the acceptance letter for medical school, and the phone call from Dr. O'Dell for the Primary Care program.  It felt good.  Good to be selected, and good to have someone else make the decision whether or not I'm in.

Now I'm the one making the call. Am I in, or am I not in. And, for someone as indecisive as me, it's painful.  So much is weighing into this decision.  Of course there are the professional factors.  Can I do OB? Do I have to cover the ER?  How nice is the hospital?  How bad is the medical community's drama?  Blah, blah, blah...  Then there are the community things.  Where would be go to church?  What could we do for fun?  Etc... And obviously the family stuff is a big deal.  Could Jason get a job?  How are the schools for the boys?  How far is it from our extended family?  My analytical mind wants to know all of the details and then create a spreadsheet or formula or something that would ensure that I make the "correct" decision.  (If you thinks that's ridiculous or an exaggeration, please ignore the fact that I had a score sheet between Grand Island, Kearney, and Scottsbluff when we were deciding on my residency.)

Right now our serious considerations are between Kearney and Grand Island.  I'm meeting with the clinic in Kearney in a few weeks, so we'll see how that goes, and my thoughts on Grand Island change as fast as the weather does.  Central City has been in contact, but Jason hasn't been too impressed so that's probably out.  We've also thought about something a little closer to Omaha, so nothing is off of the table yet.

I'm not done with residency until July 2013, so there clearly isn't a rush.  But if I'm this anxious now, I sure hope I have something figured out by then.  I'll keep you posted.

Hot Tamales

Even though my taste buds were expecting something even a little more delicious, my heart sure did enjoy itself some homemade tamales last night. 

The little creations were a gift from a patient who I met during one of my first shifts in the ER here in Grand Island and who I've been able to follow in clinic over the last few months.  I've been able to get to know her, her grandson, and their story in a matter of about 15 minutes every month.  Despite different languages, ages, nationalities, socioeconomic statuses,  etc... we've kind of bonded.  Maybe it's because we're both women or mothers, or maybe because we both like to eat (and despite that, we've still been able to cut her A1C in half!).  Regardless, I would almost say we're friends.  But now one of my first Grand Island patients is moving away.  Hopefully, she's leaving healthier and better educated about her disease.  And I'm staying here with a warm heart and a full stomach.

(And on a 100% totally different topic... why are all of these horrible cruise ship stories happening when we are trying to plan our first cruise ever for this summer?  Is this a sign?  Maybe God, like Jason, wants us to go on the Lewis and Clark historical tour instead after all.)

Tidbits

It isn't for a lack of things to write about, it's more because of a lack of time to write about such things.  And then, once I get behind on sharing all of my happenings, I don't know where to start.  Now, however, I have a brief, free, quiet lunch hour with  just me and the computer.  So, here's a couple of quick tidbits of the last few weeks.  You'll have to bug me later if you want all the details, because I'd love to share when there's a little more time.

• AEDs work in real life like they do during ACLS training.
• We waited 7 years to see Blue Man group, and got to do it on someone else's dime.  (Thanks Family Practice of G.I.!)
• I'm glad that cardiac stress tests can be normal and reassuring.
• Pink eye has almost run its course.
• To my surprise Griffin didn't pee on the ultrasound tech.  (But not surprised that we'll probably be talking about surgery when we meet with the Urologists at UNMC next month.)
• We've almost met our health insurance deductible already.  Yep, it's only January.
• Jason was in a rare, 1-hour, "shopping mood" last week.
• I found a Beth Moore study again.  Yeah!!  So excited.
• The passenger side door on the Buick is fixed.
• Owen pooped on the potty... only once... and he peed all over the floor and on my leg before that.
• I still love holding up a wet, bloody, vernix-y, wrinkly, freshly born baby and saying "Congratulations!"
• Now, I'm off to clinic.
 

It Poured

The saying goes: "When it rains, it pours."  And it was Pouring last week - with a capital P.

Sunday.  Our punishment for having fun on New Year's eve and not putting the boys to bed at their usual bedtime - or even within a few hours of their usual bedtime.

Monday.  The Huskers "played."  (I actually picked them to lose in the bowl pool, so I guess it wasn't all bad.  Especially considering I'm cleaning house in that bowl pool.  #1, baby!  And, not too rub salt in his wounds, but guess who's at the bottom of the boards... hee, hee <insert evil laugh>.)  

Tuesday.  You heard all about that already, and Griffin's doing just fine now if you're wondering.  I didn't get to post this picture before because it was on Jason's phone, but now I just can't resist.

(That's an IV in his head, and half of a cup decorated with a Thomas
the train sticker covering it to protect it from curious fingers.)

Wednesday.  Home with a sick baby.  6 months to go, and already almost out of sick days.

Thursday.  Be ready.  Here's the kicker.  I was minding my own business at OB clinic when my phone buzzed Thursday morning.  I usually don't hear my phone in the middle of the day, and if I do, I don't usually answer it.  But for some reason, my curiosity with this unknown number got to me, and I answered it.  It was my bank.  My bank? "Are you missing your debit card?"  Crap!  I've haven't been able to find my wallet since before Christmas.  I thought, for sure, it was at the bottom of Owen's toy box, or under the bed, or in a purse, or buried in our junk drawer, or tucked up under the seat in the car.  I just didn't bother to look too hard for it because I knew if I couldn't find it then, I would panic.  Guess I should have been panicking.  "An officer from the Hastings police department called and reported that he found your card in someone else's possession this morning," the banker informed me.  Double Crap!!  That yucky, violated, angry, embarrassed, sick feeling filled my stomach.  Argh.  To make a long story short, it could have been a lot worse.  It took all of a few minutes to freeze all of my bank accounts and credit reports.  Then it took a few hours to file the police report.  So far, our bank accounts and my credit report seem intact.  My eye will be on it closely to keep it that way.  All it all it was another hit to my pride, already aching from Tuesday, and another terrible event in an already terrible week.

Friday.  4:20-AM C-section to start the day.

Saturday.  All day I felt like the weather.  Not hot.  Not cold.  No rain.  No sun.  Just cloudy and dreary.

Sunday.  Today.  Thankfully, I've made it through today unscathed... so far.  Hopefully, this is the start to a much better week.

On the Other Side of the ER

The proof that this blog has been neglected lately is that I didn't even realize it had been briefly hijacked by my husband until yesterday.  I guess that's what happens during the busy holiday season, and thankfully, Jason did a great job in my absence.

Fortunately, and unfortunately, I have some extra time today to write because of a sick baby.  Trust me, it is not fun when my roles of mom and doctor collide - when I'm torn between researching differential diagnoses for a bulging fontanelle versus just rocking the crying baby to whom that fontanelle belongs.

Yesterday, I found myself in that terrible crossroads.  My phone beeped with a voice mail from daycare in the middle of my afternoon clinic.  Griffin had a fever and needed to be picked up.  Sure enough, a fever of 103.  Jason hated to leave his day of exciting meetings (*wink, wink*), but agreed to come home early under the circumstances.

A dose of Tylenol, his humidifier, and some good rest was what I figured my little G needed.  I peeked in on him after dinner as he was whimpering away in his crib with his big, puffy, tired, red eyes.  In an effort to console him I rubbed my hand over his bald head.  It was hot.  As hot as Jason's new chimenea in the backyard, which, at that moment, was burning the box it came in - styrofoam and all.  But, not only was my hand met with the warmth of his fever, it also found a thumping, tense, bulge in place of the soft spot on his shiny pale dome.  As many times as I felt this place as I've picked at his cradle cap or as I've dreamed of the long locks that will surely be growing in, it had never felt like this. 

Doctor mode kicked in.  Mom mode kicked out.  High fever plus bulging fontanelle equals meningitis.  Meningitis equals spinal tap and IV antibiotics.  Spinal tap and IV antibiotics equals a trip to the ER.  But, wait, I've seen kids in the hospital with meningitis before, and they acted a lot sicker than Griffin.  He was still eating, sleeping, peeing, and even cracking a smile in the right moments.  Meningitis? 

Still, I couldn't shake it.  Should I be a bad mom and keep my baby at home with a possible serious infection, or should I be a pathetic doctor and take my own baby to clog up the ER with a virus?  I debated.  I rubbed his head to double, triple, quadruple, 54-ple check that I wasn't making it up.  Before committing a blow to my pride by showing my face in the ER where I worked on the other side of the counter just a matter of weeks ago, and before committing our budget to the blow of an over-priced ER bill (because we DO have insurance), I wanted someone else to tell me I wasn't crazy.  After a few unanswered calls followed by a few returned calls, I had my reassurance and we headed to the ER. 

Honestly, it was weird and uncomfortable to be on the other end of things.  Do I use medical lingo?  Do I look at the monitors or ask about his lab values?  Do I calculate his IV fluid rate?  Do I ask for the T-sheet and fill it out myself?  Ugh, it was awkward.  It was even more awkward when Griffin flashed his big smile at everyone who walked in the room.  Couldn't he at least put on his whimpering, sick face instead of his completely healthy one.  Where did his puffy eyes go?  However, shortly thereafter, they found his temperature to be back at 102.7, and they were in agreement that the bulge on his head was not normal.

It was every one's favorite time in the ER - shift change, so we were told that the doctor taking over would be in to likely do the spinal tap and we would be moving up from the back rooms to one closer to the front.  (Secretly, even though I didn't want G to be sick and I could think of a thousand other places I'd rather be, I was glad that it wasn't just a "It's a virus.  Go home, and call your doctor in the morning" ER visit.)

Then, a dose of Motrin (which I hesitated to give him at home as he's just shy of the magic 6 month mark) was followed by two hours of needle pokes, IV starts, blood cultures, catheters, a fluid bolus, lots of pacifiers dunked in Sweeties, and a chest X-ray.  It was amazing what two hours (or that dose of Motrin) can do.  The heat radiating off his powdery skin had cooled, and his fontanelle was softening up and looking more like the plains of Nebraska and less like the mountains of Colorado.  We discussed the options of continuing with spinal tap, giving a shot of antibiotics, or just watching now that things looked less serious.  I was happy to forgo another needle, and it wasn't too much longer and we were out the door and back in our living room.

It's done.  He's better.  My lesson's learned.  No regrets.  (At least until we get the bill.)