Friday, February 12, 2010

Time for a beer

Sometimes I wish Moms could just call a personal timeout. Just to be fair, we should have this priviledge every quarter (although I'm sure we would all be much better moms and wives if we had this opportunity on a weekly basis). Anyway, when we call "timeout", a Supernanny-type figure would whisk into our home, play and entertain the children (without electronic devices such as a TV, Wii, or Nintendo DS) AND clean up after US. Today was just one of those days that I wished for a personal timeout.Unfortunately, Jo Frost did not enter my home and give me respite. Above is the picture of my kitchen at 8:30 tonight. A dirty crockpot on the counter with caked on spaghetti sauce. Dinner dishes stacked in the sink. Tortellini package in the other sink. I dare not even go into detail about the other counter. Let me just say, we had eggs and hashbrowns last night for dinner and I had not yet cleaned the stove and counter.

Back to my day. It started out with a young man crawling into my bed at some middle of the night hour. Unfortunately it was only Mason. I didn't feel like getting up, walking him back to his room, tucking him back in, and arguing with him...so I let him stay. The only condition was that he couldn't move (so that I could get him to fall back asleep). His idea of "snuggling" is to have at least one of his body parts touching you. Luckily he fell back asleep rather quickly - only to be followed with his "mild" (ha ha) sleep apnea snoring. When my alarm went off, I quickly showered and got ready for work. After preparing breakfast, lunch, snacks, and cleaning the table, it was time to go to school.
Let me take a quick break for two small points:
1. Today is the day before mid-winter break, which means Valentine's day parties at school.
2. Mark is out of town.
3. The kids and I leave for Dallas tomorrow morning (where they received 12 inches of snow yesterday).
Back to the morning. As we are exiting with lunches, backpacks, coats, and the beloved Valentine's cards, Lauren takes the opportunity for a quick "check list". Mind you, it was nothing even about today. It was in preparation for the airplane. Did I pack her Nintendo DS. I quickly advised that I had (well, since I had). Unbeknownst to me, I must be frequent tall-tales teller. She raced to her bag to verify. She didn't see the DS in her travel backpack. WIth her anxiety climbing quickly, I turned a 180 and marched to the backpack to show her that YES, it was in the bag. UGH.
After dropping everyone at their respected educational facilities, I went to work. Good day. Had to leave early to get to Mason's class party (as I am the class photographer). The party was fun. Great crafts, games, and even crazy dancing. Mason's first station was the cupcake decoration table (shocking). He started to eat it, but the music station started. He couldn't wait and calmly finish his cupcake - he had to bolt to the dancing (since it was to Alvin and the Chipmunks). He eventually finished his cupcake, danced a bunch more, and played a very brief game on valentine's bingo (frankly, I think the very sweet mom in charge of bingo picked his words, so he could finish bingo more quickly and head back to dancing). At this point, Mrs. Hallock, his wonderful teacher advised him to go to the card-making station. He agreed without a fuss (I'd tried getting him over there 3 different times already). He made the quickest valentine's card ever (and messiest) and returned to dancing.
After his party it was back to Lauren's school. We waited for her with Zoe (the dog) in the car. Since we drive two families home on Friday, I really wasn't in the mood to play "share Zoe", as she is flung between the middle and back rows, so I chose not to pass her around. After dropping off the kids, we drove Lauren to sibshops. After dropping her off, Mason & I headed to Mom and Dad's to change the cat litter. Lovely Zoe took this opportunity to have an accident on the floor. After clean up, we headed back home to dump off the diarrhea-dog.
Scruffy Mason was due for a haircut, so we zipped to Hair Masters. Next was QFC for "Stolpa snacks" (as Meghan calls them) - rations for the airplane, because I refuse to pay $5 for my kids to each have a few crackers. We came home, had dinner, gave Mason a bath, went back to pick up Lauren and two other kids from sibshops, drop off two other kids, and head home. Once home, I hurried everyone to bed. In the process, Zoe had another episode of the rrhea, which Lauren proceeded to step in and scream at the top of her lungs. As this was going on, I was in Mason's room trying to fix the closet doors (and yelling in the process due to frustration) that he had knocked off the track. I finally had the doors in a somewhat safe position (but not back completely on track). Lauren had hopped to the bathroom and was now crying. Why? Because I yelled at Mason for breaking his closet doors. I really wasn't in the mood for snuggling at tuck-in time with anyone, so I hurried everyone to bed. Lauren stops me to verify that I would forgive Mason (of course).
With everyone in bed, now the dogs are barking. I can't let them in the house as I need to decontaminate the area of the accident, so I lock them on the deck. Now, I can finish up a few things before I sit down to catch up on Thursday's shows: sweep the kitchen, mop, wash the dishes, load them into the dishwasher, clean the stove and counters, vacuum, fold laundry, start a new load of laundry, clean up Mark's side of the garage (since he's coming home), get the kids DVD's for the plane, pack Mason's pulse oximeter........and drink a beer. Where is Jo Frost when I need her?!

Saturday, January 2, 2010

Perpective

According to Webster's, 'perspective' refers to "the capacity to view things in their true relations or relative importance". Too often in life we forget to have perspective or to look at things from an alternate point of view.

I work at a large pediatric office. We have multiple offices in the area and have over 50 physicians. Our main location is open 365 (or 366) days per year. Yes, even on Thanksgiving and Christmas day, we are open. When I started 6 1/2 years ago, patients were more than appreciative that we had access to nurses and doctors over the weekends. We were thanked routinely for being available. Times have changed. Take the following three examples:
1. Last weekend I was literally yelled at for taking under 3 hours to return a call regarding lab results. Why did it take almost 3 hours? The lab had to finish processing the blood before we could call with results. The mother did not care that the lab had to finish processing the sample - she wanted the results NOW (despite the fact that the results would not have altered her daughter's treatment).
2. A few weeks ago a parent was angry that we couldn't refill her son's ADHD medication. First, we do not have access to charts (our charts are not on-line - they are paper and reside in the patient's "home office"). Second, most ADHD/ADD meds are "Schedule II drugs". According to the U.S. Drug Enforcement Administration, Schedule II drugs are drugs with "a high potential for abuse", "are accepted in medical use with severe restrictions", and "may lead to severe psychological or physical dependence". Think amphetamines...after all, that's what many ADD/ADHD meds commonly are! Third, they could have called on any day between Monday and Friday for a refill. And, fourth, the only problem they will have is a child with increased distractability and hyperactivity (and for only 1-2 days).
3. Today, I had a father call, concerned about his child's symptoms. The 7 year old had a fever of 99-100 for less than 24 hours, cold symptoms, and a cough. The patient had albuterol and was using it as needed. He had no wheezing, no shortness of breath, no retractions. He had a cough. At this point, we had no appointments left. I triaged the call according to protocol. Based on his symptoms, etc., home management was recommended. The child had no symptoms warranting an urgent care or E.R. visit, or even a visit at our office. The father was concerned, as his child was born at 32 weeks gestation (let me remind you, the child is now 7 years old)! He then stated he was in the parking lot and demanded an appointment. I discussed the case with the on-call doctor, who agreed that an appointment wasn't necessary, but agreed to fit the patient in at the very end of the day. By this time, the father was standing in the waiting room with his child. The child was in no apparant distress. I offered them the appointment...to which they'd have to return 3 hours later. Guess what? Viral. No treatment done in our office.

I worked the day after Christmas. We saw over 200 patients and had 130+ calls. We were fully booked by 11:30am. It was BUSY! I also worked today (the day after New Years). We saw over 200 patients and had 120 calls. We were fully booked by around 1:00pm. It was also BUSY!

Mid-morning today, a 9 month old was seen for vomiting x 4 hours. No fever. No diarrhea. Urinated prior to the appointment (so no signs of dehydration). Exam was normal, other than the vomiting - there was nothing on exam that would have indicated anything other than a stomach bug. Patient was sent home to monitor and push fluids. Had the mom called to talk with the nurses earlier this morning, we would have given them home-care advice (as vomiting for 24 hours without other alarming symptoms or signs of dehydration is not a cause for worry). Just a few hours later, the parents called back. I spoke with the mother who indicated her child continued to vomit all clear fluids, was acting lethargic, and no longer making eye contact. I immediately sent them to the E.R. for evaluation. The patient's status now? She is at Children's in the PICU on a ventilator. She had seizure-type activity, which was determined to be a stroke, as a result of a brain tumor (tumor was diagnosed this afternoon). Prognosis is still to be determined, but is not good.

Patients call and complain. Sometimes they have a valid reason to complain, but many times they do not. Some simply need reassurance. Some need common sense. Some need education on the basics of illnesses. And still there are others. Those who feel as if life revolves only around their family. Those who feel entitled to immediate responses from nurses and doctors (regardless of the issue). Those who don't care that a more critical patient warrants our help first. It is to those parents to whom today's entry is written. Those are the parents who need to view life from someone else's eyes.

This is why my title today is perspective. Within less than 7 hours, a 9 month old goes from being "perfect" to having a brain tumor. No warning whatsoever. Perfect yesterday. Today, may not survive. I could go on to generalize perspective into all areas of life, but I won't. My message is not to tell you to live in fear. My post does not mean that I will embrace EVERY action of my two special kids (and in fact, stay tuned, as I'm sure they will be driving me crazy tomorrow). My post does not mean I will be thankful for Mason's medical issues (because at this moment, his pulse oximeter keeps alarming). My post does not mean I will be thankful for Lauren's anxiety issues (because I'm not - it breaks my heart). Instead, my message is simple: Tonight, tell your child you love them. Give them an extra snuggle time. Say an extra prayer. Be thankful for your children - even the things about them that drive you crazy!

And, if you are the parent waiting for a nurse or doctor to call back (unless of course, symptoms are life threatening), please be patient. Instead of becoming frustrated, ask yourself - is it possible that the nurse or doctor is caring for a patient whose needs are more urgent?

Disclaimer

It's been MONTHS since I've posted anything on my blog - some of you have noticed. Some have not. You see, this past April while on vacation, I posted about events while on a trip with extended family members. That post was found offensive, despite the fact that specific names were not "named". Due to the conflict that ensued (and passive-aggressive behavior from the offended party), the post was removed and I decided to cease blogging on this site. I posted routinely on caringbridge, as well as facebook. During my hiatus from blogspot, I have had friends comment that they actually missed my updates - yes, even the sarcastic posts. To add to that, some of those same family members who criticized my posts, encouraged me to start blogging. One of those family members even delivered a newspaper article which toted the benefits and possible financial gains from blogging. Hmmmm.

That said, in 2010, I have decided to resume blogging, as time allows. I hereby give you my 2010 disclaimers:
1. Read at your own risk - I am choosing to exercise my rights of the First Amendment.
2. Events discussed will be truthful, unless otherwise noted.
3. I apologize in advance if I have offended you - My goal in writing is not to offended, but to discuss incidents of my life and day, which often involve family and friends.