Vent post

Because I may lose it if I don’t let it out somewhere…

  • My first 2 patients arrive 15 minutes late for their appointments – basically at the end of their appointment slot. Mother has a million questions, which I of course answer, and I proceed to spend well over their allotted time in the room. Guess who ended up pissing off every family after that because I was an hour behind all morning.
  • We are swimming in bodily fluids from all species at home. One cat has had diarrhea since early Monday morning, and I’m praying the meds kick in soon. I’m a little stressed by how much water she’s drinking and hoping this isn’t a sign of kidney failure or diabetes.
  • C had her first day in training pants today since that’s all she’s expected to use in school starting next week. As hubby put it, the poop today “muffin-topped” its way out.
  • C has been really clingy since the end of our trip to my hometown last week. She slept great there, but didn’t sleep at all on the plane rides. She woke up screaming from a nightmare at 5am today, I’ve never seen her hyperventilate like that.
  • My hopes for weaning soon seem faded. She is a monster in the mornings, and is basically unbearable unless she nurses both sides, for up to a half hour total! It’s getting ridiculous. I don’t know how to stop other than hubby needs to step in, but she’s such a pill to get ready in the mornings regardless.
  • I’ve only been back at work for 1.5 days and I’m already exhausted and a day behind on charts. I have to make it through 4 more days, then I’ll have a couple days off.
  • C’s godmother has been super flaky for the last several months, to where she’s only seen C once. She was supposed to come help hubby this week since he’s still nursing a pinched nerve, but guess who just bailed last minute again. It’s really beginning to get on my nerves, and makes me second-guess our godmother choice.

Holiday and somber news

I’ve been meaning to post about my transition to a reduced schedule, but never found the time. Now we’re visiting my family for Christmas, and it’s been really fun watching C almost run around and really take in everything in my hometown. I wish she had napped more on the flight out, but overall she did pretty well. We felt like novices when we saw parents pulling their toddler triplet boys along in a wagon at the airport!

I found myself with more time to catch up on Facebook yesterday, and read a post from a friend asking for help in finding her friend who went missing over the weekend. The last name sounded familiar, then it all came together today when I read the very sad news that her body had been found. Her sister is the nurse practitioner that performed many of my IUIs, and also helped me when I was diagnosed with gestational diabetes. So very heartbroken for her family. ūüėĖ

18 months old! (3 days late)

Wasn’t sure I’d do one of these again, but it is a milestone in my mind!

Health: Nervously waiting to see how she fares when she goes to school next month. Moving from exposure to 3 kids to exposure to more than a dozen is definitely going to bring on more colds and not so fun stuff. She’s been on daily Miralax for a couple months now, I don’t want to back down yet because she still has a tendency to hold her poop (seriously, she can wait 2 days while on the stuff, then have a giant diaper!) and her new school pushes for early potty training. That plus constipation could equal disaster.

Growth/Feeding: This kid can EAT, but her growth has definitely slowed down as expected in the second year of life. She’s about 21.5 lbs and 31″ tall, a bit below average for our ethnic background. Her feet finally seemed to grow in the last few months, so there were a couple pairs of shoes she never even wore, since she had such a delayed start to walking. She’s only gained 2 teeth in the last 8 months so a grand total of 10. The bottom molars have looked swollen for 5 months but they still haven’t broken through yet.

She still nurses in the morning and right before bed. I am definitely ready to stop the morning feed, but any attempts I’ve made recently are met with screaming and non-stop tantrums. She is just not ready. I honestly think the only way we’d be able to stop those is for me to not be home when she wakes up, and that just won’t happen anytime soon. She is thankfully not terribly picky, though certainly has a preference for pasta, bread, and fruit, like many toddlers. I don’t stress about the almost non-existent dinners these days since she often eats double helpings at Mrs. K’s. We’ll see how she likes the lunches at her new school. Getting her to drink water is still an insane struggle. She gets 12 oz of cow’s milk a day, only because she sees the other kids drinking it at daycare, and it’s the only surefire way of getting Miralax into her.

Sleep: Bedtime is still pretty consistent, from 7:30pm-6:30am, though she usually rolls around in her crib for a half hour before she falls asleep. We’ve been dealing with more night terrors in the last couple months, thanks to sickness and fighting naps, so I sucked up the cost and bought a Lully Sleep Guardian 2, which has worked beautifully, and takes the guesswork out of scheduled awakenings, without risking her not going back to sleep. Naps are usually 12-2pm, occasionally until 3pm if we are really lucky.

Development: I’d say she has maybe 30 words or phrases, I don’t keep track that well. We have to be really careful around her now, because she does pick up and understand so much more. She sings along to her favorite songs (in tune!), loves to dance and play on our piano, and is super affectionate, very generous with hugs and blowing kisses. She can feed herself decently with a spoon, but still likes us to feed her or uses her hands for speed, ha! She’s getting more confident with walking in the last couple weeks, but still likes to drop to her knees, and is hesitant to stoop and recover. Physical therapy has been really helpful, even after just 4 weekly sessions. We have 2 more left this year, and sadly we learned her therapist is leaving at the end of the year. Unfortunately they do not know if they will be able to find another therapist who can take her, so I’m debating how much to push them, since the visits are covered by our insurance through April. Our local My Gym recently reopened, and she loves going there Saturday mornings. It is helpful, but certainly not the individualized attention she gets from PT.

Daycare: C has 2 more weeks at Mrs. K’s, though with Mrs. K’s appointments for her knee prior to her surgery, C will end up attending only 8 out of the remaining 10 days. She’ll start at the new Montessori in January, along with her 2 best girl buddies from Mrs. K’s! Not too surprising, since no other facilities had openings available. That should hopefully ease the transition for all of them. I’ll be taking her for a quick meet-and-greet with her teacher in a couple weeks before the winter break, when I drop off all her forms and pay for lunches. Food isn’t included in the tuition cost, but thankfully there’s an option to order lunch, which I will gladly try for now! We just have to provide one class snack every month too. I’m most nervous about the requirement to only send training pants, and no diapers. I bought a pack, but haven’t tried putting them on her yet. Guess we’ll try the last week of the year, and hopefully they’ll fit OK.

Parenthood: I’ve finally ventured back into aerial. It’s wonderful to be back, and my body remembers so much more than I thought it would. I have more strength left than I thought I would, being gone a year from any physical activity, but my endurance and tolerance for pain definitely need to build up. Hoping I can go twice a week sometimes on my reduced work schedule. I’ve only managed to make it back once a week because it falls on a Sunday at nap time.

I am officially cutting back to 8/10 starting next Monday. It doesn’t mean much this month, since I’m working a full extra Saturday in a couple weeks, am on vacation the 3rd week, then will be working overtime (12/10!) the 4th week while the other half of my colleagues takes their holiday break. Thus is health care. Is it any surprise I would discourage C from going into this field?? Rewarding, yes. Exhausting, unfortunately. Worth it… if you can find the right balance. And that’s what I’m hoping will happen, but of course guess who was asked to work 2 more weekend shifts in January. Seriously. I’m so f’ing over it!! If I could convince hubby to move somewhere cheaper where I could work half-time, that would be lovely. But then he’d be up a creek trying to find a job he loved as much as his current one. So here we remain. Maybe his company will continue to do so well, that he’ll get a massive raise and I could cut back to 6/10? Ah, to dream…

My group held a really good seminar on preventing physician burnout recently – one of the most helpful and practical I’ve attended. Implementing some of the techniques has helped with my happiness at work, though honestly it could just be that we’ve hit an odd lull around Thanksgiving. I actually left work today with all my charts completed! Anyways, the lecturer urged all of us to schedule 2 date nights a month. I can’t even remember when we had our last date night. September I think, for hubby’s birthday. I did buy tickets for the Total Package Tour, but that’s not until June. When I looked at my schedule this month, I’m either working every Saturday, or we have other obligations. So we’re going to take advantage of free babysitting while visiting my parents for the holidays – I bought tickets for a fancy dine-in movie theater to watch Rogue One. Then maybe we can convince C’s godparents to watch her once a month next year. That would be lovely.

Gratitude

November is when things really pick up in pediatrics. Day in and day out, I’m seeing kids with colds, ear infections, wheezing,¬†sore throat, some stomach viruses, occasionally pneumonia. It can¬†put me on edge since respiratory distress is a potential behind every exam door, but at the same time, I feel like I’m running a hamster wheel and the monotony can be taxing in its own right. So to have TWO weird cases in two days can definitely get my heart rate and anxiety up. Neither of which¬†has a definitive diagnosis yet.

The first case is one of those where I ordered an X-ray to check something, which looked fine but then the radiologist notes something incidental but very weird. Hoping to have an answer on that one soon – because even the radiologist asked me to send them a message when I found out. Huh…

The second case was one of those times where I walked in the room and looked at a kid and got the heebiejeebies. Because I seriously had no idea what was going on. I have a pretty good guess¬†now after seeing the kid twice and getting some tests back, and hopefully we’ll have an answer when they see a specialist Monday. If I’m right, it’s a reportable case.

In the meantime, I now have 2 more reasons to be grateful for my healthy child. But also 2 reasons to not sleep, in addition to dealing with C’s 18-month sleep regression.

Frozen

I’m currently over a week behind on charts. I’ve been feeling frozen since watching election results trickle in Tuesday evening, then unable to sleep well the rest of the week. The only thing that has settled this week is daycare – Mrs. K decided to move forth with the knee replacement, and the timing works out perfectly with when we go on vacation. She has a few other appointments we need to work around, but thankfully we only need to send C to my friend’s one day since I’m off on the other days. Since she will be on disability for 3 months, she is forced to close the daycare during that time, and understood that we won’t come back after sending C to preschool. I’m glad we’re ending on good terms at least.

Hoping I can kick my butt into gear these ¬†next couple days and get these charts done. Think I may need a Facebook moratorium – been added to too many groups this week, and while I want to do something, the best I can do right now is donate money. My time is just too limited. Since we cut the cord, I don’t watch TV anymore, so I’m glad I did see this on Facebook tonight. Well done, SNL.

That’s it

I dropped C off at Mrs. K’s this morning, and promptly received the 3rd degree about her perceived illness – aka mild cold symptoms. Reassured her that sick kids care couldn’t even tell why she was there yesterday because they never heard her cough, and I heard her cough maybe twice and only while screaming through 2 night terrors over night. Yup, it was that kind of night since she barely napped at sick kids care. Then Mrs. K blamed us for another child being out sick with a cold yesterday.

That did it. I’m sorry, when 2 kids both come down with the same symptoms around the same time, there’s a pretty good chance they got it from the same place – likely another kid at daycare! I swear it’s like she has absolutely no trust in what I do for a living. And she basically forced my hand into exposing C to even more infections by putting her in sick kids care yesterday. I decided at that point, that I’ll be giving her 2 weeks notice at the beginning of December, since we’re on vacation the week before Christmas, and she’s closed between Christmas and New Year’s.

C is off to Montessori in January, and hopefully it’s a good fit. If not, at least there will be many more options available to us once she turns 2 in May.

Exhaustion and daycare troubles

This has been the longest week (and it’s not even the end of it), and I don’t know how I’m going to survive into the weekend. C’s fever continued off and on through Monday. I was still worried about missing a UTI because she had no other symptoms whatsoever, but my coworker examined her, and talked me out of a cath Monday afternoon. Hubby thought she was doing better that day, so we decided to give her another day. We took a few pictures of her in her costume (Peg from Peg + Cat on PBS), and that was the extent of her Halloween celebration. She blew out on it later, of course, thanks to the all the Miralax we were pumping into her while she was home with us.

She couldn’t go back to daycare Tuesday since she wasn’t fever-free for 24 hours yet, so I stayed home with her. This was a tough day, since even though she was clearly tired, she fought all our attempts to get her to nap. I finally had to hold and nurse her, and she slept for maybe 45 minutes. She was clearly stir-crazy from being cooped up for so many days, so I took her along to drop off a deposit at the preschool I’d picked, but she melted down when I put her back in her car seat, and would. not. stop. as we pulled out of the parking lot. I made the split second decision to take her to the closest park, and let her swing her heart out for 15 minutes. Thankfully that worked, and we had a relatively peaceful drive back home. Unfortunately, the lack of sleep led to her having her worst sleep terror ever that night. At over an hour, I was desperate, so woke her up by showing her YouTube video of Elmo for 5 minutes, then settled her back to sleep.

I hope she doesn’t develop the sleep-talking and sleep-walking tendencies I developed later. Out of desperation that night, I bought The Sleep Guardian, which came highly recommended by a few other pediatricians whose kids had bad night terrors. She definitely gets frequent sleep terrors when she’s sick or her schedule’s thrown off, but Tuesday night’s felt like it wouldn’t stop and there was no way I could sleep through her screaming and crying nonstop, even if it wasn’t something she’d remember like a nightmare.

I dropped C off at daycare yesterday morning, she had a bit of congestion and cough at that point, so at least we had a reason for her fever. Mrs. K was much more resistant than I was expecting at drop-off, asking me multiple times if she was contagious. Well, a cold is contagious, but she no longer had fever and was behaving fine, I couldn’t keep her out of there for a week for a mild cold! When I picked her up after work, I noticed a trash bag outside the front door again like last week, filled with her pants and seat cover. She apparently blew out twice, and I could tell Mrs. K was fed up. She sounded accusing when she brusquely told me she coughed a lot all day and had no appetite. I called sick kids care to reserve for today, and luckily they had an opening, since her cough continued through the night and I didn’t want to risk a call to pick her up early today. Of course, sick kids care told me she barely coughed, but she also didn’t poop for them. So back to Mrs. K she goes tomorrow, and I’m praying she doesn’t blow out again.

Mrs. K scheduled her knee replacement surgery for December 19, though she still is¬†unsure if she will go through with it. After everything that’s happened with this particular illness mixed in with C’s poop troubles, I’m beginning to think we will just send her to the preschool in January regardless of what she chooses. My plan was to hold the spot so C could be there while Mrs. K recovered, or change the start date to September with the new school year. But I’m concerned our relationship with Mrs. K is becoming more adversarial, and as much as I love C being right across the street from my office and the cheaper cost, I don’t know how much more juggling we can do around unexpected appointments (2 more in the coming weeks). We lucked out that one falls on hubby’s work-from-home day and another on my day off, but we have had to use backup care or pay extra for “holiday” care much more than I care to remember in the last 9 months.

So that leads me to my last tough question – what to do for backup care, since I anticipate being called more for early pickups when C moves to a preschool setting with more kids.¬†They expect her to be picked up within an hour if she becomes ill at school. It’s 15 minutes away from my office, but could I feasibly drive there and bring her back without massively disrupting my schedule? Definitely not. Hubby works an hour away in traffic.¬†My mother-in-law lives an hour away, and I don’t even think we could install a rear-facing car seat in her 2-door car. I will have to beg my friend who’s watched C for me, but as is I feel horribly guilty because she watched C the day before C got a fever, and of course her son got sick 4 days later, and now my friend is sick as well. I just have to hope that she shows signs of illness towards the end of the day and keep my fingers crossed.

Fever, again?!

I guess I was lulled into complacency by our almost 4-month break without a significant illness. C had a fever with cold symptoms less than 4 weeks ago, but thankfully only needed to stay out of daycare for 2 days with the fever. Bounced back really quickly and figured we had at least another month before I had to worry about her catching something else.

She had a blast at My Gym this morning, hurling herself head first into the ball pit multiple times, and grinning ear to ear on the zipline ride. Grandma and great-grandma came to visit, and she enjoyed their company outside, picking flowers in the yard and watching them garden. Then at lunch, she ate 2 bites of diced-up peach, and turned her head to everything else. Chalked it up to her unpredictable toddler pickiness these days, so just put her in crib to nap afterwards. She laid quietly for over 2 hours, though seemed to be awake on and off.

When I got her out at 3, she wasn’t happy like normal after a nap. Thought she was hungry, so tried to give her more peach for snack, and then she started crying and fussing¬†Figured it must be another hard poop¬†after she had a disastrous poop day at daycare 2 days ago (I had to throw out her shorts and she nearly ruined the provider’s rug), but it was soft. Then I realized she felt hot while I was cleaning her up. 103.1 temperature! With no other signs or symptoms, so I’m trying not to worry about the possibility of a UTI since she’s definitely at risk with the constipation. Her ears look clear but I haven’t tried looking in her mouth to check her throat. Tough right now because hubby’s at a work function until late tonight. Just really hope she’s better soon so we can avoid another bladder cath ūüė¶

Laid up on the couch

I’ve been experiencing back pains in the evenings for a while now, but they’ve become more frequent recently. At some point early this morning, my lower back completely seized up. So now I’m stuck on the couch after taking a very long time to get C ready for daycare. At least hubby was home and could take her up and down the stairs, but I still had to get her in the car seat and out when the time came. The pain is finally easing up after I put on Salonpas and begrudgingly took Ibuprofen – I get nervous taking NSAIDs now because my creatinine (measurement of kidney function) is high for somebody my size. I also need to catch up on charts but laying on the couch or bed just makes me sleepy.

This month has been really tough on all fronts. I did manage to cram for and pass my board recertification while nursing a sick toddler at home. Then nervously had to check twice over 2 weeks on whether I needed to report downtown for federal jury duty. Thankfully I did not, but that meant basically only seeing sick visits on those days since my schedule was held beforehand. That gets very tiring after a while – I don’t think I would survive trying to just work in urgent care. About midway through this point, my chief called me angrily demanding to know why I couldn’t release my schedule yet, and that she’d never heard of anybody being on call for jury duty for 3 weeks. I guess the scheduler must have said something about how bad our access was in clinic, and she misinterpreted my being out the first week when I was taking my exam. So that was fun. She relented after I explained but I still get the impression she didn’t believe that I was really on call for 2 weeks. Ugh.

Now I’m dealing with searching for child care again. Yup. This is more of a just-in-case situation, but Mrs. K told me that she had already put off a knee replacement surgery last year, but that her pain is getting worse and it’s affecting her back now too. I’d noticed her leaning and limping more in the last few months. She sees her doctor tomorrow (again – having to send C to my friend for backup care since I can’t leave work before 3pm to pick her up), and I assume they’ll decide and set a date for surgery at that time, but I went ahead and started the search for daycare/preschool. I didn’t want to have just a couple weeks to look like the last 2 times. Saw 4 different places on my day off, and have it narrowed down to 2. The hard part is any center is a significant cost increase over what we pay now, and of course nobody can beat Mrs. K’s location (across the street from my office). All this is happening, just as I learned that I will actually cut back to part-time in a month, which is a month earlier than I’d planned! So great in that I needed this, but not so great with the increased expense of child care. I thought about trying to find another in-home daycare, but all the recommended places are full or don’t have the hours I need based on their location. I would love to just enroll C 3 days a week, but my work schedule can only guarantee one full day off and the cost of backup care one day a week doesn’t make up the difference vs. 5 days a week.

The 2 places I’ve finalized are pretty different on almost every front except cost. It may end up being an issue of availability since the one that’s close to my office thinks they may have a spot in December but they’re not sure until end of November. The other is closer to our home, and very convenient for hubby to drop off (hurray!) and do pickups once I start working one evening a week. They’re brand new so they definitely have spots right now. In any case, at least I have some prospects, and hopefully we’ll know more after Mrs. K’s appointment tomorrow.

Can’t stop crying

I am accustomed¬†to seeing and reporting suspected abuse and neglect cases, and have done so not infrequently in many¬†years I’ve been practicing. But becoming a mom seems to have made it even more difficult. I burst into tears in the hallway at work today, and had to take a few minutes to compose myself and wash my face before moving on with seeing patients.¬†I cried again after I got off the phone with CPS, all the way home and as I entered my house. C hugged me a lot tonight, and thankfully was not too difficult with cleanup and bedtime. I’m crying again as I write this, and I’m sure I’ll be crying as I finish that poor kid’s note.