If I should die...

A couple weeks back, I was driving across town to purchase a special Christmas present for KayTar. Between school being downtown and KayTar's docs being in the medical center, I'm on the freeways nearly every day of the week, usually without incident. But on this day, that wasn't the case. I was in the process of changing lanes when the car in front of me (in the lane I was leaving) slammed on his brakes, so I had to hit mine so I didn't clip him on my way out. I'm sure I've done this loads of times without any issue, but for some reason THIS time, my car started fishtailing across THREE lanes of traffic on I-45. I was definitely not in control of the car and did not know how to fix it. I remember thinking, "When you are hydroplaning or skidding, you are supposed to turn into it..." but I couldn't remember what to do about fishtailing! But then the car was okay again and somehow, I never got hit. It could have definitely ended badly with the way my car was careening around. My first thought after I had control of the car again was, "OMG, there are so many things about KayTar's care that exist ONLY in my brain!" If something had happened to me, poor Josh would have been lost. He is very involved in her daily care, don't get me wrong...but I do all of the remembering. I know her schedule and when she needs feeds and meds and when her doctor appointments are and who her doctors are and who writes what prescriptions and what home health companies handle what and where all her records are...and and and!

As soon as I got home, I got to work on compiling some pertinent information for Josh. A lot of it was already fairly accessible, as I keep and online copy of the start of her medical binder on Google Drive and a physical copy by my bed, but it wouldn't have helped him any since I've never mentioned it to him or shown him where I keep it. The medical binder already had the following info (and the physical copy also has her latest notes from clinic, sleep studies, audiograms, ect):

-List of physicians/therapist/insurance case worker and all contact info
-Copy of her insurance card and SS number
-List of all meds, what she takes them for, when she takes them, and if they are PRN or daily, as well as her formula and oxygen information
-Equipment and supplies list (and I added what HHC handles what equipment and when to contact them, as well as how to find her glasses script info online)
- An updated Visual Guide to KayTar

In addition to this, I wrote up a walk-through of an "ideal" day in KayTar's life, a non-sick, run-of-the-mill sort of school day:

5:00am Nexium
6:15am Give 7 ml Augmentin and start feed ((dose) 240 ml @ (rate) 480ml/hr) of 8 ounces of Elecare 3 tsp Miralax, and 1 tbsp cornstarch
6:45am Feed over. Get dressed. Turn off O2. Brush hair and teeth. Pull hair into ponytail. Give 2 puffs of Advair. Socks/shoes on. Prep school feed (8 ounces Elecare, 1 tsp of cornstarch and water). Make sure glucometer bag is packed and is in the front pocket of feeding backpack. Pack lunch. Write note for her jacket pocket.
7:20am Leave for school. Bring backpack, lunchbox, jacket, pulse ox, and feeding backpack. If it is Monday, bring O2 tank and supplies (check with Mrs. H about the Augmentin that stays in the clinic to see if/when she needs more.). Drop pulse ox, feeding backpack, and oxygen in clinic.
11:00am She gets her glucose check and tube feeding at school.
3:05pm Dismissal. Pick up pulse ox from clinic either before or after dismissal time. On Friday, bring home O2 tank and supplies.3:30pm Give 7ml of Augmentin and start another tube feed. Do homework. She does her handwriting work on the paper that I have stored on my computer. [My Documents->My Pictures->September 2011->Hi-Write Paper] Most things she can do on her own, but she often needs help remembering the steps for ABC order. We do it this way (if you don’t understand from reading it, just read it to her and she’ll show you what it means): Write the alphabet on the paper. Go down the list and circle the letters of the alphabet that the words start with. If there are multiple words with the same first letter, then she writes 2, 3, 4, ect. near the circled letter. Then she goes down the alphabet and stops at every circled letter, finds that word, gives it the proper number. After all the words are numbered, then she puts them in order on her blank paper.
6pm Shower or Bath. Pajama time. Braid hair. Teeth brushing. 2 puffs of Advair.
7pm Give 10ml of Benadryl and dose of Nexium. Reading time.
7:30pm Bedtime and cuddles. Start oxygen at ¾ liter.
8:30pm Mix Elecare; 27.5 ounces of water + 22 scoops of Elecare. Lay out clothes for next day (both kids).
9pm 7ml of Augmentin and tube feed.

This is an ideal day...we both know it doesn’t always go like this, though! :) On the weekend, it all gets shifted around. Feeds are typically 4 hours apart, so set an alarm until it becomes second nature. Be sure to check her oxygen saturations periodically, if she is BELOW 96, start her on ¾ liter of oxygen and increase until sats are appropriate.

I also wrote a "troubleshooting" guide for if she is sick, kind of the thought-processes I go through when deciding how to treat her when sick. It won't cover everything, but these are the most frequent things we encounter:

Ketones/Hypoglycemia:
*When KayTar is sick, periodically check her urine for ketones. If positive, check every urine until they resolve and occasionally thereafter.*Check glucose in the morning when sick and when she is symptomatic during the day (lethargic, nauseated, dizzy/wobbly, “legs don’t work”). If lower than 70, give 2 ounces Gatorade. Recheck in 15 minutes. Give 2 more ounces of Gatorade. Continue until glucose is appropriate. If below 50, go to ER at Children’s Memorial Hermann and give them her protocol letter.
Coughing/Congestion:
*First line of treatment is Benadryl (10 ml every 4 hours) and Albuterol (2-4 puffs if coughing is not bad, a nebulizer treatment if it is bad, every 4 hours.*If the cough is not responding well to that, you can give her 10ml of Triaminic Long Acting Cough (dye-free). The other OTC cough meds make her manic, beware! If you ever have to use a different brand, do not give it after 2pm!*If coughing does not resolve after a viral illness or if she gets better (no more fever) and then spikes a new fever 1-3 days later, take her to see Dr. H...she either needs oral steroids or has pneumonia. This is her pattern.*When sick she needs increased oxygen support, make sure to increase her oxygen dose so her sats are in range and keep her on 24 hours until she is doing better.
Gut Stuff:
*Give 5ml of Ondansetron every 6-8 hours for vomiting.*If she feels too full after a feed, draw some out with venting/decompession tube.*If she is not tolerating formula feeds due to illness, slow the rate down (try 120ml/hr). If she still is not tolerating it, try slow drip Gatorade instead (a rate of 60ml/hr and a dose of 240ml will run in 8 ounces of Gatorade in 4 hours. Try to get 2 of these in during the day. Then run the pump overnight at 30ml/hr with a dose of 240 ml and she will get 8 ounces over 8 hours to keep her glucose up. Try formula at this rate the next day. When running formula over long periods of time, hang an ice pack with it. Continue to work the rates up from there until she is back to (or close to) normal, which is rate of 480ml/hr with a dose of 240ml.
Fever:
*I do not usually give meds for fever unless it is at/above 102 or she is bothered by it.*First line of treatment is 10 ml Motrin every 6 hours. *If Motrin does not break the fever or if it spikes back up prior to the 6 hour mark, you can give 10 ml of acetaminophen every 4 hours. Write down what time you give which med, it gets confusing in the middle of the night. If you know she needs both meds to keep the fever down, try to get into a schedule of alternating them every 3 hours.
*If she is feverish and ketotic/hypoglycemic and not tolerating feeds...or if she stops urinating or isn’t cognitively herself...take her to the ER at Children’s Memorial so they can manage her.

I put all of it on Google Drive and shared it with Josh. I also showed him how to braid KayTar's hair...you know, the important stuff. ;) It isn't everything and I don't think I can EVER cover all of the bases, but I feel like I got enough of the important stuff down in writing to make it considerably easier for everyone if something were to happen to me. I probably should have done it ages ago, in all honestly, but thinking about and preparing for your own death just feels sort of grim. Realizing how quickly and unexpectedly something terrible could happen was the little push I needed to finally take care of this!

(Almost) Wordless Wednesday: Love Notes

A few weeks back, KayTar asked me to write her a little note to take to school and since then I've been writing little love notes and hiding them in her sweater pocket every day. This week I got a little more creative and went with a theme, ANATOMY! Or "doctor humor" as KayTar referred to it yesterday.

Happy New Year!

So, it is 2012. Sounds weird, right? We rang in the new year with good friends and game night. KayTar wanted to stay up until midnight, but gave up at 9:33 instead. I was going to do a big sum up of 2011 for the first post of the year, but I just didn't feel like it...so I'm not. 2011 was a mixed bag for us. KayTar was healthier (as far as infections go) than she has been in previous years, but she had a rough medical year on all other fronts. Headaches, GI problems, respiratory weirdness, ect. I spent a lot of the year worrying about her. It definitely wasn't all bad, though, there was plenty of love and laughter and time spent with friends and family, so I think it was a good year overall, because that is the most important stuff. Josh and I celebrated 10 years of marriage, went to Vegas, had a beach vacation, KayTar and I had a little weekend getaway to a downtown hotel...among all the other more run of the mill fun things we did. There were the less fun things, too; the gas leak and being without gas for 16 days, Calculus, my credit card being cloned, medical tests that weren't very fun. We started seeing KayTar's new specialist in 2011 and our hope is that in 2012, someone will finally be able to successfully diagnose her! I don't do resolutions, but that is my #1 wish for this year...and it is probably about as likely as most people sticking to their resolutions. ;)

There will be a couple of changes for me in 2012. I changed majors at the end of the semester, from Biological and Physical Sciences to Psychology. BPS was dragging on forEVER because of scheduling problems. Every semester, I've tried to fit in some of the science classes with labs, and every semester the classes have been scheduled at times I can't take them. It wasn't a huge deal in previous semesters, because I had enough basic requirements left to fill my schedule, but I'm done with that now and still couldn't make the labs work. They seem to only schedule them during the kids' dismissal time or at the time Josh gets home from work...meaning I'd have to leave before he was home since campus is an hour away. It just isn't workable. Nontraditional undergrads with two kids and one income can't afford medically savvy nannies to cover gaps like these. Sooo, I looked at my transcripts and reevaluated things and discovered that I'd actually be closer to graduation if I switched, so I did it. Also, the classes are at normal times and many are offered online, too, which is an added bonus.

The other big thing is that I'm almost certain that I'm switching tracks from premed to pre-PA. It has been of those long torturous decision-making processes, so I'm going to spare you all of that agonizing hemming and hawing...I've pretty much had my fill of it already. The bottom line is that this year, we saw possible disease progression in KayTar and that has made me reevaluate my priorities. I love medicine, that hasn't changed...but if there is ANY chance our time with KayTar could be limited in any way, I cannot/will not sacrifice 7 years of time with her. PA programs are shorter in duration and I could still work in a field I love. My end goal is primary peds anyway. I don't think I will ever look back and wish I had spent less time with the kids and more time in school/training (even if KayTar does go on to have a happy, mostly healthy, full life, which is our fervent hope)...but I can definitely imagine wishing the opposite. I don't want to set myself up for big regrets. While I never think we should live our lives in fear of what might be, I also think God sometimes uses circumstances in our lives to nudge us in the right direction...and this year has been one of those nudges. So this next semester, I'm not taking any prereqs for either program, I'm just going to sit on this decision (even though I'm pretty sure about it) for the semester and maybe through the summer too, and then move forward with a certain direction in the fall...so I'm not straddling the fence and wasting time by completing two sets of prereqs. For now, I'm just going to keep working towards finishing undergrad and keep taking things one day at a time with KayTar.

KayTar celebrating at 9:30. I love how she says, "It's midnight!"

Notes from the Wobble Board.

KayTar is having a pretty good week. Monday and Wednesday she got through the entire school day without having to visit the nurse (except for her daily visit for meds and pump hook-up), and Tuesday there were some small bumps, but she made it through. She's flirting with a little respiratory infection, but doing well in spite of it.

In PT, KayTar had to stand on this thing called a wobble board, it was a wooden platform on top of a rounded rubber pillow of air that forced her to work VERY hard to maintain her balance. She would get up there and her legs would shake and her knees would buckle and she would grab onto her therapist for dear life. Lately, it seems like I'VE been on the wobble board. This semester has been stressful for me. I was chosen to be part of a STEM majors honor society at the end of last semester, which initially I thought was great. I was under the misconception that it was simply a scholarship program for impressive students (because that is all they tell you when applying!), but it turned out to be so much more than that. I had to sign up for an additional course, which was just one credit hour, and from there I found out that there were multiple mandatory events outside of class time. The society itself had something like 10 mandatory extracurricular events (the list just kept growing!) and the one hour course had several in addition to that. The class also required a lot of reading, online participation, and group work...it was my most demanding course and made Calculus look like a cakewalk. For a NORMAL undergraduate student, I can see the benefit of all of these things, but for me, especially THIS semester with the way things are with KayTar, it was impossible. A few weeks ago, I attempted to withdraw from the program, but my advisor said she was willing to compromise with me on certain things, so I tried to stick it out for the semester...but things just kept getting more complicated with KayTar and I just COULD NOT have that hanging over my head. So I finally officially withdrew last week and I feel so much better. I hate "quitting", but the truth is that if I had known about all of the hidden requirements when I applied, I NEVER would have applied. I am so careful about my schedule, because I know that there is a limit to what I can balance and I was even more careful this semester because this summer was rough for KayTar and we are seeing a lot of doctors and going through testing right now. This program tipped the scales in a dramatic way and withdrawing from it was the right call for me...and for us as a family. So, whew!

I'm not sure what I'm going to do about next semester. It has been a long time since Josh and I have really been hit by the uncertainty of raising a kiddo who has an undiagnosed, unpredictable disease, but this semester has really driven that point home once again. This summer was difficult, this semester has been difficult, and Josh and I are both concerned that next semester will be more of the same for her. We are thankful that her motility medication is helping and heartened by the good week she is having, but it seems like abdominal pain, headaches, dizziness, and other things are constantly lurking. We both hope this is just a flare up and we hope that she is on the upside of it now, but we can't say that with any certainty. Josh, who is extremely laid-back, brought up the possibility of home school last week, and he is NOT pro-home school. We're definitely not there yet, but the fact that he brought it up at all shows how uncertain things have been this year...how much our day to day with KayTar has shifted. As far as my school goes, if I had to decide right now, I'd say that it would probably be best for me to take next semester off or go back to evening classes for a while. When I decided to go to school full-time during the day, things were simpler with KayTar and it was an easier balance to maintain, but now everything is topsy-turvy again. School is important to me, but KayTar is my priority...she doesn't always need me, but I want to be there for her when she does. Luckily, I don't have to make any decisions right now...I just have to keep my head down and survive THIS semester (which in spite of all the extra stress, is going pretty well), because as my favorite Bible verse says, "Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own." And isn't that the truth!

To Do:

Cal I -> 1.1-1.4 (by Wednesday)

Medical Writing -> Read chapters 1 and 2 in  The Complete Guide to Medical Writing (quiz 9/15)

HIST -> Review chapters 17-21 for exam (either 9/15 or 9/20)

POLS -> Read pgs. 354-62, 367-86, 401-16; make cheat sheets (exam 9/14)

CSP -> Call zoo RE: group volunteering; read pgs. 7-122 in Service Learning; read pgs. 219-245 in Navigating Research; post to discussion threads for chapters

Personal -> Call pulmonologist RE: visit cost as self-pay; call insurance RE: reimbursement policy; do income verification check for insurance; call HHC RE: pump servicing and coverage under possible new plan, call HHS RE: switching plans; call possible new plan RE: coverage of therapies and DME

Drudgery -> Laundry; waiting for the city to come inspect the gas line so the plumber can start work on it (yes, STILL NO GAS HERE!)

What are you up to today?

I miss Spring Break already.

Wow, I haven't posted in a week! It was a whopper of a week, too. I suspect we were being punished for actually relaxing over break.

Monday wasn't too bad. I spent most of the day doing PreCal homework and trying to track down a new graphing calculator because my screen was crapping out and I needed it by my Thursday exam. Luckily, I found one on EBay for a decent price being sold by someone in our metro area who agreed to meet me in person, rather than shipping it. Yay! That night was scouts for the family and hospital shift for me, as usual.

Tuesday was a full school day for me and the evening was spent on PreCal homework. I think there was an emergent load of laundry done, too.

There was an increase in stress load on Wednesday, as my PreCal exam was steadily approaching and I hadn't really had enough time to study for it. I had been doing my online homework, but that doesn't really help me study, because the online format is so freaking frustrating. I work book problems to study, so I can actually learn something from it. I studied a little in the morning, then took KayTar to the ophthalmologist. Her left eye is getting worse, but he said it isn't enough to change her prescription...he said we'll do it next time. She sure missed a lot of letters, though! After I took her back to school, I went back to studying. Then about an hour later, it was pick up time, so it was back to the kids' school. We got home, started homework, had snacks/tube feeds and it was time to go to the district science fair for BubTar. He was one of the last to be interviewed, so I was there until about 6:15, then came home to wait for KayTar who had gone home with my mom during the fair. The boys went out to dinner and brought me back takeout. Once the kid's were in bed, I went back to studying...I was up until 12:45 working PreCal problems and listening to 90s punk rock. After I finished, I rewarded myself with an episode of Top Chef, so I didn't get to sleep until 1:30ish.

Thursday morning was the PreCal exam. It was fine, but not a 110 like last time. There was one problem I missed completely, it was a calculator problem and I was absent the day we learned how to do it. The rest went fairly well, I think. We were only allowed to use a scientific calculator on over half the test and I'm not used to that one, so I hope I didn't make any entry errors that will affect my answers. We'll see. After that, I started studying for my Storytelling exam (which was later that afternoon and I hadn't had time to look at yet) and skipped Govt so I could finish studying and start working on my slides for the first half of my semester long project in Cancer Bio. It worked out perfectly and I had exactly enough time to do both and get to my exam on time. It was easy, but wouldn't have been if I didn't review the material. That evening, we had science fair awards. BubTar got a gold medal! Everyone medaled, but silvers were for participation, gold was the next tier, and then a handful of kids got trophies. This was BubTar's first year participating, so now we have a better idea of how it all works. We went by DQ for post-fair treats.

Friday, I had Cancer Bio. I got my midterm back...it was an A! I'm especially proud of this one, because on the first day of class the teacher said, "If you haven't taken Genetics and Biochem, you should think about dropping this class." and I haven't had either and I'm doing well. I also finished my exam first, which I was nervous about, but when the professor gave me my test back, she said, "I'm so impressed! You finished in 45 minutes and made an A! That is the best use of time I've ever seen." Then she said, "Weren't you the one who emailed me earlier in the semester because your daughter had pneumonia?" I nodded, and she said, "You are doing all of this with kids? I'm even more impressed by how you are balancing everything!" It was very encouraging! I took time off from studying the night before the exam to go to the rodeo with the family, and I'm glad I was still able to do well on it, especially well enough to get such compliments from my professor! After class was out, I went to the pediatrician's office and spent the rest of the day shadowing. I listened to sinus arrhythmia and visualized an infected ear...and saw many cute kiddos. I know I see more interesting cases in the hospital, but I really enjoy the primary clinic more. We spend more time with the patients and I like being able to follow the same kids...I've already seen a handful of patients on more than one occasion. I can see myself being happy in the environment for a long time. I picked up Subway on the way home, spent the evening cuddling with KayTar and watching BubTar play video games, helping Josh with his homework, and watching Law and Order UK in bed. It was lovely.

Saturday, the boys went out of town and KayTar and I had a girls day. We saw Gnomeo and Juliet at the "fancy" theater, went to the big bookstore, and had ice cream at Ben and Jerry's. I brought KayTar's feeding backpack into the theater and the ticket taker asked to search it, to make sure there was no video equipment in it for bootlegging, ha! I said, "Sure, it is just my daughter's feeding bag." as I was unzipping it and he got ALL flustered and apologetic. It is no big deal to us, but I guess it is odd and personal to some people. Last night, we went out to eat with my best friend/sister-in-law and she came over to hang out after and we watched Grey's Anatomy reruns...from back when it didn't suck so much. It was a nice relaxing evening.

I neglected to even post pictures lately, so here are a handful of my favorites from the past few weeks... 

 

- Posted using BlogPress from my iPad

Blurg.

This weekend I worked my butt off studying for the organic midterm. I probably logged 24 hours worth of study time. Guess what? I FAILED. I haven't seen my grade yet, but based on the amount of guessing I did...I failed. It was like freaking GREEK. I just cannot get NMR spectroscopy to click and that was the majority of the test. I can look at an NMR spectra and determine the various groups, but organizing them into the correct molecule just isn't happening. I'm hoping the rest of the class did as poorly as they think they did (I didn't talk to a single person who thought they had passed, even the guy who loves this stuff and wants to work as a chemist.) and there will be a major curve...otherwise, I'm screwed.

I studied so much this weekend that I missed BubTar's double header baseball game. I had to keep KayTar home from her dance class. We missed the big fall festival at my school. The kids didn't get to have any friends over and we didn't do anything really. It was me and my books all weekend. Now it feels like wasted time. If I was going to fail the test, I might as well have enjoyed my weekend and my kids. I know, I know...it is important that I put the effort in and if I hadn't, I'd be kicking myself over that, too. Either way, it sucks.

I'm about 99% sure that I have an ulcer. Upper middle abdominal pain, below my ribs and above my belly button...it gets much worse when standing, so I think it is probably gastric and not duodenal. It does NOT feel good. Walking up to school today, the pain was climbing all the way up into my chest and radiating toward my back, too. It made it a bit hard to breathe. Not pleasant. I'm self-treating with Zegerid, which has helped with previous ulcers, but if it doesn't help quickly, I predict a trip to student health services in my near future.

Today was supposed to be KayTar's field trip to the farm, but we had to miss it because she has been sick. Yesterday she seemed like she was on the upswing and her fever broke in the morning, but she vomited before bed, so we decided not to push it. I feel bad about it now, because she's done great today and I think she could have gone and been just fine, especially since I was going to tag along. Bummer.

The only bright spot in this bleak, guilt-infested, grump of a post is that I got my midterm grades back for history and music and I got a 102 and 103 respectively. My history professor gave me a lot of wonderful comments on my essay, too. At least I'm competent at SOMETHING, right?

Weekend Update

I spent Friday shadowing our pediatrician. The more time I spend in the clinic, the more certain I am that I could be quite happy as a primary care pediatrician. I really enjoy being in clinic; I love the kids, I love the medicine...its a win-win. It is a very good reminder of why I'm tormenting myself with all of this school business. Earlier this week, I was saying to Josh, "Why can't I just be happy just being a history major or an English major? It would be so easy for me!" I could care less about organic chemistry...or physics next year...but I have to get through them to get to what I really want. I really want to practice medicine one day, and spending time in the clinic reminds me of that and keeps me motivated.

Today has been our first "normal" Saturday in a while (in fact, it has been our first normal week in a while, too!). We all went to BubTar's baseball game, which they lost, and then KayTar and I rushed to her dance class only to find out it was canceled! The Down Syndrome Buddy Walk was today and because a large portion of the class has Down Syndrome and attends the walk, so they canceled class for the day. While we were needlessly rushing to dance class, the boys were rushing from baseball to a trial martial arts class for BubTar. He LOVED it. He gets to attend classes for free for the next month and he's got his cute little uniform and white belt, but then we're going to have to come up with the money for classes or pull him out. It is a really great workout, though, and he really enjoyed it so I hope we can find the money in the couch cushions or something. ;) As of right now, BubTar has scouts on Monday nights and baseball on Thursday night...plus games on Saturday. Martial arts can be as often as daily, but they require two sessions at least each week...so it looks like it will be a Tuesday/Wednesday night event for him...possibly Saturdays when it doesn't interfere with baseball or scouting events. Sometimes I wonder when and how we became over-scheduled, middle-aged (even though we're actually only 27) suburbanites...but such is life with kids!

After we all got home and had Subway for lunch, the kids' went to play at their friends' house for a bit, then the girls came here and the boys went out to sell popcorn together for cub scouts. The girls are sleeping over here tonight and the boys are sleeping over there. I've been studying for midterms next week while the kids are playing together upstairs...and now I'm taking a break to blog, evidently. Josh has a test to take tonight once he is back from popcorn selling, so we'll just be juggling things as usual around here tonight. We had big plans for $1 margarita date night, but it looks like that will be postponed until next Saturday. I'll probably need it more then anyway, as I'll be cramming for organic chemistry next weekend. Eeek!

BubTar, bored in the outfield today.

Lucky.

If I had written this post on Tuesday night, it would have been titled,

"Student-Motherhood: This Sh!t is Hard."

Tuesday, as luck would have it, was one of those clusterflucky days that seem to crop up when you have something really, really important going on. For me, that really, REALLY important thing was taking a history exam in the morning, and then studying for organic chemistry for the rest of my life, or until 8:30 am on Wednesday, whichever came first (because let's face it, it might kill me). KayTar had an iffy morning, very congested, but she had no fever, so we decided to send her. I sent the nurse a quick email to let her know the specifics and hoped for the best. After completing my history exam, I skipped Music, so I could get home to study, and on my way home I got a call from the school nurse. KayTar had vomited in the cafeteria during lunch and she was chilling with her BFF the nurse. They were wondering which meds to give, basically, because KayTar had decided she just needed a little rest with the nurse and then she could go back to class. I told the nurse my best guess on the proper meds for this situation (which was mucus/cough-induced vomiting, not VOMIT-vomiting) and said that if they were sure she felt well enough to stay, I'd let her. I went home and studied until it was pick-up time. In the evening, KayTar was much worse. Coughing, vomiting (still from congestion), diarrhea (HA HA, Universe...my chronically constipated kid suddenly has the runs, and I'm changing diapers left and right instead of studying. SO HILARIOUS.) Josh and BubTar were committed to a Cub Scout engagement that night, so that left me with my books and the sickie. It was like ping-pong...chemistry-KayTar, KayTar-chemistry, chemistry-KayTar..."Mom, I pooped my pull-up." "Mom, I threw up on the floor." "COUGH, COUGH, COUGH-GAG." all evening. Then the boys got home and Josh had a paper that was due in AN HOUR that he hadn't typed or proofread yet. I abandoned my studying to get BubTar fed and ready for bed while Josh frantically typed his paper. Once his paper was done, he took over the kids and I went back to the book. I put in 11-12 hours into studying, but I was interrupted approximately 2.5 million times. It was hard and frustrating and there were several moments when I wondered what the hell I was doing, but I kept at it. In the morning, I got up a little earlier than usual to go over a few things I was still struggling with remembering and went through my index cards a few times. I had serious doubts that I was retaining anything. I dropped KayTar off at my mom's house and went to take my exam. I still don't know my grade, but I can say that when I started that test, I was relieved to see that I recognized/understood nearly all of it. There were 3 that I was fairly unsure of, but the rest I either knew or was able to reason my way through. I did not leave class with that dreaded, "OMG, I just totally bombed that." feeling I experienced once or twice in general chemistry. I really hope I did well, because I worked hard for it.

As difficult as Tuesday was, and as difficult as so many days have seemed lately between school and sick kids and other minor crises, I can't help but recognize how lucky I am. I'm lucky to have a goal that I'm so passionate about that I can torture myself like this and feel like it is all worthwhile. I'm lucky to be in a partnership where we both support each other in our educational endeavors. It makes it tough sometimes, balancing our unique kind of family life with TWO parents in college when one has a full time job, but it also adds a level of understanding to our relationship that we wouldn't have if we weren't both going through similar struggles. I'm lucky that I not only have great family support within my marriage, but in my family in general. My kids are so excited about me pursing this, they love that I'm going to school so I can become a doctor. They are always asking me about what I did in school and how my grades are, just like I do with them. My parents help out so much with the kids, especially watching them when they are home sick and I have to go to class. I absolutely could not be doing this without all of that support. I still think I'm certifiably insane to be doing this, but at the same time I can't imagine NOT doing it...and that makes me pretty lucky, I think.

PS: I changed the blog title, in case you were confused when you saw this in your reader.

A Day in the Life: Pediatrician Edition.

I spent the day yesterday shadowing our fabulous pediatrician. Beforehand, I worried that it might be a little awkward, following someone around all day without contributing anything, but it turned out to be a really enjoyable experience! I'm looking forward to doing it again next month.

We saw a lot of kids, of course...kids who were there for well-checks, URIs, EIs, rechecks, and one patient who came in for a rule-out of a fairly rare condition...kids who loved the doctor, hated the doctor, and were ambivalent about the doctor...and they were all adorable. I got a lot of smiles from all of those cuties. It was a busy day, though not unpleasantly so. It was a nice pace. We spent roughly 10 minutes (my guesstimation, I didn't pay attention to the actual time) with each patient which seemed the perfect amount of time, and from 9:30am until about 1:30pm there were not any lulls. Then we went to lunch, visited a baby in the NICU at the hospital, and came back to clinic and saw a few more patients before I morphed back into a parent when BubTar arrived for his 3pm appointment.

Things I learned, in no particular order:

1. I am not used to wearing heels all day. Ha! Obviously, I was on my feet all day and we did a lot of walking and took the stairs quite a bit. It didn't bother me a bit until I was OFF of my feet for a while...then, OUCH. Gotta work on that. ;)

2. Primary-care pediatrics is a lot of repetition. We saw many kiddos that were there for the same well-check, and so you basically repeat the same thing over and over. It isn't a BAD thing, just something that hadn't really occurred to me previously.

3. 4 months old infants are particularly adorable patients.

4. I need to learn more Spanish and get brave enough to utilize what I already know.

5. I can see myself being happy with this sort of career.

6. (which is not specifically related to yesterday) I can survive a week with roughly 3 hours of frequently interrupted a sleep per night, two sick kids, feeling mildly under the weather myself, while keeping up with my coursework and responsibilities, and still manage to enjoy myself.

PS: The pediatrician did a mono spot, a re-swab for strep, and a CBC for BubTar yesterday and all signs pointed run of the mill virus. He has a pretty inflamed throat and very swollen lymph nodes...but his fever broke this morning! I don't know if it will stay down, but it is a start! Also, KayTar seems to have a plain old URI, so I expect her to recover pretty quickly, too.

Cross-posted at Mothers in Medicine

Yeah, that pretty much sums it up.

BubTar has diarrhea now, which is a perfect metaphor for the week thus far.

Yesterday, his fever was staying in the 102-103ish range...getting as high as 103.8 while on Tylenol/Motrin every 3 hours! He peed once Sunday, once Monday, and once Tuesday...just a bit shy of 24 hour in between, so I emailed the pediatrician to see if we needed to sneak in a quick outpatient chem 7 today...and low and behold, he urinated a second time shortly after I sent it. Perfect timing, right? His fever was so high when he went to bed that I didn't feel comfortable sleeping through the night and letting his meds lapse, even briefly, so I went to bed at midnight and set an alarm for 2am. Then I woke up for the day at 5:30 as usual. Super fun times.

Back tracking to last night, after KayTar's pre-bedtime feed she vomited up about 2 ounces of it. That always raises the "Overfull or getting sick?" question, so we tucked her in next to a vomit bucket just to be safe. She was fine through the night, but this morning she only tolerated half of her morning feed before complaining about being too full and having stomach pains. This complicated the issue of whether she was sick or not, so I took her temp and it was normal. We decided to proceed with the day as normal, BubTar at my mom's and KayTar at school, unless something changed. I sent her with a note explaining her half-feed to the nurse, in case she got hypoglycemic and needed her lunch feed sooner in the day. BubTar and I were late leaving the house due to a number of different issues and I spent the entire day preoccupied with how the kids were faring.

However, I did make it to both classes, orgo and orgo lab, and neither of the kids had crisis situations while I was away. The day hit an all time low as I rushed to the cafeteria to get a quick lunch before heading home, only to discover that it is the first day of a new month...the month after my bank card expired and my new one was not activated yet! DECLINED! Awesome feeling. Even better? When the cashier, who I have never met before, admonished me by saying, "You need to learn to do some things for yourself!" when I mentioned that I thought my husband had already activated our new cards (he texted me about them in class, so I assumed he had activated them both...ass/u/me, I get it.). Then I stood near the register and called the activation number on my cell only to be LOCKED OUT OF THE SYSTEM. I had to abandon my lunch and go home hungry, and more than a little pissed off. On the way home, my mom informed me of BubTar's gastrointestinal distress.

Now it is late afternoon, the kids are home resting. BubTar hasn't peed since last night. Again. He is still running a low grade fever with meds, but at least it is LOW grade now. I count that as an improvement. KayTar is a little snotty, but no ketones in her urine yet and her temp is teetering at 100, but I'm still hoping she magically makes it through the next two days. I have my volunteer shift at the hospital tonight, classes tomorrow, and a shadowing gig on Friday...I'm worried that adding another sick kid (the one that is much harder to treat) to my mom's nannying gig might send her screaming into the night at this point. The Universe is definitely testing my resolve to be a full time student right now...and guess what? The Universe can suck it. ;)

Monday, monday.

Where did I leave off? Ah, yes, BubTar was sick and we were preparing for the first day of Granny the Nanny. And what a day it was!

Yesterday morning, BubTar woke up with a 102.8 fever, I gave him Motrin, he drank a bit of water and promptly vomited most of it up. What a wonderful Monday morning. Still, I got ready for school and brought him to my mother's house for the day with medication instructions (Tylenol/Motrin alternations and Zofran in case of a secondary vomit) and headed to school. I checked in with my mom after orgo lecture and things were okay, no more vomiting, and then I went to orgo lab.

It was the first orgo lab of the semester and guess what? I broke my flask with my sample in it and had to start over! Yes, I was the first klutz to break something in lab! At least it happened early in the experiment. My klutziness was catching because about 10 other people broke glassware in lab yesterday. I'm such a trendsetter. ;) It was a good ice-breaker, though, and I got to know the people around me.

After lab, I saw on Facebook that BubTar's fever was being awfully stubborn so I called my mom on the walk back to the car. It was up in the 103's in spite of the Motrin/Tylenol alternations and a bath. BOO! I told her I'd be there ASAP and headed back to my side of town. As I was getting in the car, I realized I didn't know when BubTar had last urinated, so I called my mom back. BubTar reported no urine since 9:30-10pm the previous night. Oh crap. I called the pediatrician's office for a late afternoon appointment and headed to pick him up.

He had a 103.7 temperature in spite of being current on his Tylenol/Motrin doses and he still hadn't urinated. The pediatrician did a rapid strep that was negative and gave us the evening for him to make some urine or else we'd have to go to the hospital for fluids. We've never been in this position with BubTar! It made me wish that he had a g-button, too. Heh. The pediatrician dosed him with Motrin since it was time and in the car, he vomited that up, along with some fluids. I thought, "This does not bode well." However, when we got home, I gave him Zofran and it stayed down and then he took in some fluids successfully and urinated later in the evening. HALLELUJAH! 4.5 hours of orgo and two trips to and from downtown make a full enough day, I think, without adding a trip to the EC in there, too. Not to mention the classes I would have to miss to facilitate that.

This morning, his fever is back up to 103.8, but he kept his Zofran down and subsequently he kept Motrin down, so I have a better feeling about today. All in all, it has been a pretty rigorous testing of the Granny the Nanny system, urgent doctor's appointments and all. Glad to know it is doable, although I never would have predicted that BubTar would be the one testing the system!

Last night I got a call from his best friend's mom...uh oh, Best Friend spiked a fever last night, too. We feel terrible! Fingers crossed that KayTar doesn't get it (even though she stuck his thermometer in her mouth on Sunday, my head...it nearly exploded when that happened), things hit her about twice as hard as BubTar, and we don't really want to scare my mom out of her nanny gig this early in the semester! It is only week two!

Daily Grind: Thursday

5:30 Alarm goes off. Hit snooze.
5:40 Alarm goes off. Hit snooze.
5:41 Reach over and pick iPod up to check email with one eye open.
5:45 Work up the resolve to get out of bed. Pull on scrub pant pj bottoms, look for hoodie in the dark with no luck. Shiver my way to the closet to pull out another. Walk to kitchen, start coffee. Mix KayTar's Miralax dose in 3 oz of water and while it dissolves, go to the other room to get a fresh feed bag and Pediasure can. Fill the bag and prime it.
6:00 Go upstairs to KayTar's room, set up the pump and plug her in. Nudge her and say, "Your pump is plugged in, so don't wiggle too much." She mumbles her consent. Go back downstairs for my coffee. Thank goodness I can fix her feeds in my sleep, because I'm not actually conscious until after coffee.
6:05 Realize all my jeans are in the washer. Toss a pair in the dryer for 30 minutes. Pick out a shirt. Get dressed from the waist up. Go to the bathroom to do make-up while listening to Bohemian Rhapsody.
6:15 Drink coffee, check Facebook, read half a blog post. KayTar is beeping, so I go check her. My iPod has been on shuffle and it happens to switch to one of KayTar's favorite songs (Your Hands by JJ Heller). She smiles in her sleep and starts to sing. I unhook her from the pump and lie down next to her. She hugs me and sings the song. I think this will be the high point of my day. Once it is over, I tell her to go wake her brother up. She's excited because he is ALWAYS up first, she never gets to wake him. I disassemble her pumping accessories and take the parts down to be reassembled in her backpack for her school feed while Josh dresses KayTar and BubTar dresses himself. Laurie Berkner is playing on my iPod. KayTar switches it to Just Dance and we twirl around the living room.
6:30 Pack KayTar's lunch. Water, pepperoni, baby food veggie. Remember she needs breakfast, too, and microwave her bacon.
6:35 Dryer beeps, check pants. Still moist. Throw them back in.
6:40 Have kids line up for hairstyling.
6:45 Recheck pants. They're passable.
6:50 Realize we are ready and I have almost 30 minutes to spare. I decide to make myself oatmeal instead of eating in the car. We only have the peaches and cream kind, boo, but it is still better than a protein bar in the car.
7:20 Take the kids to school, go through the drop off line, then park.
7:30-9:00 Volunteer in the kids' library. Do some clerical tasks, but it is very relaxing. I love the library.
9:00-9:05 Get gas for the van.
9:05-9:48 Drive to school. Park. Walk down several flights of stairs to exit the garage, stop in the nearest building to use the bathroom (I love this bathroom, because the stall walls are a bumpy texture that make me dizzy to look at, but that I can't help but touch...I know, BATHROOM GERMS, but I can't resist. Then I scrub thoroughly.), walk down more stairs to get to the ground level, walk up a hill to school. IT'S HOT.
10:02-11:15 Arrive at class, only marginally late. Most seats are full, but I spot on in the back corner. Learn things, like that the Iroquois were way ahead of their time what with respecting nature and allowing women to run things, darn dirty Europeans had to come and ruin all that and set us back a couple thousand years. ;) I also got a kick out of their "wars", they would stand in their armor, far away from one another and shout insults. The professor referred to it as a "Yo' Mama" war.
11:15 Wait in line, use the bathroom. Wash hands, eat a protein bar while calling Josh for a quick chat.
11:30-12:45 Music class. Note that both of my teachers today had sweaters wrapped around their shoulders, preppy-style. Wonder if they know we are in TEXAS in AUGUST. Sing Amazing Grace, Mary Had A Little Lamb, Frere Jacques, among others and clap out meter and rhythm. Think that the kids will get a kick out of what we did in MY music class, because it seems pretty similar to what they do in THEIR classes.
12:50 Whoops! Teacher held us over. Take several flights of stairs down, grab a Chick-Fil-A sandwich in the cafeteria and stuff it into my purse. Trek back to the car, thinking about this post in my head to distract me from the HEAT and the impending march back up all those stairs.
1:00-1:33 Drive home while listening to the horrible pop music that I can't help but love...Lady Gaga, Usher, Katy Perry and oh God, even Ke$ha. Scarf down my chicken sandwich. Am pleasantly surprised that I can "recalculate" my path based on construction before Dr. Corday (my British speaking GPS) does. I'm learning my way around town!
1:33-1:59 Restart the dryer and get laundry going (it has been piling up like CRAZY around here. There is a laundry basket in our room, about 3 feet underneath a picture frame. The other day Josh said, "So are we shooting for the frame?" I looked at him quizzically, and he said, "The laundry, are we hoping it makes it to the frame?" Heh...it was getting a little too close, honestly.)), write the first half of this post.
2:00-2:02 Lay on my bed, breaking the NO RECLINING rule. Feel my eyelids getting heavy and hop back up.
2:12 Get laundry from dryer and lay it out while dancing around to Lady Gaga. P-p-p-poker face. Start a new load.
2:30-2:31 Goof off online. See a comment from a friend on FB that mentions my blog. Swiftly delete it before anyone sees it. LOL. Josh calls to shoot the breeze and I hustle him off the line.
2:34 Leave to get the kids from school, two minutes behind schedule. Read my book, it is still AWESOME.
3:05 Kids pile in the car, happily chatting about their day. I hear BubTar mention that he needs advice from KayTar. Hmmmm.
3:15 Plug KayTar in for her afternoon feed. Get BubTar's snack, make myself and afternoon coffee. Hear BubTar asking KayTar for advice on how to make friends. Poor guy, asking his baby sister how to make friends. Someone picked on him AGAIN today. Told him that everyone hates him. My mama heart is all broken up over it. I try to talk him through it, but once he gets worked up, it doesn't get through. He's crying and hiding under couch pillows and I'm helpless. KayTar takes over the consoling (with admirable effort and pep) and I go call Josh to let him know. Boo. I draft an email to the teacher and leave it as a draft. Is that the right move? Should I talk to the counselor? We don't want another year like last year, so I can't let it slide.
3:50 BubTar is eating snack and talking to his best friend on the phone, asking him how to make friends and deal with being bullied. Best Friend gets him to laugh about all of it. The day has been saved by Best Friend! All hail Best Friend!
4:00 Get laundry out of dryer. Hop online to post my bullying dilemma on a message board I frequent. Email the librarian to track down the counselor's address.
4:30 Played Super Mario World with my little guy.
4:50 Josh gets home and goads me into helping him with dinner prep. Herb crusted pork chops, green beans, mashed potatoes, and gravy.
5:10 Talk to my mom on the phone. Hop on Facebook for a few minutes while Josh finishes dinner, BubTar play an online computer game with his friend, and KayTar talks to my mom.
5:30 Dinner. Make the kids name three GOOD things about their day. One of them came up with them easily, the other did not. Can you guess who was who?
6:00 Chore time. Everyone takes care of their little tasks. Log into my online class and post on the discussion on lobotomies. Wonder if some of my classmates might have first hand experience with this procedure.
6:45 Proudly announce that KayTar has not had a potty accident all week at school. Then immediately clean KayTar's bum, noting that she has the start of a rash, and remove her soiled pull-up, such timing. Clean the tub for KayTar while the boys leave for BubTar's baseball meeting. Update this from the bathroom while she soaks.
7:00 Dry her off and get pjs on. She play acts with her EpiPen trainer briefly, "Oh no! My lips are swelling and I can't breathe! What to do?!" and then "Oh no! I'm peanut allergic and peanuts have gotten into my belly!" She starts her arm a-swinging and then BAM, lands it right on her thigh. Goober. We chat for a while and then...
7:30 Reading time. HOLY COW, this is a treat. KayTar decides to SING me the entire chapter of Junie B. Jones. Junie B. Jones, The Rock Opera. I laugh/cry so much all my make-up is washed away. 100% pure awesome. This is definitely the high point of my day.
8:00 Bedtime for kiddos. Spend 20 minutes trying to get a splinter out of my finger. Update this post.
8:25 Quick shower with Josh (we like to conserve water, you know), get dressed for bed, blow dry hair. Lay out BubTar and KayTar's clothes for the next day. Fill KayTar's feed bag for school and put it in the fridge.
9:12 Climb into bed, intending to watch some TV and treat myself to a string cheese. Instead of watching TV, I ignore it while drafting letters to BubTar's teacher and school counselor. Fun times.
9:50 Start Masterchef with Josh.
11:35 The show is over, turn out the lights and fall asleep while Josh watches The Colony.
THE END!

Last Day(s) of Summer

Today is the last day of my summer, if you're counting weekdays. Sunday is my last day, if weekends count. Monday, my FIRST day of school, is the kids' last day of summer. Any way you slice it, summer is rapidly coming to a close. I'm nervous. I'm excited. It seems the perfect time for my blog to descend back into the lists that seem to define it during the busy seasons in life.

Things I'm looking forward to this semester:

*Shadowing physicians. I'm extremely excited about this one. Our super fantastic pediatrician has agreed to let me shadow her one Friday a month. I'm hoping to line up a couple of more docs to add into rotation, too, as the year progresses and we adjust to all of this change.

*NOT taking evening classes! It is exhausting to head to classes as the day is winding down. I'm glad that is over for the meantime.

*Having a "normal" family life. Dinner at home, not in a car! Baseball practice! Listening to my kids read at bedtime! Kissing their little heads before they go to sleep! Wonderfully mundane tasks that I will greatly enjoy.

*Biological psychology. This class has a reputation for being extremely difficult, but I am really looking forward to the material. I love biology AND psychology, so learning about the biological roots for our psychological manifestations is right up my alley.

*Volunteering at the kids' school. I love helping in the library and the kids love that I am there...even if they aren't in the library when I am.

*Finally being a university student. It makes me feel sort of like a grown-up...you know, in case the marriage, house, kids, and pets didn't already accomplish that.

Things that I'm not looking forward to this semester:

*Waking up at 5:30am. I'm not exactly a morning person and even though I know I'll settle into a routine, I'm not looking forward to that process.

*Walking through downtown in the 110 degree heat with a 50 pound backpack. Maybe I'm exaggerating about the backpack weight, but NOT about the heat. Damn, it is still soooo hot here.

*Organic chemistry. I'm kind of dreading it. You hear such horror stories...and I pretty much HATED general chemistry, so chem and I are not on the best of terms. I've also heard there is a lot of memorization and fewer calculations, which is more my speed...but until it proves me wrong, it is staying on this list.

*Not taking care of KayTar when she is sick. KayTar is my baby...my sickly baby, at times...she is also my patient, for lack of a better term. Her care, both general and medical have been my express responsibility for some time now. Stepping back from that and letting someone else handle it while I am away makes me anxious. My mom will do exactly what needs to be done and she'll keep me posted while I'm away. But not being the one handling it, even for a few hours of the day, makes my insides feel a little quivery. I'm hoping that KayTar has a surprisingly healthy fall!

This weekend...

Friday:
* We are going to a church movie night with BubTar's new little friend's family. They want to get to know us before letting him sleepover for the party, which we think is awesome!
* Clean the house.
* Bake and ice cupcakes until we drop!
* Study for my Bio II exam tomorrow.

Saturday:
* Class bright and early, 8-2ish. Exam (the first of 4 in a row for the next 4 Saturdays).
* The rest of the family will be going to Scout Fair.
* Get home around 2ish, start prepping for the party!
* Around 3-4 the rest of the family will get home, so it'll be time to make the kids presentable and finish last minute party stuff.
* 5pm the party starts! Everyone will be here for pizza, cake, ice cream, and presents...then around 7, they'll head out and 5 of BubTar's friends are spending the night.
*Later, if the boys settle well, I may sneak out to grab a drink with my oldest friend at her bachelorette party...this TOTALLY depends on the level of CRAZY at our house with all those boys!

Sunday:
* Entertain the boys until their parents arrive, sometime between 12-2 ideally.
* Recuperate. Caffeinate.
* Work on/complete a project for my Human Sexuality course that is due by midnight.
* Eat? Shower? Maybe if there is time. Ha! Sleep is going to have to wait until post-midnight, which technically falls onto the MONDAY to do list. ;)

I was feeling a little overbooked earlier today, but then in the waiting area at therapy, KayTar announced loudly, to EVERYONE, "That is my mom over there...she's going to be a DOCTOR! Isn't that awesome?!" It was exactly the reminder I needed going into a weekend like this. It may not be easy to "do it all" all the time, but it will be worth it in the end. One day, in the distant future that seems lifetimes away from where I am today, I hope that I WILL be a doctor and that I will have taught my children that it doesn't matter where you are in life at any given moment, with dedication and hard work (and sacrifice and sleep deprivation), you can achieve whatever it is you set out to do. Now I'm going to go repeat that to myself while I toss back another cup of coffee and hit the books. ;)

All In A Day's Work: Wednesday

12:00am Alarm goes off. Time to give KayTar Albuterol and Benadryl. It takes me a while to fall back asleep.

2:30am Alarm goes off, again. Time to tube feed KayTar 4oz of Pedialyte. She then decides she can't sleep unless she is ON ME. I doze a bit, but saying I slept might be a stretch.

4:00am Alarm goes off, a third time. Time for another dose of Albuterol and Benadryl. I roll her off of me and try to get a bit of actual sleep.

7:30am I wake up for the day, start the coffee.

7:45am KayTar wakes up. Test her glucose, 62. A little low for her, but not hypoglycemic low.

8:00am Give Benadryl, Qvar, Albuterol.

8:10am Test her urine. Moderate level of ketones.

8:15am Straighten my hair, pull on my clothes.

8:20am BubTar calls from school, saying Josh forgot to send him with a lunch. I call my mom and ask if maybe she can bring the poor kid something, since KayTar and I have to drive to the doctor and won't be back before his lunch. She says she'll get McDonald's and eat with him. Perfect!

8:30am Tube feed KayTar, 2oz Pediasure/2oz Pedialyte.

8:45am Make-up. Brush teeth. Dress KayTar. Pack up her meds. Gather things to entertain us at the pediatrician's office.

9:10am Leave for the doctor.

10:30am See the doctor. If she isn't better by Thursday, we'll start antibiotics. We get a referral to endocrinology for the ketotic hypoglycemia.

11:45am Get home. Test KayTar's urine, still moderate levels of ketones.

12:00pm More Benadryl, Albuterol.

12:30pm Tube feed, 3oz Pediasure/2oz Pedialyte. She eats 1 chicken nugget and a small amount of soda. Food and drink, by mouth! Hooray!

2:20pm Test her urine. Finally clear of ketones!

2:45pm Pick BubTar up from school. No conduct marks, no homework.

3:20pm KayTar has 4 oz of Pediasure...BY MOUTH!

4:00pm Benadryl, Albuterol. I'm feeling sick and/or tired and decide to skip class.

4:15pm BubTar's best friend is being mean to him over the phone. BubTar is very upset. I step in and tell his friend that my kids can't talk anymore today. This is becoming a pattern lately. We have a talk about standing up for ourselves...again.

4:30pm I have a major fall while sprinting into the next room to get to KayTar. She was coughing a ton and I thought she was going to vomit. I am seriously hurting and just lay on the floor for a while before figuring out if I can actually move.

4:45pm Josh calls from the store, asking what we want for dinner. He picks up a few necessary things plus dinner items.

5:30pm Josh is home!

6:00pm KayTar has 4 oz of Pediasure...BY MOUTH!

6:15pm Dinner. We have french dips, KayTar has a few spoons of powdered parmesean cheese. I force BubTar to answer THREE questions about his day. Getting the kid to talk about school is like pulling teeth. Isn't this supposed to start in the teen years?

6:30pm The boys go to the park with a new friend of BubTar's from the neighborhood while KayTar takes a play bath.

7:15pm The boys get home. Then it is pajama time, reading time, bedtime for BubTar. BubTar is too hyped up from the park fun to fall asleep on time.

8:00pm Benadryl, Qvar, Albuterol for KayTar. Try to get her to drink, but she is done for the day.

8:40pm Tube feed, 3oz Pediasure/2oz Pedialyte.

9:00pm Urine negative for ketones!

9:45pm Check her glucose, 91.

9:50pm LIGHTS OUT!

Life? What life?

Here's a peek at what I've been up to for the past couple of weeks...

Monday, February 15th:
KayTar has her first sick visit at the pediatrician's office in months AND ends up in the ER.
Miss Chem II.
Miss volunteer shift.

Tuesday-Thursday, February 16-18th:
KayTar is home sick, preempting all studying and party planning goals.

Friday-Saturday, February 19-20th:
Insane party prep!

Sunday, February 21st:
The party!
Collapse into heap.

Monday, February 22nd:
Cram for a Chem II exam.
Cupcake delivery to KayTar's school.
KayTar's birthday lunch.
More cramming.
Chem II exam.
Blue and Gold Party for Cub Scouts (BubTar got a TON of awards!).
Volunteer at the hospital from 10pm-12am.

Tuesday, February 23rd:
Nap.
Mourn over my Chem exam.
Read a novel.
Laundry.
Lazy.

Wednesday, February 24th:
Special Olympics Young Athletes' Day with KayTar.
Pediatrician appointment for BubTar.
Meet up with Josh briefly to pass off BubTar.
Eat in car.
Chem II.
Get Chem II grade, a miraculous 84.
Kick myself for DUMB mistake that cost me my A.

Thursday, February 25th:
Somehow I can't remember a THING about this day. Perhaps I was in a coma? I think there might have been grocery shopping...not entirely sure.

Friday, February 26th:
KayTar spikes a fever that rapidly progressed to a HIGH fever.
Biology II SI session.
Cram for Bio II lab exam.
Sleepless night with sick and HOT KayTar, fever got up to 103.9.

Saturday, February 27th:
Skip Bio II lecture to take KayTar to the pediatrician.
Drop KayTar at my mom's. (the boys were at a scout class)
Barely make it to Bio II in time for the lab exam.
Nurse a sick KayTar.

Sunday, February 28th:
Sick KayTar.
Laundry.
Trip to Target for boxers for BubTar and a bathmat. Sadly exciting as I hadn't been out of the house except for school or the pediatrician for quite sometime.
Relax.
Dinner with my parents.

Monday, March 1st:
Sick KayTar.
Make brightly colored index cards for Bio II.
Chem II.
Volunteer at the hospital from 10pm-12am.

Tuesday, March 2nd:
Sick KayTar.
Study.
Sort clothes for Spring.

Over the next week or so, I have a two DOUBLE-LENGTH Chem II classes, Bio II SI, Bio II lecture exam, Chem II study session, Chem II lecture exam, and the start of another course...just to hit a few of the highlights. Thankfully, Spring Break is just around the corner. I'm going to need it!

Happy Mother's Day

Photo and video editing at www.OneTrueMedia.com

Two years ago she was just learning to sign and now she's reading poetry to me. I can't believe how far she's come!

To Do

I have a file open on my computer with a lovely little list on it, it looks something like this:

Saturday:
Haircut
Study chapters 18-20
Work on index cards for Pathology final

Sunday:
Study chapters 21-23
Work on assignment
Complete index cards for final
Shop for new shoes

Monday:
KayTar's neurology appointment
Assignment due
Study cards for final
Shop for new pants

Tuesday:
STUDY FOR PATHOLOGY EXAM
PREP SPEECH
Pack for DC
Pack for the kids
Write instruction sheets for my mom and Josh

Wednesday:
Take pathology exam
Fly to DC

Thursday:
Speaking engagement in DC
Fly home

Friday:
Study for pathology final
Review math concepts

Saturday:
Study for final
Review math concepts

Sunday:
Study for final
Review math concepts

Monday:
BubTar's well-check
Pathology final

Tuesday:
Turn in financial aid paperwork
Take math placement exam

Wednesday:
Register for summer/fall courses

Thursday:
Hospital volunteer orientation

The list had to be written because every time I would think of exam prep and speech prep my brain would start making this high pitched buzzing noise that made it impossible to concentrate. Lists are the cure for that high pitched buzzing sound (I think the Island on LOST finally got its hands on a cosmic notepad and was able to write down the infinite storylines it was attempting to follow and TA DA! No more buzzing!) and once it was all written down, it was instantly manageable again. Of course, there are a million little things not on the list, things that keep the house running and the children cared for that are more akin to breathing than they are Things to be Done.

This weekend I spent roughly eight hours each day reviewing pathology, which was interspersed between the oh-so-frequent cries of, "MooooooOOOOOoooooom!" and I thought, "Welcome to the next 8 years of your life, Kyla." Massive amounts of studying in the neediness trenches that is motherhood. Dad gets a lot of good press around here, as KayTar likes to say, "Daddy is my favorite! He's the prettiest!" but when push comes to shove, it is, of course, Mommy who is most needed. Daddy is better left for Plan B if Mommy denies a request, like if Mommy was to be unreasonable and tell a vomiting child that she CANNOT have some bacon RIGHT NOW, then Daddy is called in for an alternate verdict.

Earlier this week, Mommy went out for dinner and drinks with friends and within 5 minutes of being seated at the table, her cell phone rang and there was a hysterically sobbing four year old on the line, saying "I--(gasp)--WIWWY--(gag)--MISS--(gasp)--YOU!--(sobsobsob)" Mommy may not be the prettiest, but she is well-loved all the same. The phone call only made me feel only marginally guilty about going out for the evening, but exponentially more guilty about the decision to spend nearly every evening in the next year out of pocket. Guilt, the native language of motherhood. We'll all get through it fine, I know, but sometimes you can't sidestep the guilt entirely.

This list and the time frame it represents are a microcosm of my life, obviously; sick kids, lots of studying, a healthy helping of maternal guilt, doctor's appointments, exams, college, and various other time commitments. The good news is that by Sunday night, everything that should have been was neatly checked off and tucked away appropriately; children snug in their beds, notebooks and index cards filled with appropriate information and filed away for later review, assignments turned into professors, and I still had time to watch a bit of television with my husband. As I curled up under my covers last night, exhausted and content, I thought, "Yeah, we can do this."

Sniffy tickles

I have this habit of exaggeratedly sniffing BubTar's neck because it tickles him and makes him giggle like nothing else.

Tonight at bedtime, I was cuddling with him while he read his reading assignment to me, and I just couldn't resist the urge to interrupt the story with some sniffy tickles.

I said, "Hey Bub, do you think you'll remember these sniffy tickles when you grow up? The way they make you laugh and laugh?"

He looked at me and said, "Well, I don't know. Will you not give be able to give me sniffy tickles when I grow up?"

I said, "Well, I guess I can, if you want...but you probably won't by then."

He paused for a moment and then questioned, "But if I do?"

I smiled broadly and said, "Sure, buddy. I'll drive to your work every day and give you sniffy tickles at your desk. How does that sound?"

Then he really laughed, I'm not sure if it was the ridiculousness of me giving Grown-Up BubTar sniffy tickles at work or the absurdity of him ever growing up and having a job in the first place. Today his big plans for the future consist of building a Death Star with his friends, cruising the galaxy, and destroying black holes for a living.

We finished our story and I kissed him and tucked him in. Then I came downstairs and wrote this, my eyes full of tears that threatened to spill out out over my cheeks, because tonight I realized that one day my baby, my first baby, will not need our sniffy tickles anymore.