JenaW
08-01-2006, 02:17 PM
and the list goes on.....
So where do I start. How about with Natalie. Things have been stable, I guess. Her oxygen is still a bit higher than we (or the pulmonologist) would like, but all things considered, she is doing well. After her last appt a few weeks ago, he wanted to scope her again, and based upon the results (how much she was refluxing and aspirating into her lungs) recommend a g-tube and/or Neissen Fundoplication (surgeries to place a feeding tube directly into her stomach and wrap her stomach around her esophagus to prevent vomiting and reflux). Thankfully, he has agreed to hold off on all of this for now (although we both admit that if necessary it would be easier and make more sense to do it now rather than later before flu/RSV season and before the baby is born) since her oxygen needs have decreased a small amount - but they are no longer climbing, and that was the major concern. At her last Early Intervention visit, she weighed 13 lbs 4oz, which means she is probably more like 13lbs 10-12oz as their scale seems to be about 6-8 ounces less than our pedi and the pulm's scales. A LONG way from the 1 lb 12oz at birth! She was on track for her adjusted age (6 1/2mos) in most developmental areas, and even ahead at 8 months for some of her gross motor skills. She is lagging a bit in social and language, but not enough that the therapist was worried. She will not take any solids at all, and we have been referred to a feeding clinic for that. I am told this is pretty common in preemies, and hopefully something that we will be able to work through, since she willingly takes a bottle, so it is not a total oral aversion. I can't believe she is 10 months old already. After watching our close friends bury their 8 month old (also a preemie) last week, I have been reminded of how lucky we are. All the things that were predicted for Natalie (never being well enough to leave the hospital, being ventilator dependent for life and requiring a tracheostomy, probably dying before her first birthday, once they admitted she would live longer that the initial 2-3 days they thought) instead happened with our friend's daughter, and seeing her lying in her casket was a strong reminder of what could have been for DH and I. I hold her a little bit tighter and a little bit longer these days, and I am reminded of just how precious life is, and how quickly it can be taken away from us.
Speaking of life, the new one growing inside of me seems to be doing well also. At almost 26 weeks, I am passed the point where my water broke with Natalie (22+weeks) and close to where I delivered her (25+). My OB recommended that we do the steroid shots"just in case" when I hit 24 weeks, partly because of my history, and partly because my cervix felt a bit softer to him (the same words they used a few weeks before I ruptured with Natalie). He is pretty confident that my previa has resolved, as he has been checking me every visit (every 2 weeks or less) and I have not had any major bleeding episodes. I should be getting another u/s to confirm at the next visit or so. Things were progressing normally (despite frequent cramping, which seems to be "normal" in my pregnancies) until this past weekend, when I developed horrible upper abdominal pain on Saturday. After a few hours of nausea and misery, when the pain started coming every 5-10 minutes like contractions (ONLY MUCH MUCH WORSE) DH finally convinced me I needed to be seen. I was 99.9999% sure I was NOT in labor (although apparently several of the women in the triage waiting room thought otherwise and said so to me and the receptionist) because the location was wrong (top of my abdomen and right side) and for once I had no cramping or other uterine tenderness. My OB happened to be on call, and once he learned I was there got me right into a room. Of course, once I got undressed and on the monitors, my pain diminished significantly. My heart rate (150's) was the only thing that really indicated how distressed I was. Of course the monitor showed no contractions, and he checked my cervix (still long and closed). He did a fetal fibronectin swab just to be sure, and since it was negative, and he had ruled out any obstetric problems, he sent me home. I guess that is the problem with having a high risk doctor who only does OB...he is GREAT with pregnancy related issues, but not so much with other stuff. He actually asked me if I was just "feeling nervous" since it was around the time of Natalie's delivery. I was pretty upset that he was suggesting the pain was made up, but understood where he was coming from, since it had all but disappeared while he was examining me. DH had to stay in the waiting room because we had Natalie with us, and when my OB ran into him later in the hallway, he asked him what he thought. DH said he thought it was my gall bladder, as the pain had been so intense and colicky. Of course the OB did not see that, and wasn't as convinced. He did agree to order an u/s of my GB later this week if the pain did not improve. It was obvious I was not having an infected gall bladder since the pain did get better, and I did not have a fever, but I am guessing I did have a small stone or some sludge causing a temporary or partial obstruction. I survived the night on 800mg of ibuprofen and zofran, and felt markedly better by later the next day.
Somedays I wonder how I am going to manage with FOUR kids under 3 1/2, since most days I feel I can barely survive the three I already have. I feel like our house belongs on Supernanny or one of those "how not to raise your children" shows. I constantly find myself doing all the things I swore I would never do (screaming at my kids, being inconsistent because I am too tired to follow through, even occasionally spanking). I know that my outburts are just that - related to my lack of self-control, usually directly due to the fact that I am overstressed and overtired (Natalie still wakes to eat several times throughout the night, plus I am getting up to pee a few times too). I try very hard to give myself a time-out and take the time to count to 10 (or higher) so I can calm down and be more effective. But some times (TOO many times) I just completley lose it. Today, for instance, during nap time for Maddie and Carter, (which is supposed to be my "do the laundry, clean the house, feed/snuggle with natalie, plan dinner, etc. etc. time" Carter comes and tells me Maddie has pooped in her crib. I am in the middle of doing a load of laundry, Natalie is screaming on the floor because she is hungry and needs her diaper changed, and the phone is ringing - all of which I want to ignore. I finish pre-treating the laundry and head upstairs to check on the older kids. I can smell it before I even open their door. POOP everywhere - and I do mean everywhere. She has smeared it all over herself (in her hair, in her ears, etc) and all over her crib and dresser. She has taken off her diaper before when she has pooped, but usually only takes it off and then tells us. She has never played in it. I was livid. I had no clue how to deal with her, except to get her out of her bed and into the tub. In the end, her "punishment" involved her two favorite things - a bath and being allowed to clean (yes, I know, she is strange - why I couldn't have inherited that trait is beyond me). I finally got everything cleaned up, and can now attend to Natalie, who is still screaming her head off, and is so worked up she is coughing and alarming her monitors. I get her changed, fed, and calmed down and try to finish the laundry. I manage to get a load into the dryer and bring another upstairs to fold (someday). I think about cleaning the bathroom, which desparately needs it. In between all of this, I have to go into the kids' bedroom about 6 times to de-escalate them and try and get them to nap. By now, from all of the stress and running up and down all the stairs I am cramping, which makes me even more cranky. I trip over some toys in my haste to grab the phone and swear out loud (good thing Natalie is not repeating words yet). Oh, it's only my husband. Won't he be happy when he gets home and sees the attricious state our house is in (sarcastic chuckle here)?!
While we are on the topic, can I complain about him, too? In his defense (before I slam him) he HAS been trying to help out. He puts the older kids to bed every night, and has been taking them out in the evening while I study (another issue entirely - I have to recertify and retake my board exams every 6 years to keep my physician assistant license current) to run off some energy, since I have not been too eager to go outside much during this heat wave we are having. You may remember my complaints a few months ago that he decided to do a fellowship (basically another year with sucky resident salary and hours) instead of accepting the attending position he had already been offered. To make up some of the difference in pay, and for my loss of income since I am not working now at all, he was supposed to be able to moonlight as an attending on his off-call weekends, for an obscene hourly rate. His fellowship is in acute pain management (he is an anesthesiologist), and his boss has decided to head up the pain service at another (affiliated) hospital, and asked DH to help get it up and running for the first two months since he is the only fellow from this area, and thus familiar with the system and staff. He agreed on the condition that he would not have to carry the pager, or round on weekends (something he does now once every 3-4 weeks). In the past, the senior resident has covered the pain service at this other hospital. Well, now apparently DH's boss wants full control over the service, and assumed that his fellows (AKA DH for Sept and Oct) would take call while on service (the ENTIRE two months, 24 hours a day, 7 days a week) and round both weekend days the ENTIRE two months. WTF?!?!?!?!? "call" is only pager call, and rarely involves actually having to go back to the hospital once he is home, but it does mean he is the last to leave, and can not leave until the last patient they have blocked is in the PACU (often as late as 9-10pm). AND, it also means that his pager goes off constantly (probbaly even more so at this hospital since the pain service will be a new thing, and the nurses will not be as familiar with the concepts). So, not only is our life completely dominated by the darn pager for those two months, he looses all chances of moonlighting and earning any extra money. AND, these are the two months before I hope to deliver. I was hoping he would be around a bit more often, so I could start taking it easy and hopefully carry this baby to term.
If you hvae stuck with me this long, thanks. I really do not expect any response. It is amazing how much better I feel already. Sometimes just venting can be so cathartic.
I am off to have some ice cream (my vice when I am depressed, stressed, anrgy, all of the above), and then to try and put my house into some semblance of order before hubby comes home.
Now where did I leave that basket of laundry.......
Jera
So where do I start. How about with Natalie. Things have been stable, I guess. Her oxygen is still a bit higher than we (or the pulmonologist) would like, but all things considered, she is doing well. After her last appt a few weeks ago, he wanted to scope her again, and based upon the results (how much she was refluxing and aspirating into her lungs) recommend a g-tube and/or Neissen Fundoplication (surgeries to place a feeding tube directly into her stomach and wrap her stomach around her esophagus to prevent vomiting and reflux). Thankfully, he has agreed to hold off on all of this for now (although we both admit that if necessary it would be easier and make more sense to do it now rather than later before flu/RSV season and before the baby is born) since her oxygen needs have decreased a small amount - but they are no longer climbing, and that was the major concern. At her last Early Intervention visit, she weighed 13 lbs 4oz, which means she is probably more like 13lbs 10-12oz as their scale seems to be about 6-8 ounces less than our pedi and the pulm's scales. A LONG way from the 1 lb 12oz at birth! She was on track for her adjusted age (6 1/2mos) in most developmental areas, and even ahead at 8 months for some of her gross motor skills. She is lagging a bit in social and language, but not enough that the therapist was worried. She will not take any solids at all, and we have been referred to a feeding clinic for that. I am told this is pretty common in preemies, and hopefully something that we will be able to work through, since she willingly takes a bottle, so it is not a total oral aversion. I can't believe she is 10 months old already. After watching our close friends bury their 8 month old (also a preemie) last week, I have been reminded of how lucky we are. All the things that were predicted for Natalie (never being well enough to leave the hospital, being ventilator dependent for life and requiring a tracheostomy, probably dying before her first birthday, once they admitted she would live longer that the initial 2-3 days they thought) instead happened with our friend's daughter, and seeing her lying in her casket was a strong reminder of what could have been for DH and I. I hold her a little bit tighter and a little bit longer these days, and I am reminded of just how precious life is, and how quickly it can be taken away from us.
Speaking of life, the new one growing inside of me seems to be doing well also. At almost 26 weeks, I am passed the point where my water broke with Natalie (22+weeks) and close to where I delivered her (25+). My OB recommended that we do the steroid shots"just in case" when I hit 24 weeks, partly because of my history, and partly because my cervix felt a bit softer to him (the same words they used a few weeks before I ruptured with Natalie). He is pretty confident that my previa has resolved, as he has been checking me every visit (every 2 weeks or less) and I have not had any major bleeding episodes. I should be getting another u/s to confirm at the next visit or so. Things were progressing normally (despite frequent cramping, which seems to be "normal" in my pregnancies) until this past weekend, when I developed horrible upper abdominal pain on Saturday. After a few hours of nausea and misery, when the pain started coming every 5-10 minutes like contractions (ONLY MUCH MUCH WORSE) DH finally convinced me I needed to be seen. I was 99.9999% sure I was NOT in labor (although apparently several of the women in the triage waiting room thought otherwise and said so to me and the receptionist) because the location was wrong (top of my abdomen and right side) and for once I had no cramping or other uterine tenderness. My OB happened to be on call, and once he learned I was there got me right into a room. Of course, once I got undressed and on the monitors, my pain diminished significantly. My heart rate (150's) was the only thing that really indicated how distressed I was. Of course the monitor showed no contractions, and he checked my cervix (still long and closed). He did a fetal fibronectin swab just to be sure, and since it was negative, and he had ruled out any obstetric problems, he sent me home. I guess that is the problem with having a high risk doctor who only does OB...he is GREAT with pregnancy related issues, but not so much with other stuff. He actually asked me if I was just "feeling nervous" since it was around the time of Natalie's delivery. I was pretty upset that he was suggesting the pain was made up, but understood where he was coming from, since it had all but disappeared while he was examining me. DH had to stay in the waiting room because we had Natalie with us, and when my OB ran into him later in the hallway, he asked him what he thought. DH said he thought it was my gall bladder, as the pain had been so intense and colicky. Of course the OB did not see that, and wasn't as convinced. He did agree to order an u/s of my GB later this week if the pain did not improve. It was obvious I was not having an infected gall bladder since the pain did get better, and I did not have a fever, but I am guessing I did have a small stone or some sludge causing a temporary or partial obstruction. I survived the night on 800mg of ibuprofen and zofran, and felt markedly better by later the next day.
Somedays I wonder how I am going to manage with FOUR kids under 3 1/2, since most days I feel I can barely survive the three I already have. I feel like our house belongs on Supernanny or one of those "how not to raise your children" shows. I constantly find myself doing all the things I swore I would never do (screaming at my kids, being inconsistent because I am too tired to follow through, even occasionally spanking). I know that my outburts are just that - related to my lack of self-control, usually directly due to the fact that I am overstressed and overtired (Natalie still wakes to eat several times throughout the night, plus I am getting up to pee a few times too). I try very hard to give myself a time-out and take the time to count to 10 (or higher) so I can calm down and be more effective. But some times (TOO many times) I just completley lose it. Today, for instance, during nap time for Maddie and Carter, (which is supposed to be my "do the laundry, clean the house, feed/snuggle with natalie, plan dinner, etc. etc. time" Carter comes and tells me Maddie has pooped in her crib. I am in the middle of doing a load of laundry, Natalie is screaming on the floor because she is hungry and needs her diaper changed, and the phone is ringing - all of which I want to ignore. I finish pre-treating the laundry and head upstairs to check on the older kids. I can smell it before I even open their door. POOP everywhere - and I do mean everywhere. She has smeared it all over herself (in her hair, in her ears, etc) and all over her crib and dresser. She has taken off her diaper before when she has pooped, but usually only takes it off and then tells us. She has never played in it. I was livid. I had no clue how to deal with her, except to get her out of her bed and into the tub. In the end, her "punishment" involved her two favorite things - a bath and being allowed to clean (yes, I know, she is strange - why I couldn't have inherited that trait is beyond me). I finally got everything cleaned up, and can now attend to Natalie, who is still screaming her head off, and is so worked up she is coughing and alarming her monitors. I get her changed, fed, and calmed down and try to finish the laundry. I manage to get a load into the dryer and bring another upstairs to fold (someday). I think about cleaning the bathroom, which desparately needs it. In between all of this, I have to go into the kids' bedroom about 6 times to de-escalate them and try and get them to nap. By now, from all of the stress and running up and down all the stairs I am cramping, which makes me even more cranky. I trip over some toys in my haste to grab the phone and swear out loud (good thing Natalie is not repeating words yet). Oh, it's only my husband. Won't he be happy when he gets home and sees the attricious state our house is in (sarcastic chuckle here)?!
While we are on the topic, can I complain about him, too? In his defense (before I slam him) he HAS been trying to help out. He puts the older kids to bed every night, and has been taking them out in the evening while I study (another issue entirely - I have to recertify and retake my board exams every 6 years to keep my physician assistant license current) to run off some energy, since I have not been too eager to go outside much during this heat wave we are having. You may remember my complaints a few months ago that he decided to do a fellowship (basically another year with sucky resident salary and hours) instead of accepting the attending position he had already been offered. To make up some of the difference in pay, and for my loss of income since I am not working now at all, he was supposed to be able to moonlight as an attending on his off-call weekends, for an obscene hourly rate. His fellowship is in acute pain management (he is an anesthesiologist), and his boss has decided to head up the pain service at another (affiliated) hospital, and asked DH to help get it up and running for the first two months since he is the only fellow from this area, and thus familiar with the system and staff. He agreed on the condition that he would not have to carry the pager, or round on weekends (something he does now once every 3-4 weeks). In the past, the senior resident has covered the pain service at this other hospital. Well, now apparently DH's boss wants full control over the service, and assumed that his fellows (AKA DH for Sept and Oct) would take call while on service (the ENTIRE two months, 24 hours a day, 7 days a week) and round both weekend days the ENTIRE two months. WTF?!?!?!?!? "call" is only pager call, and rarely involves actually having to go back to the hospital once he is home, but it does mean he is the last to leave, and can not leave until the last patient they have blocked is in the PACU (often as late as 9-10pm). AND, it also means that his pager goes off constantly (probbaly even more so at this hospital since the pain service will be a new thing, and the nurses will not be as familiar with the concepts). So, not only is our life completely dominated by the darn pager for those two months, he looses all chances of moonlighting and earning any extra money. AND, these are the two months before I hope to deliver. I was hoping he would be around a bit more often, so I could start taking it easy and hopefully carry this baby to term.
If you hvae stuck with me this long, thanks. I really do not expect any response. It is amazing how much better I feel already. Sometimes just venting can be so cathartic.
I am off to have some ice cream (my vice when I am depressed, stressed, anrgy, all of the above), and then to try and put my house into some semblance of order before hubby comes home.
Now where did I leave that basket of laundry.......
Jera