Moments of the Month

December is nearly over and I realize how much I've slacked in keeping this updated.  Sorry.  Here's what you've missed...

Impromptu day trip to Omaha.

Christmas quickly got into full swing when Santa visited the boys' daycare.

Owen turned 3.

The first big snow storm meant a snow day to stay home and play.

Santa came to the Newman house a weekend early.
He brought Owen a balance bike and Griffin a piano.

The Zlomke Christmas celebration had plenty of fun games.

Candle-light service in Texas on Christmas Eve was a
good reminder of the reason for the celebrations.

Christmas morning did not disappoint.

Owen loves bowling... unfortunately.

They were such good travelers considering
the 15 hour road trip each way.

We had a great time hanging out with family and each other.

Miracles

In our small group, part of the homework last week was to list 10 miracles from the week.  It was a great exercise to remember how blessed we truly are.  On the other hand, it was kind of embarrassing that it took me a while to get to number ten.  I guess I need to practice reflecting on the blessings of every day.  So, in an attempt to start practicing, here's a new list of ten of the many miracles from this week.

1. Delivering a baby.
2. Not needing a coat in December in Nebraska.
3. No admissions to the hospital on Saturday.
4. Being pregnant.
5. Coming home to Jason cooking dinner... and it tasted good, too.
6. The Internet.
7. The human eyeball.
8. Driving a car.
9. What you can see with a CT scan.
10. Griffin learning to play peek-a-boo.

It's a miracle.  Everything is a miracle.  Thanks for entertaining me and helping me to be more grateful for every day.

Sad Again

My apologies for being Debbie Downer lately.  There have been plenty of good things going on, too, but for some reason on those days the time to sit down and write is limited.  On the other hand, when my mind is occupied with something sad, or frustrating, or depressing all I can do is find time to think and write.  So here I am.

 

Thank you, Jesus, that my depressing moments are from my work life and not my personal life.  (Although I know we are not immune.  Just blessed.) 

 

A family that started out as patients of mine, but now I consider friends, lost their brother/son/friend/uncle last week.  Despite his battle with cancer over the last months, it doesn't make it less shocking and obviously not less painful at the age of 22.

 

Honestly, I didn't know him well like his family and friends did, but I was there when he first noticed a problem.  I was there when we found the lymph node and the c-a-n-c-e-r diagnosis.  I visited when he was in the hospital for the third time with a fever and no immune system to fight it - still a smile on his face.  I was there when his niece was born bearing his name and the proud moment he met her.  I listened to his mom and sister's worries.  I presented his case at a resident conference.  And I even got a prayer chain email from someone who didn't know my connection but was just asking for prayers when he got really sick after the transplant.  I feel like I've been there.  At least, my mind has been there.

 

Obviously, cancer, death, pain, and loss are unfortunate but common parts of my job.  Just in a few years time my heart is somewhat calloused to it all.  The words, "I'm sorry for your loss," have come out of my mouth enough times that it seems to have lost the sincerity.  Even so, when it comes to cases like this, it gets to me.

 

It's just one more example of the best and worst of my job.  While it has been an honor to be a small part of this family, this totally sucks.  Arg!

Sleepless

Surprisingly, despite frozen images from my rotations in trauma, transplant, OB, clinic, etc... that are forever etched in my mind, there are very few things regarding my work that keep me up at night or make it into my dreams.  However, now it is 4AM, and here I am. 

 

Jason closed his eyes tonight and saw Thomas the Train (yes, he actually told me that; and, yes, I said Jason not Owen).  However, as I forced my eyes closed tonight, I saw something else completely.  Words that would describe this mental photograph are difficult to choose.

 

Tragedy overwhelmed by an odd sense of genuine, enthralling, and unmistakable beauty.  (I did my best, but somehow the words still seem hollow.)

 

There are also few things that make me love and hate my job to the extremes.  Those "things" are also the stuff we doctors can't, don't, won't, or rarely talk about.  Bad outcomes.  Dirty laundry.  Dilemmas.  Mistakes.  Gore.  The unexplainable.  You know, all the stuff they put on TV.

 

Sometimes I wonder why we tend to keep all that in.  It can't be good for our health - mental or physical.  Is it: HIPPA?  Fear of lawsuits?  Pride?  Humility?  A lack of anyone else understanding and therefore fear of somehow minimizing it?  Professionalism?  Tradition?  Who knows.

 

All I know, is that I can't sleep.

A House Divided...

NO!  Susan and I are not splitting up...Abraham Lincoln gets the credit for those famous words, but it's actually Scripture from Mark 3:25 and it was Jesus who spoke those words.  I decided to raid Susan's blog because of something that has been weighing on my mind for a few days.   
I find it unreal that in the most advanced civilization ever created:

- 46 million people are on food stamps (Source: CNBC, June 2012)
- ER waiting rooms get bogged down by people without real emergencies who likely won't foot the bill and impeding the efforts of doctors and nurses trained to provide vital care to sick and dying patients (Source: numerous conversations with medical professionals who work in these places),
- 3.8% of California's population on government welfare (Source: AP, June 2012),
- Nearly 8% unemployment (Source: U.S. Bureau of Labor Statistics), and
- $16 trillion in debt yet the problem is not one election or one candidate (Source: debtclock.org). 

The problem is what we accept in our culture.  Think about it, 50 years ago,  Kennedy (Dem.) said, "And so, my fellow Americans: ask not what your country can do for you—ask what you can do for your country."   I don't even necessarily like Kennedy but his words weren't divisive, just the opposite, and he surely didn't say "Ask what your government can give you..." or this is what I "promise the government will provide...".  I would say the party motto has changed.  (Side note: I am an Independent, largely because when George Washington left office he warned people about the newly forming political parties and the dangers they would create, questioning if we really wanted the future to be a divided nation.  Plus, I want the freedom to choose people who align closest with my beliefs).  When was the last time you heard one party speak highly of the other?  Are we united now that the election is over?  I did read some gloating comments and some no-so-happy comments Tuesday night so I am going on a limb and guessing we're divided. 

After working in schools for a few years I can tell you the Kennedy quote is not the mindset of our current generation.  It's not even the mindset of my own generation, sadly.  I am not even sure it's the mindset of the many from the generation before me.  There are certainly plenty of kids who have ambition, goals, and love being an American citizen but far too many of our American children and adults believe the government is here to provide for us - that it's the answer for jobs, bailing out bad decisions, and the economy.  That's FALSE - its us, it is our job to fix these problems. 

When the people fear the government, there is tyranny. When the government fears the people, there is liberty.  - Thomas Jefferson


Now, I know sometimes kids say things without thinking and don't fully understand how our government works.  Every year, when I read "promote the general welfare" out of the Constitution I inevitably have to explain to every class period this does not mean the check some of their families receive but that government is supposed to assure the general well being of all people (not support or finance them).  That's not a joke either - I get asked every time we cover it - every class period, every year.

I predict future happiness for Americans if they can prevent the government from wasting the labors of the people under the pretense of taking care of them. - Thomas Jefferson

My reading of history convinces me that most bad government results from too much government.

- Thomas Jefferson

I never considered a difference of opinion in politics, in religion, in philosophy, as cause for withdrawing from a friend. - Thomas Jefferson
 Part of the reason, I wanted to be a teacher was to help kids realize the American dream does exist but its about personal responsibility, gaining the ability to formulate your own opinions and being educated rather than ignorant.  Unfortunately, this dream that made our country great seems to be slipping away with each spending stimulus that adds billions to the debt, the mandates that take away personal freedoms, and that if you build wealth it will be taxed at high rates because you are an evil, rich person (punishing those who succeed).  Oddly enough, many of the same kids who shouted "Obama" in the halls on Tuesday and Wednesday have aspirations to be rich. 

I spend a lot of time thinking about the different shifts in American culture, ideals, and morals over the decades.  I may not be an "expert" but I get consumed with studying our country and how/why we achieved our freedom, the concerns of the Founders, the complexities of the Civil War, how Americans survived the worst period of poverty during the 1930s, and everything else in between.  Ask Susan - she'll likely say I am a "history nerd", which is true, so I ask:  How did we get here?  Why are we so divided?  Who do millions believe they are entitled to things they have not earned nor deserve?  When did it begin? 






Three things I have learned in the past year that gives me some comfort this political and financial mess could eventually be fixed in time:

1) We need to take control and responsibility of our personal lives - faith, family, finances.
2) Men need to be men, be there for our families and role model to them with real, Biblical values because let's not kid ourselves: politicians, athletes, video games, and MTV aren't getting the job done.  For many years, when parents were parents, schools were reinforcing what was being taught at home.  Now it feels reversed and we're hoping it's reciprocated in the home. 
3) Prayer - regardless of beliefs, opinions, views, and general dislike of others - we need to pray for our leaders, families, country, and its very flawed government.  People will fail us and so will governments but when we have full faith and trust in the Lord, He will not. 

Susan - I promise I will never take over your blog for a political rant again.  Besides, your blogs are much better than mine!

Ruined Halloween

"And be sure to tell your patient that she ruined Halloween," Jason said.  

That was when I got the page at 7PM Halloween night in the middle of our trick-or-treating that I was needed at the hospital for my laboring patient whose baby was now not looking so good on the monitors.  Of course by the time I threw/dropped/gently-placed Griffin in the wagon, ran (literally, ran) the three blocks back to my mom's to get the car, drove to the hospital, and hoofed it up the stairs to the 2nd floor Labor & Delivery, the baby's heart tones looked much better.  Sigh.  Still, she was ready to push, so we pushed.  I mean she pushed.  And pushed and pushed.  After 3 hours we had all had enough so we called in back up.  To make a very long story short she finally had the baby along with a rather large tear.  I finally made it back to my bed well after November had begun.  That's the life of a doc, I guess.

And, obviously, Halloween wasn't ruined.  I had already had plenty of trick-or-treating, and Griffin had reached the end of tolerating it several houses before that.  The fun part of Halloween for me is picking out their costumes, then getting them ready and seeing them all decked out, and of course eating all of their good candy.

Owen was "Dr. Owen" and he was sure to tell everyone that fact.

Griffin was the patient, and this is the only time he was happy in the ambulance.  He is 1 now, so he thought he totally needed to walk like everyone else.

The ambulance, complete with sirens, was the talk of the neighborhood.

Photo Friday - Party of Five

Yep.  It's true.  We are excited to be pregnant with Baby #3 - due in May.

In-Service Exam

Today was the dreaded day of the annual in-service training exam.  The dreary, kind of rainy, kind of cold day was a perfect match. This exam is one that all residents have to take every year to prove that they are still learning something.  At least I think that's the point.  We aren't really graded per se, but we are compared to each other and fellow residents across the country.

 

Frankly, I don't find it all that valuable.  No one really studies for it (unless, of course, you consider going to work every day "studying"), and it doesn't really motivate me to learn any more on my monthly rotations.  I'd rather learn things that I'm going to use seeing real patients instead of learning the answer to question #225 of my exam.

 

So I just go, stare at a computer, click for a few hours, then go home and complain about it.  In a few weeks I'll spend about 4 minutes looking at my results, and that will be it.  I won't think about it again.  Probably, never again thankfully.

 

Now, that doesn't mean I'm done taking tests.  No, far from it.  Family Medicine Boards are fast approaching in April, and after today I'm already dreading another long test.  And that one actually means something.

Support Group

Saturday was a great day.  At least it was after 8AM and my pager, for the most part, stopped going off.

 

I'd been looking forward to this afternoon's event for months now.  Seriously, it's been almost a year since I met Michelle at Starbucks, and she said she had been thinking about getting a group of female family practice docs from central Nebraska together.  What a wonderful idea!  You see, I realized quickly how isolating it is to be a rare female primary care physician in a "small" town.  No one else really understands what you really do.

 

How is it different in patient exam rooms when you are genetically wired to be a relationship builder?  What is it like to come home thinking about what's for dinner, is the outfit you want to wear tomorrow clean, is the infant you sent home with a low grade fever actually septic, how is that 15 year old going to tell her step dad she is pregnant, AND what are you taking the party this weekend?  Is it normal to wonder if my male partners respect me and if my "regular" mom friends like me?

 

Needless to say, spending 3 hours with 7 women asking similar questions and wise answers was so therapeutic.

 

We met at a PraireCreek winery just north of Central City.  It was a beautiful spot on a beautiful day with beautiful women.  We ate fancy appetizers, drank yummy drinks (i.e. Diet Coke... wink-wink), and talked, reminisced, listened, encouraged.

 

I only knew two of the women and not very well at that, but unlike so many other female circles, I felt welcomed and like I belonged in this group.  The entire 35 minute drive home I smiled.  I was energized and empowered.

 

Thanks, Michelle for getting us together.  It was great to catch up, Meg, and see your handsome little man.  Ladies, I'm looking forward to our next get together at the Chocolate Bar, or Max Creek, or CoCo Key, or just passing you on the interstate.

 

(P.S.  Jess and Lindsey, if you're reading this, I think you'd love it, too.)

The Wake Up Call

Finally...I am seizing control of Susan's blog for part of one evening (she is sitting next to me, working her on-call night, and doesn't realize I am logged into her account).  

I have a major confession.  Normally, I wouldn't make my confession on a public forum such as this but I thought my confession might help other people.  My confession?  I can be an idiot!  Really profound, right?  Those of you that know me are not surprised, in fact, probably wondering why I had to make such an obvious statement.  All kidding aside, it's true.  For the first 27 years of my life I have been really dumb with some life decisions.  Of course, it's a part of growing and maturing to make mistakes but I was making huge mistakes and not realizing it.  

This past January, Susan and I made a commitment for the sake of our family to become debt free.  Some people think we're weird.  Others feel bad because we "can't enjoy life".  I think a few might even think we are really rich and hoarding money.  I bet one or two people might look at my fly ride (a shiny, red 2001 Mitsubishi Galant) and think we aren't really committed to being debt free.  In reality, only one of those things is true - we are weird.  So here is what I have learned:

Mistake #1

I have come to realize that our culture tells us we deserve things.  "I work hard, so I deserve...(You fill in the blank)" and I bought it - hook, line, and sinker - for years.  We're are told buying stuff we can't afford will fix the economy, that being broke is how Americans should live, credit cards are a fixture of society, and that rich people are evil (although ironically, most people dream of being rich).  It's the new American way, right?  I am pretty sure my great-grandparents and generations before that would drag my butt to the farm by the ear and tell me to get to work because if I want to eat, I need to earn it.  You know, those people during the Great Depression who survived on what they had & were too proud to borrow might have had it right after all.  

Colossians 3:23 - Whatever you do, do your work heartily, as for the Lord rather than for men.  Ouch!  1 Timothy 6:7 - For we have brought nothing into the world, so we cannot take anything out of it either.  Double Ouch!  You know, if God has certain expectations for me - I need to meet them.  I haven't been. 

Mistake #2

I cannot count how many times I have heard "some debt is good debt".  FALSE!  No debt is good debt.  Read Proverbs 22:7, or the abbreviated version - "Borrower is Slave to the lender".  We bought a house in 2006 thinking it was a blessing.  Turns out it was a major lesson.  At the time, you could have a pulse and get a house.  In fact, I made $7.25 an hour and Susan made $0 going to med school.  We, like many young were anxious to get the house, dog, and start a family.  All very well intentioned and filled with beautiful memories.  And to be honest, I feel a little regret but we learned so much from it - how to maintain a home, build a deck/fence, liability, lawn care, plumbing, electrical, insulation, tearing down a wall and rebuilding the same wall, etc.  Susan also had over $100,000 in student loan debt and I had nearly $30,000.  Again, being spoon fed racking up debt is just a fact of life we ate it up.  So tell me again, how is it a blessing to have nearly $200,000 in debt making roughly $35,000 per year?  That actually makes me nauseous thinking about it.  

Mistake #3

Thinking managing money properly means you love it more than anything else.  Wow, have I learned a lot about this.  Scripture tells us we can't worship God and money (see Luke 16:3) so I just assumed this meant I can't be wealthy.  Not so.  What honestly motivates us to be debt free is 1) be a good steward of our blessings and be able give like crazy (oh crud!  I forgot wealthy people are evil - no sarcasm) and 2) change our family tree and be able to provide our children the things our parents always wanted and strived to give us.  I have learned you can use money as a tool to serve the Lord, not the other way around.  I can be humble and still put our family in a good situation down the road.

Mistake #4 

Believing the next political candidate is going to fix everything and save us.  HA!  I must really be ignorant.  This one actually hasn't been a big problem for me.  I just think it's important to mention since we are on the topic of money that we spend all of this time breaking down political rhetoric and what the next candidate is going to do for us.  It's laughable, because I can tell you as a history guy, that's been going on for centuries across societies and hasn't really changed much.  What needs to change is our way of thinking, in other words being critical thinkers with real values and principles.  Besides, Jesus bluntly says (John 14:6) "I am the way, the truth, and the life" - He's the one that has saved us, not some career politician, and that's pretty clear regardless of which side of the aisle you fall on.

Mistake #5

It will take a long time to get ahead, maybe I should just live now.  That belief is an old mistake but it forced me to have a personal rule - NO SELF-PITY.  Sure, it has been a process but God created us and tells us to persevere promising we can handle all things thrown our way.  And while it may take time to get ahead, it's worth walking down the path.  

So...if you're still with me, why write this?  Well, I have been doing a lot of thinking since paying off my student loan debts (we still have about $95,000 of Susan's).  Honestly, that was a huge burden for me.  I can't imagine what it's like for my fellow graduates who had more that are still making minimum payments - in fact, mine were supposed to hang around for 15 years if I did minimum payments!  My babies would darn near be driving and I would have still been paying back student loans.  So I have learned some lessons that I felt compelled to share:

Lesson #1

I don't deserve anything I have.  I make a ton of mistakes, have skeletons in the closet, at times try to hide my faults just like anyone else.  I am a sinner saved by the grace of God - everything I have is a true blessing.  And I am not simply talking about material wealth.  Susan and I have been given an incredible family, a great network of friends and the ability to provide for ourselves.  We breathe, walk, eat, sleep, and enjoy everything by the grace of God.  Not because we are owed or feel entitled to anything.  

So, to the whiny student loan protestor group that believes the man has them down & to the college graduates who feel they deserve a job they "deserve" for going to college the message is pretty simple - WORK!  Do things you don't want to do, network, serve others, intern, and battle to make it.  Don't blame society, the economy, the wealthy and others for your problems.  When I left college, I knew it would be a dog fight to be employed as a teacher - the field that allegedly had a huge shortage in 2007 when I left school.  I was turned down for nearly a dozen open jobs before landing one.  I learned from my mistakes and got better and was blessed with a position.  I was not guaranteed nor expected to be guaranteed anything.  

Lesson #2

Don't incur new debt.  Even if we do buy a house we cannot have the mentality it's a "good debt".  This has been tough - the decision to buy a house and "settle" in GI is back on.  Debt is debt - regardless of what it is.  Sure, a house can be an investment but it can be a curse too.  Whatever happens, we are going to fight like crazy to get rid of anything we currently owe.  One thing I would do again though is to work my tail off during all of college rather than "take it easy" because I "deserved" it my first two years of school.  I seriously could have paid for nearly all of my education if I worked and sacrificed some lifestyle.  Sure, I would have scraped by working and paying for tuition but I remember buying plenty of pizzas in college with my student loan checks and I probably would have worked a little harder to get to those 8 AM classes :)  

Lesson #3

I love my friends/family like crazy.  I love my boys and wife just ever so slightly more and I love God above all.  I want to be able to serve them like I was called to.  Managing my money poorly and excusing it by saying I am trying not to "honor" it was not serving them.  Being a good manager of what I have and looking toward providing/serving them for the future is more important than serving myself now.  I think our commitment to the goal is not to be rich or make our kids rich but rather to teach them how to honor the blessings of God and how to do it the right way.

Lesson #4

Politics are politics.  Jesus saves and it's really that simple.  Getting worked up over many things we deem are "important" can be a waste.  On the other hand, there are certain principles that you must stand up for when it comes to politics and I get that because we don't want just anybody in control.  However, believing that one man or woman is going to fix our lives, or the economy because they promise to do so (with your vote, of course) is absurd.  

One reason I always respected Theodore Roosevelt has little to do with politics.  He was a man born into everything who literally could have lived off the family fortune and coasted in life.  He decided to maximize his blessings.  He urged people to live a strenuous life.  He became a self made expert on the navy, lived as a cowboy in the Dakotas, led the "rough riders", explored, loved nature, and a father.  He wasn't perfect but he wouldn't have accepted the "entitlement culture" of today - the generation of people that believe they deserve...

Lesson #5

I don't talk about doing odd jobs to pay off our debt because I need reassurance, sympathy, admiration, support, or anything else.  I am simply making the point that it takes hard work.  Many of us were born into problems, bad home lives, less than perfect situations, poverty, etc. and any other excuses we can come up with.  My family loved and cared for me very much and always wanted the best.  I knew we weren't  rich and that someday I was going to have to work.  

If somebody wants to argue about how I am a middle class, privileged white man and how I have all these opportunities that others don't have (like access to college or healthcare) let's sit down and talk about nights we didn't have heat growing up, took baths by heating pots of water on the stove, ate rice-a-roni for dinner, or worried if our dad was going to make it home from who knows where.  If someone thinks we can only be debt free because my wife is a "loaded" doctor, let's talk about the sacrifice of 30+ hour shifts without sleep, studying for hours on end after taking classes, or the hours in the middle of the night of taking phone calls from sick patients.  If we really want to fix our problems, it's time to stop making excuses and blaming other people put our big boy (or girl) pants on and do it.

It takes work, dedication and drive to not settle for what society tells us we have to be.  So, here is to kicking Nelnet/Bank of America to the curb.  So long!  See ya!  Farewell!  You can take a stinkin' hike and don't let the door hit you in the you know what.  And hey...tell your friend U.S. Department of Education that they are next, I am coming for them - no excuses!  It's time to go set my alarm for tomorrow's wake up call.

New Month = New Rotation = New West

After last month's joke of a rotation, October means getting back to business.

 

September's rotation was called "Practice Management" and was filled with semi-useful lectures on the business of medicine.  How to find a job.  How to negotiate contracts.  How to start your own practice.  How to deal with insurance companies.  How to stay confused on health policy.  Each lecture was semi-helpful (less helpful since I've already signed a contract), but the month as a whole was almost so relaxed it was boring.  As much as I love getting home at noon or 3:30 on the "long" lecture days, I was starting to get antsy to get back to "real" work.  You know it's bad when I was excited to go in at 3AM this weekend for a pregnant patient of mine.

 

That change of pace was nice for a little while, but I'm excited that now it's October.  I woke up to rain this morning so you know it's going to be a good month.  This rotation is "Sports Medicine," and I'm going to be spending it in Kearney Nebraska with the Orthopedic group there at New West Sports Medicine.  It's the middle of football season so hopefully there will be a good crop of injured athletes.  Former residents have had a lot of good things to say about the staff there, so I'm really anticipating a great month.

 

Now, it is in Kearney, which means a little longer commute than I'm used to.  Mapquest said it will take 1hr and 1min. - if I obey the speed limit, which, of course, I will.  That's a lot of windshield time.  I'm looking for a few good audio books to help pass the time instead of leaving me to my crazy thoughts.  I'm open to book suggestions, and I'll keep you posted on all of the torn ACLs and concussions.

Shut Up and Run

Yesterday, after running only twice since the triathlon in July, Jason and I ran in a 5K to support Christian Student Fellowship.  We had a lot of fun running together (which we haven't really been able to do together since kids), and obviously, we survived.

Another thing I liked about the race was the back of a few of my fellow racer's T-shirts.  My favorite shirts said "Shut Up and Run."  Obviously, they were more experienced runners than I because after the first 100 yards, I could read their shirts no longer.  But, the motto did make me smile.  And think.  

It made me think about a few patients I'd like to say it to.  "No, I do not have a magic diet pill for you.  Shut up and run."  "Yes, you can get off your diabetes meds if you'd just shut up and run."  Okay, so maybe I'd get downgraded on my patient satisfaction surveys and that might not be the most effective strategy for some people, but I may try it some day.

Really, though it made me realize that I should actually look in the mirror and yell, "Shut up and run!"  I blame it on time.  I blame it on work.  I blame it on travel.  I blame it on exhaustion.  I blame it on the boys.  I blame it on ...  But, the truth is, I should stop pointing fingers and shut up and run (or at least walk for heaven's sake).

I'd feel better.  I'd look better.  I'd eat better.  I'd have more energy, so I'd work better and I'd be more fun.  I'd be more confident.  And I'd only be out 30 minutes or less in a day.

Susan, come on.  Shut up and run.

Alphabet Soup

A1C, AAA, ACA, ACL, ACLS, ACS, ADHD, AI, AKI, ALL, ALS, ALT, AMA, AMS, ANA, AOx3, AOM, AP, APAP, ASA, BID, BKA, BMJ, BMP, BP, BNP, BRBPR, c, CA, CAD, CAP, CBC, c/d/i, CHF, CK, CKD, CK-MB, CNII-XII, COPD, CP, CPAP, CPT, CPU, CPR, CT, CVA, CVP, D/C, DEM, DO, DOA, DMII, DNA, DNR, DSM-IV, DVT, ED, EEG, EKG, EMR, ENT, EOMI, ESR, ET, FLK, FP, FROM, fT4, F/U, Fx, GAD, GC, GCS, GI, GNR, GYN, H&P, HCAP, HDL, HIV, HLP, HR, HRT, HPI, HTN, HOIII, h/o, I&D, IBD, IBS, ID, ICU, INR, IO, IRU, IUD, IV, L&D, LAD, LGA, LPN, LTCS, MAC, MCA, MD, MDD, MDS, MGUS, MI, MRI, MR, MRSA, MVA, MVP, NAD, NC, NG, NICU, NIPPV, NPO, NRP, NSAID, NSVD, n/v/f/c, O2, OA, OB, OCD, OCP, OU, OR, OSA, OT, OTC, PA, PALS, PAP, PCI, PCMH, PCN, PE, PEEP, PERRLA, PFT, PMH, PNA, PO, PR, PRN, Pt, PT, QID, RA, RF, RR, RRR, RLQ, RLL, RN, ROA, Rx, SCDs, Sig, SOAP, SOB, SQ, TBI, TID, TKA, TPN, TSH, TTP, UC, UGIB, UPJ, URI, U/S, UTI, VCUG, VRE, VS, VTE.

In other words...
PT/OT s/p Rt TKA 2/2 OA.
I&D by ID HOIII c VRE.  D/C PCN.
80WM h/o HTN, DMII, COPD, & CAD c MCA CVA on MRI is AOx3 in ICU after MVA.
Follow up for shortness of breath = ?

On Healthcare

Change.  Well, President Obama, congratulations, healthcare has definitely changed.  And it continues to change.  I'm hopeful, it's for the better, but I'm nervous it's not.  I'm anxious to see where we will be in the next 5 years.

Generally, I try to stay out of the political battlefield.  It's ridiculous that opinions on policy turn friends into enemies, and I'd rather have a friend.  However, unfortunately (or maybe fortunately), because of the career I chose, I've been forced to pay a little closer attention lately.  I've watched more political news and read more on policy than I've ever cared to before.  And I'm still naive.  The more I hear, see, and read; the more confused and frustrated I become on the healthcare debate and on our political system in general.  Why can't it just be simple?  Doctors are expected to talk to their patients somewhere in a grade school level to avoid confusion, and although, we may not always be good at that, it sure beats a 2000 page document written by lawyers (no offense) that we are expected to be "for" or "against" when we vote or at least have an opinion about healthcare reform (whatever that means).  And forget trying to find something that just explains the main points because those cliff note versions are laced with bias and manipulation.  If you find a good "Dummies Guide to Healthcare Reform" let me know.

What I've come to conclude, is that healthcare is going to be different, but NO ONE knows what it will look like regardless of who wins the election and who is making the decisions.  It's just too big with too many cooks in the kitchen.  From my very, very limited view point here's my opinion on healthcare.

The Good:

• Refocus on the importance of primary care.  I'm not just saying that because I'm a family physician and hopefully will reap some benefit (trust me, we are not hurting for business the way it is), but really, it's only what makes sense if you are trying to navigate an ever complicated healthcare system; and not to mention, if you're a pencil pusher it's proven to control cost.
• Encourage efficiency.  This kind of goes along with stressing primary care and patient care management (and to a point implementing patient-centered medical homes).  There is honestly a lot of waste in healthcare.  For example: people coming in for appointments that could have been handled over the phone (i.e. one day of cold symptoms); repeating lab tests because you didn't know the resident physician ordered it 4 hours ago or you don't have access to it after hours; prescribing unnecessary medications; ordering CTs, X-rays, and the million dollar work-up because the patient requests it or we are afraid of getting sued; or keeping a patient in the hospital extra days over the weekend, because they can't get the study they need until Monday or they have to meet the 3-midnight rule to qualify for Medicare's nursing home coverage.  Trust me, it happens every single day, and to avoid it would definitely be a good thing.

The Bad:

• Loss of patient responsibility.  (This is my beef with the idea of a "Patient-Centered Medical Home.")  It's frustrating as a doctor after explaining the benefits of a medication, of losing weight, of checking blood sugars, or of stopping smoking to have a patient come back without doing anything or maybe not come back at all.  It's frustrating and annoying, but soon it's going to make me angry because my paycheck is going to be dependent on how well my patient does.  I will be penalized if their diabetes is uncontrolled, if they don't lose weight, or if they have to go back to the hospital.  Unfortunately, it may come to a point when doctors "fire" patients (and believe it or not, if we jump threw the hoops, we have that "right") for noncompliance because we literally can't afford to take care of them.  In my opinion, it's the physicians' job to diagnose accurately, educate well, and recommend appropriate treatment; but it's the patient's responsibility to do it.
• Entitlement.  I disagree with many of our leaders that healthcare is a right.  Healthcare is a resource, and a limited resource at that.
• Treating based on evidence while reimbursement is tied to patient satisfaction.  There has been a big push in our reimbursement model to follow "evidence based medicine."  For example, when a study of sinus infections finds that there isn't any statistical benefit to starting antibiotics in the first 10 days, then the standard is that we shouldn't prescribe antibiotics in the first 10 days.  That's fine and probably good to have some standards; but it also comes at a time when we are also being scrutinized on patient satisfaction.  So now, that patient with the sinus infection comes in to clinic on day 5 of their symptoms, pays their $35 copay and finds out I'm not going to give them the antibiotic they were expecting.  Their satisfaction with me probably isn't going to be that high; which also is fine and probably good to not be catering to patient's every whim, but ultimately the choice becomes to sacrifice meeting standards or sacrifice my bonus for patient satisfaction.  It's a no win situation.

The Ugly:

• EMR.  If you're in the business you know that three-letter naughty word.  Electronic Medical Records has been the thorn in our side.  Sure, it may be better in the long run, but it is painful!  It's like knowing that being a hundred pounds lighter is good, but exercising several hours every day really hurts (and takes a lot of time).  This is one of those things I'm hopeful we'll be grateful for in the future, but I'm nervous it may become a trap to keep payers' (i.e the government and insurance companies) eyes and ears in the exam room.  It also makes me nervous because of the genius computer hackers out there, but I'm trying to be anxious about that.

I could go on and on and on.  And like I said, I'm not really into politics.  My opinions aren't because of my political affiliation, they are just that - my opinions.  Surely, I have a lot more to learn, but given how rapidly things are changing and how confusing it all is, I'm spending most of energy resisting the urge to just give up and wait and see what happens.

In a Pickle

My heart is heavy.  Have you ever felt that?  Words can't describe it well, but it is an unmistakable feeling.

Honestly, I feel like I made a mistake.  I big one.  I've been praying for something for years, and this past month I just gave up and decided to take it in my own hands instead of waiting on the Lord.  I mean it has been years - what is He waiting for!  Where's this "hope and a future" I was promised in Jeremiah 29:11? 

Now I regret my decision.  It just doesn't feel right.  And that feeling of loss was almost instant.  I feel like I've lost what God had been building in me through patience.  I feel like I lost whatever else was actually planned for me.

Nothing bad has happened, and maybe nothing will.  Maybe this is what God would have had me do anyway.  After all, the pieces were falling into place.  Slowly.  I just couldn't wait.  I couldn't stand the mystery.  My fear is that in my haste I traded God's plan for mine.  I traded His unexplainable provision for the security of the explainable!  And knowing how Good and Perfect and Powerful my God is, I want what he has planned.  At least that's what I say.  I sing "I will not fear.  His promise is true.  My God will come through.  Always."  But, I didn't live that.  I didn't put my trust or my fear there.  I trusted myself, and I feared my security.  Why are you fearful, you of little faith?  Matthew 8:26.

Now, I'm in a pickle - a really sour one.  Do I go back and gather the feathers I tossed into the wind?  Do I undo my decision?  How do I get back to the place of waiting for something better - waiting on the Lord?  There are other people involved now.  I have to confess and explain, and it won't make sense to them.  Heck, it isn't even something I can explain well to myself.  "I can't do what I promised, because I don't have a good feeling" probably won't go over well.  Or, do I fulfill this decision and my commitment and wait for God on the next one?

Photo Friday - Endless

This is almost too embarrassing to reveal.  Please don't think less of me.  Try not to judge.  But, yes, that is our sink in it's current state, and be thankful this isn't a panoramic shot.  It's awful.  I know.  This is an attempt to be honest and show that I clearly do not have it all together.  There is no good excuse for this disgusting pile, although I do have plenty of bad excuses: 

• no dishwasher
• it's Jason's job because we divided the painful chores - he does dishes, I do laundry (but don't ask about the laundry baskets)
• not enough time
• I'd rather blog; actually, I'd rather do anything!
• they're "soaking"
• the big pans at the bottom take up the whole sink, so it really isn't that bad
• maybe when Mom comes over she'll do some... Thanks, Mom!
• it's just a sign that I'm cooking more and we're eating out less, i.e. it's a good thing

Okay, maybe I'd better stop making the situation, and your opinion of me, worse, and get my elbows deep into some sudsy water.  It will be better tomorrow.  I promise.

Fireworks & Stuck

It never fails.  After a drought of blog topics and scratching the bottom of the barrel to come up with something as soon as I hit the "publish" button, great stories and great ideas flood in.  To avoid posting twice in one day and seeming pathetic - like I have nothing better to do - I "save them for another day" (which means I will forget or they don't seem nearly as brilliant or funny later).  Well, here's to throwing pathetic in the wind and here's post #2 for today thanks to an almost-more-than-I-can-handle-time-on-my-hands rotation at work.

*     *     Fireworks     *     *

On the menu tonight was BBQ Chicken Pizza.  It's not too difficult, but two boys screaming at your feet in a tiny kitchen makes boiling water difficult.  The oven was preheating, and I started cooking the chicken all the while ignoring the chaos beneath my knees and praying that a hot piece of chicken didn't fly out of the pan and onto a forehead below making for another awkward trip for me, a doctor, to the ER.

"Fireworks, Mommy," Owen reported as he looked in the oven.  I figured he saw the red hot coils glowing as the oven gathered its heat, so I just patted his fuzzy head and continued to shield Griffin's from the chicken above.  Owen moved along with his business.  By then it was time to bake the crust, so I opened the oven door.  Once my eyes stopped burning from the gray cloud of smoke that puffed out, I saw what Owen had noticed minutes before.  Fireworks!  The coil on the bottom of the oven was red, hot, glowing, and popping just like a July 4th sparkler.

I slammed the door closed to smother the fire (okay, so it wasn't exactly a fire but humor me), and pushed every button to try to remember how to shut the oven off.  With it off, I peaked through the hazy window (there was no way I was going to open that door... didn't you see Backdraft).  It was still glowing and when I saw a second spark I used my super-human strength to move and unplug it from the wall.  This time, the redness cooled and the oven again when black.  Slowly, I opened the door again; it was quiet and fireworks free.

It's even more funny because this is the 3rd oven we've had in our house since we moved just over a year ago.  Two of them have been gifts, and in all sincerity, we really appreciate the generosity!  But, maybe this is a sign that baking is not my spiritual gift after all.

*     *     Stuck     *     *

I'll keep this one short, because I do have to get up for clinic tomorrow.

Because we have the two cutest boys there ever were, it is difficult to not go in and just stare at them while they sleep.  Therefore, it's our habit to go in and hover over their beds and smile at least once before we go to bed.

Tonight, when I got home from Bible Study we did the routine.  Owen needed to be moved from the floor back to his bed, but he just rolled over, grabbed Oof-Oof, and went back to sleep in the most adorable way possible.  Then we opened Griffin's door.  He is not a peaceful sleeper.  With the sound of the door opening he flips and flops.  Sometimes he'll even sit up, all while totally asleep.  Tonight, he started to flip and flop, but he seemed a little restricted.  As I walked around his crib I saw his chunky thigh poking between the bars.  I expected him to pull it back in as he rolled around, but it didn't budge.  When I went to gently slide it back through, I realized it was really really stuck.  It took both Jason and I a few minutes to figure out how to manipulate his well insulated and now tomato red leg back into the crib where it belonged.

Needless to say, he didn't sleep through that.

Toy Box

We had a garage sale back in April, and honestly, we probably could stand to do another.  I am always finding things in my closet, in the boys' toy box, in the kitchen, in the garage, and in the basement that I completely forgot we have and that I realize we probably don't need.

 

Eventually, we will need to move, and how annoying is it to pack and then unpack a bunch of stuff you don't need?  What's even more crazy is that there were (okay, honestly, still are) some things I've kept because I've said to myself, "Well, I should keep this because when we have a bigger house, I'll need to have something to fill it."  Seriously, what am I thinking?  I guess it hasn't occurred to me that I could either not buy that big of a house, or I could put things in that house that I actually like and would use.

 

Today, my clutter frustration was targeted at the boys' toy box.  Who knew how many toys could accumulate in two and a half years?!

 

I'll admit that we are not good about making the boys pick up their toys that have been tossed throughout the house before they go to bed, and once they are asleep and it is quiet, the closest place to the toy box for all of those trucks and blocks is a pile outside of their closed bedroom doors.  Now that just seems pointless, so usually they just end of staying strewn about the house.

 

The other frustrating thing about the toy box, is that the toys don't even fit.  It takes a small feat of engineering to balance the last ball on the top of the pile.  Also, now that Owen thinks the toy box itself is a toy, it takes just one second for the whole thing to get dumped out and him to be curled up inside.  For some of the toys stuck at the bottom that is the only chance they have to see the light of day.

 

Well, today, I went through the toy box and made the tough decisions to evict a few of its inhabitants.  The broken, the duplicates, the boring, and the choking hazards all into an old moving box.  Somehow the cardboard box that was bigger than the toy box is full.  The toy box still has plenty of fun in it, and I'm confident that the boys won't even notice.  Actually, I'm sure they'll enjoy being able to find some of their favorites a little easier.
 

FYI:  Chuck the Truck and a few other had never been able to fit until now.

Photo Friday: 1 - 2 - 3

My indecisive, scatter-brained self couldn't pick just one image for this photo Friday, so you're going to get three.  Actually, my intention was to have some cute picture of us with giant corndogs and fried girl scout cookies, but another round of viruses kept us home both nights we had hoped to go to the State Fair.  Maybe we'll make it there this weekend.  Besides, I don't think you'll be disappointed with what I came up with instead.

1:  STEPS

"Don't compare one child to the next, they are all different."  Blah, blah, blah.  Owen was walking at 10 months, so, yes, I was disappointed when Griffin still had calloused knees on his first birthday.  Don't be silly, I know he is totally AWESOME, but I'm still a mom who doesn't what my baby to be the "well-some-babies-just-don't ...." baby.  I want him to be the "wow!-that's-exceptional" baby.  The one who checks all the boxes and more on the developmental milestone chart at his well baby checks.  You know, the one who graduates college at age 12, and is president by 18.  That one.  Still no amount of maternal desire could get his little legs to walk.  Well, finally, those two short, pudgy, little things figured out how to balance his big round tummy, and decided it isn't so bad after all.  While he still prefers to crawl or use his push toy, he can definitely walk now.  Yipee.  With gross motor skills improving, next we're working on language.

2: PINK SUCKER

I've never been more glad to give my baseball-loving, all-boy, first-born son a girly pink sucker.  For whatever reason, he decided long ago (like 3 weeks ago) that a pink sucker was exactly what he wanted when he went potty in the potty.  Not just any sucker would do.  It had to be a p-i-n-k one.  Who knows?  He would ask repeatedly for one as we sat and waited, and he would cry devastated when he got up from what felt like hours pant-less on the potty without results. Well... that is him holding the reward for his big achievement yesterday!

3: SIGNED

For those of you who've listened to me waiver and debate, or those of you who've read between the lines of my many self-doubts, today's the day for which you've been waiting.  It's official.  I signed.  It's done.  We're staying.  I'm content.  I even think I'm actually excited.

Yo Yo

Red.  Shiny.  Round.  It's a yo-yo.  It goes up and down, and back and forth.  Unless, that is, it's on my finger, because in that case it just goes down and stays down.

Lately (or maybe longer than that), it seems like there is a string wrapped around my waist and I'm spinning up and down and back and forth.  

Good days.  Bad days.  

Confident.  Insecure.  

Happy.  Grumpy.  

Sure.  Unsure.

Stay.  Go.  

Healthy.  Lazy.

Planned.  Disorganized.

Submissive.  Independent.

Early bird.  Night owl.

Trustworthy.  Gossip.

Strict.  Care-free.

Rent.  Buy.

Clean.  Sloppy.

Gracious.  Selfish.

Polished.  Disheveled.  

Housewife.  Career woman.

It's like a rapid-cycling bipolar patient.  Maybe, ADHD.  Sometimes I drive myself crazy.  It's exhausting.  One of these days it'd be nice to hang out on the "up" for a little while longer.

Rest assured, I know who is ultimately the one holding the string, and thankfully, it's not me!

(And, no, it's not Yo-Yo Ma either, but when I googled "yo yo" his picture came up, and it made me smile.  What a name: Yo-Yo Ma!  Even if he is Chinese, I can't imagine there are a lot of other "Yo Yo's" out there.  Well, except me figuratively speaking.  I guess you could call me Yo-Yo Mae.)

Improv

There is a reason it is called the "art of medicine."  Often, doctors have to use what they know and what they have to solve a problem.  Well, tonight was the "art of parenting."  We had a few problems this evening that required a little creativity.

One of my weaknesses is shoe shopping, so when mom asked if I wanted to go this evening of course I said I would.  Yes, I knew it would be late, and, yes, I knew that Griffin would be exhausted.  Still, I couldn't resist.  Within 10 minutes it was clear that there wasn't going to be any shoe shopping for me.  Instead, I was chasing a crazy maniac around the store as he crawled into empty shelves and ran his sticky fingers across every mirror.  (Why didn't I realize before that shoe-level mirrors would also be Griffin-level mirrors?)  That store was a failure, but we don't give up on shopping that easily.  In the next store we left him strapped in his almost-too-small-for-his-chunky-thighs car seat.  He could do less harm tied down, and maybe even would fall asleep.  Unfortunately, there is a recipe for him to fall asleep and it involves a thumb and a blanket. 

Thankfully, he has a thumb and even a spare, but without the diaper bag I didn't have the blanket.  Crap!  First, we thought we could find one in the store and then "decide we didn't want to buy it after all" as we checked out, but that just seemed wrong.  Then we figured we could let him hold whatever clothes we chose to buy, but that would take some time.  Finally, Mom dug around in her purse and pulled out an inside-out, grey and white athletic sock.  I think it was clean.  I think.  (And don't ask me why she carries a sock in her purse.)  Regardless, sure enough he clutched it right up to his face and popped his thumb in his mouth.  Satisfied with that, we had a good 30 minutes.

*     *     *

Now, if you are easily offended by "personal hygiene" you may want to be done reading here.  But anyone who has been through potty-training a toddler is likely no stranger to creativity and improvisation.  What bribe can you use?  How many stops should you plan for your car trip?  When is it too young to pee behind a tree?  Etc...  Well, tonight, we found ourselves in a little potty-training predicament.

As much as I wish I could say Owen was there, he just isn't ready.  He must have been given stock in Luvs for his birthday, because we are not ready for the transition to big boy pants yet.  Still, we constantly talk about it, ask about it, and reward for it.  So, tonight when I found him squatting, I swept him (and Chuck the Truck) off the floor and ran to the potty stripping off his diaper and praising him all of the way.  Somehow, someway there was something in the potty when we got done.  Yippee!!  To savor this special moment we pulled up his pants and ran to get a prize.

Of course his timing was impeccable because we were actually trying to head out the door for dinner.  (If you're keeping us accountable, we planned on, and budgeted for, eating out tonight.)  With prize in hand we headed out the door still singing his praises.  He walked into Runza carrying his big red sucker with a big red smile on his face.  I reached down to straighten my big boy's pants when it hit me.  We skipped a step after the potty.  A very important step.  No diaper.  No underwear.  No diaper bag.  Nothing!  Size 2T gym shorts were all that covered his little not-so-potty-trained buns.  Gulp.

Should we go home, be even more late, and disappoint our proud little boy anxious for his "hamlinger"?  Should we let him stay commando and just pray that there isn't a puddle on Runza's floor when we're done - "Dear Jesus, thank you for this food, and please..."?  Or, should I concoct some diaper out of public restroom toilet paper and paper towels?  Well, call me MacGyver, because Owen and I headed into the women's restroom as Jason ordered for us.

Using an emergency supply of something "extra absorbent" from my purse **wink, wink** we created the worst diaper there ever was.  Owen walked out bow-legged, grabbing at his pants, and questioning "Diaper?"  Still, we made it through dinner without a puddle and with a pretty funny story to tell his future girlfriends.

Never a dull moment.  These boys are keeping me on my toes.

$97206.78

The goal was to have my student loan debt under $100,000 by the end of the summer.  Ultimately, the big goal is to have it at $0 by the time we turn 30. 

We sat down for our August budget meeting at the beginning of the month just like we do every month.  After we battled out what we wanted to spend our money on in the weeks ahead, we sent out the big checks.  Thank goodness for electronic banking.

The bank account got smaller and smaller as each check cleared.  Today, I called the student loan center and dialed "1" for account balance.  An automated voice replied, "Ninety-seven thousand, two hundred six dollars and seventy-eight cents."  If your math skills have waned over the summer that is, in fact, less than $100,000.  Woohoo!  Goal achieved.

(I have to be honest that we still have $5000 left on Jason's loans, but he qualifies for a grant that should cover that.  We are just waiting for the 6 weeks of paperwork to process.  On a side note, why, in this day an age, does it take 6 weeks to process paperwork?  It has never taken them 6 weeks to process our check when we send that.  Anyway...)

Hopefully, you realize that, probably just like you, we don't just have money laying around.  I may be a doctor, but I'm still a resident who's married to a teacher.  There's no BMW in our garage.  It has taken some sacrifice to get us this far.  We didn't go on the cruise we had planned this summer, and just this month we depleted our "new car" fund.  If you see us riding our bikes to work, now you'll know why.

Still, in 20 months (or less) it will be worth it.  I'll keep you posted.

Tantrum

Maybe this will help me normalize my child's behavior, or maybe it will help me to seek help before I have a 4 year old serial killer on my hands in a few years.  You decide.  Needless to say, it was a rough evening.  No child psychology course or lecture on how to counsel parents could prepare me for this night.

The afternoon actually started out well as I got off early and headed to get the boys from daycare.  However, as we hit our driveway the proverbial "stuff" hit the fan.  (And believe me, after tonight, it is almost worth using the other word for "stuff.")  I couldn't even get him out of the car in one trip.  I had to take Griffin and our bags into the house before returning to the screaming terrible-two screaming and climbing around in the car.  Who knows what that lady and her dog thought as they walked by.

Unfortunately, it didn't end in the driveway.  I dragged him into the front door still screaming, but now he had a sweat soaked head and bright red, emotional cheeks.  His feet started kicking as soon as he spied his little brother in the entry way.  As much as I wish it was, it was not just a coincidence that Griffin caught that sandal in the leg.  Mothers know which "accidents" are actually accidents, and that was no accident.  My anger started to boil to an embarrassing level as Owen screamed in frustration and Griffin screamed in pain.  In the ten steps it took to get Owen to his room the hits and kicks pushed me over the edge.  I wish I could say that I calmly picked him up and placed him gently in his room, but the truth is that he landed on his bed with a thud and the door slammed shut behind me.  Not a proud moment.  At least then I could take a breath and gather myself.

Still, it wasn't the end of this Olympic length temper tantrum.  I removed the wiffle ball bat from his room after it was swung against the back of the door a few times.  I didn't cave when he repeatedly slapped his leg and cried out a dramatic "ouchy!"  I held the door handle closed after he broke the child-proof handle on his side of the door.  (Yes, we used to, and if possible still would, lock him in his room to calm down.)  I listened from the hall as he spat on the floor, and I HATE spitting.

Finally, there was a moment of quiet from his room.  I opened the door.  The ornery look was still on his face, but we tried to head for the time out chair anyway.  (That little red chair in the living room is not a place to throw fits with so many distractions; therefore, our strategy for the all-out two year-old fit is to cool down in his bedroom before going to the chair for time out.)  Well, we didn't even make it out of his room before he lost it.  Again.  I shut him in his room.  Again.  And we repeated that cycle.  Again.  And again.  At least by this point, I was in control, and I knew I could wait him out.

We pulled into the driveway at 4:00.  We finally made it to the time out chair at 5:00.  Then he sat with "mouth quiet, hands quiet, and feet quiet" for two full minutes.  One full hour of tantrum.  I won.

Quarantine

According to the textbooks, summer is supposed to have a low rate of infectious disease.  Our house has bucked that tradition.  Since mid-July it has been one mattered eye after another.

We've had fevers, pink eye, vomiting, coughs, sinus infection, rashes, and diarrhea.  The boys have been home sick from daycare more days than they've actually been there.  Good for our budget.  Bad for our sanity.

It's kind of funny being a doctor and being sick or having sick kids.  People (i.e. Jason) seem to think that I can wave my magic wand and make it all better.  Surely there is a pill to take.  Believe it or not, I treat my kids the same way I would treat yours if they came in, and I even take my own advice once in a while.  We've been pushing fluids and Pedialyte, taking Tylenol for fevers, and none of us have been on antibiotics because it's all viral.  The prescription is for time, and unfortunately, it's taken a lot of it.

Thankfully, I was smart enough to marry a teacher, because he's spent much of his summer break on nursing duty.  Unfortunately, now it's August, and he went back to work this week.  Hopefully the collective Newman immune system has toughened up, and we can start feeling well again.  Even though Owen's eye was mattered again this morning, I'm still hopeful.

Meals for a Month

You know how annoying it is when you go to the grocery store just to get the egg that you need to finish the brownies that are currently sitting unfinished in the bowl on your kitchen counter then you go to check out and standing in the only lane that is open has a lady with a cart piled high - and I mean HIGH?  Groan!  Well, I must confess that once a month I am that annoying lady.

For the last few months, our family has been trying to stay organized, eat out less, and spend less money.  For us, we have found that means planning our meals for the month - yes, the entire 30 days.

And yes, it is difficult.  Some important lessons have been learned.  First, plan on two carts (i.e. two people) or wait for another day to buy the big box of diapers or take two trips out to the car.  Second, don't plan a meal for every single day.  There will inevitably be a day where left overs sound better than cooking or when drive-through is okay or when your mom invites you over for a grand kid fix.  For us that means four or five evening meals per week.  Finally, get to know your grocery store.  It sucks when you have to push around a heavy cart full of frozen stuff all over the store to find raisins.

As difficult as it is, the benefits are still greater (at least for us).  Not only does it actually help us stay organized, eat out less, and save money; there have been some unexpected benefits, too.  For example, I have been trying more new recipes.  Yummy ones, too.  It also has been good at keeping our fridge clean.  By the end of the month there isn't much left so it's easy to throw away whatever is left and make room for the big grocery load that is coming.  Lastly, and more importantly, it makes us talk about, and plan for, what is coming up for the month - who has a birthday, where we are headed for the weekends, which nights I'm on call, etc...  We have avoided a few "I-didn't-know-about-that" fights in our house.

Now, you may be curious.  So I thought I'd let you see what's coming up this month on our menu:

• BBQ chicken, corn on the cob, and cole slaw
• Tomato, basil pasta and french bread (with tomato and basil from our garden!)
• Breakfast pizza with peaches
• Orange pork stir fry
• BLTs with chips and left-over cole slaw
• Fish tacos with mango salsa and chips
• Shrimp spring rolls
• Chicken pesto pasta with sun-dried tomatoes and french bread (Everything, including the chicken, is in a can and it still sounds fancy.)
• Hamburgers with baked beans and sweet potato fries
• Quesadillas with chips & salsa
• Philly cheese steaks with corn and waffle fries
• Spinach & steak salad
• Grilled ham and cheese with sweet potato fries
• Tortellini with french bread
• Vegetable stir fry
• Sloppy joes with waffle fries and green beans
• Ravioli with salad
• PB&J with chips (Yes, peanut butter and jelly!)

And the grand total for this grocery trip (which also included soap, light bulbs, vitamins, etc...) was: $240-ish.  That's it.  I'd post my grocery list and store receipt except that seems like a little too much.  Sure we'll have to go back for milk, diapers, a few produce things later in the month, and I'm sure there's something I forgot; but those trips will be few and far between and short enough to haul in two little boys without much hassle.  So, for now, I apologize to the people behind me in line, but it's working.

Triathlon

Less than 12 hours before the starting buzzer rang out I planned to be on the sideline.  Fighting a sinus infection and feeling generally unprepared I didn't think I could make it.  Instead, Saturday morning I woke up feeling better than I had in days and decided that trying and failing would be better than not trying at all.  And who knew, maybe I wouldn't fail.  Also, as much as I don't like to fail, I dislike giving up even more.  So...

I sniffed my Afrin (even though I recommend against it all of the time, I found this to be an exception), put on my suit, and headed out.  We barely made it in time, but that didn't give me much time to second guess my commitment.  I felt calm until I started to wade into the muddy, mucky waters of Holmes lake.  With just seconds before start time it hit me.  I can't back out.  I'm not on the side line.  Now I either give up or I finish.  Do or die.  Maybe "die" is an exaggeration, but I was, after all, headed into a deep lake.

Throughout the rest of the race do or die; do it; I'm doing it ran through my head.  And guess what... now I can say that I did it.

I did it, but I did not do it alone.  When we checked in, they asked, "Individual or team?"  While I signed up as an individual, it was my "team" that got me here.  In honor of that, here are a few shout-outs.

• First and foremost, my mom.  Literally, I would not have done it without her.  She was essentially the single mom for the boys.  I know how difficult it is to haul them and their stuff around, and she did it with a smile on her face.
• In as much as Mom helped practically, Dad helped keep me emotionally.  Five years ago it was me and him, and he's been in every race I've done since then.  That is, until this year.  Still, he kept encouraging me with emails, texts, etc...  He also let me use his bike, which made that part of the race tolerable.
• Keeping with the family theme, you'd be crazy if you didn't think my husband deserved a shout-out!  It isn't even worth trying to put it all into one paragraph and risk making it seem finite or containable.  If you know him, you already know he's awesome.  But seriously - AWESOME!
• Finally, my boys.  They are probably the best motivators around.  Sure, at ages 2 and 1 they never said "Keep going, Mommy," or "You can do it."  But those smiles at the top of the last bike hill said it all.
• I also want to give a shout-out to the CSG Triathlon women.  Numbers were down this year, so all the women were grouped together instead of dividing us up by age.  We were far outnumbered by the guys.  With a cheer as we got into the water, we knew we were in it together.  Through the rest of the race, it was nothing but sweet encouragement from these ladies.
• Here's some love for those confident racers who despite a lack of a model-type body came out in their suits and spandex.
• And to the Scheel's biker shorts guy.  For the entire second lap of the bike race we went back and forth.  I passed him.  He passed me.  Eventually, he won, and I had to stare at his Scheel's biker shorts for the rest of the final lap.
• My biker friend had legs about twice the length of mine, so there was no way I was keeping up with him.  However, at about the 1 mile mark on the jog a new partner came along.  I could hear her feet crunching on the gravel trail just steps behind me, but she wasn't coming up too fast.  She was just keeping pace.  It kept me going, and pushed me to go a little faster.  Every now and again she would say something encouraging to me or other racers, and I returned the favor when her jog slowed to walk on the big hill.  She smiled and then picked up the pace to follow back in step.
• Lastly, here's a little shout-out to "Element."  Thanks for the shirt.  I left my jogging shirt at the hotel.  Smooth, I know.

As I said before, I think this is my last triathlon for a while.  Therefore, I'm especially glad that I didn't let a little sinus infection or inadequate training stand in the way this year.  Even though finishing is addicting, I'm not convinced that another summer of training is in my near future.  Who knows though, I could be wrong...