Why I’m Up This Late On A School Night

I was up at 5 a.m. this morning. I need to be asleep right now, 11 p.m. But Babygirl, our sassy silly bossy girl, just went to sleep. And yes, I said bossy, because she is, and we love that about her. Per the “ban bossy” campaign, she has executive leadership skills. Superior executive leadership skills. She’s got me and hubby rocking her and singing to her (“Not Do Re Mi, Mommy! Sing Twinkle Twinkle!”) running to fill another bottle for her (Yes, bottle, and yes, I know that is ridiculous for a two year old to still have a bottle) and finding exactly the right kitty cat stuffed animal for her (“Not the Baby Kitty Mommy, I want the Daddy Kitty, right now!”). We are completely, acutely and miserably aware that we are not in control of her bedtime anymore.

Why that is and what we’re going to do about it are subjects for another post. I am too tired, and actually my attention is caught up in the Boston Marathon Finish Line. Many of you know, I’m from Boston. I write about my life as a mom in a suburb just south of the city and as a doctor at a downtown Boston hospital. The bombings last year, the manhunt, the lockdown… I was in no way directly involved, and yet, we all were. Everyone knew someone who was pushed or pulled into the events of those breathless days.

The past few weeks, there have been news and magazine articles profiling survivors and heroes; notices of memorials and fundraisers; talk and informational emails detailing the extensive preparations for Marathon Monday itself. In the past days, there has been a nervous communal energy over just about everyone. Casual neighborhood chatter drifts to “Where were you last year during the bombings, during the manhunt?”… Hubby and I recalled Lockdown Friday, that he was out of town and I was stuck at the hospital. He was in a panic about the safety of the kids, and called my mom and demanded that they all shelter inside… We remembered, together, what that was like, in a grim recounting, saying, Can you believe that happened?

Today was the actual anniversary of the bombings. The local radio and news stations covered all the events all day long. The drive home from work this afternoon was awful. It’s pouring rain. I don’t know if it’s due to the influx of people or the events or just bad weather. I got home late; we started the bedtime routine late; the kids were up late… and here I am writing. It feels like there’s a permission to deviate from the usual schedule, from regular bedtimes. It feels like a special time; not celebratory, but rather crisis-like. Anything goes, just get through.

So it is that I’m awake after 11 p.m., writing. Checking out the news reports of the memorials, the speeches, the famous folks lending support; as well as the crazy guy who rushed the Boylston finish line with two oversized backpacks, some kind of scare stunt. With the city this tense and wired up, not a good idea. But the events will go on, the race will go on. We’ll all go on.

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90 Minutes…and Pizza

This week was very intense. Clinically intense. Alot of sick folks, challenging cases and conversations. I stayed at work later than usual a few days this week; I’ve been checking emails and labs on patients after hours. Not letting work go. Not good.

So, last night, Friday night, after I stumbled in the door in the evening, and Hubby and I caught up over our dinner of spaghetti and sauce from a jar that we literally threw in a pot and made in five minutes and ate just as quickly, with one eye on the T.V. since we knew we had to be done before this episode of Curious George ended, because the kids were exhausted and were were late on the bedtime routine and they were going to start whining for stuff or beating each other any second… Anyway in that little space of time, with my mouth full of pasta and sauce on my chin, I told Hubby that I need some real downtime. Some little chunk of me-time. Time to just to go do whatever I feel like. Because if I don’t, I’m going to lose my mind.

He was absolutely supportive, and agreed to take the kids for whatever amount of time this morning, Saturday morning, so I could do whatever.

We brainstormed about what I could do. I was thinking maybe of getting a manicure. But that involves making an appointment. Too stressful. I thought I might like to go shopping. I need work pants. But that involves crowds and spending money.

Then, I thought of exercise.

Last weekend, I never made time to exercise. Somehow between the things we had planned (social events both nights!) and the things that weren’t planned (Hubby spilled seltzer on his laptop and spent Saturday at the Apple Genius Bar praying the rosary!)  I never got a workout.

Exercise is sacred to me. It’s my stress-reliever, where I sweat and meditate and work things out in my head. I’ve never exercised as little as I do recently, and I need those two workouts a week. So, missing a workout is not good.

So I decided to go for a run. No gym, just out in the fresh, cool and windy great outdoors. One of the nicer days we’ve had yet, but still quite cool.

The plan was, I would run for as long as I wanted and then shower, and then we would take the kids to the Children’s Museum. In my head, I alotted myself a 30 minute run.

But. I ran to this pond near our house. Then, I walked some, watching the ducks.  Then, as I had my phone with me, I thought I would multi-task. There are close friends I haven’t talked with in a long time. I dialed one and we chatted as I walked. Then, I dialed another and we got into a deep conversation. I walked and walked and chatted and then got home and sat outside still chatting and chatting… It felt great to catch up, to meander and jabber and not have to peel kids off my legs or break up a fight in the middle of a real conversation.

90 minutes. I’d been out for 90 minutes! I realized that I had gone way over the time I had set in my head. I realized that Hubby was still solo with the kids and probably ready to kill me.  I got off the phone with my friend, feeling guilty for taking all that time.

But Hubby was fine, the kids were fine, and all was well.

We ended up not going to the museum as it was a little too late in the day… We went to get pizza instead. It was Babyboy’s idea. He loves pizza and had just built a Lego pizza parlor. (Seriously, he called it his pizza parlor, the roof is these flat triangle Lego pieces that kind of look like pizza slices.) The kids were really very good in the restaurant.  Babygirl then had a major meltdown in the parking lot, and Hubby and I handled it with aplomb.  When we got home, the day had brightened, and we all stayed outside for awhile, Hubby and I picking up sticks and raking leaves while the kids played.

Tonight I feel a little sore from running, and a little physically worn out, but in a good way. Can’t beat it: 90 minutes of free time with no agenda, several miles covered out in the fresh air, long chatty phone conversations connecting with old friends… AND pizza.

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Latest post from MiM: Jack of All Trades, Master of None

Check out my last post at Mothers in Medicine, a reflection on a typical clinic session for us internists:

 

http://www.mothersinmedicine.com/2014/03/jack-of-all-trades-master-of-none.html

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When Women Cut Other Women Down

Back in January, we had a rough stretch with back-to-back ear infections in both kids. They had alot of pain; there was vomiting and general misery; there were multiple awakenings all night long for a few nights.

One morning during this stretch, I got up, frazzled and exhausted, and got myself to work. I did my job and saw my patients. After clinic, I ran into some colleagues in a hallway. They are all moms, as well as great doctors, and good people.

You look so, so tired, one commented, with genuine concern. Everything OK at home?

I welcome this type of question, because there is good intent there. This is someone who knows me and knows I’m exhausted and is reaching out to me, and it’s OK.

I started to explain, wanting to share about how both kids have had ear infections, and how there was so much pain this time for both of them, which was really so hard to witness, and made me sick, just nauseated with helplessness, and then the vomiting, and misery, nighttime awakenings, and exhaustion…

But I didn’t get far, because as soon as I replied:

Yes, I am exhausted, both kids have had ear infections-

One colleague cut in and snapped:

Just ear infections?  You have a kid in daycare and they get ear infections, that’s just what happens, right? My baby’s on antibiotics for one right now. That’s just par for the course. She said this with a little jeering laugh, and then she walked away.

I was stung and stunned, and reacted the best way I know how. I completely ignored her, pretended I didn’t hear that, and just went on with my tale of woe. My other colleagues listened with great empathy, sharing how they had been there, too. I remember some humorous conclusion to this impromptu hallway support group, and we all laughed.

Of course, I couldn’t go on pretending I didn’t hear that. I am still reflecting on that passing verbal slap.  But, I’ve come to a surprising conclusion.

It goes back to another episode. Babygirl was six weeks old, and I was on maternity leave. Babyboy was eighteen months old. Hubby was mostly home, and we were struggling mightily. Babygirl was completely nocturnal, and as soon as she would fall asleep for a stretch, Babyboy would wake up, ready to play. We were kind of losing our minds.

Then Hubby got sick. I came home from my mother’s one evening, me with both kids in tow, looking forward to Hubby’s help with the bedtime routine. Hubby was lying on the couch, wildly feverish, rigoring even, and holding his lower belly. I called my parents; mom stayed with the kids, while dad drove Hubby and I to the emergency room. Turned out hubby had a diverticular abscess, and he was admitted to the surgical service for several days.

Early on in that crisis, I emailed all my friends asking for help. I asked if anyone could spare some time to stay with the kids so I could visit Hubby, see what was going on with him at the hospital. At that time, it wasn’t clear if he would need surgery or not. With the two babies under two, Babygirl still not sleeping well through the night and breastfeeding all the time, Babyboy being a rambunctious toddler into all sorts of trouble all day, and me scared for Hubby, I was totally overwhelmed to the point of being nonfunctional. I was a wreck. A disheveled, delirious wreck. Still bleeding from delivery (seriously) and dripping breast milk everywhere. I am not kidding, I was pretty bad. Plus, we had not arranged any childcare (beyond my mom) yet, as we had expected that Hubby and I would be home for the time being.  And, quite frankly, at that time in our lives, we were pretty tight on cash.

Many friends answered my cry for help. But one called and chewed me out.

I answered the phone, and she started in on me right away:

I saw your email. You know there are babysitting services you can use? There’s a million of them. Let’s see: Sitter City, Parents in a Pinch, Care.com. Your hospital even has a drop-off emergency daycare, you could use them, too. Your friends are all working professionals with families of their own. What do you want- someone to let you take a little nap? We can all use a nap.

I remember holding the phone, I believe babygirl was on my breast. My mouth was dry, I was so stung and stunned. This was another doctor and mother speaking to me this way.

I reacted the best way I know how- I pretended I didn’t hear a word she said. Someone’s on their way over in a little bit, I said. I need to go now.

It was one of my rescuers that week who helped me to better understand what is really happening when women cut each other down like this. She, also a mother of two kids close in age, listened to the story, and explained, without really knowing the person involved at all:

This is someone who doesn’t easily accept help for themselves. This is someone who perceives a need for help as an unforgivable weakness.  And they’re projecting that unreasonable expectation, which is really insecurity, onto you. I feel sorry for her, because she’s likely missing many opportunities to connect with others. She’s probably pretty lonely.

I remember those words, and then I think back to the more recent episode in the hallway of my office. I remember the colleague delivering her judgment, then walking away, while the rest of us went on with my story.  We then shared all of our stories, laughing. We connected with each other, even if only for a few minutes on a mini coffee break. That is meaningful connection.

I realize now that, women who cut down other women, also cut themselves off from other women. And, I do feel sorry for them. There is some true beauty in the baring of our souls, of asking for help, and then receiving it. And vice-versa. We need to support each other through the inevitable tough times.

I’ve seen both women many times since these episodes, and really haven’t thought much about the episodes themselves; rather, I do try to be kind, and remember, this is probably someone who is really tough on themselves.

(Thank you, A.W., for your wonderful wisdom that January 2012 day.)

 

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The Obesity Epidemic… Of Our Pets

So I took our two beastie boys to the vet last week. Yes, I wrote about it last post, but it was mostly to reflect on the vet tech who thought Leonardo Da Vinci was incarnated as a Teenage Mutant Ninja Turtle.

This is also probably because I’m in a bit of denial about our major cat issue. We have a cat who officially, no exaggeration, weighs in at 22 pounds. Now, Raffy’s a very large cat- I’ve posted photos below. And, the vet says he really only needs to lose 4 pounds. Of course, 4 pounds on a cat is kind of a lot of Tender Vittles.

Leo’s a big cat too, weighing in at a much slimmer 16 pounds. He needs to lose 2 pounds. Cake, right?

Otherwise, they’re fine. Great teeth, fur, digestion, temperament…

The vet laid out a diet plan. 1/4 cup of dry food twice daily, 1/2 small can of wet food once daily. We’re supposed to put the food down, let them eat, then take up the bowls. To date, we’ve filled their bowls with, say, a cup or so of dry food and left the bowls down all day and all night. So they don’t bug us in the middle of the night to eat.

So, we’re putting down considerably less food at a time, but definitely leaving the bowls down overnight. It’s hard enough to get good sleep with the two kids. I also have them on an exercise plan. We play laser light every night, after the kids go down. Why cats are so fanatically attracted to the laser light is a mystery, but they really are.

If they went out, they’d get alot more exercise.. But they’d also likely have been flattened by the heavy traffic on our street. So, indoor cats they are, lazy, happy, and well-fed.

 

Our toddler and our cats gaze out the birds on the birdfeeder.

Our toddler and our cats gaze out the birds on the birdfeeder.

image

Both cats curled up on Babyboy’s bed (along with many stuffed animals) as they often do.

 

 

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A Little Bit Of This, A Little Bit Of That… A Little Bit Of Culture

We’ve all been healthy for a whole week, and without major nighttime disruptions. At least, none involving anyone’s vomit, nor requiring full bed changes at 3 a.m.

There are so many potential topics of interest… I could write about one of the several extremely complex and vexing inpatient cases I’ve had, appropriately camouflaged to protect people’s identities… But it’s so hard to keep details secret and still deliver the punch.

I could write about our ongoing complex and vexing child behavioral issues… But I’m just too tired.

So I’ll keep it very brief with a little anecdote about culture.

Babyboy and I took our two fat, happy felines to the vet. See, we’re considering adding a family dog to the household, and the rescue organization we plan to apply through requires a veterinary reference. Meaning, we need a veterinarian to vouch that we’re good animal parents.

Now, we hadn’t brought our beasts in for a physical in about four years. They don’t go outside, except when Leo dashes out the door and makes a break for the birdfeeders, only to be caught about thirty seconds later. They have no health issues, apart from being overweight. So, we haven’t bothered to take them in.

I know, I know. BAD ANIMAL PARENTS.

So, I made an appointment. It was my day off. I planned to get them in the cages in the car, pick up Babyboy at school, and take everyone to the vet, like for an outing.

Leo was cake to get in his cat cage. I opened the little door and he walked right in. Raffy had to be stuffed in backwards.

Babyboy was very excited at the prospect of a visit to the animal doctor. He’s fairly obsessed with doctors, not because of me, but because he worships his pediatrician, Dr. Ben. He actually pretends to be Dr. Ben, by wearing a stethoscope around his neck in classic fashion, plus my pager or anything resembling a pager tucked into his pants waistband, and carrying a notepad that he scribbles little o’s and lines and says he’s “writing a ‘scription”.

So we all walked into the vet office, a tad early. The very young vet technician bubbled over Babyboy. “What are your cat’s names?” she asked.

Babyboy readily answered, pointing at each one. “DIS one is RAFFY,  and  DIS one is LEO.”

“Oh!” She exclaimed. “Is Raffy named after Raffy, the children’s singer?”

Now, I’ve kind of heard of that guy, but Babyboy hadn’t, and he just seemed kind of confused.

“No,” I stepped in, “They’re named actually for Leonardo da Vinci and Raphael…We got them before the kids were born,” extra info offered by way of explanation for the artsy names.

“Oh!” She exclaimed again. “Of course! Of course they would be named after the Teenage Mutant Ninja Turtles. That’s so cute.”

I bit my lip here. There was not a trace of irony on her part. I do not think the girl knew that the Turtles were actually named for Italian Renaissance painters.

But when I related the story to Hubby later, and we talked about it, it was not in a making-fun way. It was more in a how-do-we-prevent-that kind of way. How do we raise children who hear the name Leonardo Da Vinci and know he was not just a cartoon turtle? Who know some basics about art and music and history…

We talked about playing more classical music at home. And (again) about turning off the T.V. Reading more books. Taking them to museums. Et cetera.

But it’s just SO HARD right now. Going to the supermarket is a risky adventure. What if Babyboy spits on someone, again? What if Babygirl throws one of her new and spectacular tantrums, again? What if she vomits during it, again? What if either/ both has a blowout poopie, again? What if they pummel each other and scream and yell and cry and, oh, hell, I’ll just stay home and order from Peapod.

Forget the museum. Not right now.

But how do we raise cultured children?

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A Big Ol’ Sickfest

Rough week. Puke, puke, more puke, sleep disruptions, illnesses, stress, fatigue… How can anyone function well as a clinician with all of this?

It all started last Sunday night, when we decided to re-sleep-train Babygirl. Over the past month, we’ve been back to getting up at 3 am with her for an overnight cuddle-and-bottle fairly regularly. Yes, we did Cry-It-Out successfully last year, and it worked. But every time there’s an illness or travel, we fall back into late-night awakenings, and need to re-train her.

So Sunday, we decided to let her Cry-It-Out. This is getting harder and harder as she is more verbal. She KNOWS what to say. She breaks our hearts. Her plaintive cries tug at the soul. Or crack us up. Either way, there is no sleeping when she is on a roll:

“Mommeee? Daddeee? I’m saaad. I need a hug!…….Mommy, Daddy! I have a booger! I need a tissue!….. Mommy! Daddy! I can’t find Binkie!….. Mommy? Daddy! Where are you? I need you! I need a hug!….. MOMMEE? DADDEE? I NEED YOU! RIGHT NOW! ………………..  Mommy? Daddy? Mommy? Daddy? Where are you? WHERE ARE YOU? I NEED YOU NOW! MOOOMMMMEEEEE!!!!”

So Sunday she was going through her roll, and we were determined to stay in bed.

Until she got herself so worked up that she started gagging and puking. We knew, that was that. No choice but to get up and clean it all up. So we did, stripped the bed and changed it and put the vomit-covered bedclothes and stuffed animals in the laundry; stripped her and washed her and cuddled her back to sleep. An hour later, we were back in bed.

Then, an hour after that, Babyboy woke up, calling out that he had a tummyache. He’s always been a good sleeper, and doesn’t wake up overnight very often. When he does, he’ll just get up and come to our room, so I met him halfway, and put him in bed with us in the hopes that he would just fall back asleep. About five minutes after he joined us, he sat up and cried, “I need a bucket!” I kind of patted him on the back. “You’re okay sweetie, go to sleep.”

Then, he started gagging and puking. In our bed. Babyboy was vomiting, right there. I jumped up and grabbed him and let him finish on the floor. We did another clean-up job, got a bucket, comforted the poor little guy,  and tried to, again, go back to sleep. But Babyboy was intermittently vomiting all night long. No diarrhea, just vomiting. We held the bucket for him, cleaned his face each time. He seemed to have the dreaded GI bug that’s been going around.

It was so very hard to get up in the morning, but we did, as Babygirl woke up bright and shiny, cheerful and chipper. Babyboy tried to drink some gingerale and vomited again. I managed to get dressed and to work. Slogged through the day.

Babyboy recovered well with plenty of TLC and gingerale. Monday night was fairly uneventful except that at 3 a.m. it was the cat gagging and puking on our bed. Both of our overweight fluffball felines sleep with us; and while both kitties are guilty of leaving hairball gifts around the house, they don’t usually puke on the bed in the middle of the night. Hubby and I woke from dead sleep, jumped up swearing and yelling, scared the bejeesus out of the cat, and then we had to do another late-night cleanup job.

Tuesday I somehow got up and slogged through work. At this point my clinical decisionmaking was suffering, I am sure.

Tuesday night Hubby and I went to bed, joking about how we better not have to get up and clean up anyone’s puke. Ha ha.

Then around 3 a.m., I woke up in a sweat, totally nauseated. I got up to go to the bathroom and realized if I stood up, I was going to pass out. I laid there wondering what to do, deep breathing, willing the waves of nausea away.

I was probably being dramatic about it, and so Hubby woke up. I told him I felt really sick and asked for a glass of cool water and a bucket. He said he was happy to, and went down to the kitchen. I continued deep breathing.

Then, BANG! CRASH!

I listened and heard nothing else. I rolled out of bed and gingerly wobbled my way to the top of the stairs, calling, “Hon? Hon?”

Nothing. Then, Babygirl started stirring. Darn. I had woken her with my calls. “Mommeee? I want milky,” she called.

“Uhhh, Okay honey, I’ll be right back.” I knew I couldn’t carry her downstairs and I wasn’t sure I could make it downstairs myself, but I crept down and into the kitchen, kind of scared. Hubby was on the floor, just starting to come to, it seemed, holding his head and making mewly grunty noises. “Ohh. Myy. God. I think I passed out,” he said. “I don’t feel good at all,” he added.

I fussed over him a bit, but by then Babygirl was going mental upstairs, and Hubby looked at me and was like, “I can’t deal with her puke tonight, can you go to her?” So I somehow made her up a bottle and rocked her back to sleep. I felt totally awful, shaky, sweaty, chilly, sick.

And so Hubby and I spent the rest of the night in feverish headachey nauseating misery. All I could think was about my clinic that morning, starting at 7:30 a.m. How will I let patients know I’m not going to be there? What about that really sick complicated patient that needs to be seen? What about my lady who is being operated on? I fretted and stressed and finally got up, dragged my sorry sweaty ass to my laptop and logged into work. I sent emails to all the patients on my schedule that I wasn’t going to be in and they would get a call to reschedule. I emailed the admin staff to make the calls. And I emailed a colleague to beg her to see my sick lady, and I wrote up what I thought at the time was a pretty complete “signout” of all that patient’s issues.

Then I collapsed into bed again. My mom rescued us in the morning, came to the house and took the kids to school. Hubby and I couldn’t move until late afternoon. We really spent the whole day just knocked flat.

When I did log back into work, I was very thankful that my colleague had indeed seen the sick patient; she had taken ownership of the case and reached out to all the specialists involved and arranged followup. But it also came to light that I had missed some very key information when I sent her my signout, and that had created a problem for her. I felt so, so bad. As hard as I tried, my 4 a.m. clinical emailing was deficient. Probably not surprising, considering I was like, presyncopal. But, still, not good. Sigh.

Hubby and I got much better by evening, my mom brought the kids home, and we all went to bed hoping for an uneventful night.

But, no. Babyboy woke up all night long thrashing in pain. He said it was his stomach, but it wasn’t the GI thing. He would drop to sleep, then thrash around, moaning and holding his abdomen, crying out, “Mommy, it hurts. It hurts.” This is not like him at all, and Hubby and I were worried. But, Babyboy didn’t seem feverish at all, and his belly was soft, and he didn’t seem bothered by my mashing on it.

So, we agreed that I would go to work, since I had already missed a day, and Hubby would take Babyboy to the pediatrician, and my mom would again rescue us by taking Babygirl.

I slogged to work. I was exhausted, and also stressed. What was wrong with Babyboy? All morning Hubby sent me text updates. I was distracted. Not at my best. By 11 a.m. we had an answer: Strep. The pedi had spent alot of time poking and prodding and trying to figure out why Babyboy was so miserable. The rapid strep test was positive. He said strep can often present with belly pain in kids.

Okay. I was late at work trying to get through my notes, all the mail and results from the days I had missed, plus calling people back… all with half a brain. Then I went and saw my sick inpatient, who was on surgical service but needed some medicine attention. I spent alot of time with her. I was so late coming home.

But home, Friday evening. Babyboy was better with a few doses of Amoxicillin and Ibuprofen. Babygirl seemed fine. Hubby and I were totally spent. We went to bed, again hoping for an uneventful night….

But no. Now it was Babygirl up intermittently thrashing around in pain, “It hurts! It hurts!” and so now both kids are on Amoxicillin.

Tonight? I am really, really hoping for a quiet night…… 

 

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