A Captive Audience

After his epic afternoon nap, with only 9 ounces of formula in him for the day, I succumbed to the electronic babysitter. I put Nathan in my lap, held him in thrall with the "Wonder Pets" and syringed Pedialyte down his throat. For the 15 minutes, or so, that TV is able to engage him, it actually worked. Then, of course, he wanted to get down and crawl around and be a baby.
His last 2 diapers have been only wet and we are encouraged.

Otitis Media + Gastroenteritis = Misery

Nate's had ear infections and a sinus infections, but Dave and I agree that until now, he's never really been sick.

I think he's finally getting better.

It started on Thursday with a fever of 102F at day care. Fever came 2 days into a course of antibiotics for a yicky sinus infection that Dave and I finally got tired of wiping off our own clothes and hands. Back to the pediatrician for shiny new antibiotics for his not-so-shiny new ear infection (his fifth in 6 months and the final clue that myrigotomy tubes are in his future). He started to throw up Thursday night. We first attributed it to choking/gagging on the copious snot in his head, but the diarrhea started Friday morning, blowing away that fantasy. He had a fever of 102F or higher from Thursday afternoon to Saturday evening. Tylenol. Motrin. Tylenol. Motrin. Tylenol. Stopped the Motrin 'cause he wasn't peeing and Dr. Mom wanted to save his kidneys.

I'd be ashamed to write down how little he drank, how little he kept in, how few times he peed, and how much came out of every other opening between Friday and Sunday.

On Friday night we were woken by a pitiful mewling. My sweet baby was laying in a little pool of vomit, clothes wet with diarrhea, and nearly smoking with fever. The thermometer confirmed eminent spontaneous combustion - 104.6F. When I did the conversion to Celsius the next morning (40.3C) I realized I had never taken care of someone with a higher fever. I sat in the rocker tired, sweaty, with a naked, stinky, nearly limp baby on my chest and murmured, like a mantra, the "fever talk" I had given to so many other parents in the Emergency Room. It is less reassuring when the child is your own. The fever dropped to 102F and he dropped into restful sleep right before I dropped into panic.

He kept drinking just enough to stay above my IV fluid threshold but never enough that I felt 100% comfortable.

Last night he seemed a lot better. He had no fever. He drank a whole 6 ounces at once and ate his first solid food in days. He motored around the living room smiling and babbling like normal. Still, his ongoing poops made him a day care pariah.

Today, instead of being at the hospital with a floor full of sick oncology patients, I am at home with a borderline febrile, gagging, pooping, fluid refusing, whining baby with the saddest butt in creation. He cries when he poops and he cries when I clean his butt. He cries 'cause he's thirsty and cries when he swallows things into his roiling stomach. He cries when we wipe his wet Rudolph nose. Being at the hospital would be easier.

Still, I do think he's getting better. His last temperature was normal. His last poop stayed in his diaper. he ate and retained a graham cracker and some yogurt.

The drinking and the peeing?

I still don't want to talk about it.

I WILL persevere and he WILL take some liquid. - One teaspoon at a time.

End of an Era

I took a ticker off the bottom of my page tonight. Likely no one will notice but it makes me a little sad. Before I deleted it, it said "Proud Mommy, Happy Baby - I've been breastfeeding for 9 months, 4 weeks and 2 days". That wasn't completely true. I just deleted it tonight, but Nathan hasn't nursed in about 2 weeks. His teeth were the deciding factor. He stopped biting almost as quick as he started, but those little top teeth just kept causing inadvertent damage. Plus, the supply was way, way down.
He finally started taking formula without much of a fight, but I stubbornly kept pumping my 4-6 ounces per day until his nine month birthday. Then, with a huge sigh of relief, I left the pump behind. I loved feeding my baby but I never loved the pump. I don't believe anyone who says they do.
I gave up the pump and kept the bedtime feedings until he seemed to want volume more than comfort and then, even bedtime became bottle time.
Now, he's learning how to drink out of a cup and he's stopped pulling my shirt down when he's tired or thirsty. Big steps forward in my little man's life. I honestly miss my tiny baby curled up on my chest but I my active explorer doesn't give me much time to look backwards. Gotta keep looking one step ahead of him to keep him out of harms way.

Thanksgiving #2

On the Saturday after Thanksgiving I finally had the day off and got a chance to cook the traditional holiday feast. Dave's parents were there as were our friend Emily and Dave and their baby Samone, but somehow with the cooking, the baby carrying, the Bellini drinking, and the eating 'til our buttons popped I only managed to get pictures of Dave with his turkey.


Before it went on the grill.


And after. (Try a grilled turkey sometime. It was delicious, and I didn't have to do anything with it!)

Thanksgiving #1

Nathan crawls, yes, honest to goodness crawling, around friends Ann and Dave's house on Thanksgiving afternoon.

He enjoys a pre-dinner carrot snack while hanging out in the kitchen (where else do people congregate?)

After dinner things got a little weird when Cecilia tried to pants Nathan and we all laughed and took pictures

And we ended the evening with a little snuggle.

We ate Ann's first turkey (way better than my first was), gorged ourselves on delicious stuffing (Nate's favorite), and topped it all off with a tasty pie. Considering I worked a lot of the day it turned out to be quite a lovely holiday.

Sleeping Beauty

Fiber Deficiency?

"How are you socks supposed to keep your toes warm if they are in your mouth?"

I said that a lot yesterday.

I never used to put socks on him. Didn't see the point in warm muggy weather. But in the last 2 weeks it has been cold, and whenever his clothes don't have feet, I've been pulling on some fuzzy socks.

He's been pulling them off.

He almost seems enraged by them, grunting and yelling until they are off his feet. He pulls them off with his teeth, then he wads them up and puts them in his mouth.

Yum.

This leaves me with a dilemma. Naked toes or wet socks?

Doesn't matter what I decide because as soon as I turn my back, naked toes prevail.

Bravery

Cold weather has come early to Pittsburgh, as, I suppose, it is to the rest of the country.

I was driving home from work, cold rain on the windshield, thinking about whether I would make it to day care on time and petulantly contemplating the failure of my car heater to adequately warm my toes in the completely non-sensible shoes I was wearing.

That's when I saw her.

A determined mom pushing a stroller full of groceries with one hand, holding an umbrella with the other, and carrying on her chest a blanket covered baby carrier with a little pair of pink fleece feet swinging as she walked.

I was struck by how much strength it took this woman to decide to go out in the weather, shield her child from the elements, in the pursuit of getting food for her family. I could feel the agony of needing things and yet worrying with every step about keeping her fragile baby safe. I wondered how she would be able to get everything on and off the bus. I wondered if she had anyone to help her out at home.

There are things in my life that are hard, but my day to day activities are so blessed. I go to the market in a car that affords me the luxury of wearing strappy shoes in freezing rain. My baby is always warm and dry unless I screw up. My husband carries the groceries.

His Four Front Teeth

To the tune of "Come out and play with me" (click for original words and music)

Oh, Mr. Toothbrush, come out and play with me
and brush my little teeth
and make them so shiny.

We brush the front sides,
we brush the back sides too,
and we'll have shiny teeth, forevermore
One, two, three, four.

Over the last four months I have taken care of two children, one 7 years old and one 3 years old, who had to have almost all of their teeth removed prior to starting chemotherapy because the horrifying contents of their mouth posed too large an infection risk to an immunocompromised patient.
Neither family felt too strongly about oral hygiene.
One father sort of shrugged and said he figured she'd get new teeth anyway.
The other father told me he just felt it wasn't worth the fight. He did seem embarrassed that a pair of college educated medical professionals had let their child get into this state.
I also watched an infant with hemophilia spend time in the ICU with bleeding complications after having all his rotten baby teeth removed.

So, I wrote Nathan a toothbrushing song.
Twice a day, in the morning and at bedtime, I brush his teeth.
Nathan likes the song and doesn't mind the brushing at all.
Dave had to learn the words because he garnered some furrowed brow confusion from Nathan when he tried to make up his own version.

It's just a little fingerbrush, but it's setting a precedent and forming a routine. When he's one and two and beyond this will just be something he's always done. I don't pretend that we will never argue about it, that he'll never refuse or pout or moan, or that we'll never a skip a night 'cause we're late or a morning 'cause we're late for school. Still, I will not have a baby/toddler/child with rotten teeth or a mouthful of silver when a little parental attention can go so far to prevent it.

His teeth, though troublemakers, are so darn cute now, and I am looking forward to playing tooth fairy and tucking those tiny pearly whites away in a keepsake box. I have to polish my future jewels and keep them blemish free.

Gimme, gimme

Nathan is talking to us.
Sort of.

The last two days have been the best of the last 2 weeks because I have been able to leave the hospital at 5pm, pick my boy up from day care and spend the evening with him. Last night I watched him swim with his dad and fed him a huge and varied dinner. (Who doesn't like roasted butternut squash with cinnamon sugar? And Cheerios?!?) Tonight we played and sang and snuggled.

And he talked to me.

At first I didn't realize he was doing it. I was carrying him around getting his dinner ready and he was waving his right hand. Fist closed. Hand going up and down and up and down and up and down. Pediatrician-mommy was starting to think he was having a partial seizure. I fed him some dinner and cleaned him up and palyed on the floor with him. The whole time he was intermittently waving that little fist.
Fist wave. Food in mouth.
Fist wave. Crawl into Mommy's lap.
Fist wave. Rubber duck into mouth.
Fist wave. Belly scoot over to music cube.

And I still didn't get it.
But finally, I wised up.
Dave and I were sitting on the floor eating dinner and to distract Nathan from our oh-so-attractive bowls of pasta I brought out a bag of Cheerios.
Wave, wave, wave went the fist as he lunged at the bag with mouth open.

Light bulb above Mommy's head.
Ah Hah! He's trying to tell me something!

The path through Mommyhood is paved with good intentions, but I never have managed to buy that book on baby sign. I have made an earnest effort to teach him "more" and "all done", the signs I know, but the fist wave was new to me. It was also news to me that the ladies at day care try to teach them baby sign, a fact that Dave confirmed.

We had to look it up, but we found out it's the sign for "milk". To Nathan, however, it seems to be the sign for "give me that please". Or just "gimme".

I am thrilled that my boy is talking to me.

He's so smart!!!

His Two Front Teeth

Nathan has four front teeth. He cut his two bottom teeth simultaneously at 5 months old. At 7 months the bottom two popped through on the same day. He took teething with the same equanimity he takes everything else. He didn't fuss or sleep badly. He chewed like mad on his rubber ducks. And fingers. But that was about it.

****

I was looking at Nathan's little teeth and it struck me that they seem awfully small. He will have these teeth until he is in elementary school. They have to chew up all the food he needs to nourish his little growing body and brain. They have to shine in his charming little smile for years. No doubt they'll be tools in fiendish 4 year old projects. He already uses them to balance himself when he is pulling up on his cruising toy. They've been used to scrape onion and crack Cheerios. All that work for such tiny little teeth in my big boy's jaw.

****

He has the "Lamb space" - a largish gap between the top two teeth, passed from my Dad through me and into my little Beaver-Bunny.

****

The top two teeth may prove to be the end of breastfeeding. It is physiologically impossible for a nursing baby to bite with bottom teeth while actually eating. The tongue forms a nice little barrier. When the top ones come in, however, all bets are off. He bit me once, experimentally, when he had only bottom teeth. He didn't do it again until he had two top teeth so he could trap my tender tissue between two razor-sharp, steel-hard, crushing-cutting implements. There were two problems. One was the bleeding lesion. The other, more egregious, problem was that my loud, fierce, soul-rending "NO" caused my little darling to start, stare at me for an instant, and then giggle. After all, the "make-a-funny-loud-noise" game is one he loves, being an adrenaline junkie. It seems I will have to find another biting deterrent, but it's hard to think rationally when I am suppressing the urge to toss him away and whimper. So far, I am perservering, but I am a little nervous every time I bare flesh for the newly minted vampire I am raising.

****

Looks like he could be getting molars for Christmas.

I've been busy this last month, but so has Nathan.

He has:

- become an expert commando crawler, scooting around at shocking speed

- cut his two front top teeth, simultaneously, allowing Mommy to see an eruption hematoma in real life

- learned how to put balls on his ramp

- pulled himself to stand on something other than parental fingers

- proved that he will eat anything: peas and wild rice (blech-gag), banana, watermelon, grapes, sweet potatoes, pumpkin, apple, carrots, toast, avocado, waffles, tomato, and even raw onion

- started swim lessons

Vacation is Hard Work

The most recent month of my fellowship was hard. It entailed the subject matter I am least interested in, a hard to deal with patient population, and as the consult service I was basically at the beck and call of the whole hospital. I didn't see nearly enough of my son or my husband. I was tired and cranky.

Thankfully, that's behind me and I'm now on vacation.
A long weekend in Baltimore. Catching up on the laundry. Reading my articles for work. Playing cards with Dave. Cooking and freezing food for future on call meals.

Staying home all day with Nathan.
What does that entail?
Up around 7am. Morning squirming and wrestling. Lots of smiling. Morning lotion application and struggling to wedge a lotioned-up baby into clothes while he takes evasive action and tries to roll off the changing table. Breakfast with food flung all over. Cleaning up the boy. Playing on the floor (balls rolling down a ramp, lights flashing, monkeys swinging). Sudden outbreak of clinging and whining that signals the need for a morning nap. Nursing. Rocking. Listening to bed time singing over the monitor. A couple hours of sleep while I try to sqeeze in all the other above listed activities. Smiling boy waking up from a nap. Lunch with food flinging. More playing and wrestling. Singing lots of silly songs. Afternoon nap - with lead in same as the first. Cooing boy waking up from second nap. Dinner for all (Nathan eats, blows bubbles in food, throws bits of finger food on the floor, starts to cry and buck before Mommy and Daddy have finished eating and then coos happily when freed from the high chair to play with Mommy's chair/plate/hair/necklace while Mommy tries to finish a lukewarm meal). Maybe a bath. More playtime with Nathan trying to adhere himself as close to Mommy as possible and protesting with every inch of separation. Nighttime application of lotion and steroid cream and shoehorning a squirming mewling boy into pajamas. Brushing four sharp little teeth. Singing. Nursing. Rocking. Asleep for the night.
Until 2am and the next time he wants to eat.

I have enjoyed every second of it, but being on vacation is tiring.

House of Horror

Halloween came early to our house this year.
This weekend Dave and I decided that Nathan needed a new toy. He loves balls. He loves lights. He loves music.
We saw the gumball machine and thought it was the obvious choice.
Maybe Nathan finds something threatening it its perky grin, its bubblegum music, or its festive lights.
Whatever the case, he's frankly terrified by it. The first time we set it up and triggered its ball-dropping, music-playing lever he burst into tears and hid his face in my chest. He's happy enough to peek at it in a quiescent state, but as soon as it is activated he scrambles the other way.
I initially found this vaguely entertaining, but it seems to be emblematic of a new stage in our little man's life. The Fraidy Cat stage.
Other evidence? He preferred to stare at our friend Dave from the safety of my arms at breakfast. Being held by someone else? Not so much. Two nights ago he chortled happily when the big green ball rolled in his direction. this afternoon, he cried.
I am so glad that Nathan feels safe in my lap, in my arms. I am actually relieved that as much time as I have spent away from the house in the last few weeks he still sees me as a source of safety and comfort. But I am stunned that my curious little explorer would prefer to be held and to watch. Two days ago he wanted nothing more than to hold my fingers so he could "walk" around the living room. Tonight he would not walk any further than my lap. With a lunge he threw his arms around my neck and settled happily in.
We are trying to desensitize him. I hold him safely and Dave plays with the toy. We are trying to show him that it is safe. And it drops balls, for goodness sake. In Nathan's world balls are tantamount to paradise. He should make friends with the ball giver.
So far, however, it seems we've turned Nathan's home into a house of horror.

It's Been A While

Fellowship is a lot of work and I've spent my out of work moments with my boys at home so I apologize for my absence from cyberspace.

I love my job. I like the people I work with. I like the patients. I like the science I am learning and the clinical medicine I am practicing. I am developing my own ways of talking to parents and patients and have received feedback that these ways are not completely dysfunctional.
I'm not terribly fond of benign hematology but I do derive a lot of satisfaction from taking care of cancer patients and their families. I am asked a lot why I chose to do this, and there is a fairly straightforward answer.
Hope.
In my experience working all over a children's hospital, there is no better environment than the pediatric cancer ward. Everyone thinks their patient population is special, but these are truly awesome kids, families, nurses, doctors, child life specialists, and social workers. I have not been anywhere else in the hospital where there is less whining, more resilience, more support and people caring for each other. Kids are kids. They aren't held down easily. They make friends with the people who take care of them week in and week out and everyone develops special relationships with their patients and their families. It's common to see a small band of children, all in crazy spunky hats roaming the halls of the clinic looking for a favorite nurse or doctor to take a picture, give a gift, or play a clever prank.
The outcomes for a lot of pediatric cancers are pretty good and we make a lot of these kids better and let them get on with their lives. Even those with the poorest outlook are treated like survivors by parents and staff. No one ever stops hoping that they get the best they possibly can.
Still, there are hard moments. Telling any parent their child has cancer. Telling a new high school grad that he'll be taking a detour on the way to his adult life. Watching a colleague suffer through the loss of a patient they have known and cared for for years. Looking at a sick little boy and just wanting to go home and hug your own baby knowing there are hours yet to go. Fearing that the karma of telling someone they will likely loose their own child will come back to bite you in the ass.
I often feel bad that I am fascinated looking at pathology slides, that I use the word cool to describe an imaging finding that will change a whole family's life forever. Still, I am here because the science fascinates me. And because the children move me.
This weekend was harder than any yet. In a sink or swim moment I sat with a family and told them that their little guy has one of our hardest to treat tumors and has a coin flip chance of being alive in two years. I did it with out the benefit of an attending physician present. Since then I have had the conversation swirling in my head trying to determine what I could have done better. I have told people before that their baby (aged 3-19y) has cancer but those babies were very likely to live to graduate from college. It's an easier conversation. This one was not.
I hated it but certainly not as much as they did.
I am humbled that the mother exclaimed "Look, E***, it's your friend Dr. Jen!" when I came back the next day.

I feel inexpressibly fortunate to have a healthy, smiling little boy.

Rue-ing the Goat

Thoughts On Exclusive Breastfeeding From A Dr. Mom

There was never any question that I was going to try to breastfeed my baby. As a pediatrician I wanted all the health benefits. As a sufferer of the economic crisis I wanted the cost savings. As a Mommy I wanted to hold my little warm sweet smelling baby and know I was doing something special. Plus formula smells gross, stains clothes, and makes baby poo look and smell like poo.

When he was just born and failing to gain weight, I was obsessed with not having to give him formula, and I never did. That was despite telling numerous patients and friends that formula was not the end of the world, said nothing about their parenting, and all the accurate blah, blah that makes no impact on an estrogen crazed new mom.

With the benefit of slightly more rational hindsight, I know it would not have been the end of any one's world if I had given some formula. That did not, however, keep me from going insane and spending an entire night sobbing when I started fellowship, my supply plummeted, and I thought I was going to have to give him formula before my arbitrary and self-imposed goal of 6 months.

There I was, a newly minted fellow, busy, nervous, trying to balance home and family with education and the needs of families whose kids have cancer, for goodness sake. So I didn't have enough milk, we went through my frozen supply, and shortly after the short one turned five months old, we decided we had to offer him some formula. My ego and sensitive sense of smell aside, I really just wanted him to be nourished. My son with the highly refined palate who finds sunglasses, carpet, and restaurant tables to be de-licious, basically refused to take formula. He'd be clearly hungry but would prefer to chew on the nipple, spit out the formula and grin. With persistence on the part of the feeder he progressed to disgusted facial expression and finally pitiful mewling. One of his daycare providers said she just felt bad because she wouldn't want to be forced to eat something she doesn't like.

After a month of struggling and never getting more than 2 or 3 ounces into him, we have finally decided that this is OK. He is growing along his own curve. While he is a little guy, he is not genetically programmed to be big and he is gaining weight, height, and head size. Plus he's smart and happy, and gives no indication that he'd like to eat more than he does. He eats what I pump plus some cereal and a few veggies. He supplements this with a hearty daily intake of plastic turtle chew toy, crib rail, and human fingers (hopefully fairly clean). At daycare they still lament that he does not eat enough but his pediatrician and his doctor mom agree that as long as he is doing well, it is not worth the struggle. We have thus decided that if he is hungry and there is no leche de madre we will offer formula and if he is not hungry enough ti take it, so be it.

And so, little man, you have won. Your will is stronger than that of the grow-ups in your life. Mommy will continue take the fenugreek/goat's rue concoction that tastes far worse than formula (and yes, I have sampled) but that also does increase supply. She will also continue to feed you at 1am even though most babies can sleep through the night by now because mommy and your pediatrician agree you need the nutrition and mommy needs the help keeping up the supply. We will watch your weight and decide what to do if you start to fall below your curve.

You will eat only what pleases you. (And though it has now pleased you for 2 days in a row to take a small bottle for formula, we will not discuss that out loud in case it is a fluke.)

The trouble I am having is this. Since we have been having this struggle, I have heard countless stories from other moms whose exclusively breastfed babies refused formula when the milk dried up. What, if anything, do we do about this? Again, as a pediatrician and a mom I know that breastfeeding as much as you can is best for mom and baby. I also know that giving formula early on can decrease mom's supply leading to more formula and less breastfeeding. But what about this? What about the inevitable fact that a working mom's supply will drop and this woman who has been martyring herself with pump and herb will come head to head with the inflexible will of a five or six month old? What about the fact that early baby foods provide basically no protein and the only source for that is milk or formula? Are we doing the wrong thing for our babies by trying to do the right thing?

Input is welcome.

Roses and Thorns . . . It's been a while

Thorns:

- There is water leaking from the bathroom into the dining room. We think it's the toilet so we are going to the basement to relieve ourselves. This is the second time since we moved in here that going to the bathroom in the middle of the night has required shoes. This time it also requires disabling the burglar alarm.

- We continue to catch mice in the trap in the living room - I think we're up to 5. Plus 2 or 3 in the kitchen and 2 in the laundry room. All this after the wildlife expert/exterminator assured me, in a friendly but vaguely patronizing way that mice don't hang out in houses during the summer. They like it better outside. I guess we are breeding domesticated mice.

-The driver's side window on my car is stuck open again - 4th time since I got the car, 2nd time in 6 months. I don't think I make extraordinary demands of the window - just that it roll up and down roughly twice a day.

- This is week two after the Great Dishwasher Explosion of 2009 and we are still without a dishwasher. Why are white kitchen appliances special order??????

- Due to the day care plague that nearly killed Dave and I, we missed floppy hat night at PNC Park - a game the Pirates actually won, and a mighty cool hat.

Roses:

- We are contributing to the education of American youth by putting our plumber's son through college.

- We are no longer finding mouse poop on the kitchen counters in the morning.

- My car's mutinous actions have not resulted in any more near death experiences, just inconvenience

- I have managed to hand wash our newly sharpened knives without slicing off any appendages.

- We have recovered from the day care plague and I finally have my voice back (after a week of squeaking and being referred to as Dr. Froggy by the hospital page operators).

- Nathan is 6 months old and per his pediatrician doing all the growing and learning he is supposed to for his age. We think he is doing a teensy bit more - learning, that is, not growing.

Heard at My House Today

"Please don't smear the carrots with the hand Mommy just washed"

"Oh my goodness, you have carrots in your eyelashes!"

"Your hair smells like sweet potatoes . . . but you ate those yesterday"

Mommy: "Yum, yum, yum, yum, yum"
Nathan: slurping, sucking, smiling

All in all, starting solids is a lot of fun.

Not Just Another Proud Parent

I'm pretty sure my 6 month old isn't actually supposed to do this. He's not supposed to cruise either but he's starting to do a little of that, too.
Yep, he's motor advanced.
He rolled over at 3 months and I actually looked askance. After all, the pediatrician in me knew that early rolling could be a red flag for neurological problems. But he seemed to be otherwise normal, so I just shrugged and smiled. He sat at 5 months. Not super early but surely not late. And now this. According to "What to expect . . .", by the end of this month, he "should be able to bear some weight on legs when held upright". Some weight. By the end of this month.
He can't read yet, so he doesn't know he's exceeding expectations, but he looks mighty proud of himself when he manages to creep from monkey to frog on his rain-forest-play-house-of-wonder. We're proud of him too.
Neither I nor Dave is sure of the source of his skills, but we have a few theories.
1. He has superpowers.
2. The freeze thaw process selects zygotes that have superior physical strength.
3. (And probably most likely) We have always challenged him. He had all the tummy time he could handle early on. We plop him on the floor with a toy just out of reach and let him work for it. We put him in the Bumbo chair when he was 2 months old and the Jumperoo when he was 3 months. We have airplaned him and held him sitting and standing as much as he seemed to be enjoying it. We always smile and laugh and clap and encourage and let him know we're proud of him, he's perfect, and it's all for fun.

He is a source of awe and joy to me every day. Every thing he learns to do, from smiling, to cooing, to raking the proverbial raisin, looks like a miracle. He seems so big and grown up and then, at the end of the day, he curls up on my chest and sings himself to sleep, and I am reminded that no matter how soon he learns to walk away, he'll always be my baby.

A Matter of Respect

I have speculated before how this year would be different for me. As a medical student and resident I was always very subservient. The hierarchy in medicine is very well defined and while it is more flexible in pediatrics than other branches of medicine, it is still definitely observed. I was always painfully aware of where I fit in the hierarchy which was basically at the bottom.
I had a year off, however, and worked as an attending, definitely closer to the top of the hierarchy. Accentuating the position difference was the fact that I worked at an adult hospital where the nurses call you doctor, instead of using your first name like they do at a children's hospital. I really felt like an in-charge professional. In addition, I had Nathan and my priorities underwent a major frame shift. Because of those things I knew I would be less content to be subservient and be a much better advocate for myself and my time. Until now, I really had not been tested.
Yesterday, however, I did something I would never previously have done. I walked out on a conference.
I was at a conference that was supposed to start at 4pm. Now, no one really expected it to start at 4pm because the attending has a reputation for perpetual lateness. His patent quote? "The name means good time, not on time." It's supposed to end at 5:15 but it basically ends an hour and a half after it starts, no matter when he deigns to arrive.
I am the opposite. I am almost pathologically on time. I know I used to make my mom crazy because to me, on time was actually late. I firmly believed that the only way to ensure being on time was to be early, and got a little hysterical if my chauffeur did not support me in this. Today, I still feel that way, preferring to be the first to arrive rather than risk being late. I find being late extremely disrespectful to the people who are waiting for you. Its sends a message that the person being late believes their time to be more valuable. I used to put up with it, but I no longer believe my time is less important than anyone else's. I have a lot of things to do and a lot of people depending on me, and I put in an effort to be on time. I deserve nothing less.
Yesterday, it was 5pm and the 4pm conference had not yet started, and I just snapped. I knew that he expected to walk in when he was ready and find us all sitting there expectantly waiting to be taught. I also knew he would offer no apology and that it had never crossed his mind to call and tell us he would be late. So I left.
A little finger of guilt nagged me as I walked out the door, but it was gone by the time I got to day care to pick up my boy; someone whose smile is undeniably more important to me than the good opinion of someone who doesn't respect me at all.

I love my husband.
I love my son.
I love my family.
I love my friends.
I love my job.
I am loved.
I love my home, but on a day like this, how could I not?

Thoughts on the Beginning

"Every new beginning comes from some other beginning's end." - with apologies for not knowing the source.

I have made it through the first three week rotation of my fellowship. I spent those three weeks on the inpatient oncology service taking care of patients at all stages of cancer diagnosis and treatment. I guess it sounds like it could be sad, but to me it is a place of incredible hope. A place where we treat every child as if they have a chance of growing up and going to college, and really, most of them do. For me, it flew by. The hours were long. It was challenging. I learned a lot. I met wonderful families and acquired my first few patients. I had an excellent teacher. I missed out on several hours of sleep. I turned out to be very good at what I do. I also loved just about every second of it.

The only downside for me was missing my family. I don't think much about it at work because I am busy and time flies, but when I get home I ache for how much I am missing. While I have been working, he has learned to sit on his own, sprouted a tooth, and gained excellent hand eye coordination. One of the best parts of my day is snuggling him to sleep at night. He reaches up and grabs my cheek and then snuggles his face into my chest and we usually doze off together - sometimes me first.

This next 3 week period is supposed to be a little easier and maybe I'll get to spend more time with my family. I'll miss it though. It really helped clarify what I want my grown-up job to look like.

Aren't baby butts cute?!?!?!?!?!?!?!?

Vanquished

When I thought about staying in Pittsburgh to do my fellowship, there was only one thing that truly scared me.
It was a person. A person with a reputation for an abrasive tongue, a short temper, and a long memory. This reputation was not only amongst the pother residents at my hospital, but also was made evident when I traveled across the country interviewing at other programs.
Outside of reputation, though, I had reason to be afraid. This person had attempted to get me kicked out of residency when I was an intern. I never was entirely clear on what I had done wrong, but it was clearly VERY wrong. Though I still don't know if they remember me and the incident, I know what it is like to be on the receiving end of that anger.
Still, I am no longer a scared to death intern quaking in my shoes when someone looked at me cross-eyed. I was the one in charge for a year. At this point, no one's expectations for me are higher than my own and I strive to live up to them. With all this in mind, I was very philosophical about coming back to fellowship and having to work with someone who probably didn't like me. Calm. Zen. In control.
And then I found out that on my second week as a fellow I was on an inpatient service with this person and my heart sunk. Bravery/bravado is one thing, but I really wanted to get off to a good start. I wanted to enjoy this bit at the beginning and suddenly I expected only to endure and try not to cry.

I am pleased to report that it went MUCH better than my expectations. We actually had a good time. There was teaching and learning and a little laughter. I was only snapped at once and while it did make my head spin, it was quickly followed by a sincere apology and a statement of appreciation for how hard I was working.

I actually am looking forward to working with this person again. I believe they have a lot to teach and realize I am motivated to learn.

All in all, I would say the first dragon has been vanquished.

Guess What?!?!?!?!

I'm only doing a rose this week.

5 months 1 week

My Bigger Boy

I have devoted a couple months now to talking about the life of my little boy. I now want to talk for a minute about my bigger boy.

I met Noah when he was five months old. I was babysitter/friend/nanny/playmate/partner-in-crime for a few years before I moved to Pittsburgh for med school. I always talked about him so much that when Dave and I met, Dave thought "my boy Noah" might actually be my son. When I met him, he's didn't even sit up on his own. Now he's graduated from fifth grade and had a poem published in the Harvard Educational Review. I'm bursting with pride.

Of course, I've always known he was brilliant. He met just about every milestone early, and taught me all sorts of valuable mommy lessons along the way.

1) Just because it's in the book, doesn't mean it will work for your child. - I used exactly once the trick of saying "good-bye" and walking away when he was refusing to leave the place where we were playing. He was supposed to run after me, but three year old Noah looked up from his sandcastle, smiled happily, and waved. "Bye Nana! Tell mommy boy stay beach by self!" And so I dragged him kicking and screaming from the beach instead.

2) Nothing is better than being hugged around the knees and being told "You're my best."

3) It's important to keep perspective when a child tells you they want to throw you in the trash. Chances are you have earned their wrath by preserving one of their vital physical features. Besides, they'll be your best friend again soon.

4) Think of popcorn as a vegetable and it makes a fine dinner. Subtext: pick your battles.

5) No one can plan a felony like a pre-schooler.
Nana (Jen): How can we get one of these cool swing sets?
Noah: I can make some money.
Nana: (thinking employment) How are you going to do that?
Noah: (exasperated eye roll) Um, on the the printer.

It really is an accident that "Nathan Isaac" has the same syllables and cadence as "Noah Hawkins", but it's been perfect because I know where my son's name fits seamlessly into all the baby songs I used to sing. It's also been complicated because "Noah Hawkins" or "baby Noah" ARE the words to those songs in my head. Putting in Nathan's name has been a little like learning a spoof when you can sing the original in your sleep. When it is late at night and I am tired, "Hush little Noah" is just as likely to come out as "Hush little Nathan". The first time it happened I felt bad all around. Bad for Nathan who was getting someone else's second hand song. Bad for Noah who's song was being passed on. Bad for me who was so far away from my big boy who I miss every day. Now, I just smile. After all, I couldn't love either of these boys more than I do.

Fellowship - Day One

For anyone who's wondering what I am thinking this morning as I get ready for my first day back at a "real" job.

1) I'm tired because my sweet boy stayed up late and woke up early (almost as if he was trying to prove the folly of my ways)

2) I'm happy because I got up a wee bit earlier than I had too and so 15 more sweet minutes of sleep are mine in mornings to come.

3) I am excited because I get to go back and see all the people in the Heme/Onc department whom I like so much and genuinely have missed the last year. (I am going armed with baby pictures, of course.)

4) I am nervous about having to find my way around the new hospital. Despite the fact that Children's is home, I have no idea where I am going this morning.

5) I miss my visitors, the Wheelers from California, who selfishly went home yesterday and left me with reality again :) but not before a whirlwind tour of toddler friendly Pittsburgh!

6) I don't want to send Nathan to day care all day. I am more than a little nervous about how he will react to the change, especially since he was "all-mommy-all-the-time" last night.

7) I am now pleasantly full off Egg Beaters, Veggie sausage, and blueberries, so it is time to pour my coffee and go!

California Boy

Carnegie Science Center Story #2
Nathan was fascinated by the trains, but he smiled the broadest at natural disaster.
There is, at the Science Center, an earthquake simulator as part of the "Natural Forces" exhibit. It's a little cafe booth that you sit down in and choose your own earthquake (San Francisco, Chile, Australia). It then shakes and rumbles and rocks. The lighting fixture rocks back and forth, but nothing falls on you. Dave and I got in with Nathan and fired up a 7.8 quake. Though choruses of "Never, never, never shake your baby" were running through my mind, Nathan was smiling ear to ear and enjoying the ride.
I guess even though he was conceived and born in the Keystone State, there is Californian in him, nonetheless.

It's in the genes, I guess

Back in 2005, the day I graduated from medical school, my entourage and I took a trip to the Carnegie Science Center. It was a fun day of wind tunnels, simulated earthquakes, and meteor rubbing. Noah was the only kid in the group, but we all frolicked. The most fun, however, was definitely had by my dad in the miniature train exhibit. It's a pretty cool exhibit, running 5 trains and a tram car with scale replicas of many famous and historical sights from Western PA. The lighting changes over the course of an hour or so to go from sunrise to sunset to sunrise again.
Some months later, when my dad visited again, one of the first things he asked for was to visit the trains again. We weren't able to because it was closed for renovation and I am sure that was the low point of his trip.
Today we took Nathan to the Science Center and learned that besides hand shape and broad shoulders he has something else in common with his Buff Grandpa. He LOVED the trains. From the moment we walked into the room, he was mesmerized. He tracked every train as it came and went with an enthusiastic flapping of legs and arms. It was genuine fun to watch him study the little lit up buildings and the glowing trains. Though this time I was the only one making "choo choo" noises, he kept up a constant babble of "bwah, bwah, bwah". He looked from track to mommy, to daddy with an incredulous, "are you seeing this?" look on his face.

My dad is coming to visit in a few weeks and I look forward to watching them enjoy the trains together.

Fathers, Part II: The Wonderful

Last year I said I was blessed to know a wonderful father. Mine. Fun. Always present. My biggest fan. Enthusiastic. Always good to me. I have been lucky to have him around helping me figure out how to be who I want to be. I'm glad he gets to be around to know Nathan and Nathan gets to know him. The distance between us makes me sad, but hopefully it is a temporary one. In the meantime, we'll spend a lot of time at airports. Just like this. This year I know another wonderful father. Dave. I have explained before how I feel like he shoulders more than his share of the parenting load. He makes our son laugh like no one else can. I am lucky to share parenthood with someone who can make up a song about poopy diapers. I knew he would be a great father. I am glad to say I am right. Nathan adores him, and as you can see, the feeling is mutual.

Fathers, Part I: The Bad

I have mentioned before that we like to watch a few TV shows around here. One of them is "Family Guy". This is the perfect storm of comedy. A family whose characters never age. An intelligent talking dog who is understood by one and all. A "Pinky and the Brain"-esque baby with a homicidal streak whom no one understands except the dog. Spoofs, musical numbers, complete non sequiturs, and just enough of a plot to hold it all together. Sure, I've never understood the chicken fights, but the clip with the head of the maid's union is the funniest 10 seconds of TV ever.

I do have a problem with the show, however, and that is Peter. If he is an example of American fathers we should not be surprised that so many families are breaking down. He is an undereducated bumbling oaf who is always doing something he shouldn't. His children don't respect him and even his dog talks disparagingly to and about him. His interactions with his kids walk a line between oblivious disconnection and slightly taunting mockery. He often makes sexist comments but nevertheless, his affection for his wife is actually as believable as cartoon love can be, and he does have the good sense to recognize that she's the best thing he's got. That said, he is in a constant state of trying to trick her or hide something from her.

Now, here's the thing. Peter is funny exactly because he is stupid, racist, and misogynistic, but his comments, quoted to another in the context of a real life relationship, would be belittling and unkind. I don't pretend to think that anyone looks at the Griffins and thinks "That's the role model for my family!" but I do think that people quote him because they think he's funny. I also think that argument made against children watching violent programming holds true here. If we can become immune to violence, then why not disrespect and ridicule? Do we really want to fill our heads with people acting in a way we would not want ourselves or our loved ones to act? Even if we are mature enough to know it's just TV, how much does it affect our subconscious?

I don't know the full answers to all these questions but it is food for thought. I know that I think the show is funny. I know that I'm going to keep watching. I know that I don't want Nathan to watch. Lastly, I know that I am glad that neither my Dad nor Nathan's act like the elder Griffin.

Roses & Thorns

Too busy creating memories to do this last week, so here's a sampling from the last few weeks:

Roses:
1. Nathan successfully cured of sinus infection
2. Nathan put himself on an every 4 hour eating schedule (HUGE improvement from every 2-3 over night)
3. Fellowship, and the time of finally doing what I want to do, is drawing nearer. Only 4 shifts left at my current job.
4. Work going pretty well for Dave.
5. My car has a pretty new paint job.
6. Survived an epic thunderstorm/tornado warning with no damage save a little water in the basement
7. Good friend Chuck came to visit and proved to be endlessly entertaining to our boy.
8. Replaced old & busted rusted grill with new hotness grill
9. Our wonderful boy wakes up with a smile on his face and hoots softly until someone comes to play with him
10. First baby cereal experience went VERY well - and we had TWO photographers covering the event

Thorns:
1. Two days after antibiotic completion, Nathan developed new day care cold
2. Daddy and Mommy seem to be fighting this one off as well.
3. I'm having quite a few sleepless nights at work leaving me sleep deprived even though Nate's schedule is getting friendlier.
4. Fellowship, and the time of the 80 hour work week, is drawing nearer
5. Nathan is spending more time at daycare

As usual, our blessings outweigh the difficulties. We have jobs, a home, enough to eat, a healthy baby, and wonderful family and friends. Our thorns are small.

Excrement and Emesis

Warning! Potty humor and bodily functions abound.

On our last day in Hilton Head, I finally admitted that Nathan was sick. When we left home he was "recovering" from his last bout of day care gripe. He was in good spirits and the fever was gone but he was still plagued with festive colored snot, especially in the morning. A week later, that part still hadn't gotten better. As a pediatrician, I staunchly held out until that 10-12 day mark that indicates that no, your child is probably not going to get better without pharmacologic intervention. As a mommy, I watched my sweet boy get a little crankier, a little more easily disturbed with each passing day. His eyes got puffy and his nose got even grosser. So, I finally called his doctor and did what I really, really did not want to do. I procured some amoxicillin.

He hates the stuff. With the ear infection it was a twice daily mewling, spitting, pink-bubblegum-smearing battle to get about half a dose into him with equal amount of time spent cleaning it off everywhere else afterwards. I had never before conceived of a teaspoon as an impossibly large quantity of liquid but it is a nearly insurmountable obstacle. Needless to say, I breathed a sigh of relief when his ear recheck was normal and we stopped the meds about 3 days early. This time around I waited until there was a flashing neon "SICK" sign over his head before I gave in and admitted he may need an antibiotic.

Anyway, there we were, on vacation, with a syringe full of sticky amox and a boy who has a very sensitive gag reflex. Here's the bullet point version of events.

- Nathan took about 3/4 of the dose.
- Distressed look
- Medicine returned with interest - about 4 ounces of warm, freshly consumed leche de madre.
- Mommy, who hates vomit more than any other bodily secretion, flees to jacuzzi tub, shedding warm, wet, stinky clothing
- Daddy and Nathan follow in appreciation of chance to sit in tub
- Tub filling slowly
- Mommy swishing
- Nathan poops in tub
- Tub emptied
- Tub cleaned
- Tub filling, slowly.
- Praying for sufficient hot water
- Nathan, sitting in mommy's lap in tub, poops - again
- Hysteric laughter
- Tub emptied
- Mommy showers
- Tub cleaned
- Tub filled, slowly, lukewarm.
- Finally, tub enjoyed by all.

Final score - Meds ingested: 0, Squeaky Clean Elsters: 3, Rookie Parent Mistakes: at least a dozen

Fortified by an afternoon nap, Dave and I were able to laugh at the whole comedy of errors. It wasn't until later, however, that Nate did as well . . . (click to see a laughing baby)

Unexpected

I had a few surprising mommy moments in the last 24 hours.

1) After immunizations yesterday, Nathan basically just wanted to lay on my chest and snuggle. He napped with a hand resting, for reassurance, on his food source. I rubbed his head, inhaled his sweet baby smell, and thought that it was kind of nice to have a cuddly day. These days he just wants to sit and stand and bounce. Not that I was glad he wasn't feeling well. But seriously, without trivializing the pain of parents with seriously ill children, am I the first mom whose ever looked at her snuggly slightly sick baby and thought it was kind of nice?

2) During a HUGE thunder and lightning storm last night, the one that brought tornado sightings to Pittsburgh, we lost power. No big emergency. That's happened before and we have a ton of candles and a gas stove and water heater. Never before, however, has Dave gone out driving through flooded and storm darkened streets to transport 100 ounces of frozen breast milk to a safe and still powered locale. (Thanks Dave & Emily!!)

3) Too lazy to light a candle, I changed a diaper last night in the pitch black of Nathan's room. I did it by feel, and did it quite well. At least it didn't leak.

Recovery

I've been asked to confirm the fate of my car.
It required an organ transplant (a new alternator) and goes tomorrow to have some car cancer removed (rust repair and repainting) but otherwise seems to be quite happy to keep going. I'm counting on it for another 3 years. After fellowship I can get the big bad attending car. (If we don't spend all our money on first class tickets to Australia, that is.)

My Beetle & Me

I love my car. If you know me well, you know that. It was a college graduation gift that I nearly worshipped from the start. Cute, perky, purple, a lot of get up and go. I thought it defined me pretty well.
At the start, we were a good team for the long drives between OC and Valencia. It flipped easily through its 6CD changer while we sat in traffic on the 405, memorizing lyrics to the Black Crows and Celine Dion alike. I washed it every weekend, lovingly polishing every surface. When I was spending nearly every waking moment with my first little boy, it provided a backseat safe haven and with flashing headlights, gave entertainment and smiles.
Later, it happily chugged across the country with Dave and I, listening sagely as we laughed, shared our deepest thoughts, and built the foundation for the relationship we have now. At a roadside stop in Utah, I'm sure it felt proud to watch me leap around like a mountain goat while Dave trailed nervously behind. It saw me through med school, mostly hunkered down in a freezing underground garage while I shunned it for the convenience of bus travel, but bearing no grudge, it would purr to life to carry me to the grocery store, the mall, or out with friends. It stoically sat out under sun and stars while I worked my 30 hour residency shifts, waking, rain or shine, to take me back to the cozy repose of my bed. And in the last few months it has had the opportunity to provide conveyance to a new generation. Nathan looks happily out the window as the scenery rolls by.
A few days ago, it tried to kill me. There I was, on my way home from working all night when all the dashboard indicator lights started to flash, the radio turned off, and the car simply stopped. Of course it did this at the only point along my route at which there was no shoulder to coast on to. The point just around a curve where two lanes merge and commuters go 60mph in an area meant for 35, trying to pass each other and gain that extra 10 feet before the red light just ahead.
There was a lot of squealing of brakes and tires, and honking, as if I was somehow unaware that I was sitting in traffic, terrified, with my hazards on, praying one of those aggressive yahoos didn't kill me. If only they alerted me to this fact, I would just move my car out of the way. Mmmm hmmmm. One little problem . . .
Over the 2 days it took to diagnose the problem, Dave and I discussed with mounting anxiety the likely catastrophic nature of the issue and expense to fix, and even discussed a new car. I was torn. After all, who doesn't want something new and shiny? It had tried to kill me and the sin of doing such a thing with Nate in the car would have been unforgivable. But, it would have truly been the ending of an era for me. I used to say my grandkids would use the frame as a playground after the car finally gave up, and a little bit of that early awe and love still resonates in my heart.
It's a 2-door. An impractical family car. But it's still cute and perky and fun and young and I still want those things to define me even if "me" has changed.

Southern Comfort

They do things different 'round these parts.

Even Nathan knows they're funny, He was cracking up (pun definitely intended) at a mini mart listening to Dave say pork cracklin's over and over. Funny words those, and he doesn't even know what they mean. Also desperately entertaining? Piggly Wiggly. I mean, come on. That's funny even to a grown up. Try it. Wait for a quiet moment and just say "Piggly Wiggly". It'll make you giggly.

Go ahead. Groan. I'll wait.

The one that got me, though, was an anecdote I heard over lunch at Mrs. Wilkes' Dining Room, a family style comfort food restaurant. A 5 million pound behemoth of a man was trying to convince Dave and I to give Nathan a bite of potato or a bean. Anything. Couldn't we see that the poor boy was wasting away. Shoveling in fried chicken and collard greens, he brushed off my objections that Nathan was a little young to try the mac and cheese. "My wife's daddy gave her little sister a french fry on the way home from the hospital after she was born." Pregnant pause (there go those puns again) while Dave and I stared, dripping sweet tea from gaping jaws. "Just to gnaw on, ya know."

Um, no. We didn't know.

I guess Nate was on his side though, because he managed, with Spidey-speed, to get a handful of blueberry cobbler. Sadly for him, Mommy reflexes caught up and intervened before he made it to his mouth.

Little Fish

First time in the pool and he loved it. Whole bein' wet thing. Drove him nuts.

Yesterday, May 26, was my four year wedding anniversary. It was also the day the California supreme court ruled to uphold the ban on same-sex marriage. This coincidence led me to a reflection on marriage, mine and the general concept, that I'd like to share with you.

Dave is my husband. He is also my best friend. No one in the world knows more about what goes on in my heart and mind than he does. We share values, hopes and dreams. He knows my sense of humor and I know his, even if all we can sometimes manage is a pained groan at the other's jokes. We often finish each other's sentences or give voice to the same thought at the same time. We are not the same person but we complement each other well. We make the other want to be better. I can't imagine the way my life would look without him in it.

This was true the day before our wedding. Getting married didn't make it any more true. Looking around my life before I got married, I didn't have any great role models for marriage. I knew a fair number of people who probably would have been happier out of their current state of wedlock but stuck around for various practical reasons - none of those reasons related to the fact that they had taken a vow to stay with the other person. In fact, the happiest, longest lasting, most functional couple I knew were not and still are not married. A fact that does not diminish their commitment to each other or the care they give to each other. Dave and I were an inseparable pair - the Lambsters - before we exchanged rings, and for me, at least, the wedding didn't make me any less likely to walk away when things got hard. I love him no matter what is recorded in the annals of the Keystone state.

So why get married at all? For one, it is the gateway to a host of social benefits and responsibilities. But Dave didn't marry me to assume responsibility for half of my six figure education loan debt and I wasn't trying to get my hooks into his 401K. For me, marriage is a kind of choosing. It sets a boundary around yourself and your partner that the world sees as more inviolate than simply dating. It is a public way of saying "This is my family. This is forever. What you do to one is done to the other." It is a public declaration of what is already true in our hearts. For me, marriage is about commitment and bringing two lives into one.

Maybe I'm naive, but I don't understand why anyone would want to deny a fellow person the right to that public declaration. Is the world so perfect that we would demean and belittle any offered expression of love? Why does anyone care who wants to marry who? I would certainly be protesting in the street if someone told me I couldn't marry Dave. Why does the government care who I love? The thing that really blows my mind, though, is the vocal outcry of religious groups against gay marriage. Why, why, why, why, why, why, why, why? It seems to me that do unto others . . . and love thy neighbor . . . are supposed to convey acceptance and love not hatred and exclusion. (Of course, it is that evident hypocrisy that always turned me off to organized Christianity, but that is a subject for another post.) In any event, with a rising unwed teen pregnancy rate, a whole segment of the population choosing to practice serial monogamy, and the divorce rate around 50%, it doesn't seem to me that the heterosexual population is doing so well with marriage and lifelong commitment. I say that anyone who's brave enough get on the scary roller coaster of matrimony deserves a chance.

Of course, the legal system doesn't care about love and the joining of souls. Proponents of gay marriage get a foothold in the courts by arguing matters of equal rights and fairness. ie. If heterosexual couples can assume certain social rights and responsibilities, denying them to homosexual couples is discrimination. And it is. I do not see another way to answer that issue. If one pair of people have the right to throw theirs lots in together and take on the world as one, then ANY two people should have that right. Period. In America, these days, we all get to sit wherever we want on the bus, and while I know there are people who wish that wasn't the case, who fondly yearn for the days of Jim Crow, at least those views have been soundly rejected by those who make our laws. I can only hope that when Nathan is old enough to discuss such things, he will be shocked and appalled to learn that this discrimination against gays stands in our history. . . and not in his present.

Every Rose Has Its Thorn

It comes as a set this week. A rose that may draw blood if you're not careful.

I just put away the co-sleeper. This feels monumental to me, as it means our little boy will now have no choice to sleep in his "big boy" crib. It's actually a little ridiculous, because it should have been done weeks ago. He is so big now, that the newborn sized co-sleeper runs a serious risk if turning him into a cube shape, like those funky watermelons grown in boxes. (Hey, he'd stack and store easily!) We had every intention of doing this last week, and he actually spent one night in his crib, but then the day care bug struck and he had a fever and was fussy and restless and it was jsut easier to have him in our room, so back he went.

This is even more bittersweet for me because the co-sleeper was his one true hand-me-down. It traveled across the US from California, on loan from Elizabeth, a good friend who had outgrown it, to be his bed and now needs to travel back to them to provide sweet repose for little Apple.

Dave pointed out that when he came home from the hospital he looked so tiny in the co-sleeper, and now he looks so tiny in the crib. It's true. He's outgrown the co-sleeper (If the manufacturers instructions don't include a warning about not letting your baby sleep in it when he can dangle his legs over the edge while laying on his back, they should.) but he's still dwarfed by the crib. Nonetheless, this step means our boy is growing up. And that's one thorny rose.

Postscript: I am embarrassed to point out this week's thorniest feature - I took only two pictures of Nate this week. (Did I mention the fever and the screaming? The lack of smiles, absence of playfulness, and generalized desire to lay limp and sleepy in my arms?) Anyway, here it is. I promise to make up for it next week and in South Carolina!

Unequal Partnership

Dave and I used to have it all figured out.
He cleaned the bathroom and took out the trash. I did most of the cooking and kept the kitchen clean. We sort of shared the laundry. The maids vacuumed and mopped and dusted. We went to the market together. Dave made the coffee. I drank the coffee. It worked. It was fairly effortless. We positively reveled in the fact that we could have almost as much fun and laughter during a trip to Whole Foods as we could at a baseball game.
Then Nathan was born. Things shifted. Dave cleaned the bathroom, took out the trash, did our laundry, and struggled to keep the kitchen clean. I nursed and kept the baby (and myself) clean and did most of Nate's laundry. Family or restaurants did most of the cooking. Dave did the shopping. Trying to be frugal, we fired the maids, so no one vacuumed or mopped or dusted - unless Dave got so fed up that he did that too.
At some point, I became capable of helping with the cooking, doing some of the mopping and vacuuming, and took over more of the laundry. I even tried going to the market alone. Dave got a little more time for himself.
Then I went back to work.
Nights.
And Nathan still wakes up every 2-4 hours to eat.
So now Dave cleans the bathroom, mops, vacuums, dusts, takes out the trash, cleans the kitchen, does some of the cooking, makes the coffee, does most of the laundry, does some of the shopping, mows the lawn, does all the heavy lifting, AND stays up 2-3 nights a week with our hungry monster. A hungry monster that has been a feverish, sick, screaming, inconsolable, snotty, hungry monster for the last few nights.
Why he puts up with us, I'm not exactly sure. I mean, Nate's got a killer smile, but all my best assets seem to belong to the baby at present.
Soooooooo, I just wanted it clearly on the record. I want everyone to know that I love him, I appreciate him, and I couldn't make it without him.

Trouble With Technology - part deux

There has been a roll out of the electronic medical record at the hospital where I work. A disproportionate amount of the learning curve has been shunted onto the nurses. The vocal and powerful MD's did not want to do anymore than read the computer screen like they would have read a patient chart. Meanwhile, the nurses have had to learn how to enter orders, retrieve lab data, print charts, print labels, communicate with the lab, and do billing. They are understandably overwhelmed and cranky. Three nights ago I sat with a sick baby in the NICU and composed haiku in an attempt to keep from screaming as the computer system kept us from doing anything to make the child better.

Sorry printer froze
Can't assess your blood today
Guess you'll get no meds

Patient turning blue
Nurse scowls at computer screen
Alarm beeps ignored

Tube please now please tube
Wristband wristband where is it
Soon there'll be no need

Baby needs bolus
Computer needs compressions
Soon I'll need a wig

Culture can't be sent
Group B Strep, E. coli, more?
Now we'll never know

In the long run this e-Record will prevent medical errors, save time and money, etc. In the short term, it's frustrating, impeding care, and making us all old before our time.

Roses and Thorns

This week has just flown by in a haze of mostly thorny times but surely I can pick a rose or two.

The Thorns continue to be illness(es). Dave (just on the mend from his own sinus infection) was back with Nate at the emergency room last night after five straight hours of screaming (Nathan's, though I think Dave joined in at the end). I was trapped at work, doing nothing except being available for the problems of other people's children, hating with every part of my soul listening to the screaming over the phone, feeling powerless, and feeling like the world's worst mother. Of course he was magically cured for the three hours they spent in the ER and then picked up where he left off when they got home. I have always joked with parents that coming to the ER/ doctor's office makes children feel better, but it is less amusing when it is your own child. We saw our doctor this morning when he developed a fever and refused to eat or smile and he was diagnosed with a "viral syndrome". A fairly irritated throat is presumed to be the source of the screaming. Tylenol and naps seem to be the words for the day.

Roses: 1) Ear infection is gone, per the lovely doctor, so no more twice daily struggles to get amoxicillin into him.

2) My first Mother's Day was absolutely charming. Nathan managed to communicate to his father a desire to send me flowers, and even chose my favorite - colorful, fragrant lilies and daisies. I had a delicious Mother's Day brunch where Nathan was pronounced the best behaved child in the restaurant.

3) Nathan has rolled over again and again, proving it was not a fluke.

4) Spent a lovely afternoon in the park with friends, feeling, for all the world like a mother of leisure.

Friend Cecilia looking Oh, so cute in the park

Nathan blows a razzberry!

Trouble With Technology

Before Nathan was born, Dave and I spent a lot of time talking about what we wanted for him. All parents do, of course, but a lot of our conversations centered on how to keep him active and healthy and smart and social in a society (and home) dominated by technology. I read A LOT as a child, teenager, young adult and am convinced that has a lot to do with my intelligence and success, (And no, I see no reason to be humble here. I'm doing pretty well for myself.) I also played outside and wandered the neighborhood with a pack of children, going backyard to backyard to climb trees and put on plays. TV makes you fat and stupid. Science has proven that. People who watch TV eat more and exercise less. Children who watch TV are more insensitive to violence and have smaller vocabularies. It truly is mindless entertainment. But it sure is fun.

These days Dave and I like to hike and swim and snorkel and explore, but we also have a Play Station and a Wii and like to watch baseball and a few TV shows. Before Nathan was born we thought we just wouldn't have the TV on when he was awake. This worked just fine when he was a newborn and slept all the time, but it has proved a little unrealistic now that he is older and awake so much more. We still don't get involved in any plot based entertainment when he is awake, but we like to watch some news or have a baseball game on while we putter around.

Over the last two days I have seen something that makes me a little ill. Nathan is mesmerized by the television. There I am blowing razzberries and making faces and he turns the other way to watch the confusion of color and motion that is playoff hockey. I suppose the attraction for him is conceptually no different from the music box on his playgym. It's not like he's actually rooting for the Pens. But still, it bothers me. It reminds me that balance is hard (says the girl who played DDR until she had stress fractures in her feet) and that Dave and I will have better luck setting an example than speaking a lesson. Though no normal child makes it through without a couple hours of "Bob the Builder" or "Thomas the Tank Engine", it's up to us to set limits and offer an alternative.

He's not going to build a treehouse on his own, but if we turn off the TV and go with him, magic can, and will, happen. For all of us.

Trial By Fever

Well it happened.

Three months old and we made our first trip to the Children's Emergency Department. Yesterday afternoon our sweet smiley boy became a hot to the touch, pitifully yowling, left-ear grabbing monster. His mood was significantly improved by a dose of tylenol but the horns came out again when the meds wore off. A phone call to the doctor foiled my brilliant plan to take him in for a next morning appointment because thanks to Susan G. Komen the normal Sunday office hours were canceled.

Convinced the ear grabbing was a malicious omen, I tried looking in his ears myself, but chickened out when the yowling started back in earnest and real tears were produced. Turns out Mommy can only be nonchalant about the tears of other people's children.

So, with a sigh, we packed up a bottle of water and a couple card games and headed off the the new ED.

After chatting companionably with a few people who had been waiting for three hours, and watching a stereotypical ghetto chick melt down and be escorted out by security, one of my friends snuck us in the back to be "unofficially seen". (Thanks Julia!!!)

She confirmed that yes, the left ear was infected, poor baby, wrote a prescription for the pink bubblegum elixir of life, and had us out in about an hour, proving that sometimes it really is who you know.

This morning, fortified with a second dose of amoxicillin and some sweet grape tylenol, our boy was UTTERLY charming at my Mother's Day brunch.