Survival of the Fittest

We survived the last week...


I now have two weeks of urgent care and many hours under my belt. I treated a ton of upper respiratory infections, diagnosed some pneumonia, uncovered a few fractures, and even sewed up a simple laceration. I have a tremendously patient and knowledgeable preceptor. I am grateful for this as it has really been solidifying my knowledge base and skills. 

At first I was having a hard time connecting with my preceptor. Oh she was great but I just felt like I was just another student to her and I wanted to be a three dimensional person with a life beyond the clinic - tough when there is no time to talk. One night before I was scheduled to work I said an earnest prayer that I could make a connection with her. The next day while I was standing in my preceptor's office I recognized a person in the photo on her wall. It turns out we were neighbors once upon a time. Connection made - it was a great day!


My urgent care clinical days are full. I've lost a couple pounds just because when I'm at the clinic I'm pretty much on a diet of anything that can be eaten within 2-3 minutes and in between patients. We see an endless stream of patients and most of the time our days extend well past the 12 hour mark.The days are more like 14 hour days with commute making it so I often miss out on seeing the kids during the day. One day, Lil Sister was so mad at me for being away she would not even look at me. It's been tough on all of us but last week was probably my hardest so it will start to get better.


I finally have a long weekend to reconnect with my husband and kids. It's been wonderful. Although, T Rex Dad and the kids have been struggling with a cold so we did not do much this weekend but we did sneak away for a brief visit to the Cabella's fish tank. It's been years since I've been there and the kids had never seen the trout or catfish tanks. What a fun free outing!

The sturgeon was by far the coolest and attracted the most attention of all of us. I took a few photos of the kids in proximity to it so you can see how large it is. This, of course, is a juvenile. The trout in the tank, however, are adults. I find sturgeon to be very prehistoric looking. (They are also very fun to fish - catch and release only, though.) Lil Sis also loved the albino channel catfish (meow-fish as she called them). She kept trying to show them her beloved "Meow-Meow".

 

It has certainly felt like survival of the fittest but we continue to survive and the little ones are even thriving. They are truly the sweetest and continue to make us smile day after day - even if their noses are red and endlessly dripping. 


This was certainly a much more pleasant read than what I almost posted - last week I had two patients yell at me because I refused to prescribe antibiotics. My preceptor supported me 100% - I did my best at educating but some folks just don't understand why inappropriate use of antibiotics is dangerous and unethical. Let me know if you want me to post my rant. (I know I still owe a posting on pediatric UTIs). In the mean time, I think photos of our outing are much more uplifting.

Lady Bug...

During lunch today, we spied a lady bug crawling up our window on the inside of the house. We take these things as good luck. The kids were most fascinated saying she was diverted from her trip to the lady bug picnic due to cold weather. Honestly, I am amazed she is alive but we suspect she is living in our ficus tree upstairs which was where s(he) returned after the visit.


First some cute photos of the event followed by a couple of very short videos (15-19 seconds each) of each of the kids holding the lady bug.

I just love their little smiles - genuine happiness mixed with intrigue and wonder - only at this age does this occur and only for a short time. I am so glad to have captured such a moment. Thank you, Lady Bug, for stopping en route to your picnic.

Oh, I found out yesterday that I passed my written master's project/exam. Sigh of relief but the butterflies in the stomach are fluttering as I think of my oral exam and last standardized patient exam. Now to just survive the last of my clinical rotations. Urgent care is fun, interesting, and really keeping me on my toes - making me a bit paranoid about my own kids and sad to see so many antibiotics being over-prescribed. Plus, I did not realize how gratifying draining an abscess can be (this is probably the nurse part of me coming out).

Gotta go - working tomorrow. Let's just say the kids have big plans for T Rex Dad on Saturday! I also have it on good authority he's pretty excited to hang out with them, too.

Moments...

These are a few of my recent favorite moments with the kids that I don't want to ever forget - little things that T Rex Dad and I will be talking about when we're old and gray reminiscing in our rocking chairs.

Moments like bedtime stories - various tales of Elmo and his lost puppy, Blankie, Yummy/Yucky, Jenny's Birthday Book, Kim and Carrots, Cris Cross Applesauce...and all their sweet voices helping tell the tales.

Moments at the Burger King play center, a place that is almost always unoccupied allowing for uninterrupted, free entertainment. I love seeing Lil Sister crossing "the bridge" (I wish I had a recording of her little voice saying that) or seeing her hanging at the top of the slide before going down the twists and turns. Or the look on T Rex's face as he is actually in the tube sliding.

There are even some great moments for me but less enjoyable ones for the kiddos - blending ice cream ingredients, a loud task, but oh so cute to see them covering their little ears.

 

The kinds of moments that help me through long clinic days when I see my kids for less than an hour in the day, if at all.

These are the kids of moments that simply make me smile.

Aquarium...

We have a new aquarium in town. It just opened at the beginning of the year. The kids were so good during my last 5 day stretch of clinical days so this weekend we surprised them with a trip to the new aquarium. T Rex Dad insisted we wait for him to join in the fun and I am so glad we did. It would not have been as fun without him.


Quick school update first -  I finished up my time at the GI clinic and will be moving to urgent care for 6 tough weeks - 12 hours shifts, the first week I'll be doing 5 days, after that it will decrease to alternating 2/3 days. Urgent care - one never knows what I'll see - no scheduled patients, just walk-ins. Maybe I'll get to practice some of my suturing skills or casting/splinting.

This week, though, promises to be a tough one. I'm lining up meals, clothes, and even some blog posts, too. I did also managed to finish the kids' Valentines and even a baby afghan with a coordinating baby doll blanket for the big sister. It ships out to Iowa this week so I'll try to remember to take photos before it is mailed.


Here are my favorite photos from the aquarium trip:

The salt water talk - observing and later feeding. Lots of Nemo and Dory fish to see, even Scar, Bubble, and Peach, too. The fish are even a bit neurotic like their namesake (anyone who's familiar with Finding Nemo knows what I'm talking about).

The sea horses were my favorite. I rotated the photo - they are actually parallel with the ground.

Petting the rays and sharks. T Rex Dad and Lil Sis are petting a ray. Later T Rex was braver and also patted a ray. He was really proud of himself. I'll be posting a video on his blog in the next day or two of him recapping the visit.

There was a balloon animal artist there raising money for the aquarium - T Rex chose a shark and Lil Sis asked for a lady bug. 

It was a really fun time and we liked how everything was nearly a hands-on experience. A really great place for little kids. It was a little expensive for an outing, at least for us on the graduate student budget. We're more into the free outings like a trip to Burger King's super cool playland (more on that later) but it was still great fun with some extra memories to keep me going while I'm away for 60+ hours this week. I just keep looking at that ticker in the top right corner...soon.

Saturday Fun...A Wonderful Day

The week was long but we have the weekend to relax and recharge our fun batteries.


It was a good week at the clinic but Friday ended kind of rough. My last patient was a middle-aged person who was dropped off by a transportation service. This person could not speak due to a health-related issue and was only accompanied by a note from the nursing home saying "check tube". Clearly the person had not been bathed in several days with soiled clothing and disheveled, matted hair. I was glad we were able to take care of the patient and offer some relief from the discomfort. As I left the clinic and walked to my car I saw the transportation service wheeling the patient out to the van. When I reached my car I sank into my seat and cried. That poor person had no one. How many other people are there out there in similar situations with no one to care for them?


Then I picked up my phone and called my dear hubby for some words of encouragement from his soothing voice. He, too, was having a rough afternoon. The CEO of his company died in a plane crash that morning. T Rex Dad did personally know him and had worked with him for many years. It is a huge loss not just for the company but for our community. Despite that my sweet husband still cheered my spirits before I embarked on the drive home. He is quite amazing that way.


That night we all just snuggled as a family. We clung to each other and thanked God for all our blessings and the life we enjoy. There are tough days but as I often say these days remind us of the wonderful days. Thus, we headed out this morning with the goal of having a wonderful day. It was a simple morning - running at the park pond followed by lunch in an abandoned shopping center. We like to keep things simple.

Watching the wild ducks from a distance. You can tell the wild from the local because of their striking colors.

Picking up sticks and rocks and tossing them into the partially frozen pond.

Just a nearby building with some reflections allowing for an impromptu family photo.

  

Then onto the abandoned mall. We used to frequent this place before the kids were born - back when we had two incomes and no debt. It was a trendy place. Alas, it is now about 80% empty of businesses and on the weekends it is nearly completely empty. However, it is the perfect indoor running place for kids who need to work off their after-lunch energy.

The day ended with a grocery trip to Target - that wasn't exciting enough to merit photos but sometimes the most mundane things can be enjoyable. We had a great day and feel like our fun levels are going back up. We still feel a bit sad about Friday's events but our hearts are not nearly so heavy after reflecting on life and thereafter.


What do you do after a rough day?

Eye of the Storm...

This week I worked on my written comprehensive to complete my master's component to my family nurse practitioner studies. Sometimes I think how will exercises like this benefit me in providing care to patients? Honestly, I know much of it is an exercise in following instructions added to some tradition. Though, last week I did apply some theory to convincing a patient to seek counseling. Maybe there is something to this theoretical application after all. (Did you ever think when you were seeing a health care provider so much was going on?)

So how did my written exam work? Last Saturday I was given a question for which I was given a week to complete the project. This was the assignment:

Discuss a national rural health issue, propose an intervention, detail how you as an advanced practice nurse would implement such an intervention working with other disciplines, and apply a theoretical framework.


I had three and a half pages just for references. In the end, it came together nicely. I'll spare you the details except to say, I have to pass this in order to advance to my oral exams. Of course, all this is going on while doing intensive clinical rotations at three different locations. I know it's sort of a make or break you thing. Add to this some of the other "T's" and "I's" that need crossing and dotting in order to graduate. Craziness. All I can say is that graduation is less than 100 days away and all is on track and we are surviving. 


Oh, this past week when all this is going on would be the week we would all come down with a cold virus. All diamonds must go through intense pressure to be born. As long as I end up being polished and beautiful when the time comes it will be worth it.


In the middle of all this week's craziness, I took the kids to the park. The weather has been mild and fresh cool air can help cold symptoms, so we bundled up and visited a very empty park. I have to say it was 35 minutes of heaven on earth playing with these sweet kiddos. I just wish T Rex Dad could have been in on the fun. He has been logging quite a lot of hours at work. Just more to juggle. Still, though, he manages to pull it together, come home, and help so I can keep up. 

There is more craziness to come as in February I start 12 hour shifts three to four times a week and then March brings oral exams. It really is a sprint to the finish line but I can see the end. Hence, the storm continues to rage but for now we'll enjoy a brief break for some giggles and smiles.

Day of Days...

It was the day, the day of days. The birthday of our little petite girl we call Lil Sister.

We themed her birthday party after her favorite book which is also the new theme of her bedroom. This book being "Jenny's Birthday Book" - a tale of the little shy black cat with a red knit scarf  - Jenny Linksky - and her birthday picnic in the park surrounded by her closest Cat Club friends. The book is by Esther Averil and was published in 1954. 

Our little girl discovered this book on her own while browsing the library shelves. After we checked it out over and over again within a 3 month period we opted to purchase the book. It is read at minimum on a daily basis. For a while, we could not get her ready for bed or nap time without at least one reading - sometimes as many as 3-4 readings in a single sitting.


Since her birthday is so close to Christmas during which she and her brother received more than a fair share of toys, we opted to give a different gift. We all went shopping and picked out materials for crafting a Jenny Linsky quilt/bedspread and matching curtains. This to complete set up of her bedroom. This is the work T Rex Dad refers to as my magnum opus. I am not a high level quilter but I have to say it turned out spectacular. I had no pattern except to follow the drawing in the book. (You can click on the image for a closer look.)

Esther Averil's whimsical writing is as charming as her illustrations.The curtains on the quilt window are made from the same material as the curtains in the bedroom. I made a matching decorative pillow and pillow case, too. Those flowers on the quilt are actually for tying the quilt and I did crochet those. My sister did the paintings over her bed. These are replicas from the book. They look almost exactly like the real ones. It makes me smile to see my sister taking up her painting hobby again.

The party itself was also representative of Jenny's party. To familiarize the kids in attendance, we started the party with a viewing of a reading of the book. It's a great video about 6 1/2 minutes long. It's just an old library film strip with someone reading it added with some simply sound effects and music.

Then a trip to the fish shoppe or "bish shop" as Lil Sister refers to it. We set up a stand where the kids could fish for prizes. This was probably the favorite activity. It was especially nice having my brother-in-law, someone I spent many hours fishing with, and my nephew running the shoppe. The fishing pole was made from a stick T Rex picked up on a recent father/son outing to the river.

Next was pin-the-nose on the cat. My sister painted a giant Jenny Cat and the kids took turns trying to put the nose on. I love old style kid games like this. T Rex does, too.

The activities ended with dancing "The Sailor's Hornpipe". It was Jenny's birthday wish to dance the Hornpipe. We turned on the actual "Sailor's Hornpipe" music, an Irish tune, and we did some jigging in a circle. When the music stopped, the kids were to find a number and stand by it. If that number was called they won a prize.

As you probably noticed, several of the kids and even some of the adults wore cat costumes - we even had a lion and Pickles the Famous Fire Cat.  T Rex wore his Checkers costume. In the book and the Cat Club series, Checkers is Jenny's spotted brother and his special talent is retrieving a red ball. I did crochet the cat ears and the Jenny scarf, too. Some of the party favors were also crocheted - I made necklaces for the kids - flowers in red and yellow for the girls and red stars for the boys - much like T Rex's red ball necklace also handmade.

We opted for a "no gift" policy at the party because she had just received so many things for Christmas. Instead, I took the kids shopping for the prizes and favors which would be handed out instead of gifts being received. Most were non-toys like stickers, books, crayons, bubbles, sidewalk chalk, with just a few cars or rubber animals/dinosaurs. All were well received and I enjoyed seeing the kids give rather than always receiving.


The food, cake, and ice cream were all homemade. Since the Fish Shoppe was a major decoration we did some seafood - tuna sandwiches and shrimp cocktail. My mom's tuna and her macaroni salad have long been favorites of mine and also of the crowd as I did not get a single sandwich. I added some deviled eggs and turkey cream cheese wraps to the mix, too. My sister did her homemade salsa with chips and her famous ranch dressing dip with veggies. 

The cake was a Better Homes devil's food cake with butter-cream frosting. It is actually just to round cakes with one with a part cut and used as the tail - extremely easy. Honestly, getting the frosting the right color was the toughest part. The frosting was deceptive because it was colored black and one would expect it to be a chocolate chocolate cake but it actually wasn't. I was amazed at how much black food coloring it took to get it this black. 

Our little girl LOVES anything sweet and she had no issues putting the cake or ice cream away. I made a batch each of chocolate and vanilla ice cream - nothing compares to homemade. T Rex would not even go near the cake. His auntie was kind to make him some sugar cookies which I think he ate about a half dozen without us even knowing. I guess that's what celebrating is about!

It was a wonderful celebration and made even more memorable having those special to us and our little daughter there to witness the event. That night, after her party, like Jenny, she said her prayers of thanks and drifted into sleep - dreaming of her birthday...