Mid-term Study Buddies...

You're probably expecting to see a photo of some of my fellow students. Well, since this is a distance learning FNP program, I don't see any of my classmates.

Rather, I have other "study buddies"...

First, and also the most conducive for quiet study time, Miss Anya. She's been a little sad of late having lost her "pet" Sonador. But she seems to be enjoying the exclusive attention and having the left over Cheerios T Rex drops to herself.

Next, there's T Rex. I get so many lovely comments from you about how impressed you are that I can do school and take care of a little one as well as get projects completed. Well, a lot has to do with this little one being such a great kid.

He has learned to pick up his toys and put them away. He knows when I'm working that he needs to play quietly and then when I declare it's "T Rex Time" he knows it is his special time to do what he wants with me.

I am unbelievably blessed to have such a sweet little one in my life. T Rex Dad also tells me every day how blessed we are with such am amazing child.

And lastly, there is Little Girl. We don't yet have a blog name for her (taking suggestions) and I usually just refer to her as "little girl" anyways. She also keeps me company while studing - especially today while I was taking my midterm. I have to say, pregnancy is a unique thing. It's not my favorite thing, but having a person growing inside is quite amazing but also a little distracting with the kicks, turns, and hiccups. She was, however, very well behaved during today's exam, and did not distract much.

As far as getting through this week, I have to thank T Rex Dad. He has a big project at work that he's been working extremely hard on - logging in to work from home during his "non-work" hours in addition to T Rex sitting while I study and making brownies for me to stave off any chocolate cravings I might possibly have (he's trying hard to put weight on me - I'm getting there). During my exam today, he checked in every little while to make sure I was hydrated. He is truly the best! I am certain I'm biased but again, I feel so blessed to have him with me during this journey called life.

And so there you have it! Mid-terms are over and I can go back to a somewhat normal existance with my family.

This blog is also celebrating it's one year anniversary and soon to have it's 200th post. So, in honor of this and since I'll have more time, a little giveaway...

Leave a comment to this posting about someone you feel blessed to have in your life (husband, child, pet, etc.). The prize - any of my posted projects from the past year (toddler pants, bib, Christmas diorama, purse/bag, toddler backpack, apron, jam, pickles). I will announce the winner on my 200th posting this upcoming week!

Weekend Update...

Here we are again, the end of another weekend and the beginning of another week.

Let's recap...

Vaccines, crowds, farewells, Christmas gifts, eating out...

In no particular order:

We braved the cold and crowds so T Rex and I could get our H1N1 vaccines. T Rex Dad was not considered "high risk" so he has to wait until more vaccine becomes available.

I did a lot of research on the vaccine - it is not "new". It is made the same way as the "regular" flu shot. From my limited understanding of virology, H1N1 sounds to be similar to influenza A. The "regular" flu shot is a combination of influenza A and influenza B. And the H1N1 vaccine is grown the same way. If you can get the mist, do so - in the "regular" flu there is 50% better protection than with the shot. There are some groups which are excluded from the mist (pregnant women, kids under 2, and anyone with a chronic illness like asthma).

Oh, and the reports about Guillain Barre, the paralyzing disorder, being higher with this batch of vaccine are not true. It is based on reports from the 1972 swine flu and there were actually more patients getting the syndrome in the non-vaccinated group than the vaccinated group.

So, short version - get your vaccine! It's safe and free (in the US). Let me know if you have any concerns or questions that I might be able to assist with.

Left: Trying to entertain T Rex during the long wait. Right: With another expectant mom and a very close family friend - we waited in line together. (Remember those safari pants from a couple weeks ago? Well, those are for her baby boy.)

Inside the "old K-mart" - this was where the clinic was held. They did a great job moving people along. It was crowded and busy but at least it was warm inside! What made it hard is most of the folks in line for their vaccines were young children (under 4) and pregnant women.

We had T Rex Grandma and Grandpa over for farewell dinner as they are headed to Arizona for the winter. We will miss you!

This past week at playgroup, the three original founding moms had our photo taken. Caitlin's photos turned out the best so you might head over to her blog and see the full set. These ladies are very special to me, and it is so wonderful that we can share this journey together. Thank you for your friendship, Caitlin and Colleen.

Left to right: Colleen (37 weeks), Caitlin (25weeks), T Rex Mom (27 weeks)

We also enjoyed some soup, salad, and bread sticks at Olive Garden - T Rex friendly restaurant. Always an adventure going out to eat with a toddler - can anyone relate?

Because he was so good, he picked out a new toy at Target - we stopped over for supplies. This is what he selected. I posted more photos of him playing with his letters on his blog.

Note the Target sticker on his shirt - he was very happy to receive one.

I did sneak in one project this past week. Did you ever do those book report dioramas when you were a kid? Well, this is a glorified version of that, with a Christmas twist.

T Rex Dad liked this one so much we'll be keeping it. If I pull together another one, it will be a gift. This weekend I did also get to go to the fabric store, minus a T Rex, and picked up a few more things for more Christmas projects. So stay tuned, as midterms pass, there will be plenty of time for projects.

And, of course, lots and lots of studying (with a few distractions from my little one) - midterms start this week. Wish me luck - I will need it!

These are the books for my pharmacology class - I could recycle them as a booster seat in a couple months! The top one has so many pages that it is numbered by chapter then page. There are over 100 chapters. Yikes!

How was your weekend and what's on your agenda for the week???

Wordful Wednesday - Motherhood

I really did not understand my own mother until I became a mother. Funny, how that works...

I did not understand how much the random hug means,
Or how a simple art project can bring out motherly beams.

I did not understand how much worry an illness can cause,
Or the heartache of watching my child cry in pain because.

I did not understand how long "nine months" is,
Or how tough birthing a child really is.

I did not realize how beautiful the night can be,
Even when my child is crying endlessly.

I did not realize public tantrums can be so frazzling,
Or conversely how uneventful public outings can be dazzling.

I did not realize how projects take longer when I have a little "helper,"
And how meaningful those projects become because of said "helper".

I did not realize how much, Mom, you love and care for me,
It just took having my own child to truly understand and see.

~ T Rex Mom

For more Wordful Wednesdays, visit:

Weekend Update...

A few random things from this weekend...

Projects, playtime, photos, farewells, but no school work!

First, our youngest canine child went to her new home this weekend. We've been looking for a home for her for nearly a year. With three dogs and a child who's allergic to them, we made the decision to find a home for the youngest one, knowing she would have the least amount of trouble bonding with a new family due to her age. It was really tough saying goodbye but she is going to a really great home and is already being spoiled! Farewell, Sonador...

Next, an outing to the park. T Rex had not left the house for nearly 2 weeks due to illness and my school schedule. Needless to say, he had some serious energy to burn off. He and T Rex Dad played hard. More photos of the play session on his blog.

It's also time for a profile pic (26 1/2 weeks). Bidding farewell second trimester.

And then the random cute photo with my little T Rex, just for fun!

And for projects, there were a couple.

First, our Halloween cards. These are the second version. T Rex got into the first set of finished cards and tore off the pumpkins and scribbled on the ghosts, so we made another set this weekend. The ghost is his footprint - what can I say - the kid LOVES to foot paint! They are being sent to long distance relatives. Inside is a photo of T Rex in his Halloween costume. And the relatives can also see how big he is by the size of those feet!

Spoiler Alert!!!

These are for T Rex's friends for Christmas. If you want to be surprised, then don't finish the rest of this posting. However, if you don't mind getting an early preview, then keep reading...

These are Christmas shirts for the kids in T Rex's play group as well as a couple of cousins and other friends near and far. The photos turned out a little dark but you get the general idea.

And that, Folks, is the weekend update! Now back to school work and laundry...

What did you do this past weekend?

What If...

Today's posting is prompted by Jenner's.

The challenge:

Write a short story based on a moment in your life that imagines what would have happened if you had made a different choice at that moment. For example, what if you hadn't taken that job? What if you hadn't said "yes" to the marriage proposal? If you can, share a little about the moment that inspired you to write the story.

Skip to the bottom section for the "What if" or continue reading if you'd like the full, detailed story.

Nearly a year ago, I was still working for a wonderful company. Yes, it was a drug company and people tend to consider them "evil" but really they treated me so wonderfully and was also ranked consistently in the top 5 companies for working mothers. When T Rex was born I took an extended maternity leave. I was gone from my job for nearly five months. It was wonderful to have that time to focus on my new child and experience life at home. I had always been a "go, go, go career woman" so there was little doubt I'd be back to work as soon as my five months were up.

Going back was harder than I anticipated. I had fallen totally for this new little person in my life and leaving him, even for a job I loved, was one of the hardest things ever for me. When I returned, I also had a new boss. His tag phrase was "It's go time" - enough said. I had to hit the ground running. Plus, we had a new drug we were launching. In a short time I was back in the swing of things. I spent most of my working time in my company car and so that's where I did my pumping. I managed to find a car adapter for my breast pump.

This went on for six more months until T Rex finally only needed milk first thing in the morning and right before bed. When I had overnight travel, T Rex Dad would go with me so I could nurse T Rex (he never took to a bottle). I tried to limit my travel to day trips when I could but it made for long hours in the car and little time for breaks. Plus, I hated being so far from my son.

Then right before Thanksgiving I was told one of the drugs I was promoting was going generic and to anticipate a possible reduction in work force. I started to see the writing on the wall. I worked in a low potential business area. I was pretty sure they were going to eliminate my position entirely. Our territory was performing first in the region. We were totally rocking but even if we achieved 200% of our goals (which we nearly did), we still would not bring in the same amount of business as someone in a big city would with just meeting 25% of their goals.

Fast forward, I finally get word in January 2009 that indeed my position had been eliminated. The kicker was someone else working for my same company on a different team resigned that same day. My boss, who I grew to respect during those 9 months, told me of the developments and said I had the choice to take the open position or the severance package. The only thing, this open position would entail more travel than I was already doing. Argh. I was not sure I was up for that. Nor, was our family up for that. It was a lot of hard work on T Rex Dad when I traveled.

I took a few days to consider my options. I could not tolerate the idea of being away from T Rex more than I already was. T Rex Dad said the decision was entirely mine but I really needed to consider the magnitude of my decision. After a few sleepless, cry-filled nights, I found myself in the bedroom sitting on the bed sobbing when T Rex Dad found me. He held me for a few minutes and then I knew what I wanted.

I called my boss the next day, thanked him for everything, and asked to take the severance - I was going to pursue my long awaited dream of going back to graduate school to be a nurse practitioner. Fortunately, I still had 2 weeks to pull my paperwork together and apply to school.

I waited and waited (okay, only 3 months) and finally the letter came in the mail. I was in! T Rex Dad and I had been discussing how we were going to fit another child into our plans and I was worried how I would fit it in with school plans. Thus, I signed up for the part-time program and we decided if I was pregnant within 4 months it would work out. If not, then we would have to wait three years to finish school before adding a second child to the mix. Two weeks later, I found out I was pregnant.

So, "what if" I had not been laid off or if I had taken that job - well, I'd still be the "go, go, go career woman", not a step closer to pursuing my dream of being a nurse practitioner, and I would not have a baby girl arriving in the new year. And, all those hours I would have been away from T Rex being on the road, I cannot even imagine how unhappy we all would have been. Honestly, the time I would have been missing with my little guy and my husband the past 9 months, I could have never gotten that back. That is truly priceless. We are happier now that we've ever been - even taking a 50% cut to our income and making some tough cuts to our lifestyle. But, we really do see this as the golden time of our lives with our growing family. How blessed we are!

Thanks, Jenners, for the prompt. And thank you, Everyone, for sharing this intimate story.

T Rex Mom

Antibiotic Use

We've been learning about infectious diseases in my pharmacotherapeutics class this week. It's actually pretty interesting. The hot health topic as of late has been flu and H1N1 vaccines. However, I guess I did not realize how over-prescribed antibiotics are. Really interesting to me - far more than flu vaccines (which, by the way, I am still advocating).

Why would over-prescribing of antibiotics be a problem. Well, we're basically breeding more resistant bugs. And over-prescribing does not neccesarily mean prescribing antibiotics when they really aren't needed. It also means prescribing ones that are more powerful than neccessary.

Ever had sinusitits or a sinus infection? Most common cause - viruses. Thus, antibiotics won't work. Viruses can take 7 to 10 days to clear. You can definitely feel miserable during that time, but studies are finding there is little to no difference in symptom resolution if antibiotics are given for an acute case of sinusitis and that most patients improve without antibiotics. Only patients with moderate to severe symptoms should be given antibiotics therapy, and then narrow spectrum antibiotics should be used. If it lasts longer than 10 days and the nasal discharge is no longer clear, then antibiotics might be appropriate. I know, when you go to the health center feeling bad, you want to walk out with something. But sometimes, Tylenol or Ibuprofen, sleeping with a vaporizer, and some intranasal saline might be what you need. Along with rest, of course.

Bronchitis: More than 90% caused by viruses with only 5-10% of cases being bacterial. That's what we all ended up with in our household following our recent virus. It's been two weeks and I still have a pretty horrible sounding cough. The cough can linger 3 to 4 weeks. Wow! That was news to me! If it is caused by influenza, then the influenza should be treated within 48 hours of symptoms but otherwise, you have to let it run its course. Fun stuff? You can use adjunct therapy in the form of Tylenol/Ibuprofen, bronchodilators (i.e. albuterol - we all took a few puffs from T Rex's nebulizer and that helped), cough meds, and vaporizers. Again, if viral, no help with antibiotics.

Otitis Media (middle ear infection) - if you have kids, you're probably familiar. Viruses actually only account for about 30 to 40% of cases and it is really difficult to distinguish between viral and bacterial. However, there is now more movement toward a "wait and see" policy before prescribing antibiotics for middle ear infections. Some things that would disqualify from waiting: symptoms for more than 48 hours, bilateral ear involvement, antibiotic therapy within the past 7 days for whatever reason, less than 6 months of age, possible impending rupture of ear drum, ear tubes, hearing impairment, chronic condition, recent ear infection within past 3 months, or another bacterial infection. The key is treating with the appropriate antibiotics and not going for the "big guns". Amoxicillin (as long as no allergy) is an absolutely appropriate choice to start with or maybe even Augmentin (again, as long as no penicillin allergy).

Urinary Tract Infections or UTIs (refers to infection anywhere along the urinary tract): 90% are caused by E. coli. This actually makes a lot of sense if you think about it. Your gut is heavily colonized with E. coli. And it's portal to the body is relatively close to the urinary opening (especially in females). Thus, it is very common for the bacteria to migrate up the urinary tract and cause cystitis (bladder infection) or pyelonephritis (kidney infection). The key to diagnosis is a "clean catch" urine specimen. If proper technique has not been used, then it is possible to get contamination and get a false positive. Risk factors: use of diaphragm and/or spermicide, pregnancy, estrogen deficiency, prostatic hypertrophy (men), incomplete voiding. Although, most common in females, it can also be seen in males (especially older). You can even get a UTI from infrequent trips to the restroom because you're just too busy. So, when nature calls - go. Or, a child that has a high fever and is dehydrated and not urinating as frequently, this, too can happen. Hydration, hydration, hydration!!! The key to treatment, the correct antibiotics. Going straight to something like Cipro or Levaquin might be over kill. Bactrim or Septra is by far the drug of choice.

I guess the take away here is often antibiotics are not necessary and if they are, make sure you're getting the right ones. Tell your practitioner you want one that is appropriate for the bug you have. And ask if it might be appropriate to "wait and see" since often there is no difference in symptom resolution with or without the antibiotics. Not all antibiotics work the same. And not all bacteria are the same. It takes the correct drug to kill those bugs. And if we keep using "big guns" the day will come when there is nothing else we can escalate to and then we really will have to let the illness run its course.

Please let me know your thoughts on the matter. When you make the effort to see someone about the illness you have, do you expect to walk out of the office with a prescription for something?

How do you feel about the new "wait and see" policy?

Did you find this posting interesting or helpful in any way?

Is there an infectious disease process you'd like more information on?

Weekend Projects...

We're on the mend here. All of us still have coughs and a little bit of residual wheezing but a significant improvement from a week ago. We canceled all our weekend plans and stayed home and rested. However, we did manage to squeeze in a few projects here and there...

T Rex Dad gave T Rex a much needed hair cut...

I finished two more baby gifts. (Hopefully, the ladies these are for are not reading this. However, if you are, I hope you like the designs!) I still have a couple more to go, but this was a good start.

On the left is a jungle print for a baby boy. On the right is a turtle print for either a boy or girl (they did not find out baby's gender ahead of time).

Lastly, autumn is officially here. How do we know this? When the river is covered in morning fog, that means it is officially autumn here.

What did you do this weekend?

All Rules, Out the Door...

Rules that have been broken this week...

1. No sleeping in T Rex Mom and Dad's bed - the past two nights I have actually sat up in bed - literally - holding and rocking T Rex so he would stop screaming in his sleep. I suspect that he was having a bad headache related to sinus congestion, thus, laying flat was causing pain. He has never had an ear infection so I did not think that was causing the pain. Rule #1 out the door...

2. All meals will be balanced for nutrition and there will be no throwing of food at the table - when the toddler gets sick, his appetite disappears and it becomes impossible to coax him to eat anything. So, when he's sick, he can eat whatever and whenever he wants - chips, yogurt melts, puffs, cheese puffs. And, if he wants to toss the unwanted food off his tray, he doesn't get the "angry eyes". Rules #2 out the door...

3. Potty training does not take breaks - With the high fever T Rex has had, it's decreased the amount of urinating he's been doing. This past week he was only urinating 2-3 times a day. This definitely puts a hamper on the potty training. And I was really wanting to measure his output so there were times when I'd just strap on a diaper and forget about PT. (Those cloth diapers have been a hit - T Rex is not a fan of disposables anymore. I think he thinks the cloth ones are "big boy pants".) Rule #3 out the door...

4. No more than 30 to 60 minutes of Elmo or Baby Einstein videos per day - When T Rex gets a virus, it generally goes right to the chest and exacerbates his asthma. This last one was no exception. Nebulizer breathing treatments can take 5 to 15 and up to 30 minutes, once, twice, or four times per day. You can do the math. That is often more than an hour per day and the only way to get him to sit still for those treatments is by watching his shows. Rule #4 out the door...

It took a week to break the rules and get into bad habts. Now it's going to take a month to get back to where we were at. Heavy sigh...

Rule #5...Rules #1-4 become null and void during illness!

Can anyone else relate to this?

"Not to Worry, We Are Still Flying Half a Ship..."

Our household has been struck by a horrible virus. In fact, I would say it is probably the worst cold virus I've ever had. I had the honor of becoming symptomatic first - ahead of the boys by almost 2 days. Thus, I was the lucky one to make the trip to the health center to be tested for flu - ever had your nose swabbed for flu? Definitely not fun.

The good news - a negative test. However, that still did not explain my horrible cough and chest pain. The on-call physician seeing me wanted to test for a blood clot in my lungs - she was suspect because of the presentation of the symptoms and with me being pregnant. That was definitely a scary thought. Luckily, that test was also negative. However, being a bad virus, it had to run its course. Let's just say, I don't remember much of the past 48 hours.

T Rex Dad did an amazing job keeping the household running, caring for me as well as the active toddler T Rex. We did everything possible to try to keep me isolated from the rest of the household and took precautions to prevent disease transmission. Alas, it failed. And today when I returned from a follow up with my physician, I found both my boys on the couch, eating salty chips, watching TV, and shivering under blankets.

Luckily, I am feeling decent enough to start to take care of them. T Rex actually brought his nebulizer mask to us tonight asking for a treatment. This virus is really bad because even folks with healthy lungs get horrible chest congestion. And little ones, like T Rex, who already have compromised lungs are especially hit hard. They say a picture is worth a thousand words, well, see for yourself...

(You can see his neb with mask in the background.)

I truly feel so bad for the boys; I definitely know how they feel. T Rex Dad said at one point I was hallucinating from the fever. At least the cough has decreased and I can stand unassisted.

I have to wait a few more days before getting my flu shot, but we all will be getting them as soon as we're better. And I would pass that advise along to you too. And don't forget the H1N1 vaccine - it should be out in the next week or so and it will be free. All the health care providers I've spoken to say it is best to get both these vaccines to protect yourselves as well as your family. (As long as you don't have a severe allergy to eggs or cannot get flu vaccines.)

Alright, time to get back to school work. My professors gave me a couple extra days to prepare for the two presentations and paper due this week. And I know T Rex will be waking in a few hours asking for another breathing treatment.

Be well.

Let me know, have you had your flu shot? Have your kids? And are you planning on getting the H1N1 vaccine? And if, not why?

(P.S. Anyone know where the quote in the title came from?)