Bedtime Routine

Looking in the mirror tonight as I was taking out my contacts there was a big wet spot on my shoulder. It put a smile on my face to go with the bags under my eyes. I love, Love, LOVE getting to put Owen to bed! This week has been especially busy, so I haven't been able to for a while. It has been sorely missed.

Our routine starts with dinner. Tonight we shared macaroni and cheese and ice-cream. Don't worry, we each had some other, more nutritious food, but he didn't want my chicken and I definitely didn't want his squash. For a very good - and messy - reason, dinner is followed by a bath. Next, after sharing a few smiles with the cute and wet baby in the bathroom mirror it's a few more minutes of play time. Tonight we played fetch with Herbie outside and enjoyed a few minutes of peek-a-boo. Shortly before the clock hits 8:00 the bottle gets made and we head to his room. He gets the bottle in position as I pick out the story for the night. He eats. I read. We rock. By the end of the bottle and the second book, his eyes are as heavy as bricks. I kiss his shampoo-scented head and lay him into his crib. (Tonight I held him a little longer on my shoulder and his wet lips created the spot on my shirt that I was admiring as I took out my contacts.) As soon as he softly hits the mattress, his hands reach out for his blanket which is snuggled up to his face before I can pull my hands out from under his little body. Some days there are a few last exhausted cries while other days he falls asleep without another peep. So precious!

48 Hours

Thu 5:00 pm told to go home (so I don't go over hours) by the same supervisor who gave me a new admission 30 minutes ago; fyi - it takes longer than 30 minutes

Thu 7:00 pm Sam's

Thu 9:00 pm getting Owen to sleep a little past his bedtime

Thu 11:00 pm asleep

Fri 1:00 am asleep

Fri 3:00 am puking Burger King for the last hour and thinking about paging on-call friends to call me in some Zofran

Fri 5:00 am seriously alarm clock? I just was getting back to sleep. Lightheaded. Still nauseated. And I'm on call today!

Fri 7:00 am rounding

Fri 9:00 am rounding

Fri 11:00 am finishing rounds

Fri 1:00 pm headache

Fri 3:00 pm hope for a nap is long gone, but thanks for offering to take my pager, Amy. It was a nice thought.

Fri 5:00 pm busy Friday afternoon making everyone crabby

Fri 7:00 pm got dinner before the cafeteria closed, but didn't get to eat it because called for another admission (it was still sitting there when I went home 17 hours later)

Fri 9:00 pm working on yet another admission

Fri 11:00 pm jabbing an abscess with a scalpal... yumm

Sat 1:00 am thinking this night will never end

Sat 3:00 am admitting a too-complicated-for-3am-admission

Sat 5:00 am finishing up paperwork

Sat 7:00 am rounding

Sat 9:00 am rounding

Sat 11:00 am trying to leave Children's, but pager won't freakin' stop

Sat 1:00 pm going to sleep

Sat 3:00 pm asleep

Sat 5:00 pm asleep

Sat 7:00 pm asleep

Sat 9:00 pm just waking up from my "nap"

Sat 11:00 pm ready for bed

Zebra

There are some diseases that medical students spend hours reading about, studying, and memorizing. On rounds we are pimped about them, and if we're at a loss for a diagnosis, we may order the tests for them. However, we never really expect to see them. These diseases are known as "zebras." Our usual montra is: "common things are common." That means those tough, less than straightforward, cases are usually an uncommon presentation of a common illness and not a common presentation of an uncommon illness. Regardless, we all secretly hope to be the one to come across the path of a zebra.

Yesterday, when my alarm clock rang, I didn't wake up thinking that this would be the kind of day that I would remember for the rest of my career. I went through the same morning routine and walked into the resident workroom at Children's at the same time - 5:57AM. I looked at the board and saw two new patients on my list. Before that moment my hope had been to not have anyone new so rounds would be a little less rushed. Afterall, without a single day off and three long call nights, I was exhausted. That hope quickly evaporated, and I sat down to get the scoop on the new kiddos from a couple of exhausted, and relieved, residents.

One of the new ones sounded particularly interesting. Especially because no one knew quite what was going on yet. There were several tests pending, so we were in hurry-up-and-wait mode. By the time rounds started and before we could dream up the random obscure things this could be, we had our answer... malaria! My first case of malaria!! While this disease affects millions of people in countries around the world, we don't see it here very often. Thankfully. (And don't worry, I don't expect there to be a Nebraska outbreak anytime soon.)

So, even though my morning ended up being a lot more hectic than I had anticipated. I am grateful for a great learning experience!

And the cherry on top of my sundae Friday was that I got to tap a knee at clinic later that afternoon. And the whip cream - a weekend off!! YEAH!

A Mess

Yesterday evening was a combination of exhaustion, sleep deprivation, missing my son, missing my husband, and empathy for one of my favorite patients all rolled into one very emotional few minutes. I ended up as a sobbing mess sitting in the rocking chair with a sleeping Owen in my lap as I tried to read overly scientific articles about rare, terrible diseases that this little precious patient could have.

Thankfully, after a few hours of rock solid heavy sleep, I was back under control. However, we still don't know what is wrong with this patient, and we're almost down to grabbing at straws to come up with something. Anything. We've consulted a specialist for just about every one of the little organs in his body, and we keep coming up empty handed. At least that's what the specialists keep saying. The nephrologists say it's not a kidney problem. The hematologists say it's not a blood problem. The oncologists say it's not a cancer problem. The pulmonologists say it's not a lung problem.

It is getting more difficult to go into their room every day and say that we're back at square one. Again. Pretty soon, saying, "At least we know it's not ___, and that's a good thing," won't cut it. What's worse is that the little puffy, tear-filled eyes that peak over the crib every morning remind me of Owen. My heart breaks for them every time, and yet they have been taking it as well and as appropriately as anyone could expect - concerned, worried, terrified, and collected. Hopefully, this nightmare they are living will reach a conclusion sooner rather than later. Then, and until then, we will pray.

I should probably be sleeping right now, and trust me, these eyelids don't have much strength left in them. Too much longer, and I'll end up in the mess I found myself in last night. Hopefully, tonight's sleep will be extra refreshing. Not only because I need to catch up, but also because my turn to be on call is rolling around again tomorrow. If it is anything like Saturday, when I honestly think I only peed twice in my 30-hour shift, my eyes, and every other part of me, might not be able to take much more. Goodnight!

Survived

Four days into one of the most feared months of my intern year and I'm surviving, actually, I may even be liking it. (There's a little hesitation because I don't want to ginx it this early.) My team is fun and easy to get along with, and the attendings are great teachers. That makes for a great combo! This month might not be the end of me after all.

Yesterday was my first of seven call nights. Never, not even once, have I heard of someone getting any sleep on a call night at Children's, at least not more than 30 minutes, so I geared up for a long night. To everyone's surprise it was a relatively calm night. If it weren't for the perfectly wrong placement of the pharmacy tube directly on the other side of the wall from my pillow that was sending medications up to and down from the floor all night long, I might have even had a couple hours of sleep. One down, six to go - the next of which is Saturday. Oooh... my stomach just contracted a little being reminded that it is just two days away.

Vacay

Jason and I spent this weekend relaxing at Lied Lodge in Nebraska City. Let me tell you, it was a much needed get away! It was "much needed" for a few reasons...

First of all, it was a celebration of our sixth anniversary. Can you believe it - 6 years?! That alone is more than enough reason for a vacation in our opinion. Every year we've tried to do something fun, and on our tight budget we usually try to find somewhere to go that is close to home. Also, not only was it our anniversary, but we hadn't yet spent a night away from Owen together. Even dinners out together have been sparse lately, so we really needed this. Nebraska City turned out to be a perfect spot. It was romantic in a Nebraska kind of way. There wasn't a white sand, moonlit beach to walk along, but the sunset is just was beautiful there as anywhere, and the coziness of the wooded lodge and the winding forest trail were the perfect settings for some great conversation. I would recommend it to any local couple who is looking for a place to just get away for a day.

Another reason we needed this trip was to honor the end of Jason's summer break. He heads back to work this week, and neither of us is looking forward to it. We needed to do something this weekend to keep us from dreading the busyness and chaos that surely lies ahead.

Lastly, I have been anticipating this long weekend since I got my rotation schedule months ago. When I saw what was planned for August, September, and October, it didn't take long to ask for a four day weekend to close out July. This is my final weekend before beginning back-to-back-to-back in-patient months. Yikes! And, my first month is at Children's, which I've been nervous about since I knew it existed. My stomach is a little uneasy right now knowing that it has been a while since I've taken care of kids sick enough to be hospitalized, and it's also turning a little because I'm on the floor with most of the kids with cancer. Not only will that be incredibly taxing emotionally, but also they can get really sick really fast. Honestly, I'm hoping that the fear of it has been built up and exaggerated so much in my mind that I may actually be pleasantly surprised when I make it through this. Regardless, don't hold it against me if you hear less and less from me in the weeks to come.