I was saving for...

Each of the kids has a savings account with the goal to put aside money for their future needs. Recently there was an article about a father of 8 who would not save for college because he felt it was the child's responsibility to find a way to pay for it and that to do so would stifle their development. I do not disagree with him, however, I would still like to save money to help towards college.

Up to right now I'd never touched any of the money we've saved for the kids. Soon I will be making a withdrawal from one child's account to pay for braces as this is an immediate need. Additionally, Since a certain child's refusal to adhere to the no-climbing rule, has caused the necessity of a multi-thousand dollar contract job, I've had to pull funds from said child's account. In keeping with our old testament lessons if you break it you need to make it right. So this child's savings (which is technically her parent's money until she's of age) is going towards paying a portion the bathroom remodel bill). My hope is we'll still have time to recover her savings before she's college age.

Hey Dude, Hang loose!

While driving to speech and OT today we passed a Toyota Prius with a vanity plate that read, "BYK4LYF" or something like that. Yes, literally I passed him as I might pass anyone going a bit slower than myself. There was nothing aggressive about my actions at all and as I'm oft to do I gave wide berth in doing so. Still, this middle aged fellow was making a very unexpected single middle salute against the side of his window as we came within viewing distance. At the time, my thought was "what a nice guy! Perhaps he has a thing against large vans polluting the environment or something." I wondered if he was just carelessly resting his arm held up by his longest digit or if this was seriously some sort of gesture of contempt that I would endeavor to drive into the lane next to him. Perhaps I was blocking out his sun.

Anyway, while there were far more frustrating things today, this guy is just a strange blip on my radar. It only occurred to me much later I might have flashed him the hang loose sign... well, perhaps that's not something he would have recognized anyhow. I suppose I probably did the best thing, and that would be continue driving without paying much attention to the disgruntled man. I'm certain he'd like my husband's car, given half the time there's a bike strapped to the top ;)

No turning back now

The demolition has begun. By the end of the day the bathtub was also gone and all the drywall (or whatever walling was used back when this house was built) was gone. Much to our delight the studs and remaining structure look good (at least to our untrained eye). We didn't see any signs of water seepage or damage what-so-ever.

Though the day was not without a bit of drama. When the workers initially began work they mentioned that they thought we needed to completely removed the radiator piping for the demolition. The contract guy hadn't mentioned our radiator lines being a problem, so this threw me for a spinning loop. After talking to a representative from our oil provider, who also services boilers, we learned that removing and replacing radiator lines is no small task and one they wouldn't likely be able to get to for several weeks. It wouldn't be cheap either. So I told the contractor that touching those pipes was pretty much a no-go. Thankfully, the worker figured out a way to remove the tile on the wall without disturbing the pipes. What a cloud of doom that had been. I couldn't help but feel like such an idiot for not being better prepared. It was such a relief to get back to worrying about what paint color we should select for the wall.

I'm not sure how far they'll get tomorrow, but the original floor is still here, so I imagine there's more demolition to come. We weren't home when they finished today as our long awaited appointment to see the Oral Surgeon was this afternoon.

Should you ever need to get to Bethesda Naval Medical Center, please note that there's virtually no parking for oversized vehicles. Our family vehicle wouldn't clear most of the parking garage spaces, and so eventually my husband had to drop our son and me off at the front door and search for a spot in the NEX parking lot.

While we were ontime for our appointment we wound up waiting perhaps an hour before being seen, and by this point in time much of the staff had gone home, and nobody was available to run the 3-dimensional x-ray that would have been needed to determine the exact nature of the teeth my son has in cleft affected region of his gum line. Perhaps we'd like to schedule another appointment for another time?

Since at that moment we were being seen by a 4th year resident, not the doctor we were suppose to be seeing, I requested that he at least come in, look at the x-rays I had (taken by our awesome dentist) and give me an opinion, as we've already wasted spent two months waiting for the chance to consult with an oral surgeon.

To be perfectly honest, if I were willing and capable of paying 100% out of pocket, we could have consulted with a civilian Oral Surgeon months ago. I was kind of mad at myself for not being more prepared to just go elsewhere. I've got a few names, but no clear path to utilizing our insurance to cover this. When our orthodontist wrote up the consultation request, I contacted the Cleft Team and asked them for a referral. To which the response was, "who said they (The Bethesda Cleft Team's Oral Surgery) couldn't see you?" Then, the cleft team coordinator promised to bring our case up at their next team day meeting. After which I heard nothing for several weeks. Actions, or in this case, inactions speak louder than words.

So in the mean time I ask our dentist to take a look and see if he could pull the "extra tooth." He'd already pulled a tooth from this exact same spot, perhaps all we needed was another simple extraction and the third tooth could descend?  However, his x-ray couldn't guarantee that these teeth weren't fused together, which can happen in cleft cases. So we tried again to get a consultation. After my husband made the call, scanned and sent the consult request, they scrounged up an appointment a month later.

So, after all this waiting, first the couple of months, and then today in the office, to hear "oh perhaps another time" was just a touch aggravating. However, I'm quite proud of myself for not having to drop the "I'm a nurse card" and was able to negotiate some sort of plan out of the doctor today. I suppose I probably come off as over-invested mom, since I didn't use all of the proper terminology, but had essentially verbalized comprehension of the possible scenarios before the surgeon stated them in his terms. Thus, he got right to business in formulating a plan. Either there are two separate teeth and he will extract one, or they are fuses and the whole "deformed" tooth would be removed.  While I'm not sure of the soundness of this plan, and if there might still be a better solution (save if the teeth are fused, could they perhaps shave it or something), at least we have made some forward progress, and have a date (in less than a month thanks to a cancelation). In the mean time I can research this further.

The thing that was most insulting was the whole time we were waiting to be seen, the staff could be heard making jovial idle chit chat in the hall ways. They didn't seem to be very busy at all. Had someone been tracking us from the beginning, they could have been running that x-ray while we waited. Of course nobody was attending to my son's case at all until they'd all gone home. By time we were done consulting with the doctor, the whole place was deserted, building lights out. My impression of the department is it didn't seem very efficient. If I think about it much more I'll be too nervous to allow them to work on him. What if they're this idle and inefficient when my kid is under sedation and his airway could become compromised? Do I trust them with his life? Seriously, while rare, children do sometimes die while undergoing routine procedures all too often because someone was being complacent and neglected to attend to the basic oxygenation needs of the patient... Joan River's being our most recent tragic example. Oy... I'm not feeling very reassured now am I?

Braces: soon it will be two in metal

and we will be so broke!

This week has ben B U S Y. Apart from our regularly full schedule, we had a bunch of additional appointments and Dad had to go out of town for a few days. I signed a contract to have our damaged bathroom fixed and spent a copious amount of time reading reviews on various bathroom accoutrements. I think I've looked at nearly everything in the bathroom sections online and in store at both Lowes and Home Depot. All the kids (except the baby) saw the dentist for the bi-annual dental check up and cleaning. Yes, all in the same day, because our dentist is 1. either crazy    and/or   2. really sweet and understanding. I pick number two.

The following day we had back to back orthodontist appointments for the oldest two children. The eldest is currently in full metal gear, receiving full treatment. While his sister has just finished being evaluated for the necessity of a stage one orthodontic treatment plan. She has quite a few baby teeth in the upper jaw that don't seem to be coming out as quickly as they should. Though the first four permanent teeth are in on the top front, the canines and bicuspids (I think that's it) are so large and crammed in that they aren't descending as they ought, and so they aren't doing a very good job pushing the baby teeth out like they normally would. Meanwhile, one of the front permanent is showing signs of wear from the poor alignment. Everyone is in agreement that we need to start work on her teeth now. So very soon we will have two in braces. The kids have been strongly encouraged to consider becoming orthodontist when they grown up, as it seems to be a very promising and lucrative career.

Our week of the mouth isn't quite over, as Monday the oldest will see the oral surgeon to assess the maloccluded tooth/teeth in the cleft affected region of this gum line. Our dentist couldn't be sure if the x-ray was depicting one giant tooth, or two individual teeth trying to descend into the same spot at the same time.  This appointment will be all the way up in Bethesda and I suppose we should count ourselves lucky we've only waited two months for it.

Go ahead and ask me about bathtubs! Our current, 1966 pink bathtub is cast iron and likely weights a whopping 300-400 lbs. They're going to take a sledge hammer and break it apart before removing it. Many still hold the classic cast iron as the pinnacle of timeless quality, but nobody wants to lug one up a flight of stairs, so we're going with a inexpensive metal cast-iron -want-a-be tub that is hardly half the weight, and I pray equally as nice. My hope is that a white enameled tub will remain undated and timeless. I also picked out the nicest, cheap, porcelain tile I could find at Home Depot, and decided it won't be necessary to tile the entire bathroom wall as it currently stands. We'll save at least $400 by only installing tile floor and bath surround. Pray there aren't any surprises waiting for us behind those walls. The contractor didn't think we had anything to worry about, but you never know. It might take as much as two weeks to complete. I sure hope it goes faster.

It was my husband's turn to bring home the St. Joseph statue from his Covenant Keeper's meeting last week. I wonder if that's a sign for me to drop in a prayerful request to the Holy Family household protector. Sure seems like a good idea, don't it!

Oh the dread of holiday gift procuring

It never gets any easier and inevitably every year I'm overwhelmed by the prospect of having to somehow procure gifts for so many folks. Sometimes I bulk completely and pair back the list in true Grinch fashion. Sometimes I cave and buy insignificant trifles for folks who would probably prefer not have such drivel. However, it's been a some many years since I resorted to loading up a credit card, going into debt over Christmas, and so I'm not about to start that now either.

Last year I read someone's blog mentioning a family tradition of only receiving three gifts per child in accordance to the three gifts the Baby Jesus received from the Magi. How could I keep myself within these confines and still be able to sneak in those dreaded gifts of pajamas, socks, and underpants?  Still we've decided that this year, from the parents at least, each child will only receive three gifts. This should make our family tradition of coming up with hints all the easier as I will default to a new rule for hints which will require the use of the words gold, frankincense, and mire.

How will I plan and implement this gift procuring procedure? So far I've given notice of the changes and requested a highly prioritized Christmas wish list.

We will continue with the drawing of names for the sibling exchange, to be on Thanksgiving. In addition we'll also celebrate the feast day of St. Nicholas, with a little something in the shoes on December 6.

Front lines

If you work in the ER you rarely know exactly what's coming through those doors. While indeed it's your job to be ready for almost anything, sometimes you're still going to be taken by surprise. My time working as an ER nurse was considerably short when contrasted to those who do this work as a life long career. Still I think that most ER docs and nurses in the country would be caught off guard when facing something like... oh the first case of Ebola in the country to ever just walk into some random ER. That hospital in Dallas didn't know what hit them. Sure they might have thought to listen the hoof prints and think zebra (Ebola) instead of horses (flu), but how where they to know the first ever case had just walked through their doors. I really do pity them. We can all look back at it with 20/20, hind sight vision, but I don't think we have the right to blame them for not being more prepared. Whatever happened after the positive lab result might well be a different story. However, seeing how the two nurses currently infected were said to have been in contact with the patient very early on, before they knew what they were dealing with.... I'll withhold criticism.

I've worked in a few different ER's and whenever I happen to be in one I can't help but continue to be curious about the efficiency of the particular department. Not all ER's are equal. I consider myself to have been very fortunate to have received extensive training by an ER nurse educator who worked hard to ensure the entire staff received continuous updates and ongoing training. When I moved away from this ER I was utterly shocked at how vastly different the second place I worked for was from the first. They were like night and day in the level of ability to handle higher levels of acuity. With the first ER they also knew their limitations and ensured that patients we weren't equipped for were bypassed for our facility or transferred STAT. Our pediatrics wasn't as high caliber as the children's hospital up the road, so if the kid looked too sick to us, nobody hesitated to call Children's. However, if someone was having a heart attack or stroke, we had them covered.

Of the four different Military Treatment Facility ER's I've been to, only one garnered my respect for how it was ran. The ER at Fort Hood had a Emergency Doctor's training program affiliated with the nearby Trauma facility, Scott and White (where I had applied, but they only wanted me if I'd go fulltime and I could only do PRN at that point with my firstborn on the way), so those doctors always struck me as up to date and "with it." Still other MTF's we've been to, patients had to wait hours before they were even triaged. Almost all MTF's assign a medic to do triage while in the civilian world one of the charge nurses does the initial assessment within a certain time frame, because to do otherwise leaves a potentially critical patient at risk and the hospital liable.

From a practical standpoint I wonder, given it's cold and flu season, a time when lots of folks usually come to the ER with fevers and vomiting, how is a nurse to know, immediately, that the person who has just entered her ER has Ebola and not just another case of the flu? Sure at first we could point to recent travel outside the country (and even more specifically Africa) as a big red flag. I take a little sliver of comfort that our local Pediatrician's staff, and our neighborhood ER (not a Military Treatment Facility) screens for travel outside of the country and have for quite a long time (because they've always been on the look out for Tuberculosis). Yet, even these questions aren't the first things a patient is asked, and one can well imagine the number of transmissions that can occur when a vomiting person presents to a crowded ER waiting room. The check-in clerk usually sits behind a glass window, will have passed a clipboard and admitting paperwork back and forth, and the germs begin to flow from one bustling clerk to the next long before a medical person has began asking question.

When I read the first Ebola case sat in the ER for several hours before they began to suspect Ebola I have a hard time criticizing this given most folks have to sit in the ER for a few hours before all the test results become available and the diagnosis is confirmed.

Another thing that's weighing on my mind is the assertion that medical personal are or should be willingly self sacrificing, like it's part of their job description to get sick and die. Before I had children it was easier to envision myself being the person willing to rush in and be that hero. More so now than ever, I realize I can't go back to work in this sort of environment, because I have so young ones who are utterly dependent upon me. In addition, having a child on the autism spectrum extends my commitment to my children even longer. Always in the back of my mind I worry about what will happen when I'm no longer around to care for my eldest. For the immediate and foreseeable future, should something happen to me, it's been made painfully clear that nobody is willing to step in and fill my shoes. I can't be so selfish as to sacrifice myself, because I'm not here for me, I'm here for them; my children, here and now. I must live for them, or nobody will care for them. With a back up plan like this I absolutely bristle, my nerves on end, when I hear folks take for granted the possible ultimate sacrifice a nurse might make when they go into that line of work. In fact, belittling the sacrifice a soldier makes because "it's what s/he's paid to do" also irritates me.

Just some thoughts I had to get off my chest. 
  

Can you see it?

My husband took a trip to NY this past weekend to reconnect with longtime friends from college. (I envy his strong connections, I truly do...alas, I have no such buddies in my life...not like those). Anyhow, I stayed home with most of the kids and he took the eldest along for some "man" time. Admittedly, there were a few moments when I was a bit jealous that I didn't get to go.

One of the pictures my husband took was the front of a pub in Cold Springs, NY. At the time he didn't notice anything in particular. Being somewhat notorious for taking random pictures, perhaps he thought the name was interesting. Having occasionally (back in our cable days) watched Ghost Hunters, I noticed something in this picture right away. Can you see it?

 

Yes, there's a rather large orb, which may or may not be that big of a deal, but I noticed more. So I transferred this from my husband's cell phone onto the computer and showed it to him. At this point he saw the same thing I did without me pointing it out. I'm curious how many others will notice it too.