And two more months slipped away...

Happy Belated New Year, blog and blog friends! I will spare you the "busy, busy" rigmarole because you've heard it all before. Needless to say, it hardly seems real that the last time I logged on to post anything on the blog was back in October! Life and time have continued to move forward at the speed of light. Over the holidays we (or, more precisely, our builder) finished building the house, we closed (i.e. hemorrhaged money), and then, for extra fun, we moved in...the week before Christmas. Why (you ask incredulously)? Because I'm insane (in the membrane...er, sorry), apparently, and, more accurately, because I already had requested that week off in order to (HA, HA!) relax the week before Christmas. To add to the fun (and this torture was completely self-inflicted, by the way), we just didn't feel *right* about depriving poor little CindyLou and Bean of a Christmas tree and decorations until the week before Christmas (think of the *children!), so we bought a tree for the rental, decorated it and the rental house (including the outside, of course!), undecorated, bought a new tree for the new house, and the decorated the new house once again. I cannot vouch for my mental stability, that bit of madness was unbelievably ill-advised. Regardless, despite several snags, we arrived safely and soundly in the new house before Christmas. Santa even found us and everything! Whew!

So now, I am digging out of boxes, cursing the paper clutter and all of the things that can't be thrown away, but do not yet have a "home." Paper clutter is my true nemesis. We all love the new house. It is so nice to be in a home that is truly "ours" from the very start. Cindy Lou's bedroom is bedecked in lavenders, pinks, and fairies. Bean's is bathed in blues, "Cars" characters, and, let's not forget, monster trucks. We are very happy here, which is good, because (hear this internets) I AM NEVER MOVING AGAIN! (I hope.)

Work is going well, getting back into full swing since the holidays. I find I have so much less to complain about these days. Likely because I am not much on the front lines any more (no more midnight phone calls about cough syrup selection), I am getting more sleep, and more weekends off to play and love on my sweet little family. I still have the occasional fist-clenching moments, like the two sisters, due a week apart. The younger went into labor first, even though the older was *due* first, and the older got so p*ssed off she *refused* to come to the hospital bedside to support her sister. I mean, *dammit* she *always* gets *her* way. (These are grown ass women we are talking about here, you wouldn't believe the adolescent machinations, mostly on the part of the older sister.) Younger sister's baby ended up having an unknown health problem after delivery, which would have made me feel like a criminal that I wasn't there for *my* sister during that time. Older sister's baby was born about a week later and was *perfect,* and I got the vague impression she was feeling quite smug and justified about that. Sad, sad, sad.

There was also the patient whose MIL jumped all over me when, after going to have a "for fun" ultrasound where the US tech said the cord *might* be around or near the baby's neck, I tried to explain that, if indeed the cord was around the neck, there was not a thing in the world I could do about it! I spent 30 minutes with the patient and her MIL, even obtained a (completely normal and beautifully reactive) NST. At the MIL's visit to my partner the next week (for her own medical care) she expressed to them how I just "rushed" them right through the appointment, and how her DIL needed "more TLC" from our practice. GAH! The unmitigated *gall* of that woman! I give up. Haven't seen her or DIL since, and I'm not crying about that one little bit.

So anyway, time marches on...double numbers are luck for me, so I think 2011 is going to be a good one. Maybe, just maybe, I can lose the rest of that weight, organize my life, de-clutter, become a great cook, run a marathon, found a charity organization, and still find the time to be the world's best wife, mother, and doctor. Hmmmmm, probably not! Good to be back, and I hope to write more in the coming year. Hope you are still out there and listening!

To Get to the Other Side

There are times in life when everything seems to fall right in to place, and then, there are times like now. I can see the shimmering oasis of a new life, just on the horizon. A better call schedule, closer to family and friends, a chance to work in a collegial (not competitive) environment, more time with my precious kids and husband, and a chance to grow as a physician. Between the oasis and where I stand, however, is a treacherous, rock-filled, rapid river, swirling and threatening my ability to ever reach the opposite shore.

Obstacle #1 - Our house is on the market, and we have shown it at least a dozen times. Yet, despite positive overall feedback, not a single offer. I don't mean to boast, but our house is a beautiful house. I love it. I was ready to buy it the second I walked through the front door, and I can't believe that everyone else that sees it doesn't feel the same way. We never thought we would have to sell this house. Maybe we should have thought about selling it before we bought it. If we don't sell before we move, we'll have a hefty house payment, along with any rent payment we need to pay in Newville. This alone will be a financial strain.

Obstacle #2 - Mr. Whoo has yet to find a job, nor procure an interview in Newville. Granted, he has only starting looking in earnest recently. However, he is looking for work in the finance world, which isn't the best place to be seeking employment given the current state of our economy. We have been fortunate that he was able to quit his job last fall when our family really needed it, but now we worry that the employment gap may cause an impetus with new employers. Plus, without an additional income after the move, there will be more financial strain on our family. (See Obstacle #1)

Obstacle #3 - My current place of employment is not letting me go without a fight. There have been veiled and outright threats of lawsuits and damages and liabilities for me leaving earlier than my contract had mandated. There is also the matter of giving back a portion of student loans paid by the hospital. The fact that we would have to pay back was not unexpected, however, the amount that we calculated is about half of what the hospital estimates. We are procuring the services of a contract negotiator and a lawyer, who seem to believe we have a case for inducement, but I'm having angina just thinking of it. Not to mention the fact that, if the hospital's calculations are correct, they want us to pay up in less than 2 months. Add more financial liability to the swirly, cold, and fast water.

Obstacle #4 - Emotionally, I am wrung out. I am completely exhausted, and barely hanging on by my fingernails to make it to the date I indicated I was leaving. Being on call, continuously, with only 4 days off per month (plus vacation time), has left me completely burnt out. I find it hard to drag myself to work and muster compassion for my patients. They deserve better than the doctor I am right now. My health, mental and physical, is suffering. The remainder of my contract is a mere six months, and by finishing it out, I can alleviate much of the financial burden of the above obstacles...for the price of my very sanity. I want to cry just thinking of it.

So, I sit here on the bank, pining for the oasis, and unsure how to navigate the obstacles that lie before me. Oddly, I am reminded of the "old school" computer game, "The Oregon Trail." When faced with a river, you can try to ford the river, float the river, or hire someone else to help you across. Right now, I am pining desperately for someone to throw me a life line, or at the very least, a strategy for surviving these treacherous waters. The best advice I can relate to our readers is to know what you are getting in to before you sign a contract. There is no such thing as a perfect job, and if it seems too good to be true, it, in all likelihood, *is* too good to be true. Caveat emptor...and pass the caulk.

*cross posted at Mothers in Medicine

In the Middle of the Night

It's time for my husband's annual "man weekend" with his high school buddies. For almost a decade, he and his friends find a cabin in the woods somewhere and behave (I am assuming from the pictures) as 10 year olds...that drink. Junk food, video games, and staying up way too late are part and parcel of the festivities. They look forward to it every year, and I'm happy to have him go. (The wives have a "girl weekend" in the spring, just to be fair.) So when I found out that he would be out of town for a weeknight (when I am on call for my patients), I thought to my naive little self, what's the worst that could happen? Ha. Ha. HA!

So I went about my regular single parenting duties in the evening relatively unscathed. Picked up the kids, got dinner on the table while Bean protested loudly that it wasn't fast enough for him, wrestled two squirmy kids through bathtime, and got everyone tucked in by a reasonable time. Then I prayed really hard that I could make it through the next 12 hours without having to leave the house. The peace lasted roughly 3 hours. The first warning bell came as a page from triage. A 38 weeker, possible early labor, contractions 20 minutes apart. The triage nurse said she was pretty sure the patient was "not doing anything" but we decided to observe her and let her walk for an hour. My second warning came at 1 am. The patient had indeed changed her cervix from 1 to 3 cm. A definite keeper. "Ok," I pleaded with the nurse, "PLEASE keep her comfy and pregnant for the next 5 hours so I don't have to pack my kids up in the middle of the night to come to the hospital." The nurse was fairly confident that the patient was not contracting regularly, and could probably coast until morning. I settled into an uneasy rest...until 2:30 am. I returned the page, thinking that I was going to have to drag in to cover for the patient's epidural. Imagine my surprise and dismay when the nurse answered the phone with "She's 9!"

Shit. Shit. Shit. It was off to the races...throwing on scrubs, rousting the kids up in their PJs, and flying down the highway in the middle of the night. "At least it will be fast," I chanted to myself as I sped to the hospital. I deposited the kids with one of the nurses and stepped into the delivery room just before 3 am. The patient was completely dilated and ready to push. She hadn't even had a chance to get *any* pain medicine, epidural or otherwise, due to how quickly she had progressed. So, the patient started to push, and *then* all hell broke loose. The first push sent the fetal heart tones down to the 30s. Ummm, surely that wasn't right! I placed a scalp lead to get an accurate tracing...still in the 40s-50s. Scalp stim...up to the 60s. Oxygen, reposition, knee chest. Nothing would bring the rate back up. The baby was at zero station. Too far up for vacuum or forceps. We tried a few pushes, but the head wasn't descending fast enough and the heart beat was a slow tick, tick, tick of a baby running out of time. After a quick verbal consent, we called the OR to let them know we were coming down for a crash section. "We aren't ready!" they said. They had another case going and needed to call in a team. "No time for that," I said, "This baby needs to come out now."

We ran the patient to the OR. The staff assembled a rag-tag team of recovery room nurses, opened the crash section cart, and haphazardly prepped. There was no time for a foley or to count instruments. Every second felt like an hour, though only 5 minutes had passed from calling the section to draping the patient. The patient went to sleep, and we got the baby out in less than a minute from the skin incision. She looked like a *million bucks*! She squalled as soon as she left the womb. She was pink! and happy! and had Apgars of 8 and 9! and didn't look at all like her strip suggested. I had truly feared the worst, the last terminal decel that I had seen like that, the baby had anoxic seizures after delivery. Luckily, this baby was great. The collective sigh of relief was audible in the room as I placed her on the warmer. The rest of the surgery proceeded smoothly, and I was happy to let the family know how well she had done.

As for the kids? I ran back up to labor and delivery to find them happily snacking on graham crackers and juice. CindyLou was entertaining the whole floor, and she kept saying how she wanted to be a doctor "just like mommy." (Oy.) We got them gathered together, I thanked the nurses profusely, and drove back home. "I like to go to your work, Mommy" Cindy Lou chirped, "It's still *night time*!" Once at home, the kids went back to bed without a fuss, and I crashed into the best 2 hours of sleep of my life.

The moral of the story? I survived! It could have been the worst case scenario, but we all made it. The kids did fine, the patient did fine, the baby did fine. It could have been a disaster, but it wasn't. I am ever so grateful for that, and never have I been so convinced that I *never* want that to happen again! Scary things do happen in the middle of the night, and sometimes the outcomes are not as good. I'm thankful for the nurses and OR staff that did what they could to make the surgery happen quickly enough. I'm grateful for the compassion the nurses showed to me and my children by caring for them when I had to care for someone else. Most of all, I am so thankful that my kids were able to take it all in stride and go with the flow. They are pretty amazing. I hope you all have a wonderful weekend, and are not bothered by scary things in the middle of the night.

Feliz Naviblah

So where was I? Oh yes, Thanksgiving travel with an infant. The day started out well enough. We had splurged on the extra luxury of actually departing from the teensy tiny airport in Whooville, as opposed to driving 2 hours to BigCity to fly out as per usual. The flight left around 9, so we got to the airport and checked in around 8. No baggage to check (thanks to Mr. Whoo), but I did have my (oh so stylish) breastpump, a diaper bag, and a 14 pound infant in the baby bi.jorn. The first two puddle-jumping flights were great. I had a bottle of freshly pumped milk so that I didn't have to get half naked in one of those itty bitty planes. Bean had his second breakfast and filled his diaper in that order, and all was right with the world. We arrived in the BigCity airport with just enough time to change Bean's pants and for me to grab a quick bite to eat. Our next flight was scheduled to go out on time (a first for me on this particular carrier with the letters N and W prominent in the name). Then it all started to unravel.

The flight was full, not unexpected for the day before Thanksgiving, so I had to check the breastpump planeside and the diaper bag was too fluffy to fit under the seat so I took as much as I thought I would need (diaper, blanket, burp cloth) and jammed the bag into the overhead compartment. I was seated near the front of the plane, window seat, next to a rather portly gentleman. Being of an ample posterior, myself, we were very, ahem, cozy (read jammed together with very little room to move). Bean was sleepy and cranky, so most of my attention was focused on getting him settled. It took a while to notice that we were taxiing a little longer than usual. Then the announcement from the pilot, inclement weather in our destination was forcing them to delay departure for approximately 30 minutes, so we were going to sit on the runway until we could take off. Ummmm, WTF? They didn't know that the weather was bad before they jammed us on the plane? The cessation of movement awakened the Bean, so my last weapon in the arsenal, the almighty boob, was offered in the most awkward and uncomfortable way....ever. We got through the wait on the tarmac, and he fell blissfully asleep once we were in the air. The remainder of the flight passed uneventfully, until we reached the destination. Then, for some undisclosed reason, we then proceeded to circle the city, unable to land for an additional hour and a half. I *had* to pee, and Bean needed a new diaper. When it became evident that we weren't landing any time soon, I braved the airplane bathroom, infant in tow. Of course I was very near the front, and the bathroom was all the way in the back, so I did my best not to whack each and every aisle seated passenger with either my arse or my baby's feet. Peeing in that laughably small restroom with the baby in the baby bi.jorn was effort enough, but changing a diaper in there? Damn near impossible. I put the burp cloth down for a minute on the only available counter space (the sink) only to have it get sopping wet. Bean screamed throughout the whole ordeal, for extra fun, and I was near tears myself by the time we had finished. I did my best to avoid the disapproving eyes as I headed back toward my seat with my overtly vocal, unhappy child, wedged myself back in between the window and Mr. Portly, offered Bean the other boob, and willed the plane onto the runway, like, yesterday.

We did finally make it to the ground, a grand 10 minutes after my connecting flight had departed. (No, of course, I wouldn't have the *good* fortune of the flight being delayed!) I want to know, if the weather was so terrible, why flights were still leaving on time?? It was about 1:45 pm (felt like midnight) and the next flight out wasn't available until after 7 pm. With the darkening skies and this carrier's oh so stellar reputation, that wasn't a gamble that I was willing to take. I had been scheduled to arrive at my destination city at approximately 2:30 pm, my sister in-law, niece, and nephew were to pick us up, and then we were to drive 3 hours north to the Grandparent's house. I phoned my sister-in-law and we both agreed that she could drive to my present airport and pick me up before my next flight even left (ha, ha!) So we estimated that she was a little less than 2 hours away, so I took myself to the Chili's and ordered fajitas and a margarita. All was right with the world once again....until Bean blew out his diaper and needed a full wardrobe change, bunting and all.

Flash forward 3.5 hours when my sister-in-law finally arrived, having underwent a small circle of hell, herself, involving ice storms, driving rain, and holiday traffic to get to the airport. As we settled in the car, I thought, surely, things would get better from there. Fate laughed loud and long at that assumption. The weather went from driving rain to freezing rain to blizzard-like snow, the traffic got increasingly snarled, and the three children got increasingly testy. What should have been a 4-5 hour drive turned into an 7 hour drive. We had reached a tenuous peace, with all three children finally asleep. We turned the radio to an all Christmas music station, and proceeded to laugh about how horrific the entire journey had been. Just after we had reached the last 30 minute leg of the trip (through snowy, country back roads), my nephew began to cry to get out of the car seat. Then my niece awoke and cried because she was still sleepy, my poor SIL was doing all she could to see the road through the blizzard, and there was no placating the children. As we turned onto the final road to the Grandparents house, Bean awoke to complete the trifecta, the screaming escalated, the road was icy, we were behind a car going precisely 2 miles an hour, and playing in the background? A cheerful "Feliz Navidad." Delirious from prolonged travel with children, my SIL turned the volume up over the throng of screaming voices, and we sang along at the top of our lungs....either to save our sanity, or because we had completely lost it, I am still unsure. We slid past the driveway just after midnight, arriving safely but insane, a mere 16 hours after the journey had began (it takes 11 hours to drive the distance between our houses). I vow to never, ever, fly anywhere ever again. That is all.