Thursday, July 25, 2013

UMSL

 
Well my new baby is my new job at UMSL. I liken it to a new baby because I'm 6 weeks in, and I finally feel like I'm getting a hang of the wife/mom-of-2/work balance. Why is it that the 1st six weeks of any big adventure just completely take over your life? I will say that this transition was also complicated by a trip to Chicago (post coming soon...way fun), Amelia's hospitalization, and my being out of commission for 4-5 days with a self inflicted back injury that was worse than labor. Aside from all of those added bonuses, I'm happy to say that at the end of week 6 I've figured out how to still get dinner on the table and wash clothes for my family. The social life has been limited, but I'm sure we will work that back in, too.
 
So, the job.. .It's a great fit for me. Average age of the patient is about 25. We see a lot of the same disease processes over and over, so this will be a great opportunity to get 'good' at some diagnosing and treating. Today I was running a special on Chlamydia. Every person I've tested in the last week came back positive. Those are not my favorite phone calls to make ;) I also do at least 2 paps a day. So come see me... I'm a load of fun, apparently! (Just kidding... my malpractice only covers students and faculty in the Univ of Missouri system). So don't really come see me.
 
 My schedule has been hit or miss this summer, but starting Sept 1, I'll be working Mon, Thurs, and every other Friday. Perfect. In MO we NPs collaborate with physicians who agree to mentor and back-up our work. The docs contracted with UMSL are fantastic, and I'm excited to build relationships with them. One has already offered me another little part time job which I'm sure I'll accept because it's a great non profit opportunity, and I can't say no. He's also the director of the Institute of Family Med of St. Louis... and sometimes a girl just has to network.
 
My co-workers are on par with a typical 'nursing' job. My first day of work resulted in no orientation to the clinic, but full disclosure of my boss's terrible divorce and the background of every transgendered patient we see at the clinic.
 
Stay tuned for many more adventures in UMSL's hood... I hope to work here for a very.long.time.

Sunday, July 14, 2013

Grant's Farm



I'll be honest... we went to Grant's farm so long ago that I'm sure I can't remember most of the day's details to share. The pictures were great, however, so please enjoy!
 
We rushed out of the house to get there when it opened at 9. It was memorial day weekend, so we thought it might be crowded... and crowded it was, indeed! Also, the weather was absolute perfection. A rare end-of-May chill was in the air, so people came out in masses.
 
Owen was beyond excited to get on the tram.

I think this is Grant's house. The house itself has been moved several times.

Elk
 

I love how close you can get to the animals!
 
Hook 'em horns. This one's for you, Chels.

This baby calf was literally days old and oh so adorable.
"What do you call a mother cow that has just given birth?"
"De-"calf"-inated" 
 
As soon as you get off the tram, there is a carousel waiting. Perfecting marketing!

Love these two
 
Next up was feeding the crazy, assertive goats. This little guy had it figured out.
 

Owen was quite comfortable with his bottle of milk while the goats were behind the fence...

But inside was a different story. They were kind of scary.. and they were chewing on my jacket and jeans. I was pretending/trying to not look as scared as O!

We both got a bit more brave.

Then came the Budweiser wagons and free beer which Mike and I obviously sampled.
It was noon somewhere, after all.
 
The best thing about Grant's farm in Mike's (and my) opinion is the Clydesdale house. I'll be the first to admit that I'm even more frightened by a large horse than a goat eating my lululemon jacket, but these Clydesdales are nothing short of majestic.

I think this guy was named Stu.

I'd love to see them all walking together in a parade or something.
 
I'll wrap up by saying that I continue to be impressed with St. Louis' vast amount of diverse and wallet friendly family activity options. Grant's farm will certainly be on our list of things 'to do' for many years to come!
 



Thursday, July 11, 2013

9 Months: Clapping

This month, Millie has been working on developing her 'sweetsie'. She waves hi ALL of the time now. She claps to the mere mention of the word 'yay', shakes her head no toward the antibiotics, and we're even working on her being 'So big'.

The babbles have really picked up. I hear DaDa and YaYa the most, but today I swear I heard a Ma!

We haven't had her 9mo WCC yet, but we know from the hospital &
check-ups that she's about 18lbs.... I guess I need to start thinking about new car seats soon.

Soo BIG. She's wearing 9 & 12 mo 'summer' clothes and 12 mo sleepers.  

This is a pic from the Botanical Gardens. We had a play date with the Francis clan a few weeks ago... I LOVE her belly and sweet cheeks in this shot.  

She's not showing it off here, but her pincer grasp far outweighs Owen's at this age. And despite the fact that she has zero teeth (will they ever come in?) she's gumming her mum mums and puffs well. She's also EXTREMELY 'gaggy'. She'll cough and choke on anything. Cheerios, more than one puff, a small piece of Ritz cracker. It may be a bit before we really transition to finger foods.  

Hi, I'm sweetsie. I also respond to my name now.

Amelia and her best buddy Luca, gumming some mum mums.
Luca's parents are probably our best 'new' StL friends. He was born 9/22. Maybe we can get them hitched.
 
Love that baby butt. She's always on the move.

Same baby butt + ruffles. Still love it. She totally has her object permanence down now too. The favorite game is to throw toys down over and over and over... to any willing party.

The obligatory monthly 'sleeping' picture. But how cute is she? Still sleeping 12-13 hours at night. Her day time schedule is hit or miss, but generally she's between 2-3 naps.

"Hi. I stand all of the time, I cruise along this ottoman, and now I can transfer between
2 close objects."

As she is getting older, she's wanting to feed herself more & more. And she's the queen of blowing raspberries when she's done eating. So naturally, I don't get dressed for work until I'm literally walking out the door. Anywho.... this month's new foods: Yogurt, blueberries, plums, white potatoes, grapes, mango, and pumpkin.
 
I know that I'm biased, but I do think she gets prettier by the day....

Saturday, July 6, 2013

View from the other side

This isn't a view that I particularly wanted... the view of being a parent of a sick baby instead of the nurse. For the record, I much prefer being the nurse.
 
Here's the timeline of events:
June: Colds off & on. Constant runny nose & drooling. I chalked it all up to teething/putting everything in her mouth....but some of that gunk found its way to the upper lobe of her right lung. And it stayed. And then it got infected.
 
July 3: I left for work at 8, got home at 3. Kappa Claire said Millie seemed a little extra tired that day and had already taken 3 (1 hour) naps & she didn't eat as much as she usually does. When I got home, though, Millie greeted me with a huge smile and crawled right over. I agreed that she seemed sleepy, so I put her back down at 3.
 
5:00: Millie wakes up from her 2 hour nap. Unusual for this time of day, but maybe she needed a catch up. I get her up and notice she's breathing rapidly, but she's in great spirits.
5:30: She eats most of her solid food. We read books (she loves it) and she still seems tired so we get ready for bed. Still breathing quickly. Temp 98.4.
6:00: Takes only 2 oz of formula and falls right to sleep. At this point I notice her breathing is quick, shallow, and she's using accessory muscles to breathe. (This is not a good sign... it's like they can't get enough air just with their normal lung function so they start using belly muscles to really try to expand those lungs).  I decide to watch her really closely & I think to myself that I'll need to set my alarm to check on her periodically overnight.
7:00: Put Owen down. When I came out of his room my folks just happened to be in my living room. They brought Fritz's. What a fun surprise! My mom looks at Millie's breathing and agrees with Mike and I that something is off.
7:30: I call the on-call nurse (who called our pediatrician) who also seemed bewildered by Millie's obvious respiratory distress but lack of any other constitutional symptoms. She suggests maybe she has a small airway obstruction (a good thought... ) and so we decide the ER is a good idea. Especially since the next day is a holiday!
8:15ish: We head to St. John's Mercy Children's ER and leave my folks with the Os. Upon arrival, her respiratory rate was 64 (fast!), and her O2 saturation was 92%. It should be 100%, and 92 really is not good. Still no fever (99ish), and heart rate is about 160 which matches her high resp rate. She's really wheezy. 
9:00: We get her first Albuterol treatment to help her breathe better. She was not a  fan of the mask but she tolerated it, and her sats perked up to about 94%. Given the work she was doing to try to breathe, I was not at all thrilled with 94%. I knew something was up. We get her chest xray and then just try to help her calm down and go back to sleep.  
11:00ish: Her oxygen continues to be low 91-92%. Her chest xray reveals some right upper lobe pneumonia (at least we have a cause). She's now rocking a big fever 101.8 and she's miserable. Resp rate still in the 60s. Heart rate 180 (fast!). The ER doc comes in to tell us that he's considering sending us home with antibiotics and breathing treatments. As he's in the room, her O2 drops to 89%. (I'm starting to freak out a bit and there is no way I want her at home without something to monitor her O2). The doc watches the monitor and says....'Looks like she's telling me she needs to stay". I couldn't agree more. We put oxygen on her and she perks up to 93-94%. She HATES the nasal cannula, and is pulling at the tape, but we obviously force her to keep it on. We also get another breathing treatment & our first dose of antibiotics.
1:00am: We finally get upstairs to our room. Meet our nurse (Donshay)... I was so tired I just kept thinking it reminded me of "Jon Jay". They, of course, have to get more vitals and another weight (naked), and Millie is pissed about being naked. Screaming, tears, tearing at the nasal cannula, etc.
 
We get her settled down. Her O2 is about 95-96% on 2L of oxygen and she's sleeping. I run home to get some things and get back to the hospital in the 2:00 hour.

 We quickly discover that button onesies/sleepers are necessary to help keep the tubing and monitor cords 'contained'. One is coming from her face, the other from her toe. The next morning (July 4), we feed her breakfast and her antibiotics which she promptly throws up. This, we find out, is our ticket for another night in the hospital. She didn't eat much/pee much at all that day, and so they had to monitor her ins & outs closely. We did get that antibiotic dose down on the second try.
 

Throughout the day we were able to titrate her O2 down and she remained at about 94-95%. She wasn't much for sleeping in that big ol' hospital crib, so she slept on daddy's chest. She took to some pedialyte and started to perk up a bit, too....which helped us avoid an IV. The breathing treatments every 4 hours seemed to help loosen some of that gunk, and she started to be able to cough up some of it. I've never been so thrilled to hear her cough!

She made it through the second night with out oxygen, and she tolerated her breakfast and antibiotics on the morning of the 5th, so we got a ticket home! We weren't even in the hospital 48 hours, but it sure was a trying and exhausting experience.
 
Some of her personality came out during this ordeal. Despite all of this 'stuff' attached to her/being done to her, she was super excited to see all of the people. She was waving, smiling, & clapping for us and the staff. Everyone kept telling us how cute she is (duh!). She's so sweetsie.
 
Amelia- I do not plan to be at a hospital again with you until you are having a baby or something! But praise God this is just something acute and you have the immune power (aided by antibiotics) to fight it! Love you baby girl. xxoo