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Tuesday, November 30, 2010

thanksgiving 2010



Hope you all had a Happy Thanksgiving. We had a whirlwind of a trip home to NC. I mentioned that I would be offline for the week, since we would be in BFE. I assure you that I was indeed in BFE. We were down a long dirt road, where there is no internet access there, and cell-phone service is iffy at best. I love it!!  It is the perfect place to get away from it all and enjoy time and good food with family and friends.

Chris shot guns with his Daddy and made some memories with his brothers. They had a good time with a variety of guns that all make alot of noise and scare me to death. I cooked the entire Thanksgiving spread with with his Mom, and Karsen learned how to make home-made buttermilk biscuits. YUM!

Everyone was BLOWN AWAY by how tall Dylan was. A few months ago he was almost as tall as both of his grandmothers, this time he was much taller than them. Everyone wanted to know, "What am I feeding him?"

We enjoyed sitting by a fire roasting hotdogs and marshmallows and making s'mores with all the cousins in SC. That visit was long overdue.

In all, we made four stops along the way through our NC and SC trip, slept in 3 different beds, ate turkey with all the fixings two days in a row, saw one of our favorite families, all before we got back on the road for the 10 hour drive back on Saturday. Sigh, are you tired yet? Well, it gets  more interesting.

What's grosser than gross? Dealing with a stomach virus on a road trip. Yep, Dylan woke up sick on Saturday morning and he vomitted all the way home. Poor thing. Poor me. Poor anyone who was sitting in the same car as he was. It was rough. I think it was quite fitting that our appetites were absolultely killed after several days of eating everything in sight. Nothing like having a little balance in your life. Ha!

We made it home safe and sound to a very cold Columbus. It was 25 degrees outside and 45 degrees in our house. Whoops! I thought it was a good idea to turn off the heat. Maybe not. We ended up spending the first night back home in front of the fireplace all snuggled together because it took about 18 hours for the house to get warm. What a memorable night. Fortunately, we were all so exhuasted that we slept great as Chris kept the fire going all night for us. <3

And suddenly it is almost December...they are calling for snow tomorrow. A fitting start to our first December here in Columbus. I start another rotation tomorrow. My birthday will be a week later, and I look forward to my sister's long visit later this month. And then there's Christmas! I will check in when I can in December~the most wonderful time of the year.

P.S. Where did this year go?!

Tuesday, November 23, 2010

Going to Carolina

Can't you see the sunshine, can't you just feel the moon shining!?
Sorry, I have been known to bust out in song when I get really excited~Ha!
We are OFF to NC for Thanksgiving to spend the holiday with family and friends! I am really ready to see everyone. This is probably the longest that Chris' parents have gone without seeing Dylan and Karsen.


Karsen with Nama and cousins, Leigha & Jake
June 2010
They think we are arriving late tomorrow, but we are REALLY getting there today. Sneaky snakes, huh?

Happy Thanksgiving, everyone!

 I am taking a much-needed sabbatical from the internet. Partially, because we will be in BFE
(without internet service). ;)
See you next week!

Friday, November 19, 2010

Letters of Intent: Dear New OBGYN (the rated R version where I died on the table)

Disclaimer: You should only read this post if you are a female over 18 years old, as there are several references of a sensitive nature that may make one uncomfortable/won't understand unless you have had a pelvic exam. Even if you are a female over 18 you may still be uncomfortable, so proceed with caution.


Dear Mr. Dr. New OBGYN,
Oh, if you only knew the anxiety I had about seeing you for the first time. It is never ever never fun to bare all to a complete stranger. I mean, I am a nice, proper southern bell, and well I DON'T know you.


(Google)
I really appreciate your discretion to come in, meet me, sit down, and talk to me a while first. You wanted to hear all about my past medical history, specifically about my hellish pregnancies, aka hyperemesis gravidarum, that I experienced when I was pregnant with Dylan and Karsen.  I wanted to make sure you knew that battling hyperemesis is serious work; that it was more than just morning sickness. Were you the man for the job? Thank you for patiently listening to me talk. Thank you for the (discouraging) encouragement you gave me when I asked you how aggressive and proactive you would be with dealing with HG. Your response was:
"I am aggressive as the individual needs me to be. You would definitely need to start off on a PPI/H2 blocker along with scheduled anti-emetics like Zofran as opposed to using them as needed. The management of nausea and vomitting in pregnancy is much like treating chronic pain, it is best to stay ahead of it before it gets really bad as opposed to waiting until you are already very sick and then trying to chase it to find relief. If you know you have a wild, mean dog that you are about to deal with, instead of chasing him around, how about we just close the gate before he gets out of the yard?"
WOW. Thank you Mr. Dr. New OBGYN. I love your candid response, and the fact that you threw in a metaphor about chasing a wild dog really spoke to my southern roots. You were basically speaking my love language. Thank you. Now, I will show you my goods. Ha!~ Seriously, I did NOT think or say that!
He went on to say:
"It sounds like you have walked through hell twice. If you decide to go through another pregnancy, you will likely walk through hell again. So, if you and your husband decide you want to take that journey through hell again, I will gladly walk through hell with you all."
(google)

Ummmm, thank you? It was quite unsettling to hear him say HELL 4 times in 3 sentences regarding a future pregnancy that I may or may not have. I could not decide if I was encouraged or discouraged. Alot to think about....

On to the pelvic exam....(I know this is what you want to hear all about anyway). Ha! Well I won't go into details (you're welcome), but I do want to share one (or three) things with you. I have a running list of Things Your OBGYN Should Not Say to You During a Pelvic Exam. Seriously, it is of future best-seller quality...a possible book maybe...Oprah would love it....publish date TBA. Consider the following copyrighted, people! ;)

(google)
The first thing an OBGYN should not say to you when you are 18 years old...and having your 1st visit there with your Mom's doctor....once you awkwardly slide down the table with your knees rigidly apart, your OBGYN should never start the exam and then casually say, "Oh, you look just like your mother." Seriously, there is not enough counseling in the world to heal that wound.

(Google)
The second thing a new OBGYN should not say to you once you assume the position and the exam has begun is, "You must work out". Um, what are you looking at Mr. Dr. Man? My legs?, my bum?, my who-who or WHAT? OMG, I slowly died on the table. Seriously, you should have asked me how many times a week I exercise [to assess my heart-health] when I was fully clothed and we were talking before the pelvic exam started!! Then I could tell he got nervous because he realized the inappropriate timing of his comment. He starts rambling, "I mean you just appear thin and toned" I just laid there and nervously said:
"Ummmm, I am a "social exerciser"...you know like a social drinker, I usually exercise when I am with someone else who is exercising"
And then we both got very uncomfortable (or maybe it was just me)....I heard crickets in the background. LOL. Thoughts to myself as he palpated my ovaries "Seriously, Social exerciser? what the flip is that, Heather? stop-talking-NOW."  What felt like 140 minutes later, he finished and as I was scooting back up the table, holding the sheet across myself, trying to maintain a smiggin' of dignity, he goes on to say the third thing an OBGYN should never say during a pelvic exam. "Everything looked great!". 

I cringe and try to smile as I die a little more and say thanks and see you in a year.....or sooner if I decide to venture to Hades Mr. Dr. OBGYN! Gotta run now, but it was so nice to meet you.

Signed,
Deciduous and mortified Heather

Thursday, November 18, 2010

good morning, charlie!


Last month's rotation was not without a little bit of fun! For Halloween the Pharmacy team dressed up as Charlie's Angels. One of the other PharmD students from Ohio State (Megan, on far left) had very convincing Farrah Fawcett hair going on! The Angel in the middle was our boss, Dr Novak, maybe the smartest Clinical Pharmacist EVER. Then there's me! I'm on the right, smiling because it was the last day of the rotation! Right after this, I happily turned in my pager.

Wednesday, November 17, 2010

i have learned a thing or two~ pediatric pulmonology



Image at: columbusparent.com

I finished my 5th rotation a couple of weeks ago, and it was by far the most challenging rotation of my P4 year. Here's a snapshot of my time at the Children's Hospital.
From day 1, I quickly learned that I would be expected to follow ~15 patients with the pulmonology team each day. It was my responsibility to go to rounds and be ready to answer any question the attending doctor, attending fellow, residents or medical students had about the patients. 

 Image at: theage.com.au

Which antibiotics is little Bobby on? Are they appropriate for what we are treating? Can he be on P.O. or does he still need IV? Does he need a PPI? What is the dose of Zosyn for a 14 month old, 15 kg baby? What is the motility dose of Augmentin? Does little Haylie need one or two flu shots this year? Is her pain medication adequate? How much PRN did she use yesterday? Should we increase it? To what? Does she have Miralax on board to prevent the opioid induced constipation? What are her allergies? Did CJ have a bowel movement yesterday? Was it large? Do we need to HOLD his Vancomycin due to the most recent levels? How are his kidneys? What are his Ins/Outs? Let's have a look at the Chest XRAY....

 Image at: healthguide.howstuffworks.com
And the list goes on and on.

It was so intimidating initially to be the go-to person for the team of DOCTORS?! I wanted to say, "HEY, y'all ummmm, ehhhh, I am just a pharmacy student. To-be-sure, you aren't depending on me for all this?" But, they were! I was surprised at how heavily the medical team relied on the Clinical Pharmacist and her two students for the entire month. It took me about two weeks to even trust my own recommendations (without looking them up twice and verifying first before saying a word), but after that- I hit my stride. What a wonderfully, satisfying feeling. To truly realize that, "WOW, I have learned a thing or two the last 3 years". :)

It was a change for me to work with kids and babies.....my heart could barely stand the fact that all these beautiful children were there because they were very sick. We had two patients in particular; two sisters, ages 3 and 5, with beautiful hair... so blond that it looked white....they were both admitted with cystic fibrosis exacerbations. They ran around their hospital unit in the sweetest yellow PJs with their hair flying. I watched them laugh and play and prayed that a cure would be found for cystic fibrosis in their lifetime, please......

My next to last day there was the most challenging.

A week before we had a little 17 month old baby admitted with altered level of conciousness; I looked at his medical record and read the saddest birth story ever. He was born to a 15 year old mom that had premature rupture of membranes. Her water was leaking for 8 days before she told anyone about it and went into active labor. At delivery, the baby was born in respiratory distress and having seizures. His prognosis was not good.

17 months later...he was admitted to the pulmonology unit to see what was going on. His electrolytes were a mess, and he had signs of infection. He was given a certain medication that could potentially worsen this. The medical team asked me what to monitor, what to expect with that drug, how long will the drug be in his body.....etc....I sat there scared for the little guy because clinically he was failing. Please, don't let him suffer.

He fought for a week as many medical technological advances helped him hang, but finally his body couldn't fight anymore. His family had to make the tough decision to let him go...he was technically brain dead.  Several head CT scans showed cystic brain (essentially just fluid) where normal brain matter should have been. An abdominal scan showed massive infection despite being on 3 different IV antibiotics. Nothing else could be done. His sweet soul went to rest the next to last day of my rotation.

It was a very trying month on many levels. Physically, I did not get much sleep. It was all one big blur quite like the newborn days from way back when.  I had to be there before 6:45am to have time to work up all my patients before medical rounds at 9am. I also had homework/projects/research to do at night when I got home. I logged >250 hours for the month. Do the math. That is just pure insanity! Academically, I had to function all on cylinders. They expected my very best, and that is what I strived for each day. At home, everyone suffered. Laundry wasn't done. Housework fell behind. We ate too much take-out. Chris tried to take up the slack. I am not sure who was more relieved at the end of the month, them or me! No sacrifice, no gain, right?!

This month, I am OFF. YAY! Next month, I look forward to the being at the VA Ambulatory Care Clinic. It will very different from last month, 95% of the patients will be (cranky, old)  men! I am looking forward to the challenges it will bring as well and praying that it will afford more work/home/life balance. One month closer.

And the countdown to graduation continues....

Satisfaction does not come with achievement, but with effort. Full effort is full victory.
Mahatma Gandhi  

Sunday, November 14, 2010

Saturday, November 13, 2010

hocking hills

Our destination today:

Ash Cave, Hocking Hills OH
Image at: escapingtoparadise.com

Will be back with my own pics later! :)

Friday, November 12, 2010

a day in the life, my internal dialogue

Today was a teacher's workday. Rewind to any other day of the school year...our normal routine is that it usually takes an atomic bomb landing to wake Dylan up. And then he still hardly wakes up! Not this morning, not on the one morning where we can sleep in....nope. He was up bright and early at 7am. Of course he was.

We had coffee and eggs and toasts and talked about how to spend our day out of school.

I decided I was sick of looking at the dust in the corners. Well, actually I accidentally used the bathroom downstairs in the basement: READ: Dylan's territory. OMG, after that I decided I needed to CLEAN. So we spent the morning (we meaning I) cleaning, vacuuming, dusting.....I felt much better after it was done.

Then we made our way to Target with the windows down, it was such a beautiful day. Karsen and I wanted a bagel from Brueggar's. Dylan decides he does not eat bagels. Ok.....

Off to Target we go to get snow boots. Yes, I just typed that sentence. Dylan is now in size 8 MENS!  We found a pair that we both liked, and I realized that this was no small victory! One less thing on my to-do list.

The new Diary of a Wimpy Kid book came out this past Tuesday, and Dylan's goal was to get it today with his birthday money he had saved from last month. Target was SOLD OUT. Meijer was SOLD OUT. Start the pouty attitude. Like it was my fault or something. Yes, life is unfair!  Finally, we go to Barnes N Noble....they had it! Mission accomplished. Return the sheepish, sweet look on his face. My heart melts when he says "Thanks Mom". He counted down to the days until this book was being released.



Fast forward one hour, we are back home. I love walking into a clean house :) Dylan is downstairs reading.  I bet he will have the entire book read in the next 20 minutes.  Countdown starts. Karsen is in the living room flipping and jumping to Miley Cyrus songs on Napster. Actually, I am the DJ; as I am blogging, I am finding her fast or slow songs depending on her mood...well actually depending on which "routine" she is working on. She is wearing her new leotard that we got her for her birthday. She loves gymnastics as much as I did when I was her age. <3

I have mentally planned what we will be having for supper. Wondering if we will watch a movie and snuggle on the couch tonight.....Chris Brown, "Forever" is playing now...Karsen thinks this song would be good for a floor routine. Yep, I agree baby! Chris will be home soon, going to start dinner. I love Friday nights.

indian summer

Olentangy River, OH, Fall 2010
picasaweb.google.com
*Indian Summer -a meteorological phenomenon that occurs in autumn, in the Northern Hemisphere. It is characterized by a period of sunny, warm weather, after the leaves have turned following an onset of frost, but before the first snowfall.(according to Wikipedia)*


I am so thankful for Mother Nature's sweet grace. She is easing me quite nicely into winter with the most beautiful indian summer weather. Everyone has told me that this Fall in OH has been exceptionally warm and sunny. I believe it is because I have prayed without cease for a not-so-cold slap-you-in-the-face kind of winter weather. I wanted a true Fall, and a nice gradual transition into the first real winter of my young life and that is what we have been having. :)

Actually, this week we have gone from freezing in the morning to highs of 60s-70s. Today we actually got HOT while we were out running errands. I sure did not complain at all. I know by the looks of all the sleds, boots, scarves, and etc...that I see everywhere that winter is so on her way! And we better get ready!

We live about 1/2 mile away from the Olentangy River. It is a beautiful area with running and biking trails that span about 20 miles from downtown Columbus all the way north into the countryside. I have been told that the river will look like this by mid-January.

Olentangy River, mid-winter 2009
krygier.owu.edu/

Oh my sweet word!! Indian summer, stay around as long as you want! I will surely miss you when you leave.

Since the weather will be so lovely, (for one more weekend according to the mean weather man on the news) we are heading to the Hocking Hills of southern Ohio to go hiking tomorrow! We are going to enjoy this weather while we can.

Tuesday, November 9, 2010

9

Happy 9th birthday, Karsen~! We love you!

Friday, November 5, 2010

because he knows i'm deciduous

One weekend recently, Chris surprised me with a fire pit. Evidently, eveyone in OHIO has a firepit. (Um, I know why~because it is already freezing here at night!) He and the kids spent the afternoon putting it together.


Even Miley came over to help.


 It is the little things like this that the kids really missed while we lived apart for a year. Time with their Daddy. There were just some things that I couldn't do to make up for his absence. Like....build things. Totally Daddy's territory.


The mandatory "smile at Mommy" pic of the afternoon.


The finished product. Smiles all around. I think the kids were already planning on roasting marshmallows in the next 15 minutes.


 Basically, Chris knew that this was the only way to get me outside when the weather starts getting cold. Ha!


And, it worked. Man-made fire. Hot!


We have enjoyed it several times already.  
Dylan was reading "Scary Stories" to Karsen and Ky (until they genuinely got scared and I had to make him stop).


Now, maybe I will live through the winter.

Thursday, November 4, 2010

apple orchard afternoon


Thank you, Mr. Man for driving us around the apple orchard.
It was a perfect fall afternoon.


 My sisters visited for the weekend with my nephew Kyland. They surprised Dylan for his birthday, and the kids were so happy to see them. I had really been missing them too.


Kyland lost his first tooth while he was here, but he wasn't going to let that stop him from eating some apples.


After the trailor ride through the orchard, we got some treats. The boys got ice cream, Karsen got hot apple cider.


To keep track of how fast they are growing.


My sister was able to take a family pic of us in the orchard. I had to laugh because we look like "city folks" in our sunglasses in the apple orchard. Ha!


Happy Fall, y'all.

Wednesday, November 3, 2010

Tuesday, November 2, 2010

Halloween 2010

Our first Halloween in OH~ The kids had a blast. It worked out perfectly. Karsen got to walk around with her girls, and Dylan was "dropped off" for his first "party". Here are the boys.


Princess Leia, NEO from the Matrix, and Osama Bin Laden. (?!?) Creative, huh? lol~Oh my. Dylan rolled his eyes like a true "tween" when I told him he actually looked more like Edward Cullen from Twilight. LOL. Yes, we dropped him off at a friends and they hung out there for a while, drinking hot apple cider, hanging out by the fire pit, and scaring whoever walked by. Then they walked all around the neighborhood. About every 20 minutes I called him on his cell phone and he answered by saying "Hi, Mom, I'm OK."

Just checking, NEO. ;) He had fun and felt very independent; I could tell.

Karsen met up with her friend, Rachel, who lives on our side of the neighborhood.


Later on we ran into the rest of the girls in the neighborhood. They all shrieked as the parents were taking pictures and blinding them with the flashes from their cameras.


About 30 minutes later, Karsen told me she was cold~thank goodness, because my feet were freezing!  It was about 39 degrees out, but it felt like 19 with the wind. So, I was ready to go too. We called Dylan and picked him up on the way home.  Everyone had a HAPPY HALLOWEEN!

Deciduous Heather