Ears. . . . .

Micah and I were in the family room, on the 4th of July, I think because I was sewing and he was finishing dinner, which is more of a process than a meal since he's a dining dawdler.

And while he was contemplating his dinner, he looked up and me and asked, "Mommy, will my ears always be this way?"

Oh, holy hell, really?  Today this comes up?  And what I want from him in the way of details as to why this is on his mind aren't forthcoming.

We've talked about this with him before, around the time he was having the atresia surgeries.  Micah was told that the atresia surgeries were not negotiable because we wanted him to have the best hearing possible.  But the microtia repair surgeries are up to him, and at that time he said, "No more surgeries, I don't want big ears."  He was four at the time.

(And then his father decided that it was finally time to have him circumcised, which will definitely give him something to talk to his future therapist about.  But that's a different story about parents who break promises.)

The issue of microtia has pretty much been way, way off the conversational radar since September 2010, which was when Micah had his last atresia surgery.

So I slapped on my parental verbal tap shoes and offered him a quick recap of the past, and told him that going to the doctor to talk about surgery to create bigger ears is entirely his choice. (I try to avoid the words "normal ears", we talk about big ears and little ears.)

He then asked if the surgery to have ears made that look like Thea's ears could be done in Dr. Choe's office instead of the hospital.  And when he was told that it would be at a hospital and it would also not be Dr. Choe performing the surgery, he would need to see a special doctor called a plastic surgeon.

Micah then said that if it couldn't be done by Dr. Choe in his office, he does not want big ears.

Issue closed, for now.

Foreskin's Lament

Title cribbed from Shalom Auslander's book (which was a very good book, BTW.)

Today was the day Micah and his foreskin parted ways, his fourth time under anesthesia in less than two years.

The surgery was done at Summit Surgery Center in Voorhees, NJ, which was a pale approximation of our experiences at Englewood Hospital for Micah's atresia surgeries.  Whether you are for circumcision (Steve) or against (me, at least in this specific circumstance), in Micah's case, the debate is closed.

What I found completely appalling about the experience and people I was trusting with my child:

- requiring Micah's adoption certificate prior to surgery (I took it along the first two times to Englewood but never needed it); revenge was had by sending them the certificate which is entirely in Chinese with the exception of our names, our address and Micah's name; it had to be translated (no one asked me if there was a translation, which I have as well as a notarization of the translation, so I did not feel obligated to offer what I was not asked for.)

- the anesthesiologist proving that she did not consult the chart where 'Family History Unknown / Patient Adopted' is on almost every form I completed, and which also included the Chinese adoption certificate, but asking me has anyone in the family have any problems with anesthesia?  Really great for instilling confidence in a parent;

- the surgeon running three hours behind, we arrived on time at 10 am.  Upon registering, I was told that Dr. Packer was 'a little behind' which morphed into 'running an hour behind' and quickly blossomed to 'more than an hour behind.'  Fortunately we had a late dinner Sunday night, but Micah was really thirsty by the time he got his apple juice in the PACU;

- each time Micah was going to surgery with Dr. Choe, I put on a set of scrubs and carried him into the OR and stayed with him until he was under anesthesia, no such luck here, and since I assumed that this was the standard, I passed on the pre-op Versed for Micah and he got wheeled out of the room by four total strangers and was terrified.  Whoever at Summit Surgery Center decided that the cost of  laundering a few extra sets of scrubs that cannot be billed for was less important than a dose of Versed, which can be billed for deserves a blistering case of herpes;

- the urologist who told us that Micah would be in the bathtub within two days, and back in the pool a few days later who today told me that he's out of the pool for a week, see one item wish list above and add him to the list;

- I was repeatedly asked, 'You're here by yourself? '  Umm,no and yes, not that the question deserves an explanation, but we have TWO children, so one had to get to/from her summer camp program, the other had surgery today.  I was there with Micah, therefore not alone.  Steve took care of chauffeuring Thea. Divide and conquer, and BITE ME. Thanks for using a tone of voice that made me feel like an escapee from a leper colony.

The outcome of this is that I will forever be grateful the care we received at the Ambulatory Surgical Center at Englewood Hospital.   And Summit will feel my rage and wrath on the Press Ganey patient satisfaction survey.

Micah is doing fine, and has already came up to me and asked 'Can I take a look at my penis?'  So I helped him drop trou and check it out.  He seems satisfied that the major parts are still intact and is off to play with his surgery day loot.

Micah's Atresia Surgery Follow-Up

Note to self:  No more 9:00am appointments in Englewood, the NJ Turnpike traffic just sucks at around Exit 13/Exit 14.  I have become a lazy suburban slug, and do not cope will with ill-mannered, opportunistic weasels who do not believe in the use of the turn signals.  I hope they all get coal in their stockings.

The first part of the appointment was with the audiologist, Courtney.  Micah likes her, and she gives stickers, so his cooperation was no problem.  Then we had to park in the inside waiting area for his appointment with Dr. Choe.  Since I had two Matchbox cars in the back of the car waiting for the next trip to Englewood, Micah made bridges and garages out of brochures while another patient's spouse grilled me about Micah's ears.  This fairly observant guy noticed Micah's ear canals are behind his ear cartilage instead of in front of them.  Even without benefit of caffeine, I played the part of spokesperson for microtia/atresia because at the end of the story I could say that Micah is a normal four-year old in terms of speech and language and then resume playing Matchbox cars with him.

When Dr. Choe called Micah's name, he shot out of the waiting area and gave the doctor a running knee-level hug.  The report from the audiologist is that Micah still has a mild conductive hearing loss.  Dr. Choe took out the debris from the ear canals.  The right tympanic membrane has healed well and right where it should be.  The hearing loss is likely due to fluid behind the tympanic membrane, and since we're giving him Sudafed, Claritin and Nasonex there isn't much else to be done other than teaching him how to blow his nose.

The twice per week Ciprodex ear drops are finished, other than after going swimming.  Only swimming in chlorinated pools, no ocean or fresh water.  So good thing the pool at the hotel were staying at while in Maryland over the holiday is very, very well chlorinated if our past stays are any indication.

After the visit, Micah picked out a plastic camel from the toy basket (despite other more appealing choices), and we went out to the desk to make the follow up appointment in FOUR months.  We've never gone that long between appointments since just prior to the first surgery in August 2009.  Very good news since it will be April before we need to make the trip again.  Which almost counts as a Christmas present for me.

Went to Target for Micah's reward, standard operating procedure.  Picked up two more birthday party gifts for Micah's friends, Cameron and Max, had pizza with him and then dropped him off at Dutch Neck and made it to work by 1:15 pm.

Micah Update

Last week Micah had his four-week post-op follow-up with Dr. Choe.  His right ear is healing well and doing great. He was cleared for immersing his head again, the Ciprodex drops are down to twice per week, and better yet, we don't need to make another pilgrimage up the NJ Turnpike until December 15th.   At that visit, Micah will go into the booth again so the audiologist can check his hearing, both with and without the single BAHA he's still wearing.

Micah is hearing noises like the house creaking in the wind, the sound of water running in the shower upstairs and the softest whispering I can manage.

Meanwhile and far away, Micah seems to be doing well at his schools.  He seems to show a preference for Beth Chaim; just today he asked if he could 'take a break from Dutch Neck', the public school pre-Kindergarten program. 

Photo Catch-Up

I never have the Ohm and its cable, the memory card from the camera and the flash drive in the same place at the same time I'm blogging, so invariably I've got to go back to old posts or shove a bunch of random photos into one post. So here's a few bits of September 2010:

Micah's First Day of Pre-K, v. 1.0.1

Thea's First Day of Rec Soccer - 09/18/2010

2nd Grade Girls' Soccer - Go Ravens!

Lion Dancer at Autumn Moon / Lantern Festival in Philadelphia - 09/18/2010

Mini Lion Dancers at Autumn Moon / Lantern Festival - 09/18/2010

Pool Toys - our pool is finally open!

Micah's Third Surgery - 09/21/2010, with Bunny Bear v. 2.0

I want to go home. . . . . 09/21/2010

Surgery Day

Today started at 3 am, an hour before the alarm was due to go off.  Thea had allowed Micah to sleep in her room, on a pallet on the floor because his room is being painted, both must have woken during at the night and (shades of Jet Lag 2007), we all were in the same bed.

The night before the kids went over to Thea's friend's house so both Steve and I could attend the 2nd and 3rd grade back-to-school night at Wicoff.  Kalani's parents must have held an exorcism as part of their evening plans because reports were that both Thea and Micah were very well-behaved.  B-to-S night was a complete disappointment after which the full impact of what we once had in the Mandarin-immersion program hit like a meteor.  (It didn't help that PBS showed "Speaking in Tongues" on language immersion programs and seeing a high school student who had been in Mandarin-immersion for about nine years giving a speech in Chinese and a child from the housing projects in San Francisco who was reading to his mother from his Mandarin textbook after being in an immersion program from kindergarten through 2nd grade.)  Not the best night before surgery.

Micah got scooped out of bed at 5 am, plunked into pajamas and a button up shirt and put in his car seat.  Surprisingly in the dark and without the GPS, it was an easy trip other than Micah treating me to "I don't wAAAAnt to have surgery" every five to ten minutes or so.  When we got the Ambulatory Surgery Center's check-in desk he was almost immediately asking the ladies there, "Where's my bracelet?"   And just as she's done twice previously, Shirley put Micah's ID band on and gave Bunny Bear a band, too.

Since this is our third time there, just about everyone looks familiar, and the nurse who took Micah's vitals remembered him (she may have been the PACU nurse's relief when she went to lunch on the first trip to the recovery area).  The anesthesiologist was new, but she was nice enough to get Micah's previous info from medical record (hard copies, no EMRs there) since the anesthesiologist in March was worried about hyperthermia (no, you wrapped a child who sleeps near naked year round in warm blankets and cooked him).  But Micah was scheduled for 7:45 and Medical Records opens at 8 am.  Helpful. 

After Micah got knocked out and settled on the table, I went back out to the pediatric waiting area which is just a small area carved out from the regular waiting area and fasting patients' waiting area.  Several adult patients and the persons accompanying them attempted to sit there, but Shirley waved them off ("THAT'S the PEEEDIATRIC waiting area, you can't sit there) which as the one person sitting there made me feel like the lone leper.

Two hours spent between Facebook, the EMR from work and the Kindle passed quickly.  There was one call from the ER - and after Shirley called me to the desk for the call she proceeded to attempt to untangle her rather fercociously twisted phone cord which made me want to wrap it a few times around her neck.  Just a call from the surgeon saying the right ear was done and he wanted permission to clean out debris from the left canal while Micah was still under anesthesia.  I'd signed Micah's and my life away in terms of consent already, so the call was unnecessary.

Dr. Choe came out a little bit later and said that he'd revised some scarring behind Micah's ear, drilled the bone to make a wider canal, but the reason for Micah's loss of hearing on the right was that scar tissue that formed pulled the tympanic membrane away from the ossicles and not regrowth of bone.  All of which is good news.

About fifteen minutes later I got to go back to the PACU to see my little guy.  He was cranky.  Each time he has had surgery, a different child has come out of the anesthesia.  First surgery:  irritable, crying Micah.  Second time:  peaceful Popsicle eating boy.  This time: sour, cranky boy with nausea.  He had some ice chips and then two little containers of apple juice, and then complained his belly hurt.  So Bunny Bear and I gave belly rubs, we survived a couple of dry heaves and spits and were on our way getting out of there.  We had total parking karma today, and I brought the umbrella stroller so once all the paperwork was signed, I could just pack him in and wheel him out.

Thus ends another atresia surgery.

On the way home we made the obligatory stop at Target where Micah chose just about the most obnoxious, noisy truck on the shelf.  The nice cashier saw Micah's gauze head wrap and just busted out with "WHAT'S WRONG WITH HIS HEAD?" and since it was a cross-cultural thing, I didn't answer with "NOTHING, WHAT'S WRONG WITH YOUR MANNERS?"  On three hours sleep I was not up for being Little Mrs. Atresia Ambassador.

Then we dropped off our purchases at home and brought in the mail, went to Wicoff  School to see Tesh and Thea, then to Steve's office to say hello, then the farm stand in Lawrenceville for the wonderful corn, back to Princeton to the bank, then to pick up Thea at the after school Chinese program and a last stop at the pharmacy in Plainsboro before going home.  Then while I was shucking the corn, Thea and Micah watered the plants in the front yard, fighting for control of the hose the whole time. 

While Thea was doing her homework in the kitchen, Micah finally fell asleep while snuggling on the sofa with me.  Thea, Steve and I ate the corn while Micah was asleep and I got him up to eat his traditional post-surgery dinner of half-dozen steamed dumplings.

Since Micah's room is in a state of upheaval due to having it painted (bye-bye ugly, nicked up royal blue, bye-bye ugly lighthouse border.), color still undecided though leaning to something in the warm light gold spectrum, so he's with us tonight - and he needs to sleep propped up a little bit by pillows.

Follow up appointment is next Wednesday.

Six Days and Counting Down

Pre-op appointment with Dr. Choe today.  Micah got his ears cleaned out, which I always find fascinating seeing what comes out: right ear practically nothing, left year, a bit of waxy material and a bit of the beach.  Micah giggled through most of the cleaning, and did a fairly good job of remaining still all by himself. 

All systems are go for next Tuesday's surgery.  Pre-op audiogram occurred before the ears got flossed out, so I think that the slight suboptimal performance of the left ear was related to the coating of debris that was in there.

Meanwhile on the drive up to Englewood, Micah is making his case that his hearing is just fine, thank you and he doesn't really need surgery.  Until I told him that no surgery, no trip to Target for his handsome reward.  Brief moment to consider options, and he's fine with the surgery.

Labor Day Weekend

. . . not much a big deal around here.  Since we're in countdown mode for Micah's right ear (scar tissue revision) surgery, I made an appointment for him at Quest for his CBC.  The Jamesburg location was three miles closer than the one in Somerset, so even though it was uncharted territory, proximity won out.

The advantages of having blood drawn on the Saturday of a holiday weekend:  only one other patient at the lab.  We got checked in, Micah's blood was drawn and we were out of there in about fifteen minutes total.  The two phlebotomists were in, out and had the bandaid on Micah before he could say "I don't want a pinch!" (He asked me if this was like a shot and I told him it would be more like a pinch.)  Most of the whining seemed to be more for effect than actual pain.

Secondary gain from going to the Jamesburg Quest, it's nearby the Crate and Barrel Outlet.  I love that place, even just for looking around.

Following the 'pinch,' we had to make the obligatory pilgrimage to Target.  This was made more necessary due to the fact that Bunny Bear went missing earlier this week.  Really missing, not just misplaced and on a day where we made more than half dozen or more stops.  Problem solved by eBay, where there were vendors willing to sell their Bunny Bears for $30 (greedy mercenaries profiting from the suffering of others) to $99 (greedy b*st*rds with unreal expectations as to what a 12-inch polyester bear in a bunny suit is worth). 

There are variations of Bunny Bear on Amazon, but Micah's version is old school: the bear's bunny suit comes off, the newer versions the manufacturer (TY) cheaped out and made the suit part of the body, thus saving them 50 cents worth of fabric and labor costs.  The tale that we spun for Micah was that Bunny Bear went off to get a new bunny suit and would be coming home after he got his new outfit.  Thanks to package tracking from the USPS, I knew that as of Friday, the new Bunny Bear was in New Jersey, and by Saturday morning it was in Plainsboro.  What I didn't know was if it would actually be delivered.

So a decent bribe was needed to cover my  backside if the Postal Service failed me.  He picked out a stuff animal, a golden Labrador, who he named Lucky Bucky.  On the drive home from Target, Micah actually removed his bandage on his own - usually he whines about that almost as much as getting stuck.

His reward was the arrival of a small white plastic envelope which had his Bunny Bear.  The look of excitement and relief on his face was wonderful.  And no more midnight arrivals in our bed with the piteous announcement of "I miss sleeping with my Bunny Bear."

Thea starts school Tuesday; Micah has a short visit to his classroom on Tuesday, but this week is nothing but chaos as far as scheduling.  Micah's morning program at the Congregation Beth Chaim Preschool doesn't start until next week.  We still don't have a solid after school program for him:  the school district offers no aftercare for preschoolers, the Beth Chaim program does not want to take him back after school.  Underlying all of this is how do working parents with preschooler and kindergarteners manage in this throwback to a bygone era school district?

This past week the kids got their school physicals and immunizations, new shoes were purchase, haircuts gotten and school supplies collected.  Another reason to hate this school district:  both kids' teachers had marble composition notebooks on the supply list.  I have hated those things since 1970 when I was in Mrs. Isenock's 5th/6th combination class.  They are miserable for getting them to lay flat to write in them comfortably and I didn't think that they were even manufactured any more (and good riddance!)  Not only are they still made, but they are actually difficult to track down in the greater Princeton-Plainsboro area.

One day closer to the start of school. . . .

Micah Update

Micah is once again able to be in the water, on the water, under the water.  Good news for Micah's summer.

Until September 21, when he will have surgery on his right ear to revise the scar tissue.  Not so good news, but the hearing tests he had at school and the appearance of the tympanic membrane give us two choices:  revision or hearing aid, and since Micah doesn't have a lot of cartilage to support a hearing aid, it would need to be one that sits in the ear canal.

So make a note, our new house's pool will be closing as of September 21. . . .

The surgical coordinator at the ENT's office was totally on her game: we walked out today with all of our forms, a surgery date appointments for a pre-op and one-week post-op appointment.  Back to Englewood Hospital, one more time on the first day of Fall 2010.

Addendum:  Just got the answer to a follow-up question, no additional donor skin needed for the revision surgery.  Yeah!  Micah's left leg graft site has developed a bit of a keloid, so I'm glad that he doesn't need to make another donation and risk another scar.

15 Days Later

Today I picked Micah up at school to drive back up the Turnpike once again to Dr. Choe's office.   I am now back in the groove of going up there and don't really need the GPS.   And we were early for our appointment despite the elevator being broken and having to climb up five flights of stairs to the PH level.   My knees did not like the climb up or the trek down, though Micah thought the acoustics in the stairwell were interesting.  As I am sure everyone who heard him did as well.

Today the sponges came out of Micah's ear canal.  The silicon disk is still at the end of the new ear canal and is propped against the new ear drum, and in two weeks that, too, will be removed.  We're also down to putting the Floxin otic drops in once a day, instead of twice.

All good news, just rather dull the second time around.

Follow-Up

Micah is eight days out from surgery, and today was his follow up appointment with Dr. Choe.  Fortunately the surgical coordinator made the appointments for us weeks ago, so we were ahead of the curve.

The fluid behind his right tympanic membrane is gone; thank you Children's Sudafed.  And there was no debris in the canal.  He's still wearing his left BAHA.

All is well with the new ear and we're now back to instilling five drops twice a day onto the sponges/into the canal.  Minor drama getting the prescription filled, with no help and misinformation from our local CVS: "It's nowhere in the CVS system."  I picked it up at the CVS on Nassau Street at 7:30 pm, so the pharmacist who made that statement is not going to be appearing on my Christmas card list any time soon.

Meanwhile, laptops are giving major grief.  The Windows XP Security malware made an appearance on my work laptop, locking me out of Internet Explorer and creating pop-ups that got in the way of Intergy.  My annoyance grew to major proportions around midnight, and after finishing my chart notes I made a trip to the office at 1 am to drop it off, and I picked up my personal laptop, which is having power cord issues but those are easier to manage, for now.

So between the computer problems and the pharmacy idiocy, I have been a crab today.

Next follow-up with Dr. Choe in one week, on April 7.

Photo Update - Micah's Surgery

6:30 am at the Ambulatory Surgery Center, Englewood Hospital - not quite clueless, but in a good mood.

In the PACU, still somewhat dopey, but croaking, "I want Mommy."

Ice pops, on the road towards being discharged.

30 hours later.

Just before the dressing came off.

The new ear canal with the Merocel sponges in it.  The marks in front of the ear are surgical markings.  There is a small bruise on the right side of his mouth from a clip for facial nerve monitoring.  Compared to August, the incision is much smaller, and tucked behind his ear cartilage.

Day After Surgery

Tesh came over to work in de-cluttering the garage.  I wish I had taken before and after photos, but 'before' would be too mortifying to share with the general public, and 'after' is still a work in progress, though a million times better than what it looked like at 9:30 am.

Got to love Tesh, who took a lot of stuff off for donations, to FreeCyclers in the Princeton area, especially the lady who came six minutes after I put up a Curb Alert for two tricycles.  Gone.  Big plastic race car bed.  Gone - though it didn't go until some time after 4:30 pm when Micah and I went off to Target.

Meanwhile, the boy who 24 hours prior was under anesthesia was riding his bike in the driveway, digging up rocks in the front yard, 'helping' sweep in the garage (if you count sweeping the dust and leaves back IN instead of out). We got a call at 9:00 am from the anesthesiologist, checking on Micah and how his temperature is. (Normal.  No fever, nothing.)  Then a 3:00 pm phone call from Englewood Hospital to check on Micah - again the concern was touching, but he was napping and oblivious.

We unveiled his new ear at dinner tonight.  The incision was closer to his cartilage so there isn't a big line of steri-strips behind his ear.  The Merocel sponges are poking out more, so I have a bandaid over them, but other than that, it doesn't look like much compared with the previous surgery.  The skin graft site this time is a bit more leaky, I've already put one piece of Tegaderm over it, and its managed to get a little dislodged by Micah constantly being in motion, so we have a little bit of watery/bloody fluid leaking onto his underwear.  Nothing that a run through the washer and a little detergent can't handle.

All in all an uneventful day.  And uneventful is good.

Surgery Day

August was the perfect storm of perfect circumstances.  Fast forward six months, and history is not going to repeat itself.

First, Micah is aware of what's going on, and he started immediately upon arriving home with ranting that he didn't want to go to the hotel, hospital or basically anywhere that I was going. . . .

The drive up the NJ Turnpike in the rain was less than pleasant. . . . .

The hotel put us in a room just off the elevators, next to an event room where there was something going on that involved chanting and keening, which managed to come through the wall. . . .

My watch battery is giving up the ghost. . . .

I am wearing green scrubs (to take Micah back to the OR scrubs are required) and when I went to go take them off, the nurse just said "Oh, leave them on" and shipped me out to the waiting area.  The extra layer is keeping me warm, but I feel like a dorky green bean.

Micah is the only pediatric surgery today, so instead of being ushered into a pediatric recovery room to sit and wait, I am out in the regular waiting area with the TV blaring.  With three TVs blaring actually. . . . .

Micah curled up on my lap after we put him in a hospital gown and had big, fat tears rolling down his cheeks, and then started outright wailing on the walk to the OR - he didn't even want to drive the cool car like last time, I had to carry him. . . .

Fortunately the crying means increased respirations, but it still took him longer than last time to go out . . . .

I did get a call from the circulating nurse to let me know his ossicles were good and that the facial nerve was well out of the way of the area the surgeon is creating Micah's ear canal.

I have about an hour, maybe 90 minutes until I can see my baby again, and this time, I will put a towel on my lap so he doesn't pee on me like last time - and I brought extra pull-ups along, too.

I hope the surgeon doesn't make the gauze turban too tight, last time Micah looked like he had had a facelift instead of an atresia repair.

Three Days and Counting

. . . until Micah's second atresia surgery.  Nothing really exciting to report.  The pre-op visit with Dr. Choe was Wednesday.  The Princeton area is still recovering from the previous weekend's storms and the power lines and trees that were knocked down.  We've been without River Road, our primary access to Route 27 and Route 1, Thea's school - just about anywhere, until Friday afternoon.

It seems like there was one area that was hit harder than ours, Bergen County.  Exactly where Englewood and Micah's doctor are located and where we needed to be at 12:50 pm on the 17th.

And right on Grand Avenue there was a police car blocking traffic so that a very, very large tree could be cut up and removed from the road.  Thank you GPS, but the re-routing made us a few minutes late for the appointment. 

Micah went back in the book for a pre-op audiogram, which was similar (for the left ear) to his previous audiogram.  Moderate conductive hearing loss on the left, mild conductive hearing loss on the right.  This time though he did the test without any of the gimmicks used on younger children; he just sat in the chair with the headphones on, talking with the audiologist and repeating the words she said and then listening for the beeps.

Dr. Choe's check of the right ear canal found fluid behind the ear drum, so Micah is now on Children's Sudafed to see if that helps with helping his eustachian tube to drain. 

Paperwork signed, more copies of the pre- and post-op instructions, the one-week follow up appointment confirmed and we were back on the Turnpike and heading home.

Since I was off from work, I got to go to the kids' swimming lesson at Can-Do.  It's the start of the new session, but since Micah won't be able to attend the make-up session for the snow day (scheduled for May) he was allowed to attend the first day of the new round.  It's going to be hard for him in the coming weeks to see Thea continuing with lessons while he's waiting for his ear to heal.  The previous surgery was at the end of August and he wasn't cleared to submerge his head until December.

Tonight, while working on my charts, I flipped to Discovery Health and watched a segment on a child's right microtia repair with Dr. Reinisch. It was interesting, but right now Micah wants to keep his 'little ears'.

Creepy Crawler, Part I

Today the number on my blog's hit counter went up astronomically, at least for this particular blog in a single day.  A jump of two dozen may not raise anyone else's eyebrows, but it's an event in this small niche in the blog-o-sphere.  So I went to look at the page that tracks the visitor information, and most of them had a questdiagnostics.com web address.  How very Big Brother Is Watching: Quest must have a web crawler that hunts down references to itself and it doesn't just come looking one time, it returns again and again and again. . .

So while I was temporarily excited a cracking 1,900 hits (proof I'm working too much or need some other form of diversion if something as trivial as that gives me any sort of a thrill), when the reason was known it creeped me out.  Go away, Quest Peeping Toms, you've aggravated me enough for the past 24 hours!  The title for the previous post was changed.

And BTW, Micah's blood work was fine, and I managed to find time at the end of the day to fax it to Pre-Admission Testing at Englewood Hospital and put a hard copy in the mail as well.

Two weeks from today at about this time we'll be home and Micah will be at home almost back to his usual full of energy self - with another gauze turban around his little head.  Another to-do list item, buy Conform gauze for when (not if) he pulls the bandage around his head off and extra Tegaderm for his skin graft site so I'm not making a spur of the moment run to CVS.

Quest-ing, Quest-ing, Quest-ing

Once upon a time Thea's photograph was featured in the Quest Diagnostics 2004 Annual Report because of an email I sent to the company complimenting the two phlebotomists at the Princeton location who drew Thea's blood when she was just 14 months old.  It is her small claim to fame, aside from meeting former president Jimmy Carter on her first day in the United States on our flight from San Francisco to Cincinnati.

I don't think Micah will be smiling out from the pages of the 2010 Quest Annual Report.  The Quest drawing station in Somerset on a Saturday is nothing short of semi-organized chaos and the waiting time, even with an appointment, is deplorable.  But we survived, and life moves on.

So this morning I arrived at my desk, powered up the laptop, pulled up Micah's chart in the EMR and there was no lab report.  It was a CBC (complete blood count) and a CMP (comprehensive metabolic panel), not exactly a strain on the system.  Most of these drawn at my office are 'resulted' as the lab calls within 24 hours.

And me being me, promptly went to the lab and asked one of the medical assistants to call Quest and find my kid's blood work, drawn two days ago.

The answer was that no report was available because the specimen was just being processed today.

You. Must. Be. Joking.  48 hours later?  Really?

So I still am shuffling around Micah's pre-op clearance form, waiting for that lab report, seething all the while.

Quest can bite me, and as soon as I can put it in more polite terms, the corporate office will be hearing from me.

Weekend Stuff

Micah (and I) survived going to Quest Diagnostics in Somerset yesterday for his pre-op blood work.  The little waiting area was packed with every chair taken.  I signed him in (having made an on-line appointment I was hoping that there would be some preference given over the walk-ins.)  Micah started whining that he didn't want to have his blood drawn, but the nice woman who sat next to us started to talk with him and distracted him out of fretting mode.  She was especially kind because I left him sitting with her a few minutes after I had heard a staff person call out, "Mitch!" with no one answering.  The light bulb in my head was on a two-minute delay before the thought burbled to the surface, "Could somehow, in some universe of mispronunciation, this person have meant Micah?  And oh yes, she did.  So I had to sit at the desk doing paperwork, while this nice stranger quizzed Micah on his Thomas the Tank Engine trains and other hot topics for four-year olds.

The difference between pre-op blood work in August 2009 and now is that instead of just whining, he can now fully express his annoyance and fear.  Last time it was just me, Micah and Freddie the Fast Phlebotomist (his real name).  This time it was two Latina phlebotomists, who kept telling Micah, "It's ok, Papi" while he was saying, "I DON'T WANT you to take my blood.  Please, DON'T TAKE MY BLOOD."  Fortunately, whichever one actually did the sticking was successful on the first try.  Thirty seconds, one gauze bandage and a few stickers and we were out of there.

Naturally for pain and suffering endured an appropriate bribe had to be offered, so we went off to the Toys-R-Us in Somerville (much nicer than the Princeton/Lawrenceville store).  Micah had $8 worth of coupons from his birthday, and I had to get something to make up gift baskets for Micah's school's fundraiser.  I have two nap quilts, but I wanted to put stuffed animals and a few books or puzzles to fill it up a little more.  Lucky us, Animal Alley was having a buy one, get one free special that day: one giraffe, one kangaroo/joey combo in the cart.

Then Micah and I made a donut stop at the drive-thru Dunkin Donuts in Hillsborough and we headed home.

For the afternoon, Steve took the kids to see his mother, so I had time to go to the post office, grocery store and Michael's for more supplies to finish off and decorate the gift baskets.

I also drove past a house for sale in West Windsor that is in one of the school districts that Princeton International Academy Charter School will be drawing from. . . . .more on that later.

Thea has been asking, asking, asking for stuffed peppers, so for Saturday's dinner I made four stuffed peppers and extra stuffing (which is how Thea likes it: stuffed peppers without the pepper, which seems perfectly logical to her).

Today Thea needs a haircut and has homework to finish, the house needs vacuuming and organizing, most of which will probably not get done (the home stuff, the haircut and the homework are non-negotiable.)

Movin' On Up

On Monday when he goes to school, Micah will be moving from Miss Margie's room to Miss Karen's room - the room that is usually the last stop before graduation and kindergarten.  We were notified by Summit School that the school does not anticipate Micah being enrolled in Fall 2010 because he has met his speech and language goals for his age and needs to have more exposure to normal-hearing preschool peers.

To say that that I was stunned is beyond an understatement. Not exactly what I was expecting to hear: Micah won't be eligible for kindergarten until 2011.

Though a bit of a bolt from the blue, this news is a testimony to Micah and how well he is doing with language acquisition, to the school and its staff for what they do for the children who are fortunate to be enrolled there, and to all those who have in any small way been a part of Micah's speech and language development.

But then, let's re-focus on the shock and awe of it all; it's like being kicked out of the nest a year earlier than expected.  Summit School is such a wonderful environment for students and their families, it feels a bit like Linus's blanket.  And by leaving, we're left to figure out what to do with Micah for the upcoming school year.

 I had indigestion for the entire afternoon after we got the news, without a Tums in sight.

Amongst all the possibilities, I'm not so sure about the school district's preschool, and it probably operates like its kindergarten: half day sessions.  Four hours of school is little use to working parents.  It will take a lot of convincing for me even to consider that as an option.  Micah seems to want to learn Chinese like Thea, so YingHua International School might be an option.  Beyond that, I need ideas and soon.

Meanwhile I'm working on getting ready for Micah's surgery.  Today I mailed off the forms to the Pre-Admission Testing Unit at Englewood Hospital, Saturday Micah will have his CBC drawn at Quest.  Next week I need to get one of my co-workers to do a quick exam for Micah so another pre-admission form can be sent in, then we have some downtime until the pre-op appointment with the surgeon on the 17th.

That downtime that will be filled with Family Fun Night at Micah's school on the 12th, another chemotherapy session for my mother (her sixth and final!)on the 15th, working and being on call for two weekends, having a senior nursing student shadowing me at work tomorrow - and the usual swimming lessons, homework harangues and other nonsense.

The Envelope

Saturday an envelope came in the mail from the ENT surgeon's office.  Paperwork, a thick wad of it.  Including a pre-op clearance form and a prescription slip to have a CBC drawn.  The strange thing is, I distinctly remember asking at Micah's December office visit did he need another pre-op clearance and blood work since it's been only six months since his last one and other than growing taller and a little bit heavier, nothing substantive has changed.

So I thought it was just bureaucracy in motion, one of the office staff just stuffed the usual sheaf of forms in an envelope. Send an email off to the doctor, and it will all be clarified.

But no, he said we could forego the CBC, but it was preferable if it was done.  Well, snot.  Now I need to make an appointment at Quest, prepare and bribe Micah to make this happen.  And cross my fingers the same phlebotomist is working, he nailed it in about one nanosecond before the whining could even get started.

I've already promised Micah a Nintendo DS for going back to the hospital.  He was getting balky and telling me that he only needed one ear fixed, he didn't need two surgeries, and thanks to the nice Nintendo carrot, he has not brought it up again.  And he will remember.  Friday night he had left a car the babysitter bought for him in the backseat of my car, and he was promised by his father that he would go out to retrieve it in the morning.  The first thing that came out of Micah's mouth as he woke up Saturday morning was, "Daddy, you put on pants and shoes and go get my car?"

(And by the way, Mommy went out to fetch the toy car in case you were wondering.)