August 7

I looked at the schedule for Thursday and didn't see an "L" in either the morning or afternoon sessions.  I got a major feeling of happy for whatever brought that good fortune my way.

Until I realized that this might be the date that court was rescheduled for.  Back in spring I got a notice to appear in court in Mansfield Township, for an incident that happened last fall, November possibly.  It was a weekend I was on call and a guy called stating he was a patient, he had been in the Emergency Room for seizures and was out of the medication he used, Alprazolam, and whatever the ER physician gave him didn't work.

Fortunately the practice was an early adopter of an electronic medical record system.  I looked this person up on my laptop.  By name.  By date of birth.  By telephone number.

Nothing.

Then his story shifted to "Well, I've signed up to be a patient, but I haven't come in yet."

A likely story.

So I told him that I was quite sorry, but he did not appear on our roster, we don't prescribe controlled substances on weekends and over the phone and if he was truly having a problem going back to the ER was the solution to his problem.

Then I wrote a short note about the incident and sent it to my collaborating physician, who forwarded it to the practice manager.  And she reported it to the local police.

It turns out that this scammer used his actual phone number.  hello?  Idiot, even I have watched enough 'Law & Order' to know about burner phones.

Then, not to waste any of my ever- dwindling supply of brain cells, I forgot all about it.  Until the summons arrived for a June 19 court date.

I had to go back and read the note I wrote to remember the details.  So here's to hoping for another postponement.

The Crash, 2013

Sometime, late this morning, my computer froze while I was in the middle of a patient visit for someone with multiple medications for multiple issues.

Ugh.

So I logged out, restarted.

Tried to sign in.

Nothing, nothing and more nothing.

Deadness.

And I sat there stunned, almost unable to reboot my own brain to start using pen and paper again.

It was horrible, and made more horrible by the fact that most of the paper charts have been scanned and shredded.

Gone.

Having to rely solely on patients' memories for their drug allergies, medications is not fun, I work in the world of "I take a little white pill."  Really, really, could you be any less specific?.

And the process of identifying the problem would take at least two hours.

And all data from 12 midnight onward was lost.

Well, shoot.  Glad I didn't wake up after laying down with the kids to snuggle Wednesday night to finish those last two charts, they would have been done after midnight.

And I'm the lucky fool on call tonight, though fortunately it's been quiet - it just annoys me that four days after being on call for the entire weekend, I'm back on call.  Once upon a time, whoever worked the weekend got at least a week's reprieve from call.

So to symbolize my heartfelt dissatisfaction with Vitera, I made a voodoo doll, Vitera Man, and stuck four lovely pins into it.

Vitera Man,

 my 1st attempt at making a voodoo doll

 I think I may be on to something, a cottage industry of sorts. I would have rather worked on my quilt projects but I felt compelled, pulled drawn to quickly whipping this up.  The best part was sticking in the pins.

Right about the time I finished him, I got the email that the system was working again.

But I still cannot access Intergy from home, so I may have to go back to my pin cushion and grab a few more pins.

=========================================

Happy Birthday to my Dad.

He would have been 83 today.

Miss you.

Bugged Stomach

Yesterday I worked in the morning, picked up Thea at school at 3:15 and we went to the library so she could work on her Third Grade Inquiry paper and pick up Harry Potter and the Deathly Hallows.  We spent a couple hours there and then went to fetch Micah from Kindergarten EDP and made dinner.  Thea managed to finish her homework at the library, so they were free to play before and after dinner.

We started the getting ready for bed process at 8 pm, which counts for ahead of schedule compared with most days.  Since Thea finished getting ready, she wanted to read. Whatever Thea does, Micah also wants to do, so he grabbed his Harriet Tubman book and his Alligators & Crocodile book, and also hopped on our bed.  Just before sending them off to bed, I looked at the page number of the Harry Potter book and she was on page 446.  In a book I thought she had just picked up that afternoon.

After everyone was asleep, I went downstairs to sew.  Something did not feel right in my stomach, but I put it off on the way I sit while sewing: on the edge of the love seat, hunched over the sewing machine that sits on the coffee table.  It's a bit of an ergonomic disaster, but it usually causes discomfort in my butt and legs from sitting on the edge, rather than in the stomach.

I finished the twelve pinwheels I was working on, with the brain trying to remember if we had any Pepto-Bismal in the house.  And then all hell broke loose, and lunch, dinner and everything else that was in my stomach decided to relocate.  I question my choice of having the powder room painted green, not very soothing for those who are queasy.

Once upon a time I debated which I would dislike more, having cold symptoms for two weeks or so or one to days of a stomach virus - and at that time, the vote went to the stomach virus.  As of last night, I have reconsidered and changed my mind, I'll take head congestion and coughing anytime, anywhere.

And if projectile vomiting and dry heaves were not indignity enough, horrible chills came right on its heels and made me shiver and shake.   The normal two quilts, down comfort with duvet and fleece blanket could not make a dent in how cold I felt.  It took Steve coming home and putting three more blankets over me and warming up two rice / buckwheat pillows to finally over come the worst of it so I could fall asleep at 3:30 am.  And three Cokes with crushed ice to overcome the taste in my mouth that was telling me that my tongue had kissed road kill.

And for being out sick today, I really did just stay in bed and sleep.  No TV, no computer, no reading.   A whole day where I could have been at the sewing machine, and I just could not do it.  My first accomplishment for the day was sorting and putting away one basket of laundry and making the bed, which didn't happen until after 2 pm.  Second accomplishment was getting to Thea's school to pick her up and take her to religious school by way of Forest Jewelers to get a new watch battery for Steve's wristwatch and Wawa to get Thea a snack.

Fortunately, no one else in the house has come down this with this - so I'm blaming the lunch food at work yesterday.

Bits and Jots

Once upon a time, I wrote a blog, not well and definitely not often, but I tried to maintain a chronicle of what was going on in our lives.  Having kids who have school and social lives, plus working full-time, has just about drained my batteries for blogging - and life has just been sort of normal:  no surgeries, relatively few doctors' appointments, no traveling.

But every now and then there is a pang of guilt and today was one of those days.

I now have most Fridays off, which I am loving, loving, loving.  Not that I am actually accomplishing much, but sometimes it's not about how much I get done.

I've gone to a Friday Souper Sew and a The Sew Must Go On at Olde City Quilts, so I am still trying to sew and quilt.  I am also starting a Saturday Sampler at Pennington Quilt Works.  It's $30 for the starting package and then if the month's square is finished by the next Saturday Sampler meeting, the next square is free.  If it's not finished, the next square costs $6.

This morning I went to Ying Hua International School, Thea's alma mater for Pre-K through grade 1, to talk to the preschool class about nursing.  Though it wasn't much of a talk, it was more of a hands-on, let's try out the stethoscope and bandage up the classroom's stuffed animals.  The class was just so cute: there was the jump-right-in-with-boundless-enthusiasm kid, the shy-guy who has to warm up to what's going on, but once he does, he figures out how to disassemble the oto-ophthalmoscope, the little girl who has some mad bandaging skills and does it perfectly the first time.  I don't think they learned all that much about nursing, but I think they had fun.

Meanwhile, the kids are taking skating classes on Saturday mornings.  Thea's taking another trip through Alpha 2 during the next session; Micah is going back on the ice mostly to hang out with his friend, Benjamin.

Thea is in her second year of  Brownies, accumulating a few more patches and badges for me to sew on, selling cookies - it's her one chance to hang out with girls her own age.  We've been having friends from school over: Tommy, Jeffrey, Adam, for Wii dates.  We're lucky because Adam comes conveniently packaged with Veronica, who is in Kindergarten with Micah - and they live right up Krebs Road from us.  How lucky is that?  Thea just finished up her stint on Rainbow Patrol, which is her school's version of safety patrol, keeping kindergarteners from running in the halls.  The Third Grade Chorus is getting ready for the Spring Concert, chorus day is one day we have not problem getting Thea off to school; she already singing most of the spring program.

Micah is a chatterbox, much too much at times. Still needs a lot of working on patience, waiting and taking turns in conversation.  He's starting to read, which is a skill that also seems to require more patience than he is capable of.  Micah has a "I just want to do it, dammit" attitude, which just mesh with patiently trying to put the sounds that letters make into words.  After ice skating, it will be time to decide whether it's Spring Soccer or something else for him.

The 100th day of school has come and gone.  I've got to look up how this tradition came into being, it was not on the school calendar at Lewisdale Elementary School in the mid- to late 1960s.  There was an assembly at school, which Thea found to be too loud.  If the school year is about 180 days long, why would the 100th day be more of a cause for celebration than the 90th day or wherever the half way point falls?

Time to cut and sew. . . .

Earthquake

CNN and the local news stations probably covered it better than I will, but just in case Thea and Micah ever read this for the chronology of their lives, yesterday was the East Coast Earthquake.  It was 5.8 on the Richter scale and its epicenter was in Mineral, Virginia.  By the time the temblar traveled to New Jersey, it was a bit after 2:00 pm.  My office was back to work for the afternoon session, and the patient I was seeing was a new patient, the adult child and sibling two of my other patients.

I was on my feet about to do the abdominal exam portion of the check-up when a rumbling came through the floor, the walls were moving, and we were all left looking at each other with "Did that really just happen?" expressions on our faces.  Which was the same expression of the other faces I saw when I stuck my head out into the hall to see if anyone else felt anything.  Everyone went outside, I managed to grab my purse, keys and tote bag, if that building, made of spit, tissue paper and Elmer's glue, was going to come down, I was not going to be digging through the rubble before making my escape.

My biggest fear was explaining to Thea that New Jersey CAN experience earthquakes; after she saw news footage of the quakes in Japan and Haiti, she was worried that something similar would happen hear.  No, never we swore, very, very, very unlikely.   Thea said she felt it, but was not scared, and Micah probably though that he was the cause of it all.  The owners of the daycare where YingHua is holding its summer camp decided to close early (wimps) so Steve had to pick up the kids.  Meanwhile back at my office, no patients cancelled and the remainder of the afternoon session went on as if nothing happened (and compared to Haiti and Japan, nothing really did happen.)

Square Number Six, WIP

News from the quilting zone:  It's a paper-piecing work-in-progress week.  Three of the four squares that will make this square are done and the teacher loaned me the ruler used to cut the stitching lines so I can finish it.  I think she was willing to loan out her ruler because I had the most improved attitude.  I arrived at class early and announced that from what I had seen on YouTube, I'd rather have a simultaneous root canal and rectal than learn how to paper-piece a quilt square.  But using her template and instructions, I completed 75% of the square even with having to rip out tiny stitches twice. I rock, at least in my own mind.

For the twelve square sampler, I need to pick three patterns from the Quilter's Cache web site, but most of the 'one pin' patterns (which means it is for a beginner) are dull, dull, dull.  They all seem to be a re-working of squares we've already done.  I bought the fabric for the back of my quilt, the blue fabric with the whitish coral-like batik print, my tribute to the fabric that just about everyone wanted me to not choose and which everyone seems to like now that it's in with the other four fabrics.

Meanwhile back at the Krebs Road homestead, two floor to ceiling built-in bookcases are being created by Mike, who is also painting the butt-ugly mantel white and re-hanging it (so it's level, which will be a new development).  The progress over the past three days has been phenomenal, from framing on one side with one shelf in on Monday, to both sides done and ready for painting today. The wall behind the bookshelves will be purple.  And once the paint is absolutely dry, in will go all the books that are stacked all over the living room, dining room, kitchen hall and wherever else.  For all the nights I've driven through Princeton looking in the windows of the homes at the walls upon walls of bookshelves, I will have a smaller version that are all my own.  Next the putting green green carpet will be out of the family room and the majority of the ghosts of owners past (and their horrific style) will be gone, at least on the inside of the house.

It's a full moon this week, which explains why the work week seems longer and longer, even though it's more than half over.  The level of neediness and craziness, either together or separate is escalating with each day. 

On Call

Switched my weekend to work from next weekend to this weekend.  While I am eternally grateful to Karen for flipping with me, I'm also dreading being tied to a telephone until 8 am Monday.  Two calls already, but related to electronic prescriptions not making it to the pharmacy at the speed of light - and one was for my last patient of the day (4:30 pm) who was calling at 5:30 pm because it wasn't there.  If I do one thing when I send an electronic prescription I tell my patients that it usually takes more than an hour for a prescription to transit cyberspace to the pharmacist, and possibly more time for the pharmacist to actually fill it and put it on the shelf for pick up.

God save me from people who worship at Our Lady of Instant Gratification.

Other than work and call, we're going to a Lunar New Year dinner for PIACS, the Mandarin-immersion charter school that hopes to be up and running in the fall.  Micah has been accepted into its kindergarten class.

Then the usual Sunday ice skating lessons - Thea will be moving from Pre-Alpha to Alpha, Micah is staying in the same class, and Chinese school, and making cupcakes without eggs for Micah's Valentine's Day party at Dutch Neck (mercifully, the synagogue preschool does not celebrate St. Valentine.)

Update:  11:46 pm call.  102 fever - do I need to go to the emergency room?  Said a few naughty words after getting off the phone and went to bed.  Do people really, really NOT know how to manage a fever?  Really?

Countdown to Chemo. . . .

Back to Maryland again.  My mother's first chemotherapy session is tomorrow, and so on one of the biggest car-travel days, I'll be heading back down to Maryland.

Yesterday I crossed over the NJ Turnpike on my way home from work and the southbound lanes were a solid parking lot (I work just above Exit 5, if the reader is a coinnoiseur of the Turnpike); it looked like the northbound lanes were also starting to slow to a crawl.  That was Saturday at about 3 pm.

Fortunately things were relatively quiet at work - it's always a bonus when we're finished and the staff can go home by noon, and call has been almost nil.

So I'll get four to five hours listening to the Philadelphia and Baltimore oldies stations, reliving high school and college - and feeling like a bit of a geezer.

Home Again . . .

. . . .after hitting rush hours in several metropolitan areas due to my exquisite sense of timing.

Today we went with my mother to the oncologist, Dr. Mathur.  He cared for my father after Dad was diagnosed with lung cancer, and he also counts a few of my mother's friends among his patients and who give him good reviews.

First, the children behaved well during the appointment. Second, my mother behaved well, even though the full impact of what she's up against thwacked her over the head in a manner that was almost straight out of a Roadrunner/Wile E. Coyote cartoon.

Chemotherapy.  She anticipated that one.  Not a problem.  Looks like she'll be getting Cytoxan and Taxotere every three weeks for six cycles, and Dr. Mathur says she will not lose her hair.

Having a port implanted by which the chemotherapy would be administered.   Not so much.  Did not go over well at all, like a fart in church as my father would say. Her face showed everything from petulance to just being pissed.

Radiation after chemotherapy.  Didn't see that one coming at all.  This took us both by surprise, but it's also more than four months down the road and it is because of the size of her tumor, 4.3 centimeters, and anything above four size-wise should have it.

So after getting yet another folder of information for my mother to peruse, and with a tentative start date for chemotherapy of November 30th, we sent back to Wall's Bakery and bought more of the massive eclairs, and six chocolate-frosted donuts.  For the therapeutic power of chocolate, naturally.

Then we dropped my mother off for her manicure appointment.  Mom was in desperate need of some grown-up time, since Micah was back in Manic Chatter Monkey mode.  We headed for the little red caboose again (just across the tracks from the nail salon, but we drove anyway) and then to Oma's Special Park to kill 90 minutes before picking up my mother burning off some energy.

At the park, Thea and Micah entertained themselves for the most part, until they were joined by a little blond cherub.  LBC was about four, just in between my two age-wise. And he also combined the balls to the wall energy of Micah with the bossiness of Thea.  Just an ugly, ugly combination.  After listening to him for five minutes, I was ready to toss him down the near well or mine shaft.  Fortunately Thea snapped out of it, asked what grade he was in (Pre-K) and then asserted herself.  Micah was just the happy little synchophant, happy to be bossed around by any and all comers.

This gave me time to phone the surgeon's office and have a chat with the same nice lady I spoke with last week - just wanted to see if we needed to call about the port or would that be one of the topics that Dr. Personality would bring up at the two week follow up appointment.

After Micah and I fetched Oma from her manicure, with me finding that the O.P.I. nail polish color 'Suzi Skis the Pyrenees' was not the cool blue from whatever magazine at LabCorp, but a heinous, sooty grey, we made another trip to Hunan Star III.  Dumplings and egg drop soup for the kids, chow mein lunch specials for the grown-ups.  I know chow mein is about as un-Chinese as you can get as far as the cuisine goes, but the chow mein at this place totally evokes the memories of the chow mein at the Great Wall on Hamilton Street in Hyattsville which was my first memory of Chinese food. An authentic, edible childhood memory.

Then we went back to Oma's to pack up.  So far the only thing I left behind is a copy of the New Yorker magazine I was reading.  But we're going to be back again on Friday, so no big deal.

Micah slept from Waldorf to the Delaware toll, so he's wired for sound. Thea brushed her teeth, put her pajamas on and went to bed, and tonight she was so tired that the usual "I'm scared when I'm alone" didn't even come up.

And miracle of miracles, I am on call this weekend and there have been NO CALLS.  I've checked in with the answering service twice.  And I know I am cursing myself by putting this into words, but since I'm no longer in the car, and I have my computer at the ready, I don't care.

Tomorrow, the Penn Kresge Challenge walk in Philadelphia for T. and me, back in the car once again.

Labor Day Weekend

Work yesterday, not a hellacious Saturday but not as easy as the nice weather should have made it. Lots of "I want to nip this in the bud," which is frustrating because most of the 'buds' are viral and will take care of themselves.  Thea and Steve went to the pool, last good day for the Princeton Community Pool, weather-wise.  Micah and I went to Target, more large Bandaids for his ear, medium blue polo shirts for Thea for school, picking up a CD of pictures.  Charting waited until after the kids' bedtime. . . . .the perfect sedative, non-pharmacological, free.

Today the answering service didn't call until after 11 am, miracle of miracles.  Usually it's around 9 am on Sunday that someone finally thinks that it's a decent enough hour and whoever is on call must be awake.

This afternoon, it was sunny in Princeton, Steve's sister was at her beach house, so we went for a drive .  And the closer we got to the Shore, the more clouds, the more wind.  Not a great beach day.

The boys went to the beach, nothing will deter Micah from playing in the sand.   Thea stayed with me, and is going through the basket of games and picking things like Jenga and Tri-Ominos to torture her aunt with.

No matter the weather, the beach is still wonderful - and it's my first glimpse of the ocean all summer.

Micah just got back - he's a popsicle.  That child doesn't have enough body fat on him to maintain 98.6 in the face of no sun and a brisk breeze.  More later. . . .

Go Away Week, I'm Done With You

If yesterday felt like Thursday, then today should have been Friday. I just want this week over and done with. And despite having a half day tomorrow, at 5 pm or so I will be on call through Monday at 8 am, and I have to work Saturday. Not fun. It's supposed to rain on Saturday, so everyone will be home contemplating their aches and pains rather than heading for the Shore.

Today I found out that one of Thea's best pals at school will be moving to Chicago in two weeks or so. Nuts. They're so cute together, they love Pokemon cards, knights (and running around with swords and shields), and just play so nicely together.

Micah is talking, talking, and cracking people up - today he came to the office andwhen I found him, he said "Hello, Daddy" knowing full well that he was being funny. Two days ago, he was sitting at my desk, drawing a picture and when Sarah asked him what he was drawing, he replied "Kitties." Except that he put a "T" at the front of the word and dropped the "K". So Sarah said, something to the effect of, "Oh, you're drawing a CAT." And he corrected her by saying, "No, I am NOT drawing a CAT, I am drawing KITTIES." Except with the T for K substitution, again. And more loudly than the first time, because she clearly didn't understand him, in his mind. He might have perfect diction by the time he reaches kindergarten or first grade, but he's not going to be living that one down for awhile.

CPR

I thought my CPR certification expired in May of this year - it's good for two years, so it's easy to forget about. And this time I really did it. It had expired back in February, oops. Score another point for mommy-brain.

Thanks to my wonderful assistant, Meghan, who did all the leg work to register both me and the other NP I work with (who had a much, much better reason for letting her CPR card expire), tonight was the night to get legal as far as BLS goes. Thanks to the office for paying for it . In my mind, suffering DOES NOT build character, especially when one has to pay for one's own torture.

Thank you to the instructor, who made it practically painless - except for a little stress on the knees kneeling over the Resusci-Annie to do the chest compressions, and wonderfully short.

Another piece of bureaucratic minutiae, the State of New Jersey actually processed my CDS license in record time. A CDS is a controlled/dangerous substance license, which is a ridiculous $20 annual fee and the time it takes to go on-line and answer the questions, plug in the Visa card number and print the receipt. Why this is necessary when I already have a DEA license (which is federal, good for three years, and costs a about $350 more than the CDS license), I have no idea. It probably costs NJ more than $20 to maintain the record, send out the renewals and process the document. Or maybe I'm just cynical. Me? Cynical? Never.

Off Topic Rant

Not about kids, microtia/atresia, adoption, or the usual.

How to annoy your health care provider:

Saturday afternoon. Office hours are over. It's the weekend. Call the office. Leave a message with the answering service that you need a medication renewed. Your health care provider looks at your demographics and medications in the electronic medical record, and assumes that it's one of the medications that regulate blood pressure or cholesterol. In other words, important.

Even though it's not an emergency-emergency, health care provider returns the one call, only to find out that the patient needs his prescription for Viagra 100mg renewed. It's Saturday night, after all.

THIS IS NOT ANYWHERE REMOTELY CLOSE TO AN EMERGENCY, it's so far from one, though it will be come one when the HCP has irritation leads to her having an MI. After she decides whether to laugh or fume.

Damn Pfizer, damn those Viva Viagra commercials.

And because the health care provider doesn 't feel like contending with further phone calls or wasting time or breath giving a lecture on what is the nature of an actual emergency, the prescription is renewed.

This gets filed right up there with patient who called the answering service on a Thanksgiving Day a few years ago needing a refill of her Premarin. Perhaps a few hot flashes would help her roast her turkey and help her remember to renew her medications during normal office hours. (And I will admit to being a chump and renewing the prescription; my bark is much worse than my bite.)

But because HCP is annoyed, no refills on the Viagra prescription. Patient can tick off one of the health care provider's colleagues on another Saturday afternoon.

I hate being on call sometimes, though it does provide material when I have nothing else to write about. If nothing is happening I'll have to recycle the poison ivy on the privates story (another patient on another Thanksgiving Day, a tale whose lesson is sometimes you should sacrifice privacy if you cannot recognize poison ivy before relieving yourself in the woods) or the compound swear word story from the days of working in prison.

Weekend Update

Call this a weekend of a whole lot of nothing much special, and it was good. A little bit of cleaning/purging yesterday. Hanging out and straightening up (finding the Fisher-Price police car parked behind a bin in my closet - it's been MIA for days.)

The pools went up Saturday, and the kids got in a quick swim Saturday after coming back from visiting their grandmother. Today Thea's friend Emily came over so they could have a splash party - now we have three pools: our original baby pool, the large rectangular pool from Aunt Shannon and the pool we got last weekend while at Oma's (which she didn't want to keep at her house.)

I went through back issues of The Journal for Nurse Practitioners and finished a half dozen CME tests, put up a stack of books for sale on half.com, and picked up the nine thousand Matchbox cars, trains, playing cards and other debris that Micah has scattered over the living room and foyer.

To be finished off with a dish of chicken and cashews (reheated), the NY Times crossword, True Blood and the season premier of Entourage.

And the good thing about this weekend is that my right knee is merely making me aware of its presence versus its usual shrieking at the top of its lungs at the end of the day. It will go back to being miserable after about four hours of pounding the floor tomorrow at work, but it was nice to have a break for a couple of days.

Blogoversary

What a horrible addition to the ever-evolving English language. July 1st marks the day that I've been blogging for two years, starting a few days before we left for China to meet Micah. It started as pure avoidance of the chore of packing up three suitcase and two carry-ons for four people.

Once upon a time, in the Land Before Blogs, I tried to write a letter to Thea once a month on or around the 13th of each month, and I did fairly well for about two years. It's stashed someone on one of the computers, along with all the emails that I sent from our first trip to China. Between 2004 and 2007, along came blogs, and here we are.

It was an uneventful, eventful day. Micah went back to school, survived his transition to Miss Margie's classroom - and his BAHA is back from its vacation/spa treatment in Colorado. The audiologist at school went to put it back on his band, but we'd taken out the mounting piece (they're expensive, and if he tugged off the BAHA it could go flying, never to be seen again.)

Only one call so far, I'm on call again - with the one provider out on family leave and one on vacation, the grace period that usually comes after a weekend on call is not in the cards.

After dinner the kids and I went to fill up my car's gas tank, and while we were waiting at the gas station, we saw a double rainbow. We could actually see the arc going up into the clouds and then down again. It was pretty cool - but unfortunately if I would have tried to photograph it, the rainbow would have appeared behind all the powerlines that run along Route 1. Once the car was happy, we went into town to Thomas Sweets for ice cream - and along the way there were people out for walks who were pausing to look at the rainbow.

Thea had chocolate ice cream, so Micah had what she had, until it went onto the ground. Thea nearly died (she was promised any that Micah didn't eat and he quickly lost interest). They ran around the grounds of an old school building is next to the ice cream parlor, which provided the opportunity for them to be snacked on by mosquitoes - both had at least two or three welts, so it was Benadryl and hydrocortisone cream all around after their showers. Somehow the bugs don't seem to like old, grumpy B+ blood, so I was unscathed.

I'm on a new medication for pain, new as in new to the market - and one I wouldn't have chosen mostly because I had to endure months of him hyping the as-yet-unreleased medication without really being able to say when it would actually be on the market. It helped without knocking me out, the knee still hurt a bit, but I was moving better and in a better mood because of it.

Happy Birthday, dear Blog, you're probably better and cheaper than a therapist.

Been a while. . .

. . .since posting anything. Then I read about the sheer numbers of blogs that are created versus the number that remain active one year after their creation. I have to look up the actual statistic so I can misquote it properly, but it's staggering.

In a 2008 survey by Technorati, of the 133 million blogs created, only 7.4 million have been updated in the last 120 days. (Source: the NY Times June 5, 2009 article, Blogs Falling in an Empty Forest, http://www.nytimes.com/2009/06/07/fashion/07blogs.html).

So rather than being one of The Fallen, I will write about not much going on. Thea finished school on Friday, the school had a little end of the year celebration Saturday, which I missed because I had to work. Yet another virus has crawled into my upper respiratory tract, first masquerading as allergy symptoms before it segued into my nose, throat and trachea. As long as it just passes through with the kids missing the worst of it, I can live with the annoyance (not really but it sounds so much more noble than I am hacking, miserable and would prefer staying in bed all day with endless cups of tea.)

Micah has another week of school before a few weeks off. He'll be moving to a new classroom for the summer session, which I think means that he's making good progress. The date of his surgery has not changed during the past two weeks, so I am somewhat hopeful that it may actually be set.

Meanwhile, the new physician assistant started at work. She's been coming in a few days here or there, but this week is her first full week. Thanks to her it wasn't a horrific Monday, and I arrived home with all my charting done for a change. And this probably means that a meteor will strike the house tonight.

No new photos of anyone - unless I count the pictures of a patient with some sort of strange photosensitivity reaction. The patient is going to a dermatologist, but had another flare and wanted to go back on the prednisone that I had prescribed for a prior bout, but also wanted to have the specialist see the skin at its worst. Conveniently I had my camera in my car so I retrieved it, took a few pictures and uploaded them to print at the local CVS. Considering all the semi-obscure labs the specialist wanted drawn turned out blisteringly normal, and considering that we don't have the means of doing punch biopsies at work, the pictures will have to do.

Short-Term Experiment in Sleep Deprivation

Working more or less full-time is not for me. The house is a disaster, and I vacillate between not giving a damn and being horrified at the squalor. Dinner is happening later than we usually eat and therefore bedtime is also sliding. Once the kids are asleep, I retreat to my chair/ottoman in the living room and chart. For hours, and hours. And then I read correspondence - and since one of the providers is out, it involves reading information on patients that I am not all that familiar with and then updating medications and diagnoses.

That first week and how well it went was a total fluke, and made it seem like I could do it.

On the up-side of life, Thea has been incentivized to go to sleep on her own, without one of us sitting in her room until she falls asleep. It doesn't take her that long to fall asleep, but the tape of Chinese school songs she's been listening to for the past three months is beginning to wear on me. Five nights of going to sleep on her own and she gets a packet of Pokemon cards, which is her new obsession, thanks to the boys in her kindergarten class.

We also had the last parent-teacher conference of the year and got Thea's end-of-the-year report card, and she's still the same smart kid she was for the previous two reporting periods. Reading and doing math well above grade level. The surprising part is how well she does in Chinese considering the total lack of reinforcement we're able to provide her at home.

She also lost her sixth tooth. The first one came out last year while we were at Oma's - it was the first couple of days in July maybe (without going back to the blog log to look.) We've bankrolled the tooth fairy to the tune of $10 so far ($5 for the first, $1 for the subsequent ones.)

Micah is making decent progress in being potty-trained. He wakes up many mornings dry and is able to hold it until he gets to the bathroom. Since he's still sleeping with us, the overnight diapers will be the last to go.

Other than those few tidbits, there hasn't been too much to write about - or I'm just too tired to search the cobwebby corners of my brain for something interesting.

Can't Wait for the Week to End

It's only Wednesday, but I'm done. Last week, all five days were fine - I got my AM charts done before or during lunch, and a good number of the PM session finished before leaving, life was good. The kids got picked up, were happy in the office. This week not so much. It feels like going scuba-diving in a port-a-potty.

Yesterday we got home and when I went to get Micah out of the car, he had his left BAHA in his hand, the battery hatch cover was no longer attached to the BAHA and the battery was no where to be found. Perfect, just perfect. One BAHA costs about $4,000, and would probably need to be sent to Colorado to be fixed. He got hollered at but good; he's been trying to twiddle with the volume dials for months, which we're quick to put a stop to, but overall no real harm done with a little moving around of the dials. This, on the other hand, was serious. Fortunately the hatch could be reset in its tracks and wasn't permanently damaged, for now at least.

Before/during/after the BAHA incident, I was on call, and it's ever so much fun to be home alone with kids AND at the mercy of the answering service. This was thanks to Steve's bridge buddies changing the game from Wednesday to Tuesday.

So after getting the kids put to bed, I had more than a dozen chart notes to write, labs and radiology reports to go through and the rest of my in-box to peruse.

The first part of next week promises to be no better because the other NP in the office is out until Thursday.

Three Days Off

I survived my first week working Monday through Friday, 8:30 to 4:00. I don't think I've worked that sort of schedule since before Micah came home - and then only infrequently because my usual schedule was Monday through Thursday. I could do this because the practice manager creatively came up with a solution to my children's pick-up schedules: she made a staff person available to run up to Princeton, pick up Micah off of his bus then go to Thea's school to pick her up and bring both of them back to the office. This gives me two extra hours per day to see patients.

Other than the toll it's taking on my knees, it worked out well. Thea and Micah like Tesh. The traveling makes them a little more tired at the end of the day, but they're enjoying walking around the pond, feeding the koi - and trying to feed the mallard couple and the geese. I'm happy it's Memorial Day weekend, only four days of pounding the hallways next week. Yay.

This week was hard on them because Monday and Wednesday Steve had things to do after work, and Tuesday and Thursday I had places to be. Gettiing dinner, baths, and bedtime done singlehandedly takes a lot more planning to make sure they get to bed on time.

And the extra good news is that the provider who needed to take time off may be able to return earlier than expected. So just as I get used to that full-time paycheck, it will be back to part-time, and I won't mind one bit.

Happy Memorial Day weekend all.

CME Frenzy

Saturday I went to Morristown Hospital for a free CME program, the First Annual Vascular Update. Not exactly a topic to rock my world, but free is free - and come 2013, I've got to have 150 hours of continuing education, something in the neighborhood of 1,500 to 2,000 clinical hours worked, a sheaf of forms and $350+ to renew my ANCC board certification.

During the down time at the seminar, I pulled out my Palm and went into ePocrates and started whipping through a few mobile CME programs. Most of them are in the 0.25 to 1 CME range (by comparison, the seminar was good for five hours of credit).

Then today while the kids were playing in Marquand Park (aka the Sand Park, to Micah, which means that he brings home about a pound of sand in his shoes), I took the Palm with me and banged out a few more programs. While starting dinner, I put the PDA on its cradle and synch-ed it. The CME certificates then started to filter into my email. I usually get maybe a dozen emails a day, if that. B-O-O-M, 55 emails arrive.

Then I needed to print the certificates, and enter the information on the spreadsheet that I made to keep a running total of my CME credits, and I went from having two CMEs to 39.75 and two lines in my spreadsheet to 64.

Now back to slacker mode, already in progress. My goal was 30 to 40 credits a year, done.