MICU part 2

I have learned a lot on this subinternship. I thought I would learn a lot about the administrative stuff, writing orders, all that crap. I have, but I've also learned a lot about thinking about disease. Consider the following comparison: treatment of disease is like hiking through the forest. At the beginnig of my third year, I was barely able to recognize anything abnormal, to notice that there were trees in this forest as 'twere. I was too focussed on walking along the path and getting the motions of a physical down. By the end of third year and where I am now, I can see trees, and occaisionally discern between types of trees. I can now recognize when something is abnormal and know what to do about it. But I still see a lot of individual trees. What my attending does which I cannot, is to stand back, and say "this is a 3rd generation mixed forest of deciduous and coniferous trees, typical of the pacific northwest, most specifically the costal region between latitude 35 and 50 degrees north. I can say "this guy is hypotensive, hyponatremic, hyperkalemic, is covered in non-blanching livedo, and has 2+ pitting edema of his lower extremities. He is also anuric." This pt does not immediately scream SEPSIS to me, although he does more now than he did 2 weeks ago. It's really hard to put all the pieces together and parse between the important,the urgent, and the less-important, and identify a unifying diagnosis and come up with an appropriate treatment plan. I guess that's why I'm still a student, huh? At least watching my brand new interns, I can see myself doing what they do and being able to at least function at that level.
SS

Bad things happen at night

It's true. I'm on my medical ICU rotation right now (MICU) and I'm on overnight call every 4th night. I usually sleep for 2-3 hours a night when I'm on, and then go home at 12 or 1 the following afternoon. That adds up to about 30 hours on at once, which happens every 4 nights so I work about 75-80 hours a week. This is a foreshadowing of internship. I have had two firsts for my medical career during this rotation.

Last tuesday night, we got a transfer from an outside hospital. It was an 84 year old lady with a history of small bowel obstruction, dementia, and coronary artery disease. She arrived on a levophed drip (powerful vasoconstrictive medication for maintenance of blood pressure), and intubated. Her family had allegedly retracted her DNR status and now wanted a full court press. We were barely able to get a femoral arterial line in, and when we checked the CT from the outside hospital, it confirmed our clinical suspicion that the bulk of her bowel was dead. Surgery was reluctant to take her to the OR, for the obvious reason that she would likely not survive her operation. We contacted her family and they informed us that they wished us to withdraw care, which we did. She expired about 10 minutes later as we watched.

Four nights ago we received a call that one of our patients was seizing, had probably aspirated, and was now becoming bradycardic (her heart was slowing). We ran upstairs, started bag masking her, and had to begin CPR. After several rounds of vasoactive drugs, her heart actualy started beating again and she returned to her baseline, which was incredible. This was my first experience in a code and I'm glad that I did 6 weeks of anesthesia to practice bag masking pt's, since that was my job.

MICU has been quite intense, that's for sure. I do enjoy the complexity of these patients, but caring for them is like trying to replace the transmission in a truck, at night, by flashlight, at gunpoint, when you're a bicycle mechanic. It's really hard for me to see the big picture, I can spot many of the abnormalities, and piece some of the parts together, but placing all of them together as part of a coherent whole is far beyond my current knowledge base.
Spiff.

What's On My Mind

We're back from a much-needed and great vacation to Michigan. We saw some family and spent time with some wonderful friends. We left the cabin with mixed feelings, being ready to be off of vacation, but not ready to leave our friends who live far from us. We were not quite ready to start life again, and were wishing for a few more days to decompress at home before Spiff started into 4th year.

But, we got home, and he started right up. Starting 4th year is sort of a strange thing. For the first time, he isn't starting up the same big thing as the rest of his class. Everyone picks their own schedules for 4th year, and so everyone has something different to start off the year. Some of his classmates are studying for and taking Step 2. Some are doing research electives. Some are out of town. Some are doing dissection with a very flexible schedule. And some, like Spiff, started off the year with a bang by doing an intense sub-internship. He is in the MICU (adult intensive care unit), and he is on a Q4 overnight call schedule for three weeks. The means that he has to spend the night at the hospital every fourth night for three weeks. It's pretty intense, he has to do a whole ton of rounding (like 8-12 hour each day!), and he's tired. I know there are residencies that do this kind of schedule for several years in a row, so I can't complain, but it's still a tough thing to start up with.

And then in just two weeks, Spiff heads up to Rochester, MN for a 4-week anesthesia away rotation. Gunner and I will be leaving to visit my family for those four weeks, and while Spiff is enjoying a nice, month-long interview process, I will be enjoying my family. We will be camping and visiting Yellowstone (which I haven't seen for 11 years). I will also be running this event with my sister. I'm not in very good shape, so I'm a bit nervous to tackle the distance and altitude. But as long as the team doesn't care that I'm super slow, I'm just excited to do such a cool event with one of my favorite running partners ever!

Also, we're enjoying Spiff's sister, Mhana's, adventures while she researches doctoral paper material in France for the Summer. Check out her blog here. She writes good, that one.

I also recently found out that one of my good friends from college has breast cancer. It has spread to her bones and is incurable, although the doctors say it is treatable. She is only 33, has a wonderful husband who loves her, and has three little kids. I can't stop thinking about her and how unfair the situation is. I keep praying that her treatment will give her years with her children, but it even that doesn't seem good enough. I want her to grow old with her sweet husband. I want her to see her children to adulthood. I feel so helpless. And I am already grieving for her.

Spiff and I have discussed many times recently how we seem to have so many good friends who are going through terrible trials in their lives. My friend with cancer, another good friend who's pregnant wife had cancer on her tongue (thank goodness it was taken out and she is cancer free for now), good friends with infertility problems, friends who's children have been diagnosed with serious health problems. They have all been on my mind and in my prayers. While I am so grateful for my own family's current health, I find myself feeling guilty being grateful that it's not me. At least for now.

I feel so helpless. I wish I could do more for these people I love so much, and each and every one of them have been shining examples of how we should handle trials that come our way. They rely on the Lord. They share their experiences with those who love them, so that we can all at least pray for them. I'm sure they suffer more than they show, but they certainly do seem to handle things better than the way I imagine myself handling similar situations if I faced them.

And that is what I have been thinking about lately. Now I'm going to bed. Hopefully Spiff can get a few hours of sleep in the on-call room at the ICU tonight.

OB-GYN part 1

It seems fitting that a specialty which refers to itself with a five letter abbreviation is one that is chock full of abbreviations, to the point that our syllabus was annotated with a glossary. I imagine this is some subconcious throw-back to the days when physicians spoke in latin both to impress their patients and to conceal their thoughts. Here's a sample:

CC: VB for 2hr
HPI: HC is a 38 yo G4P3103 at 37w5d c/o spontaneous VB this afternoon after waking from a nap. She denies any LOF, d/c, and has postive FM. Pt denies pain, no h/a, dizziness, RUQ pain, or VC. Pt only c/o BRB with dime sized clots. Denies any dysuria, pyuria, hematuria, no n/v/d.

Gyn Hx:
Pap-no hx of abnl pap
STI: neg trich, GC, CT, HIV.
Sx: LTCS for FTP

OB:
G1: 2001 IOL for dates at 41, F 6#7
G2: 2003 SVD at 33 F 4#1
G3: 2005 LTCS a 38 for FTP F 6#9
G4: current, pt desires TOLAC.

Med Hx: none
Sx: LTCS
Rx: PNV and Fe
Allergies: NKDA
Fmhx:
BrCA: mother, maternal aunt, MGM,
CAD: PGF
DM: mother, MGF

A/P
Pt is 38 G4P3103 c/o VB.
1. U/S
2. FFN, CBC,
3. consider MFM consult.


For the medical purists out there, I know that this is an incomplete H &P and that the assessment and plan are incomplete, but I'm illustrating a point. Here is a prose version:

HC is a 38 year old female with a history of 4 pregnancies, 3 deliveries, 2 term and one premature. She has a complaint of vaginal bleeding. She denies any loss of fluid, vaginal discharge (i.e. purulent discharge), and has felt fetal movement. Patient does not complain of a headache, right upper quadrant abdominal tenderness or vision changes.

Gynecological history:
patient has never had an abnormal pap smear
-no sexually transmitted infections like gonorrhea, chlamydia, trichomonas, or human immunodeficiency virus.
-Her only procedure was a low transverse cesarean section
Obstetrical history:
-G= pregnancy
SVD= spontaneous vaginal delivery
IOL = induction of labor
x#y= lbs and oz
TOLAC= trial of labor after c-section

Family history:
MGM= maternal grandmother
CAD: coronary artery disease
DM: diabetes mellitus.
BrCa: breast cancer

NKDA: no known drug allergies
FFN: fetal fibronectin a test than can help predict the probablility of labor or rupture of fetal membranes.
MFM: maternal fetal medicine: high risk OB doctors.
U/S: ultrasound.


A lot of these abbreviations are very standard, but the OB specific ones can be challenging, especially since they can be interpreted multiple ways i.e. VB could mean vaginal birth, or vaginal bleeding. Mostly there has been a movement towards the standardization of abbreviations in medicine as well as a decrease in their use overall, but OB is a lone holdout.

My Portable Fomite

I wear a short white coat that I loathe. I have had it since my first day of medical school and have worn it nearly 6 days a week for the last calendar year. Sometimes I'm better at washing it than others. It has some ring around the collar, numerous ink stains in the breast pocket, and two pockets that are in the process of being torn off, and stained cuffs. It weighs between 6 and 7 pounds.
Contents:
Breast pocket: 1 cracked cheap-o school logo pen.
1 stolen Bic pen.
pocket lint.
Maxwell's pocket guide.
2007 Tarascon's Pharmacopia
1 pen light.
2 ID badges in a semi-opaque holder.
1 monofilament in badge holder.

Left inner pocket:
2009 Sanford Guide to Antimicrobial therapy
Pocket Medicine 3rd edition.
2 old H&P pages with notes.

Left outer pocket:
1 Littman Cardio 3 stethoscope with freebie Army light attached in the likely event that the penlight craps out.

Right inner pocket:
1 FACTS card (little card that I have to get signed periodically during a rotation)
1 gestational age wheel
1 old tongue depressor still in wrapper
2 procedure cards (similar to FACTS card)
2 scholarly papers
4 old H&P's
1 bandaid in wrapper.

Right outer pocket:
study book du jour, in this case Case Files for OB-GYN
2 current H&P's
1 more scholarly paper
1 page of notes from lecture
Sometimes a reflex hammer and tuning forks, depending on how likely I think it is that I'll do a neuro exam (usually these stay safely in my bag or even more safely in my locker 7 miles from the hospital).

Sleeves: miscellaneous dirt, MRSA, VRE, cruddies.


This little gem is my friend for another year, after which I can swap it for a longer version. After I graduate I am going to dowse this one in kerosene and set it on fire, both for sanitataion and catharsis.
-Spiff.

Gunneropolis

Gunner loves cars, and he has recently taken to driving them around on little "tracks". He uses anything that makes for a good road, including the circle on a See 'n Say, the straps on Spiff's school bag, and the tiny little loop on the base of a stacking toy. He's actually pretty creative. It has made me want to buy a new toy for him, a race track or road, something that would probably cost $20-70 that we shouldn't spend on a toy.

Today, my awesome friend, Maggie, helped me make this:
If you can't tell, it's a cuddly little felt town with roads for driving little cars around on, complete with red fire station, blue police station, gray library, pond w/ park benches, and a gazebo in some lucky person's backyard (lower left). I'll call it Gunneropolis. He loves it. I love it. It was fun to make, and it cost about $3.

Thanks, Maggie! Drive on, Gunner!

Lightbulb

Okay, two things before I tell my story:
1. I recently got out some toys for Gunner that I had kept hidden for a while. It is a set of pretend food and dishes. I got them for him for Christmas, and I hid them for a while because I was tired of picking them up off the floor.

2. Gunner loves helping me when I cook and bake. His job is to dump cupfuls and spoonfuls of ingredients into a bowl. He is always right there by my side when I make cookies, dumping in the salt and baking powder. Sometimes he doesn't get the dumping action quite right and gets a facefull of flour, to his great dismay, and my great entertainment! Of course, he enjoys the perk at the end of mixing of licking the beaters.

Alright, on to my story. I made dinner rolls the other day, and as usual, he was right by my side on a kitchen chair, helping me out. As I was rolling out and shaping the dough, with my rolling pin and pizza cutter, he gasped, climbed off the chair, and ran out of the kitchen. I thought he was just tired of baking or just excited to play with his long-lost toys. Then he returned with this:
I gave him his own little piece of dough to cut. Man, I stinkin' love watching him figure things out!

Potty Talk

Let me begin this little discussion by stating that I have no intention of potty training my son for a long while, so I'm not really looking for actual potty training advice at this time. That being said...

Gunner has been very interested in the potty lately. He plays "Pretend Potty" by having us help him sit on the potty and go through the motions with him. He runs to the potty after doing some business in his diaper to show us that he knows relatively what it's all about. He also runs up to me after I have done my business on the potty to help me pull up my pants. (Is this too much information? I don't know since I have forgotten what it's like to have any privacy.)

The other day, Gunner and I had a 10-minute conversation about the potty. He initiated this discussion by pointing at the potty, turning around, scooting his little tushy up to it, and the swinging a leg up, like he was saying, "I'm going to sit on this thing, now." So I helped him on, he sat there for a few seconds, and then hopped off. Then he sat on the floor with me and told me lots of baby-babbled stuff about the potty. Then he stood up, backed up to the toilet, swung his leg up, and sat back down on it. He continued this routine for several rounds. The whole thing was very endearing.

He is very obviously interested in the potty. I would like to fuel his interest and keep him excited about the potty, without actually potty training him yet. We have talked about getting him his own little potty, but a friend suggested getting a toddler-sized seat that connects right to the actual toilet seat instead.

So I am wondering what people's opinions and experiences are with their little ones. How did you fuel any existing interest? What devices/products did you use? And where do I find these gems?

Countdown

Wowzah, it's been hard to think of something to blog about lately. It's the end of 3rd year, and I'm really feeling it. My patience is low, my creativity is almost nonexistent, and I can hardly wait the two weeks for Spiff to be done with his OB/GYN rotation which marks the end of 3rd year and the beginning of a two-week vacation!!! I feel like a kid who just can't quite wait for Christmas. Maybe I should make a paper chain.

Before this turns into a total whine session, I'll write about some of the things we've been up to.

Spiff participated in his first triathlon a few weeks ago. It was a mini-tri, with a 200 yard swim, 9 mile bike ride, and 2 mile run. He said that the pool was very warm and the bike/run route was very hilly, and it was hot and sunny. But he had a good time and finished in 52 minutes, which put him at 5th in his 20-29 age group. Not bad for a first try!

I am amazed at how grown-up Gunner is these days. He is becoming so independent, and he knows what a big kid he is. He knows his body parts, he loves reading with us, and he loves, loves, loves being outside. He is also coming up with a whole bunch of new words. My favorite new ones:

Larli (Charlotte...his very best friend in the whole world)

Gah gahn (all gone)

Lellow (yellow)

Gaing (again)

Mmbomeh or Bubby (bummy/bum/tushy)

Our primary class is going well. Thank you for all of your fabulous suggestions! We have some great kids in our class, and I've actually been enjoying it. The 4-5 year olds are a whole lot different than the 2-3 year old nursery kids. The main differences are their capacity to color for a long period of time, and the fact that they want to tell us all kinds of stories. They ask over and over again if they can tell us something, and if we tell them to wait (for the sake of some kind of continuity in the lesson), they completely tune us out while they hold onto their thought. They wait for a pause in the lesson and then say, "NOW can I tell you something?"

Their stories are cute but hard to listen to. They ramble, and there is hardly ever a point. One time last week, we tried to wrap up a little girl's story by saying, "Alright, thank you." And she yelled at us, "I'm Not Finished Yet!!!"

Okay! Sorry to offend. Go right on and finish. We're all ears.

My favorite quote of the class so far:

Spiff asked, "Why should we obey our parents?"

One kid responded, "So we can get stickers."

Anyway, we're one day closer to the end of 3rd year. I can't believe Spiff is almost a 4th year! I'm going to go make my paper chain now.

Primarily Primary

Spiff and I are the ward's newest primary workers (CTR4). When I was released from the nursery, I found myself surprisingly broken-hearted by the loss of my coworkers, my wonderful class and the familiarity of something I felt like I finally had gotten the hang of. As I prepared the lesson for today, I became less and less excited to try my hand at something so new. Spiff on the other hand is looking forward to a change of pace. This is the first time he hasn't been in the Elder's Quorum presidency since he returned from his mission six years ago.

Our first day went quite well, considering that we both felt like fish out of water. I also think we both enjoyed it. I had to hide my face several times to hide the fact that I was cracking up at the silly things the kids were doing. And as an added bonus, the kids listened really well! They participated, and we ended in about the right amount of time, so we didn't have to scramble for boredom busters at the end of church.

The highlight of the day was singing time. The chorister is a genius and brought a game for the kids that she made at home by cutting eight holes out of a large cardboard box and covering them with pieces of tissue paper. She calls it "Singing Time Punch Out". Like a game on the Price is Right, kids are called up and they punch out a hole, which has the name of the next song behind it. Not only do the kids get to take turns participating, but they get to legally punch the crap out of something! Pure genius!

Anyway, we're in new territory, and we need your help. My question to our faithful readers and anyone who has experience teaching primary classes:

What are your genius ideas? What do you do to make your lessons interesting? Do you have any awesome tricks or games that engage the kids?

Swing

"Life is difficult. This is a great truth, one of the greatest truths. It is a great truth becasue one we truly see this truth, we transcend it. Once we truly know that life is difficult-once we truly understand and accept it-then life is no longer difficult. Because once it is accepted, the fact that life is difficult no longer matters." Thus wrote Scott Peck in his work The Road Less Travelled. I would not say that my life is particularly difficult, far from it really. Like you, I have friends and aquaintances who have survived or are currently living through hellacious trials. In particular, I have two friends whose children are sick with diseases which may them within the next 6 months or 16th birthday. I cannot conceive of the grief and pain that such a burden must be for them. Obviously, life can be punctuated with periods of great pain and anguish, which are tempered by periods of joy and elation.

As we raise little Gunner, I see just how much inner dampening of our emotions happens as we age. He has no filters or coping mechanisms to suppress rage, fear, grief, sadness, joy, and exuberance. As a consequence, he throws tantrums, and two minutes later gives us a hug while belly laughing. He feels the full spectrum of unfiltered emotion. I think he is acutely aware of how vulnerable he is in the world, because to be 18 months old is to be utterly powerless. I recall as a child my mother would tell me that adolescents think they are immortal. As a teen myself, I recalled those words, but never felt myself immortal, but perhaps invulnerable and supremely confident in my own strength and intelligence. As a parent myself I realize now that nobody is spared heartache and pain and that my invulnerability of adolescence was an illusion founded in ignorance. Now that I have friends who have survived tragedy the fact that Bad Things can happen is more real than it used to be 10 years ago.

Though there is pain and hardship in life, there are occaisionally moments of perfection as well. In popular psychology this is known as "flow", but as a rower, my coaches identified this concept as "swing". In rowing this would be those all too rare moments when the boat was perfectly balanced, when everyone was concentrated on their technique, the boat was surging smoothly through the water and bubbles from the bow-wave were audible under the hull. Time slows down, physical pain may be present but is irrelevant, and for a few brief minutes, there is perfection. Inevitably the spell is broken and we return to the real world where things break and don't go according to plan. As Scott Peck elucidates in The Road Less Travelled, these moments are the exception, rather than the rule, although we frequently lead our lives as though the reverse were true, and that any deviation from perfection is the aberration.

Where do I find swing? There are times when biking when my feet turn effortlessly despite intense exertion and the pedal stroke is smooth and perfectly round, the bike is rolling as though pushed by a tailwind. Downhill skiing is the perfect mixture of danger and concentration that allows me to swing. Recently I have found it in brief moments while inline skating. And professionally, I have experienced during my anesthesia rotations. I am not a very emotive person, but there have been times during these last two rotations where things felt as "right" as they did when my lightweight men's four man shell was perfectly balanced and slicing through the water. Since I have never yet felt this way during any of my other rotations, I can say that anesthesia is definitely for me, without reservation.

Editor's note:

It has come to the attention of the editorial staff that there was an erratum in the previous post. Windy did not in fact have an accident after her prolonged journey.

PB4UGO

Spiff often tells me that when he is an anesthesiologist, he wants a personalized license plate that says N2B8R. He also wants one that says PB4UGO. I thought of that today when I was stuck in bumper to bumper construction traffic on the highway and I regretted my decision to just hold it until I got home.

I went to a mall with a good friend today so she could retrieve the purse she left at Cabela's last night. It was supposed to be a short trip, there and back, with a stop at the play structure so the kids could run around. Out and back, before lunch and naps.

But it wasn't.

We missed our exit on the way there and had to call a friend to give us directions. My friend's camera was dropped and broken on the way into Cabela's, one week before her son's 1st birthday. We stopped to play at the structure only to discover that all three kids were ravenously hungry and weren't up to playing. We went in search of food and missed the entrance to the food court. By the time we got them all fed, they were tired, and we were in a hurry to get them back in the car and home before a meltdown occurred. I thought about visiting the ladies' facility, but in my need to avoid critical mass, I decided to hold it for the relatively short drive home.

And then we missed our exit on the way home (purely because we weren't paying attention) and ended up across the river and into the neighboring state.

Since we had gone so far from our missed exit, we decided to keep on going and go home on a different highway, which turned out to be 12 extra miles. After finding that highway, we turned homeward and got stuck in construction traffic, 15 more miles from home. At which point both younger kids woke up from their way-too-short naps. Sigh.

It was a terribly funny day, and we got a good laugh. And when I got home, I was oh so happy to see my bathroom, though naturally it was too late.

So it begins...

There is a story in Spiff's family that is told again and again. When Spiff was a young child, he found the slots on the dishwasher (the vent) to be the perfect size for coins. He proceded to fill the front of the dishwasher with various pennies, nickels and quarters which then lived inside the dishwasher door for the rest of its existence. They never retrieved the cash.

This morning, while I was doing laundry, and going up and down the stairs to our treacherous unfinished basement, I noticed Gunner playing with the doorknob to the basement door. Months ago, before he knew how to descend stairs safely, I turned around from doing laundry downstairs, and I found him sitting as quiet as a mouse at the top of the stairs. We immediately put a doorknob cover on the door.

As he was playing with the doorknob this morning, I thought for sure that he was figuring how to open it with the cover on it. I imagined him tumbling down the stairs onto the concrete basement floor, and dread filled my heart until I took a closer look and found this:

It must be a boy thing. And cute or not, I fear for my dishwasher.

New Hobbies

I've decided to take up speedskating. Why? Because there's spandex involved. Well, not really, but it does seem like all my other sports do involve an inordinate amount of lycra. Swimming-speedo, Cycling-shorts and jersey, rowing-unisuit (think modest wrestling suit), and now speedskating which involves essentially more cycling gear. Why speedskating you ask? Hmm, again, true to form it's a relatively obscure endurance sport rewarding technique and stamina and filled with lactic acide and pain. It's fast and graceful. My real wish is to do long-track speedskating like the olympics, but there are only a handful of 400m ovals in north america, and none of them are here in town. Short track can take place on any regulation hockey rink, so that is a possibility. There is a speedskating club here in town, but I'm not sure I can justify the club dues and the equipment on our student budget. So, that leaves us with off-ice speedskating, which is inline skating.

In the good ol' days of 8th and 9th grade, I used to skate frequently on my trusty Bravoblades by Rollerblade. Since I no longer sport a men's size 7 shoe, those skates are long gone. I have instead decided to work my way into speedskating from the ground up, using cheap-o recreational skates until my legs are ready for more advanced skates. Craigslist was good to me on thursday, and I got a pair of skates, pads, and a bag all for $60.

I tried them out in the park that evening and fell back in love with skating. It's like running only faster. I went to the larger park here in town and managed to skate the 5 mile circumference in about half an hour. At least now I have a baseline to compare myself with.

Since there don't seem to be any local inline clubs, I have been using Youtube for technique and tips, although I might have to spring for a book and maybe try to find some real people to work with as well. My current goal, pending a match at my #1 in Minnesota, is to to do the North Shore Inline Marathon near Duluth. We'll see...

Gunner

Gunner has been doing some very cute new things that I don't want to forget about. Here's a small update of our almost-18-month-old.

He jumps. He can get both feet off the ground! He stops just about anywhere at any time of the day and jump, jump, jumps. He knows he's cool. And I'm pretty proud of my little athlete.

He started singing! I will say to him, "Can you sing, La La La?", and he will respond, with a curled up tongue, "daa, daa, daa", or stick his tongue way out and say "laaaa, laaa, laaaaaaaaa." And of course, he has to applaud for himself.

He nods his head when he wants something. For example, if he sees you with a cookie, he will come up to you with his head nodding, like he's saying, "Yes, you will give me some of that, please, now, thank you."

He likes to knock on doors. He likes it so much that he will start "knocking" as soon as we pull up to someone's house, while he's still in his car seat. And of course, he keeps on knocking all the way to the door.

He plays the piano with us. He sits next to us on the piano bench and adds his contemporary flavor to any piece we play. When he gets tired of me playing, he grabs my arm and hooks his around it...and holds me captive. It's so cute, but it sure makes it hard for me to get any real practicing done while he's around.

He loves balloons. We brought two helium balloons home from a party a couple weeks ago, and he loved them so much that he would not let go of the string they were attached to. We had to pry his hands open to get him dressed, which sent him into hysterics until his arm was through the sleeve and we could give the balloon right back. He even went to bed with them one night (don't worry, we took them away just after he went to sleep).

He also loves little cars. He clutches them almost as tightly as he clutched the balloons, and won't let go until he's asleep. He is also starting to play imaginatively with them. So fun!

He grabs my hand and takes me places. If he wants to go somewhere, he'll grab my hand and pull me along. He even does it when I'm holding him, although it doesn't work very well.

Some of his words:

Dad "Da"

Mom "mommy"

I Want That "mommymommymommymommy"

Car "car" (he said "car" about five times one day, but hasn't said it since.)

Usually car, truck, train, plain, helicopter, or any vehicle is "brmmm brrmmm"

Airplane and helicopter are "brmm brmm" with a flying hand motion.

Duck "duck duck duck duck" (always with a head bob)

Bird "bir"

Dog "doggie" or "dah"

Cat, a high pitched squeal

Fish "whish"

Ball "ba"

What is that? "Thisisthat"

No "nah no" (or when he's tired, it's a whiny, "Noooooooooooooo!" to everything.)

More, not a word, but a hand motion (think "milk" in baby sign)

I'm loving being his mommy. He's so cute and fun, and I love his happy personality and enthusiasm for live. He makes me happy every day.

Deepest Desires of My Heart

I am not a garage sale-er. I have been to a few yard sales, but I generally don't go out looking for them. I have friends who find amazing things at amazing deals at garage sales, and I sort of wish that I would do it. Apparently, my subconscious thinks so, too.

I have had my eyes on a few items for Gunner. I have looked in stores and online a bit, but haven't purchased anything since they seem like such a luxury. And what are these items? A tricycle and outdoor play equipment (namely a water table) for Gunner. I didn't realize how much I desire, want and covet these things until I had multiple dreams where I find happen upon a garage sale and find perfect deals on these toys. And then I wake up and realize that it wasn't real.

And Gunner is still without a bike. A bike which I thought I bought for him, but that he can't yet figure out how to ride.

I can't tell you how disappointed I have been when I wake up from these dreams. Or how strange I have felt to have dreamt them at all.

I guess I want these things so badly because my boy would love them so much. He loves loves loves other children's bicycles. He's not big enough to actually ride them, but he sure does love to climb on them, sit on them, scoot around on them, and it's an extra special treat if someone will actually push him around on them.

The water table is just an extra. We don't own our back yard, so I don't feel like I can put a kiddie pool out there. A water table sounds like a super fun and easily-storable Summer Fun option for us. I know he would love it.

It's funny that my apparently-very-deepest desires revolve around the potential commercial happiness of my son. I wonder why I'm not dreaming about a month-long vacation with Spiff, say...in Hawaii...without Gunner. Imagine the sleep we'd get! That sounds like a better dream to be having. But I sure wouldn't see Gunner's amazing little smile and hear his contagious laugh if I left him with Grandma and went off to Hawaii without him.

I guess that's why I dream about garage sales.

Easter

I taught my nursery class our Easter lesson on Sunday. All seven 2-3 year olds were so excited to learn about Easter, and they asked me to tell the story over and over. I told it at least 4 times. We talked about how Jesus died, was put in a tomb (Me: say Tomb. Them: "Tooooom!"), then was resurrected three days later. They especially loved the part about how the stone was rolled in front of and then away from the tomb. They are cute kids, and it was a fun lesson to teach.

Then during coloring time, I remembered that one of the kids had just had a birthday. So in order to highlight the birthday girl, I asked her, "What did you do on your birthday?"

She replied, "Well, I was resurrected on my birthday."

I obviously got the meaning across very well. Happy Easter!

Close Call

This is my dad's plane...

And he loves flying it. Flying makes him so happy that his wife and four children don't really mind his risky hobby. In fact, my mother has worked through her fears and has embraced his hobby. Because Dad is a good, safe pilot, Mom often goes flying with them, and they take small trips together in their little plane.

It was on one of these small trips, just last night, that my dad was forced to make an emergency landing. They lost power, landed on a snow machine road (thankfully not too far from home), and Search & Rescue went to pick them up. The landing was perfect, so my parents and the plane were uninjured. Search & Rescue responded quickly, and their big concern was that Mom & Dad were without heat on a cold evening on a snow-machine-accessible road. They think the plane lost power because the carburetor iced up. This has happened before, and they have taken preventative measures to keep it from happening again.

I spoke with my mother late last night, and she seemed chipper, energetic, and unconcerned. This reassured me enough to be able to fall asleep.

I was at a party when I found out. It was late, and I checked my phone only to find that I had missed two calls from my siblings, who never call that late. I knew something was wrong. The first message I received from my sister informed me that my parents' plane had "gone down", but that they were fine. The second message was from my brother who said, "Why aren't you answering your phone? Pick up your phone! We have news."

These messages left images in my head of balls of flaming metal careening to the ground from the sky, and images of my parents barely escaping the burning wreckage. Of course I was grateful to my siblings for letting me know what happened, and I am so very grateful that Mom & Dad are okay. It doesn't do much to slow my imagination, though.

Ever since our family has embraced my father's passion, we joke that my parents will die together in a plane crash. And quite honestly, for them, I don't think it would be a bad way to go. My dad would probably be smiling all the way to the ground, and my mom would be happy to be holding his hand. And neither of them would be left behind to live life alone.

On the other side of things, anyone who is familiar with Stephanie Nielson's story knows that dying in a plane crash maybe isn't the worst thing that can happen. I have bigger fears than that now.

And last night, when I received those messages, my thought was, "I'm not ready." I quickly found out that everything was fine, but I was still shaken. I'm not ready to live without my parents. I'm not ready for them not to be in Gunner's life. I'm not ready for them to not be a phone call away. It sounds petty, but I'm not ready to go without my mom's cooking advice and Dad's computer, car and building knowledge. I'm not ready to deal with the loss of my parents in any way, and I feel for those people who are dealing with that.

Today I'm grateful for the safety of my parents and that my dad is a good pilot.

Next project: Figuring out how to get their plane off of that snowy road and back to the airport.

Interference

Gunner is a Long Hugger. He is one of those people who goes in for a hug and just doesn't know when to quit. I have had him in nursery a few times and watched him chase down some of the younger kids (older than him), tackle them to the ground with a hug, and continue to hug them while they are begging anyone to help get this kid off them! He hugs babies, and he's mostly soft with them. He hugs older kids, and mostly they just want him to leave them alone. I can tell that he has good intentions, but he just doesn't know when to quit.

Besides that, he is very enthusiastic when he is around other kids. He wants to be involved with them, but they generally don't want to have anything to do with him. This means that when we are together with other kids, I spend my time running interference. I try my best to teach him how to behave around other kids, and to keep him from hurting them (feelings or otherwise). This means that I spend this time keeping him from pushing, taking toys, pulling hair, knocking down towers, and especially tackling with love.

It is exhausting.

I babysat a good friend's 2 1/2 year old for most of the day a month or two ago, and she and Gunner spent the entire day fighting.

I get together for play dates with friends, and I spend the entire time chasing him around, trying to keep him from doing any of the above things. By the end of the play date, I am so tired, frustrated, and stressed that I have wondered if it is worth it for us to get together with other people at all.

But not yesterday. Yesterday I babysat two children. The older one is 3 1/2. I'm not sure whether it's an age thing, or a combination of age and the fact that she is a big sister, but she was amazing! He did his regular tricks, including tackling her with long hugs.

And she just laughed. She hugged and wrestled him back. She played soccer with him. She encouraged him to play with her. She and Gunner actually played together all day long. It was actually easier for me to be at home yesterday while babysitting all day than it normally is because Gunner was being entertained, and I didn't have to constantly referee.

Really what it comes down to is the fact that Gunner should have been a second child. He needs an older sibling. I don't know how we're going to accomplish that, but in the mean time, I'm going to insist that he play with this little girl. A lot. Which is extra good for me since I love spending time with her mother.