"Illness"

I had an intersesting patient this week. JM (we'll call him) is a 43 yo male truck driver with history of asthma, depression, and alcohol abuse who was admitted from clinic after a pulse oximeter (hand held device that measures O2 in the blood) read his oxygen saturation as 78% (normal is 98-100%). At home he has been prescribed multiple inhaled bronchodilators, inhaled steroids, theophylline, and 5 L of 02 via nasal cannula. He was taken from an oustide clinic to the ED, treated with albuterol inhalers, his pulse ox checked again, and it was decided that he should be admitted. His past medical history is significant for numerous admissions for asthma exacerbations, but under names with different demographic information (eg birthday).

The story gets interesting when the pt is admitted to the unit, a blood gas is done which showed a respiratory alkalosis. This means his blood was basic (high pH) with respect to the physiologic norm. Asthmatic patients in crisis are generally unable to sufficiently expel all of the accumulating CO2 due to their constricted airways, and treatment is aimed at opening those airways so that efficient ventilation and thus gas exchange can take place. In the absence of good ventilation, CO2 builds up in the lungs and makes the blood acidic. This patient had the opposite problem, however, which called into question the diagnosis of acute exacerbation of the asthma, which would typically present with an acidosis, rather than an alkalosis.

A respiratory alkalosis can be seen in the case of hyperventilation. When the respiratory rate increases, more CO2 is blown off, decreasing the amount of CO2 in the blood, thus increasing the pH (rendering the blood alkalotic or basic). Why would the respiratory rate increase? In the case of an acute, pure respiratory alkalosis, panic attack is high on the list of possible causes.

The patient was dishcarged to be cared for by us on the floor team after a brief stay in the unit. We checked his blood levels for some of his home medications which showed that he had not been taking them at all. While staying on the floor, the patient rested comfortably, but when visited would complain of chest tightness and would have very poor respiratory effort, shallow breaths, and appear to be in moderate distress. At night and during the day, the patient could be seen to be napping or sleeping comfortably without any evidence of shortness of breath, difficulty breathing, or increased respiratory effort.

The clinical picture I have painted you led us to suspect that his current condition was not an acute exacerbation of asthma. The tricky thing about taking care of patients such as this is parsing out how much of their illness is organic (i.e. deriving from diseased lungs), and how much is psychogenic, i.e. what components of his symptoms were derived from his mind. Despite being psychogenic, the symptoms the patient complained of and the signs he demonstrated on exam are nevertheless real, just not fully explainable by an organic process localized solely to the respiratory tract and consistent with a diagnosis of asthma.

The real challenge is also trying to differentiate whether the pt is conciously faking, i.e. malingering, in order to get some secondary gain i.e. time off work, disability, drugs, or something else, or whether the psychic gain is unconcious. In patients with conversion disorders, a psychic stressor manifests itself through physical symptoms. It is possible, then, that our patient has some stressor in his life that is so profound that his body manifests physically what the mind is feeling psychically. Alternatively, our patient is faking his symptoms or exaggerating them in order to recieve care and to be placed in the dependant role of "patient". What makes this kind of patient especially trying is that it is very tempting to disregard all of their complaints as being psychogenic, when of course they may actually be genuinely sick. It's the old problem of crying wolf. In Aesop's fable, the villager's eventually turned their back on the boy who was eaten by the wolf in the end. The same thing can happen to patients with factitious disorders who every now and again will be genuinely sick, but have cried wolf so frequently that they are disregarded. Trying to sincerely engage a patient in whom you are questioning the legitimacy of their symptoms is very challenging. Those who have cared for a factitious patient will know what I mean, those who haven't may think I am callous for even entertaining the possibility of considering that a patient may be feigning illness. What do you do when this patient comes back to the ER short of breath?


*Editor's note: the patient presented is a composite and the information presented does not reflect the clinical course of any one person for whom I have cared. JM is a pseudonym.

It's all in the details

I played for the high school solo/ensemble festival yesterday. I am very happy that it's over, and the kids did very well. I even managed to talk people into switching their schedules around so that I was done before noon. It was a pain for a lot of people to switch around the solos, and I feel bad for being demanding, but I couldn't justify being gone from Gunner all day long. It worked out in the end, and even the parents ended up being happy about things.

I have grumbled a lot throughout this experience about learning the music and about scheduling issues. And they really are issues for me. But after rehearsing with the kids and their awesome teacher, I remembered how much I enjoy it. Not all of the music is horrible, and even the horrible stuff is sort of exciting when it's played well. These particular students are fantastic. They're smart, they work hard, and they're talented, and I love being their coach/accompanist. I thought at one time of pursuing a career in coach/accompanying. I don't think I could ever do it for professional musicians, but I do love doing it in the student to teacher/coach situation.

One of the things I love about it is the attention to detail. I remember a piano lesson in college when my professor pointed out to me that I wasn't holding a note long enough. I was completely shocked that I hadn't noticed the full note value. Or that it even mattered that I notice that particular note value. And then I went to grad school and realized that everything about music is about the nuances. Every little note has to be held for a precise length of time, every rest released at an exact moment. There must be attention paid to every accent, staccato or slur. Not to mention the numerous musical directions slathered around the pages.

These are things I didn't pay attention to as a high school student, and like I said, I was shocked to find out that they were important. I enjoy teaching students about these things and watching them figure it out. I enjoy coaching them on ensemble issues, including cues, transitions, tempos, rhythms, especially since most of the kids haven't played with an accompanist much, or at all.

Anyway, this is a long way of me saying that I'll probably do it again next year. I will most likely go to the state festival later this Spring to play for the five kids who scored high enough. And I have told their teacher that I will accompany for his middle school students in their solo festival coming up in April.

Medicine

It's been a while since I've written, mainly because I haven't felt like anything noteworthy has happened. I'm currently doing my medicine rotation and enjoying it far more than I thought I would. I'm not sure where I came to the conclusion that I wouldn't like medicine, but I carried that prejudice with me for most of the first half of this year. I have done one inpatient rotation at a local private hospital, as well as an acute care rotation at the VA. I have to say, the VA rotation was pretty cush. 8-330 everyday is a pretty nice schedule. It's going to be hard to get used to getting up early and rounding all day again.
Medicine has been a pretty pleasant surprise. In fairness, however, I was at an outside hospital with residents who let me act somewhat like a sub-intern, so I learned a lot without having to spend all day rounding. I doubt that I will enjoy the endless cogitating and head scratching that constitutes the in-patient medicine at our university hospital.
We are currently in the midst of planning our fourth year schedules which is pretty daunting. All of a sudden I have to figure out what I want to be when I grow up. Since before starting med-school, I've always thought I'd be an anesthesiologist and am still about 90% sure that's what I want. There's a nagging 10% though, that is thinking hard about cardiology. We had a really cool grand rounds lecture this morning on the physiology of the heart and it was more interesting than anything I"ve heard in a long time. I'm thinking hard about putting a cardio elective early in my 4th year in order to muddy the waters. Cardiology has a few problems with it, however. It's a longer road than anesthesia by 1-3 years (depending on if I do a fellowship after anesthesia), and I have to outcompete my other fellow Medicine residents to make it in. I'm pretty tired of competing and jumping through hoops. On the up-side, however, it's really fascinating, acute, and heavy on physiology.

I have one more month of medicine before I start my two three week anesthesia electives this spring. I guess after that I should have a better idea of whether I want to spend my professional life doing anesthesia.

Drug of Choice

I couldn't fall asleep last night. For two hours, I tossed and turned in the bed next to Spiff, who was sleeping as soundly as I have ever seen him. The more I tried, the worse it got, and the madder I got that Spiff was sleeping so peacefully as I thrashed around next to him.

I finally gave up trying and in my desperation, I took some Tylenol PM, the miracle drug of my pregnancy with Gunner. During said pregnancy, I took one pill almost every night to fight off the insomnia that haunted me for 9 months. Last night, I took two. And sweet relief, I slept like a champ for the rest of the night.

The recommended dosage on the box is two pills. But Wowzah! Two pills! I'm chasing Gunner around this morning, feeling like I could fall asleep every time I blink.

Poor Gunner has an impatient, tired mommy. Oh, so tired.

A Few Things

Here are some things I've been doing and thinking about lately. Not very interesting (or positive, really, because that's just how I've been feeling lately), but here you go anyway:

I am training for another half marathon. I have been struggling with finding the motivation and a good schedule to run. Spiff has been working early in the mornings most of the year, so I have had to resign myself to running at the gym in the evenings. This is double hard for me since I'm not really a treadmill runner, and it is hard for me to exercise in the evenings. But I'm grateful to have a membership at the gym to give me a place to run. And I ran with a group of girls on Saturday at the park, and I felt like a piece of my soul that had been missing from my life was handed back to me. I guess I really do need this, and that will be my motivation.

Gunner is going through a new phase. He is finally making the transition from two naps to one, and it's a tough one. He has really been struggling with sleep in general. I think it's a combination of teething, coming down with a cold, and sleep deprivation, but it's causing some very poor behavior from an extremely grumpy child. I can't figure out what to do to help him.

Also, it is high school instrumental festival time again. I have accompanied for some students in this event for the past few years, and I have enjoyed working with the kids and their super duper nice teacher. However, I'm feeling a bit tired of it this year. I'm just not excited about doing it. I'm not excited about the music itself, which tends to be difficult for me to play, unpleasant to listen to, and difficult to put together with the kids. Plus, this is the schedule I just received for the kids' performances on festival day:

8:18

8:59

9:17

9:30

9:45

2:32

3:42

Anyone else notice the LARGE break before the last two students? I have a baby and just can't be available all day like this! And it happens every year. Grumble grumble.

I have committed to doing it this year and can't back out, but I think I'm done with this event for a while.

On the plus side, I just read a gloriously good book. It was the kind of book that is so good that I read it really slowly, just so it would take me longer to finish it. It was also so good that now I'm really sad it's over and just want to read it all over again.

I also made a really yummy dinner yesterday and shared it with some friends. Gunner enjoyed destroying my kitchen while I cooked all day, and I got the benefit of doing some service and enjoying good food.

And my sister-in-law, Mhana (for those who read her blog), is coming to visit us in a month! I can't wait!

Now I guess it's time for me to go clean up my kitchen and think about which book to read next.

Pick-Me-Up

So, I have had a pretty rotten day. My feelings were hurt in a way that made me question my abilities and spirituality. I'm dealing with it.

And in so doing, I found this blog entry that made me laugh out loud, several times. I bet that the "Voice of Reason" had no idea she would be the pick-me-up I so desperately needed today.

Make sure you read the comments. My favorites are the ones about the squirrel, Mormet, and the "recipies".

I'm sinking

Appreciating My Two Hands

Spiff and I went ice skating last night. It was pretty much an awesome night to go ice skating at the outdoor rink in town. It was snowing (a fairly wet, slippery, sloshy snow), and so there weren't a whole lot of people out and about, which means that there weren't a lot of people at the rink. But it wasn't very cold, and it wasn't snowing very hard, so it was really quite awesome. Spiff is a pretty good skater (surprise, surprise), but I have only been on ice skates a handful of times, the last time being two years ago. I was surprised last night to find that it wasn't as hard as I remembered. Plus, my rental skates seemed to fit better and were way more comfortable than the last pair I rented, and it left me feeling all empowered and daring.

So, we skated a bit, and we even tried a few tricks. For me, that includes turning around in very large, slow circles, and then feeling super triumphant. I even tried skating backwards. And as I doing these bumbling tricks, I thought, "This is so fun! And I'm probably going to end falling on my face."

Not two seconds later, I fell flat on my face. A kind rink-worker dude saw the whole thing and came right over asking me if I was okay. Sadly, Spiff missed it, and turned around to find his dear, sweet wife on the ground, and he came rushing right over. They helped me up (yes, I needed help up), I brushed the snow off the entire front of me, and sporting a nice new bruise on my chin, I tried putting on my brave face.

I wish I could say that I hopped right up and continued to skate because, seriously, how embarrassing is it to break into tears after something like that? But I did something to my left wrist when I fell, and it left me feeling like an weepy, insecure eight-year-old, for the second time in two weeks. With my newly hurt wrist, I hobbled off the rink to have Spiff take a look at it. (Somehow, hurting my wrist causes me to hobble.) We did continue to skate for a while, and it really was very fun. I skated more conservatively, and Spiff was the perfect gentleman and held my hand so I could keep up with him and so that we could skate around the rink together.

So, my wrist is not broken, but it sure does hurt a lot. Little things that I take for granted are so very difficult today. Like picking up my son. Putting on gloves. Getting dressed. Grabbing and holding on to anything. Anything that involves twisting my arm or grasping in any way.

I'm just feeling so grateful for my general health today. I'm grateful that I have two hands and two arms to help me with my daily tasks. And even though I'm frustrated that my stinkin' wrist hurts and that things are difficult for me today, I'm grateful that I will heal and be able to go back to taking advantage of that fact that I have two working arms. And then I think I just might carry Gunner all day long, just because I can.

Doing My Civic Duty

I served on Jury Duty today. I did my civic duty. I am slightly disappointed to report that doing my civic duty involved me doing absolutely nothing at all.

I arrived at the Civic Courts building at 8:00 a.m., where I was herded into a large room and given a badge. As Juror #289, I sat in my chair and waited for an hour while they got organized. During that hour, the government workers occasionally called people up to the front desk, and I thought it was going to be a busy and interesting day. Boy was I wrong! I made myself comfortable in my chair and tried to read my book. But between the TV that was spewing its inane daytime programming, the man sitting behind me who fell asleep and snored for hours on end, and the fact that my chair did super-human feats in making my buttocks numb, I found myself lacking the attention I required to get into my book. It felt like I was on a really long flight, or a bus or train that didn't end up taking me anywhere. Plus, the front desk workers stopped talking at 9:00 and didn't address us until 11:30, when they dismissed us for an almost-two-hour lunch.

When I got back in my seat by 1:15, I thought that surely something would happen. I was again disappointed. The front desk workers didn't address us until 3:30, when they finally called a jury pool of about 30 people. I sat in my seat, my little heart pumping, feeling a bit like an 8-year-old hoping to be picked for the dodge ball team during P.E. I was so hoping to be picked. I wanted to see what the court process was like. But mostly, I wanted something to end the maddening boredom that was the waiting room. My number was not called. And The Chosen Thirty received their assignment to return for court the next day at 9:00, and then they were released!

And the front desk workers, again, said nothing to the rest of us.

Just when I thought we might just end up living and dying in that soul-sucking waiting room, Heavenly Angels came down from above, in the form of a front-desk worker, and told us that we were released to go home at 4:00. And that we don't have to return tomorrow!

Hoorah! I have fulfilled my service to the court system for now. I think that as long as I will myself to think of it as SERVICE, I won't feel like it was the biggest, fattest waste of a day in my entire life. But since I haven't yet convinced myself that I did any sort of service at all, I currently do think that it was the absolute biggest, fattest waste of a day. My Jury Duty Experience= Not interesting or fulfilling in any way, shape or form.

But Thank You to my awesome friend, Angela, who took care of Gunner for me All Day Long. You are a Super Goddess Mommy!

Theme Day

Look at what I bought at Costco the other day. Notice the theme? I just love spending money on these things that we (almost) literally throw down the toilet. Sigh.

On a side note, Gunner threw a tantrum in Target yesterday. I decided not to let him make such a public display, so I picked him up and marched him out of the store. While I was thinking, "Boy, I sure taught him a lesson.", he was probably thinking, "Yes! We're getting out of this stinking store!"

Faulty Gadgets and Billowing Plastic

You may be asking yourself how we have been spending our time lately. Then again, you may not, but I'm going to tell you anyway. We have been child-proofing and plasticking. (Is there any correct way to spell "plasticking"?) The child-proofing has been a frantic and futile attempt at making our lives more relaxed at home with Gunner always two steps ahead of us. He figures something out, we child-proof it, and then he is immediately on to two more things. It is amazingly difficult. Hats off to anyone who manages to child-proof their homes so that they aren't constantly chasing their toddlers around the house saying, "No! Leave that alone, for the thousandth time!!!"

And the plasticking ("spell check" says that I should be saying plasticizing, so there you go). We have the world's oldest windows in our home. Well, probably not the world's oldest, but they are at least 100 years old. In the Spring and Fall, the windows themselves don't open, and if we do manage to get them open, it takes a 10-man construction crew to get them closed again. Needless to say, I miss having fresh air in my home during the nice seasons of the year. However, there is no lack of fresh air in the Winter. We have a healthy cross breeze blowing through our home, through the large cracks in the ancient windows during the Winter months. In an effort to reduce the amount of Winter weather we invite into our home, not to mention the reduction of the heat bill, we have spent much of our lives putting plastic on our windows. We do this again and again because the stuff keeps falling down. I am so tired of reapplying plastic that I feel like I would give my arm, my legs, and even a bit of my left brain if we could have new windows.

Here are some our recent adventures in child-proofing. We buy gadgets at $4-5 a pop, and they end up not working. My advice: do more research than we did before buying any commercial child-proofing gadget. We recently had mishaps with these items:

The toilet lid holder

This lovely gadget doesn't fit onto our tank. As you can see, Spiff added an extension (which is a couple of Gunner's blocks, artistically attached to the device with electrical tape), which makes it fit...BUT the stinkin' suction cups are weak enough that Gunner can just pop the whole thing right off without even trying very hard. We don't use this.

The sticky latch thing.

This is a product we bought to keep Gunner out of the corner cabinet in the kitchen that holds all of my baking supplies. He loves that cabinet, and he loves loves loves emptying it out. So we bought a latch to keep the baking soda and vanilla safe and sound. It works great on the cabinet so far.

We decided to try another one on the shower door (heaven forbid that we may want some privacy from Gunner while in the shower). But obviously it didn't work. Notice the sticky stuff that has detached from the gadget itself. I would feel better if the sticky stuff didn't stick to the shower surface. But, no. It doesn't stick to itself.

We have baby-gated off the bathroom for now.

Plastic Windows

This is our bedroom window. Notice how the insulating plastic is Billowing! I couldn't get it to lie flat because of the breeze that is blowing through the closed windows. It also took four strips of tape on the bottom ledge to keep the breeze from blowing the plastic right off the tape. Our bedroom got down to around 35-40 degrees during this last cold snap. The old windows are so bad that it felt like we had an open window in our room. We now have two billowing windows in our room, and thankfully it is much warmer now.

If this last re-plasticking job doesn't work, I think I may have to offer my body parts to our landlords as a sacrifice for replacing the windows. But then again, how could I ever get down on my knees and beg if I have already given them up as an offering?

Surgery Part 1

It's been a month since I last posted, and it's because I haven't figured out how to talk about my experience. The sub-rotations that I participated in were, in order: pediatrics, pediatric urology, general adult sugery, and orthopaedics. In general, I think my experience suffered from a lack of hands-on learning. Medical students generally round on patients before the team rounds, finding out how patients did overnight, what changes occured, and formulating some semblance of a plan for the day. They then present their findings to the team during rounds and any modifications or additions are added before the workday begins.

Surgery differed from this in several regards. On pediatrics we would pre-round in the usual manner, but the residents did not make any use of our information, but at least wanted to hear what plans we had come up with. The afternoons on pediatrics, however, differed from other rotations in that the medical students were not really included in the floor work. Normally students follow labs, help write discharge orders, follow up on consults and imaging studies, additionally, if there are any OR cases happening, the students would scrub in for those. The two weeks I was on pediatrics did not have very many cases, so the afternoons were often devoid of any OR time. Rather than include us in the floor work and teach us about medical decision making, the residents would just tell us there was nothing happening, and tell us to sit and study. I have nothing against study time, but if there is nothing happening for 5 straight hours, to me it makes sense to let some of the students go home or to the library if they want because there is truly nothing happening.

Pediatric urology was interesting in that it was an inpatient rotation, but we had only 2 patients who stayed overnight, so really it was more like a day surgery rotation since we never had to round on patients. I did learn a lot from Dr. P, the peds urologist. His clinic was the smoothest running with the lowest percentage of no-shows of any clinic I have yet assisted in. He also was the only attending who actively taught about how to relate with patient's families and about non-medical aspects of satisfying patients and their families.

More to follow in Part 2

-spiff.

I have a button and it's not on my shirt...

I have a button and it's not on my skirt.
I have a button. It's a part of me.
It's the button in the middle of my tummy!

It's my Belly Button, found underneath my sweater.
It's my Belly Button. And it's holding me together!

I'm sure that this is the song Gunner would be singing, if he could sing, as he eats Cheerios in Sacrament meeting. A couple months ago, I tried to entertain my wiggly little boy by sticking Cheerios in his belly button. He thought it was hilarious, and preceded to play peek-a-boo with the button-Cheerio before snatching it out and eating it.

Then two weeks ago, as we were sitting in sacrament meeting, Gunner was getting fussy. I handed him some Cheerios, and on his own, he lifted up his shirt and stuck a Cheerio in his belly button. He entertained himself, and the people sitting next to us, for at least 15 minutes. It happened again today, so apparently this is standard sacrament meeting entertainment.
Forget quiet books. Break out the Button Cheerios!

Making it Feel Like Christmas

As I have mentioned previously, I have had a hard time getting into the spirit of Christmas this year. Christmas shopping was a bit stressful this time around, Spiff was very busy in his surgery rotation, and our vacation with my family has seemed so far away! But I have finally managed to catch the Christmas Bug, and I am very excited about the upcoming festivities. I realize that I am responsible for making it feel like Christmas. I also realize that this will be more important to my family as Gunner gets older, so for future reference, here are a few things we did this year that helped me get into the Christmas Spirit...

My friend, Maggie, gave me a Christmas tree! Pretty awesome gift, huh? They bought a new one last year, and she gave us this great little, pre-lit(!!!) tree, which Spiff and I decorated, and which I am completely in love with! I love the lights, and they have been on every waking hour since we put it up. This little tree has been a great centerpiece for our family this month, and was the thing that really helped me oust my humbug. Thanks, Maggie!

Apparently, it's very important for me to decorate my home in order for it to feel like Christmas. We put up the tree, an advent calendar on the wall, and our fabulous Playmobile nativity scene, and it makes me giddy to go into our living room!

We also attended a Christmas festival in the historic district of a local suburb. We got bundled up, braved the cold, and walked among the festive streets. We tried chestnuts roasted on an open fire for the first time. They're very good, but oddly taste a bit like potatoes. And we watched the Santa Claus Parade, filled with all kinds of Santas, carolers, and even the Sugar Plum Fairy. Very fun!

Uncle Sam Santa?

Frontier Santa

So, Merry Christmas! We wish you all have a wonderful holiday season!

5 Year Ago Today...

Spiff and I Got Married!

Our Wedding Luncheon, post ceremony:

The Winter Wonderland Reception:

Happy Five Years to Us!!!

That's what we were doing five years ago.

Spiff's sister was defending her BA Honors History Paper (well, that...and attending our party). What were you doing?

The Homeless Man

Gunner is apparently aspiring to be a hobo when he grows up. He has a diaper box which he pushes around the house, filling with various and sundry articles of interest. Currently the rather weighty contents include: 1 empty 2 liter soda bottle, 1 24oz parmesan cheese container, 6 boxes of easy mac, 1 empty box of wheat thins, 1 tupperware full of cheerios, 1 3/4 cup measuring cup, 1 jumbo Lego, 1 Power Ranger cell phone, 3 floating bath animals (a whale, a polar bear, and a starfish), a container of hand lotion, a rubber spatula, an aluminum trivet, a Kitchenaid serving spoon, 12 board books, and a silicone oven mitt. I guess wherever he decides to settle he'll be well fed (assuming he can get into the easy mac), and entertained.

Fast Sunday

I'm having a first today. Well, not a Real first, but a first-in-a-long-time kind of first. I'm not pregnant, and I'm not a nursing mother anymore, so I'm fasting. And oh, boy, I forgot how difficult fasting is. First of all, I forgot about the blessed occasion until after I had already cooked oatmeal for Gunner and me for breakfast. Just as I was about to spoon it into our bowls, Spiff reminded me that it is, indeed, Fast Sunday. So I replaced my bowl into the cupboard, fed Gunner, and listened to him hum away as he enjoyed what was Going to be my breakfast.

Also, I am in the nursery, and snack time was slightly torturous for me today. I do enjoy the fact that we nursery leaders get to enjoy snacks with the kids. It is a small, but delightful, perk in such a difficult calling. But since I couldn't have my Craisins and animal crackers today, at least the kids were well behaved.

Now I'm home, waiting around for dinner time, and I'm having to fight the strong urge I have to be crabby with my family. My body thinks that my belly button is well on its way to merging with my spine. My stomach thinks that I have betrayed it, and it has absolutely convinced my mind that I might Not Ever Eat Again.

I will admit that I was able to listen to and absorb more of the testimonies in Sacrament Meeting today than I have in a long time. Whether that was because of my renewed efforts in fasting, or because Gunner was actually a good, non-temper-tantrum-throwing boy, or a little bit of both, I'm grateful to have felt the Spirit today. I guess that's why we do this to ourselves. Right?

Ho Ho Ho

Gunner met Santa in the mall yesterday. He was walking the halls during a break, drinking a Mountain Dew. Gunner looked at him like he looks at all strangers, with a uncomfortable stare that I know as, "Mommy, someone is looking at me." He was otherwise unfazed by Jolly Old St. Nick. And no, I didn't get his picture taken with him.

Pet Peeves

What is this? This is the worst doorknob that mankind has ever designed, patented, and produced.

Unfortunately, our house is equipped with five of these masterpieces. As you can see, it readily separates into at least two pieces. The metal rod that you can see doesn't quite fit the hole it's supposed to fit in, so even when the whole miserable assembly is in situ, it rattles around. It rattles around in the lock, and it works its way loose from the horrible glass knob as well. Basically, there could not be a more annoying doorknob. I actually prefer using a screwdriver which fits the hole and, despite being removable, doesn't have to be adjusted twice a week.

It's Christmas Time!

Yeah, yeah, yeah, I know that Thanksgiving is in two days. And I'm very excited to spend the holiday with friends this year! But I have spent all day working on Christmas gift projects, and it has gotten me all "in the mood for Christmas Cheer". Well, sort of. I have finally started my shopping for the season (hooray for me!). However, I am feeling a bit like a humbug this year because I have no great gift ideas. None! For any of my family or friends. Add that to the fact that we're living on a student budget, and my inner Scrooge starts grumbling.

On the bright side, we get to spend Christmas with my family this year! I'm so excited about that that I can hardly stop myself from packing tomorrow and camping out at the airport for the next month. I know that once we get on the plane, all of the stress of shopping, the Christmas parties and concerts, and the Christmas cards will be mostly over, and it will be time to party! Family, prime rib dinner, egg nog, pie, games, and lots of people around to entertain Gunner for the entire vacation! Let the countdown begin!