not so different

I tend to think of my days as fairly frustrating. Even if things go pretty smoothly, it’s because I’ve put a lot of thought and effort into planning the day out and forestalling problems.

Ladybug doesn’t always do what I tell her to do. I spend a great deal of time catching her and making her do what she was told. Any particular thing I tell her, I have about a 50% chance that she’ll start crying and flopping on the floor. It’s frustrating.

Rabbit throws everything I feed him on the floor, after first smearing it all over his clothes, and handing some to Ladybug so she can rub it in her hair. He wakes up from his nap exactly as I try to lie down to rest – no matter what time I try it. It’s frustrating.

————-

I met up with some old friends from the surgery residency this afternoon. There were four kids under 3, so we let them “play” together while I caught up on news.

“I’m the chief on Dr. M’s rotation now,” one of them said. “I had a flashback the other day to when I was an intern there and you were the chief. He was yelling at the nurses, saying the exact same thing he was saying way back then. ‘I’m operating in the pelvis, for goodness’ sake, you have to give me the long instruments!’ ” (Knowing Dr. M, I’m sure she edited his remarks for the kids’ sakes.)

And I could instantly picture myself back there, in the distinctive green scrubs of that hospital; the old-fashioned, un-updated tiled OR walls; Dr. M’s room, one of the biggest in that OR, but still with lights that never seemed bright enough for what we needed to see; and one of his classic pelvic cases. That’s the thing about operating in the pelvis: it’s so deep. You can never see enough. The cases are long, and physically taxing because you spend the whole time craning your neck to see all the way down, while also tugging as hard as possible on the retractors to try to improve the view, and with your second or third hand trying to manipulate the necessary instruments. And of course, the scrub tech would be handing us normal-length instruments, seven or eight inches long; and Dr. M would have to protest to get the correct, extra-long clamps and scissors and needle drivers, more like twelve inches long. He’d been operating there for years before I was on service, and it’s been several more years now – and they still can’t give him the right instruments, for cases he does every week – for cases which are his particular specialty.

I was only operating as an attending for a few years before I retired, but the same thing happened to me. Every.single.time. I went to do a laparoscopic inguinal hernia, I wanted the same piece of mesh, the same camera, and the same three instruments. Just three. For goodness’ sake. Three instruments. And every.single.time, at least one of those things would be missing. Often more than one. How hard can it be to make a simple list, and send those instruments to a case which was booked at least a week in advance?

———

And I thought, I forgot how frustrating life as a surgeon was, too. At least now the people I’m taking care of and banging my head on the wall over are my own flesh and blood. And since they’re currently babies, I am very hopeful that I will be able to teach them better behavior. With God’s help, I think I have a better chance of success than Dr. M does of solving his frustrations.

 

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Out and about

We ran out for one errand this morning. I’ve worked out that right after his morning nap, Rabbit doesn’t necessarily want to nurse right away. So I got Ladybug on the potty, threw diapers in the diaper bag, made sure the umbrella stroller was in the same car as the baby seats, and ran out the door. I think we left about fifteen minutes after he woke up. Much better than 45min – 1 hour, which is how long it took to get out the door three months ago.

(This matters because, although I consider Ladybug potty-trained, it’s still best not to push her too far. I figured I had 1-1.5hrs before things got dangerous.)

We got into the city, and spent 15 or 20 minutes finding parking, since I was determined not to pay for it. Then I tucked Rabbit into the wrap which I had pre-tied, and Ladybug hopped in the stroller happily. Rabbit was not happy at all, but he agree to chew on an apple slice, which kept him happy for the rest of the walk.

We strolled the 4 blocks from the car to the tea shop I wanted. The weather was beautiful, ridiculous for March 1. The sun was shining, and there was a soft breeze. I thought to myself, This is fun! I’m out with the kids, they’re happy, and I’m not even dragging the diaper bag. I could picture myself turning into the kind of mother who cheerfully, nonchalantly sets  off to do things outside the house with the kids. Visit friends more. Go to the park more often.

The lady in the tea shop didn’t scowl when I walked in with a toddler at eye level to all the lovely, delicate porcelain tea sets. She found me the Earl Grey Cream tea and some red tea (some as a birthday present for a friend, and some I figured I would get for myself since we had gotten ourselves this far).

Ladybug, meanwhile, was murmuring to herself, “Potty. Potty. Potty.” Or maybe she was saying “Buy tea. Buy tea. Buy tea.” I calculated that we had only been out of the house for 45 minutes, she couldn’t be in desperate need of a potty yet (and there was none easily accessible in that neighborhood; lots of little shops which probably didn’t have a place that I could get into while wearing a baby and maneuvering a stroller).

I paid hurriedly, and we set off back to the car. Rabbit was tired of the apple. I thought I had made a careful note of which streets we had turned on, but I had missed one. We walked around an extra block, uphill. By now Ladybug was asking for apple, or water, or both, and Rabbit was getting fussier.

Back at the car, Ladybug was saying “Wawoo. Wawoo. Wawoo.” But refused to drink when I gave her the bottle. . .  Rabbit was not at all happy to see his carseat again.

We set off. I thought, we’ll be home about an hour and fifteen minutes from when we left, it’s not too bad. My sister called, and we discussed babywearing apparatus and instructions. Then Rabbit started screaming. And screaming. And screaming.

We finally got home, Rabbit nearly hoarse, Ladybug quite grouchy. She was dry, he wasn’t. We had a whirlwind of potty, dry diaper, nursing, lunch, and finally deposited everyone in bed. And I collapsed.

I’m going to have to rethink this “lightheartedly going places with kids” idea.

On the plus side, they slept like rocks all afternoon, till a neighbor got out a saw and started making a racket. I love my neighbors. . .

Baby led weaning at our house

The last post reminded me to discuss how I’ve been starting solids with the kids. (I hate to say “my approach” or something silly like that, seeing I’m only on #2.) Back when Ladybud was quite little and I was reading all the attachment parenting/natural parenting stuff I could, I came across the concept of baby-led weaning.

It started in England, where, in British English, weaning just means the introduction of solid foods, not necessarily the end of nursing. The idea is that you wait to start solids till the child meets a couple criteria: sitting up pretty much on their own, able to pick up finger-sized objects by themselves, and interested in food. (For both of mine so far, this has happened around 5.5 months; they’ve been swiping wildly at my plate since 5 months.)

Then, you basically let them have some of whatever you’re eating, with a couple caveats:

  • they can’t handle salt well at this age, so don’t give them anything that contains added salt
  • this is your chance to teach them to eat healthy food, so minimally processed is best; no added sugar, either
  • nothing so small that it would choke them if it goes down the wrong way, eg peanuts

Typical starter foods would be thinly sliced apple; sliced avocado; fingers of banana; carrot sticks (either raw or steamed); steamed broccoli florets; finger-sized pieces of chicken or steak (and I’ve given fragments of hamburger, too). Bread isn’t such a great idea, because it contains quite a bit of salt. I’ve also done grown-up cereal, ie cooked oatmeal or home-made granola, just by setting a bit on the table in front of the child. (This is how Ladybug came to be convinced that a normal breakfast is crunchy home-made granola mixed in kefir.) Scrambled eggs are good, too.

Then you gradually add in more and more of whatever you happen to be eating. No need to puree it. No need to hand-feed them. At some point you add in (child-sized, plastic) silverware. They make quite a mess at first, but at least you’re not dealing with them spitting out the puree you stuck in their mouths. My rule with Ladybug, after the first month or two, was that if she started throwing food or throwing a bowl or spoon on the floor, I would take that as her saying she was done eating and ready to get down.

I know picky eaters don’t necessarily manifest themselves till age 3 or 4, so with Ladybug not quite 2, I’m in no position to say for sure. However, she is notorious for eating absolutely anything. In the last week, she’s had kimchi, spicy tofu, orange slices, blue cheese, steak, oatmeal, cabbage, and mashed turnips. The other day I put hot sauce on my eggs, and she first asked for some on hers, then insisted that she needed “mo! mo!” And her favorite food is a date, which she calls “Dee! Dee!”

This approach has made feeding the children very easy for me (no cooking special things for them, no keeping some food without hot sauce, no pureeing – although I do love to make pureed vegetable soups, and those were very handy). I also don’t worry about only introducing one food at a time. I take it slow at first, just because they’re not quite sure yet what to do with the food. But once they’re interested in eating, I let them have whatever. And, it’s really encouraged the adults to eat more healthily – less salt, less sugar, less processed foods.

Mr. Fixit has several food allergies, which I would dearly love the kids to be able to avoid, if possible. Recent research shows that children introduced to peanuts (in peanut butter) between 4 and 11 months were less likely to become allergic than children who were introduced to them later. Based on this, I fed Ladybug all the foods I was concerned about (nuts; peanuts; peaches; eggs; dairy; carrots) by the time she was 9 months old. So far, no problems. (But again, it’s too soon to tell for sure.)

New bibs for a new eater

Rabbit just turned 6 months old, and I’ve been letting him play with solid food for about two weeks now. I had made 8 bibs for Ladybug when she started eating (the store bought ones I had were too small; in retrospect, I realize they were drool bibs, not food bibs! but I was also tired of the velcro getting dirty and not sticking). But that’s not enough to last between laundry loads with two kids eating, and they’re all pink-themed.

So today I took two hours, between the tail end of Rabbit’s morning nap, and an unusually cheerful period for both kids after lunch and before afternoon nap, and hammered out 7 new bibs. Why 7? Because that’s how much PUL I had left in my stash!

I take a rather unfortunate approach to sewing: I hack and shortcut every single thing I can. Thus, these bibs are not neat or perfect, but they didn’t take long, and they work.

So, in case you’re interested, here are the details:

PUL from Joann’s, with a 50% off coupon; left over from making changing pads for first baby.

Flannel from clearance at Joann’s, left over from buying way too much for first baby, thinking I was going to make – I don’t know what all.

2/0 sew-on snaps. (Why 2/0? Because that’s what was in the drawer!)

I pinned a pre-existing bib (which had originally been traced from the largest storebought bib I had, and then enlarged a bit) onto the PUL folded double, pinned it in 4 places to hold it steady, and cut around it; then used one of the new PUL pieces as the template to cut out the rest, for a total of 7 PUL backs.

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Then I took each PUL back and pinned it, with the patterned side up, against the wrong side of the flannel, such that when it was cut out, I ended up with a complete bib, both right sides facing outwards, and pinned all the way around, ready to sew.

I took the random red thread that was on the machine (which just happened to be a great, cheerful fit with the bright colors of the PUL) and set the machine on zigzag – as wide as possible, and pretty short (if you have a serger, that would be perfect for this; I don’t have), and ran around each bib.

Then I grabbed a leftover card of snaps, and sewed them on. (That took another little while.) If I had a snap press, that would be great for this. Sometime – when Mr. Fix-it finds one for cheap!

bibdetail2

All set! 7 new bibs in one day. I’m very happy.

Now I have no excuse not to get the pants that have been hanging next to the sewing machine forever hemmed. . .

The new colonialism – abortion for Latin America

This is just a quick overview of this subject because naptime is almost over and we have to jump in the car.

I have long admired the Catholic Church’s very coherent teaching on sexuality and abortion, called Theology of the Body for short. More than any other Christian group, they have a consistent, meaningful explanation for God’s creation of the human body and sexuality, and how that should work itself out in various moral dilemmas in postmodern culture.

Specifically, with regards to contraception and abortion. This short article summarizes how the introduction of contraception led to abortion as a commonplace in America today. This is a longer article, but well thought-out, and with lots of documentation, demonstrating again the direct link between a society accepting contraception, and a society demanding abortion.

The current concern about Zika virus causing microcephaly in Latin America demonstrates the link even more acutely, as for example in this article, which links to several liberal publications calling for increased abortion access. Essentially, women were advised to avoid getting pregnant until the epidemic is under control. In the minds of American liberals, that equates to an urgent need for access to abortion – in case the contraception fails. In case you doubted the reasoning of the first two articles I linked to, this one makes it incontrovertible.

(Plus, of course, shades of colonialism are quite obvious: we need fewer brown-colored babies, and especially fewer handicapped brown-colored babies. And the fact that the people of these countries deliberately chose to restrict abortion? It’s irrelevant; we know what they need better than they do, and we’ll get it for them, one way or another.)

An anniversary

I realized the other day that it’s been almost exactly a year since my last day of work as a surgeon. It’s funny, for such a huge change you would think I would have some significant thoughts about the occasion.

But I don’t really. I don’t know why. It’s possible that deep down I regret it, so I don’t think about it. More likely, I’m so busy with the kids, and so happy doing what I always pictured myself doing, that I don’t need to think about it.

It’s still weird though. 7 years of education, 5 years of residency, 2.5 years as an attending; 14.5 years total; nearly half my life. And I just walked away from it.

It’s not very far away. Maybe that’s why I don’t think about it being gone. Mr. Fix-It tells me about his day at work, and I’m learning to see surgeons through his eyes. It’s a strange, upside-down, mirror-image kind of sensation. And my brother calls at least once a week to tell me about his irresponsible co-residents, his demanding attendings, an annoying bureaucrat. I get to hear about exciting surgeries from him, with no pain or commitment on my part. I would probably feel a lot different if I didn’t have him as my back door to only-the-best-parts of surgery.

During my last pregnancy I had a couple of undoubtedly significant dreams about surgery, ones where I desperately needed to fix someone, but couldn’t find my way into the OR, or couldn’t get anyone in the OR to give me the instruments I needed, or couldn’t manage to stay scrubbed in to the operation. They were pregnancy dreams, of course, the crazy ones where the solution is always just around the corner. I thought maybe they meant I really regretted my decision. But after Rabbit’s birth they went away. Can’t be too significant then, right?

Or maybe I’m secretly pleased by the stash of contraband instruments, needles, and suture I’ve got packed away. An old surgeon never really dies. . . .

One down, 49 to go

Just have to say, I’m so happy with the outcome in Iowa. There’s still a long ways to go, but it was a good step in the right direction, towards getting Trump out of the picture. Then we can have an actual serious policy discussion.

And Hillary in a down-to-the-wire finish with Sanders? Perfect. I think she might actually implode if she loses a second presidential nomination to an upstart. Maybe then the Clintons would go away and stay gone.