I get to sleep in!!! Which, if porter follows his normal pattern, means we'll be up between 5:30 and 6:00. Porter isn't feeling well and has goopy, red eyes, so we may be headed to the dr tomorrow. I had big plans for the week---cleaning, organizing, and exercising---but porter may have other plans.
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Sunday, January 31, 2010
Saturday, January 30, 2010
Last call!!!!
And it doesn't have anything to do with a bar closing. Today is my last 24 hour call at the medical center---ever!!!! Well, as long as my schedule doesn't change for some reason, and that seems to happen a lot. My next rotation is nights, and then I go to the VA, and than I'm done!
I just finished my absite exam (American board of surgery in training exam) that we have to take every year, and now I'm just getting to the med center for my last 24 hour call here! Should be interesting with senior bowl and 3 mardi gras parades tonight.
****Walking update: it must be just something he does at daycare. He was back to crawling at home, although it's obvious he can walk. He wants to hold one hand or he drops down to the floor when you let go. Imminent though I'm sure.
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I just finished my absite exam (American board of surgery in training exam) that we have to take every year, and now I'm just getting to the med center for my last 24 hour call here! Should be interesting with senior bowl and 3 mardi gras parades tonight.
****Walking update: it must be just something he does at daycare. He was back to crawling at home, although it's obvious he can walk. He wants to hold one hand or he drops down to the floor when you let go. Imminent though I'm sure.
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Friday, January 29, 2010
Finally walking!!!! .....maybe
Jared called me this morning to tell me that when he dropped porter off at daycare he was walking. He said when porter's feet hit the floor, he walked over to his friend mason, and then turned and walked to the toys. Ms. Wanda said he's been walking more and more, but he doesn't at home. So, I guess we will see what happens tonight when he is at home. I will hopefully have some walking pictures or videos to post!
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- Posted using BlogPress from my iPhone
Tuesday, January 26, 2010
Porter's new "obsession"
Hairbrushes. And hairbrushing. Hair, cars, whatever.....
If it needs brushing, he's all over it.
Jared said this morning they were slow getting to daycare because porter had to brush his hair. For 20 minutes.
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If it needs brushing, he's all over it.
Jared said this morning they were slow getting to daycare because porter had to brush his hair. For 20 minutes.
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Saturday, January 23, 2010
Mexican
We did Mexican a day early because we were already in mobile and Daran and Sissy can't come tomorrow.
Porter has started eating a few chips while we wait on our food, but today he took it to another level.
At first I thought he might be just imitating us, but he got a little dip and then this happened.
We ended up having to get him his own little bowl and putting a "safe" amount of cheese dip in it (to keep ours from getting gross and not enough for him to get his whole hand in it).
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Porter has started eating a few chips while we wait on our food, but today he took it to another level.
At first I thought he might be just imitating us, but he got a little dip and then this happened.
We ended up having to get him his own little bowl and putting a "safe" amount of cheese dip in it (to keep ours from getting gross and not enough for him to get his whole hand in it).
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Saturday morning
O-M-G!!! I took porter for a walk this morning. Our neighborhood is very hilly and I used to be excited about that, but not anymore. I have decided that it is much more fun to be in shape and stay that way than be out of shape and try to get in shape. I gave in to residency and motherhood for the last 14 months (like I really had any choice) and I am ready to start my "Get my life back" campaign, which includes getting my body back. This is going to be rough. Porter enjoyed it though--he had his snacks and juice, and pointed at everything (and sometimes nothing) the whole time.
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- Posted using BlogPress from my iPhone
Friday, January 22, 2010
It's Friday!!!
Fridays mean somthing again. I'm off this weekend. Yea!
Jared is hunting so me and Porter bonded over breakfast.
Now we're sitting behind the school bus. Over and over again on the 2 mile ride out of the neighborhood. That's lots of bus stops. Thank goodness Elmo is with us.
Porter is still not walking, but we are getting closer. His teacher at daycare walks him up and down the hall during the day, and last night he took 5 steps from a chair to the window. His teacher said he would have already moved to the next class if he was walking, but now they are thinking of moving so that he would be around kids that are walking. However, porter is in charge of this whole thing, so even that might not work. He'll do it when he's ready.
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Jared is hunting so me and Porter bonded over breakfast.
Now we're sitting behind the school bus. Over and over again on the 2 mile ride out of the neighborhood. That's lots of bus stops. Thank goodness Elmo is with us.
Porter is still not walking, but we are getting closer. His teacher at daycare walks him up and down the hall during the day, and last night he took 5 steps from a chair to the window. His teacher said he would have already moved to the next class if he was walking, but now they are thinking of moving so that he would be around kids that are walking. However, porter is in charge of this whole thing, so even that might not work. He'll do it when he's ready.
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Thursday, January 21, 2010
Streakin'
I may have started something we shouldn't continue later, but sure is fun now.... While we are waiting for the tub to fill up and after porter is naked, we fill the time by streakin' through the house. It consists of running around screaming while Jared chases us. Porte thinks it is hilarious. For the last few days he is climbing up me and pointing toward the door before I can even get his diaper off. Oh well, we'll have to have a little talk the first time he goes to stay at a friends house, or he may just teach them about steakin'.
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- Posted using BlogPress from my iPhone
Wednesday, January 20, 2010
The trauma post
WARNING: This post is going to contain graphic descriptions and pictures (by clicking a link). This is merely a post to inform and somewhat vent about the contradictions of my life. There is some shock value in this post, but again, it is truly a representation of what my daily life is like.
So to begin, I need to give a little background. In residency, there are different teams of surgery residents that work together on a certain subset of patients. We call them services, and here at the med center we have 3: Trauma, General Surgery, and Cardiothoracic Surgery. I am currently the chief of the Trauma Service, meaning I am the highest level resident in charge, and am the one ultimately responsible for the decision-making on a resident level. The attending is the "boss" that is above me, whom I answer to, and ultimately is legally responsible for what we as residents do. Trauma is a 24/7 job--we never know when someone is going to get shot, stabbed, get in a wreck or do something else to try to kill themselves. We know that a trauma is about to arrive, or may have already arrived, when we hear overhead, "Trauma alert to the trauma room, trauma alert to the trauma room." We also get pages on our pagers. Then the entire trauma team, which includes residents on the trauma service, as well as respiratory therapists, nurses, and CRNAs, all go down to the trauma room to see what we got this time. This happens all hours of the day and night. That is why I rarely sleep much on call. A new report has come out recently showing that USA Med Center has a very high trauma acuity, like 49th in the country. That means that there are only 48 other hospitals in the whole country who get more and sicker trauma patients than we do.
All that to tell you about a trauma I had over the New Year Holiday, and how it affects my life (or doesn't I guess). We had a trauma alert, and go downstairs. When we get there we find out it's a gunshot wound (GSW) to the chest. This could be nothing, but it could be very bad. So the guy rolls in and he isn't intubated and doesn't have IV access--not good for him. We quickly get him intubated, and put in 2 cordises (very large IVs that are put in a central vein that you can give lots of stuff through very quickly). We then proceed to put in bilateral chest tubes to see if he is bleeding into his chest. He is. And BTW, he is in pulseless electrical activity (PEA), so we are doing CPR this whole time. So, he is bleeding from his left chest. Leads you to believe he may have an injury to his heart. The next step in the algorithm is to open his chest--right there in the ER. So we do. It's called an ER Thoracotomy, and how to do it is described in the trauma literature, so we all are well trained in this. We take a scalpel (we call it a knife) and cut him from sternum to as far down on the bed as we can go following along his ribs all the way down to bone and muscle, and then keep going, until you are looking at heart and lungs. Then you open the pericardium to relieve any tamponade (blood inside the pericardium that might be exerting pressure on the heart). He did have tamponade, and we evacuated a lot of blood. We then realized that he did have a bullet injury to his heart which we needed to repair very quickly if we were going to save him. So then we proceed to clamshell him. That is when you take the knife and do the same thing on the right side of the chest, so you have one big cut from one side to the other. One of my former attendings used to say that you could see the soul through this incision. The easiest way to complete this is to take a pair of trauma shears (really big scissors) and just cut through the sternum and the ribs on the right, which is what we did. Here is what it looks like. Next I sewed up the holes as best we could while my 3rd year resident was providing internal cardiac massage, which is like providing CPR, but better. Meanwhile, the nurses are trying to give him meds to help restart his heart, and lots of fluids and blood, because when you are doing this, most everything is already leaking out of the heart onto the floor. And here is what that looks like. This patient unfortunately did not survive, though hopefully you can tell that we worked really hard and did everything we could.
After this occurs, we leave the trauma bay for the cleaning staff to come in and clean up, go tell the family he didn't make it, and go on about our business, which for me means try to go get some sleep. Then I get up, hand off the pager to the next team, tell him that he missed a clamshell last night, and go home.
As I was telling my mom this story while I was on the way to the grocery store with Porter, I realized how really wierd this whole almost double life is. I do some really strange things at work every day, and then come home and am hopefully a normal mother. (No comments please ;) ) She is totally grossed out and horrified, but it doesn't really effect me at all. How am I going to explain this to my child one day, and how do you teach him to have respect for life and death when sometimes I seem to have none? And I wonder if it is ok to talk about moments like that in front of him. I imagine it has effects on adults, so how could it not have implications for children--they're so innocent. Just things I think about.....
So to begin, I need to give a little background. In residency, there are different teams of surgery residents that work together on a certain subset of patients. We call them services, and here at the med center we have 3: Trauma, General Surgery, and Cardiothoracic Surgery. I am currently the chief of the Trauma Service, meaning I am the highest level resident in charge, and am the one ultimately responsible for the decision-making on a resident level. The attending is the "boss" that is above me, whom I answer to, and ultimately is legally responsible for what we as residents do. Trauma is a 24/7 job--we never know when someone is going to get shot, stabbed, get in a wreck or do something else to try to kill themselves. We know that a trauma is about to arrive, or may have already arrived, when we hear overhead, "Trauma alert to the trauma room, trauma alert to the trauma room." We also get pages on our pagers. Then the entire trauma team, which includes residents on the trauma service, as well as respiratory therapists, nurses, and CRNAs, all go down to the trauma room to see what we got this time. This happens all hours of the day and night. That is why I rarely sleep much on call. A new report has come out recently showing that USA Med Center has a very high trauma acuity, like 49th in the country. That means that there are only 48 other hospitals in the whole country who get more and sicker trauma patients than we do.
All that to tell you about a trauma I had over the New Year Holiday, and how it affects my life (or doesn't I guess). We had a trauma alert, and go downstairs. When we get there we find out it's a gunshot wound (GSW) to the chest. This could be nothing, but it could be very bad. So the guy rolls in and he isn't intubated and doesn't have IV access--not good for him. We quickly get him intubated, and put in 2 cordises (very large IVs that are put in a central vein that you can give lots of stuff through very quickly). We then proceed to put in bilateral chest tubes to see if he is bleeding into his chest. He is. And BTW, he is in pulseless electrical activity (PEA), so we are doing CPR this whole time. So, he is bleeding from his left chest. Leads you to believe he may have an injury to his heart. The next step in the algorithm is to open his chest--right there in the ER. So we do. It's called an ER Thoracotomy, and how to do it is described in the trauma literature, so we all are well trained in this. We take a scalpel (we call it a knife) and cut him from sternum to as far down on the bed as we can go following along his ribs all the way down to bone and muscle, and then keep going, until you are looking at heart and lungs. Then you open the pericardium to relieve any tamponade (blood inside the pericardium that might be exerting pressure on the heart). He did have tamponade, and we evacuated a lot of blood. We then realized that he did have a bullet injury to his heart which we needed to repair very quickly if we were going to save him. So then we proceed to clamshell him. That is when you take the knife and do the same thing on the right side of the chest, so you have one big cut from one side to the other. One of my former attendings used to say that you could see the soul through this incision. The easiest way to complete this is to take a pair of trauma shears (really big scissors) and just cut through the sternum and the ribs on the right, which is what we did. Here is what it looks like. Next I sewed up the holes as best we could while my 3rd year resident was providing internal cardiac massage, which is like providing CPR, but better. Meanwhile, the nurses are trying to give him meds to help restart his heart, and lots of fluids and blood, because when you are doing this, most everything is already leaking out of the heart onto the floor. And here is what that looks like. This patient unfortunately did not survive, though hopefully you can tell that we worked really hard and did everything we could.
After this occurs, we leave the trauma bay for the cleaning staff to come in and clean up, go tell the family he didn't make it, and go on about our business, which for me means try to go get some sleep. Then I get up, hand off the pager to the next team, tell him that he missed a clamshell last night, and go home.
As I was telling my mom this story while I was on the way to the grocery store with Porter, I realized how really wierd this whole almost double life is. I do some really strange things at work every day, and then come home and am hopefully a normal mother. (No comments please ;) ) She is totally grossed out and horrified, but it doesn't really effect me at all. How am I going to explain this to my child one day, and how do you teach him to have respect for life and death when sometimes I seem to have none? And I wonder if it is ok to talk about moments like that in front of him. I imagine it has effects on adults, so how could it not have implications for children--they're so innocent. Just things I think about.....
The Cove
We watched a documentary called The Cove last night. It is about the slaughtering of dolphins in Japan. As divers and spearfishermen/women, it was a very sad film to watch. Dolphins are fun to watch and interact with in the water, and it's heartbreaking to know that this is going on. It's a great movie, and there is a website for the movie and the organization that is trying to put a stop to it.
www.takepart.com/thecove
Sunday, January 17, 2010
Straws
We get through the last part of Mexican night every week because we get him a straw. That gives us at least another 10 minutes.
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- Posted using BlogPress from my iPhone
Headed you know where....
It is Sunday afternoon, so that means Mexican time. We're on our way now. Jared had to wake me and porter both up from a nap.
Porter is grunting. I think he is using this ride as his potty time. And he is watching his new Elmo video. He is grunting and tv frozen. Amusing.
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Porter is grunting. I think he is using this ride as his potty time. And he is watching his new Elmo video. He is grunting and tv frozen. Amusing.
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Post Call
Last night was busy, so I didn't get much sleep at all. I'm struggling. Jared isn't back from the hunting camp yet, and I am anxiously awaiting his arrival so I can get a shower. We have been playing hard despite my stinkiness and tiredness.
Playing on the slide.
Wild hair is returning.... The longer it gets, the wilder it gets.
So much for this being a fun little toy. He figured out the day after Christmas that there is a little latch on the front that opens it. He just pulls the latch and bypasses the song.
Serious concentration..... He LOVES playing with the fingernail clippers. I know it's probably not the best toy for a 1 year old, but he is obsessed with trying to "figure them out" and I only let him have them when I am watching closely. It's interesting to watch. Occasionally he will grunt--like that will help him get it.
Playing on the slide.
Wild hair is returning.... The longer it gets, the wilder it gets.
So much for this being a fun little toy. He figured out the day after Christmas that there is a little latch on the front that opens it. He just pulls the latch and bypasses the song.
Serious concentration..... He LOVES playing with the fingernail clippers. I know it's probably not the best toy for a 1 year old, but he is obsessed with trying to "figure them out" and I only let him have them when I am watching closely. It's interesting to watch. Occasionally he will grunt--like that will help him get it.
Friday, January 15, 2010
Whew!
The sound of a helicopter makes a trauma resident cringe. Thankfully, this was not a trauma. We always look out the windows to see what helicopter has landed when we hear it. It wakes me up when I'm here sleeping.
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- Posted using BlogPress from my iPhone
Tuesday, January 12, 2010
14 months old!!!
Porter is 14 months old today! He is pretty much over his little chest cold and had a good day at school today, after a really bad day yesterday. It is crazy how much he is learning every day, and coming up with new things. Just in the last week or so he stopped going down the stairs head first, and started a much safer, turning around backwards and backing down the stairs. Don't know where he got that from because we've never shown him how to do it. He likes to get in anything (cabinets and the dryer), and loves to crawl under things. He finds it challenging to try to crawl under things that are really low, like our chairs with the rails around the legs, and our coffee table. He is saying new words all the time, with his most recent being "bubbles." He can say hotdog, hot, bite, up and down (and he points when he says it), quack, juice (but it's more like the -ce end of the word), paw paw/pa pa, ball, boo, daddy/da da and I'm sure I'm forgetting some. He doesn't say mama at all, but I have gotten him to copy the sounds mmm, mmm before. He calls me da da, if he calls me anything, but I don't think he really does that yet. He shakes his head no whenever he is doing anything he knows he is not supposed to do, lays his head and cuddles on any soft blanket he happens upon, and loves to read to himself. He doesn't walk yet, but is starting to get much better balance, so I know it won't be long. (He inherited Goodson feet from his Granddaddy and me, and just has little nubs for feet, so Jared blames that on the not walking yet---he's still a size 3 1/2.) He still loves to get a bath and now loves to brush his 9 teeth. He goes to bed a 8:00 and is up at 6:00am sharp. His routine breakfast is a nutrigrain bar and milk, and his favorite foods are chicken, hotdogs, kraft cheese singles, and fruit cups. HIs favorite thing in the world though, is his daddy. I'm like stinky garbage when he's around. He can make him laugh like nobody else, and of course, his daddy spoils him like nobody else.
Monday, January 11, 2010
What can I get into tonight?
Saying bye bye as he pulls the door closed.
That would be a juicer in pieces that he is crawling past. "My work here is done...."
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That would be a juicer in pieces that he is crawling past. "My work here is done...."
- Posted using BlogPress from my iPhone
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