I realized today that it's been a week since Little Monster nursed and that means we are done. If I'd realized it at the time I imagine I'd have been nostalgic a little bit but since it was 30 seconds of chomping and then giggling, I was mostly just DONE. On the one hand, given how much I disliked the whole thing, whoa making it to 14 months was pretty spectacular. I had so much frozen milk that I stopped pumping in January for daycare and she didn't switch to store-bought milk until 13 months so that was incredibly freeing. Up until that last time I decided that with the biting/yanking/causing bleeding I'd stop offering and if she wanted to request to nurse, she could bring me her nursing pillow (ok, so it's a polar bear stuffed animal). I turned her down once since then and she was grouchy but she's also getting like 5 teeth all at once. It's so sweet of her to save teething for when I have high stakes school stuff coming up, isn't it? (extreme sarcasm)
My first final is within the week (they are strung out to torture us this semester). Life as we have known it for so many years is really going to end.
It's a very weird set of emotions that's all wandering around my head these past few days, part relief that at long last there will be no more "I'm going to the library for the night" or "No I can't play right now, I have a test tomorrow" and part terror that I have no idea how we will cope with the new world. It of course doesn't help that we are buffering school and real world with a year of extreme wackiness where I'm gone lots and terrible twos (pre-twos?) and new label management that comes with getting an appropriate IEP and so far with one special ed teacher I'd like to fire. Seriously it's been a week with the label and we aren't going to disclose everything to you in an email because we aren't stupid. No need to be rude and disparaging and suggest that the kid won't even qualify for an IEP (and how could you know that anyway, fool?).
The time left in school and with a baby who really is more toddler every hour is so short it is mind-boggling. It has seemed through all of pharmacy school as if it were never-ending and with the bonus year, that's certainly felt more and more true up until just this week. Now there is hardly enough time to get everything ready. I've ordered my work clothes to fill in my wardrobe. I've bought myself a rice cooker and will probably buy some jars for lunches tonight. My travel plans for the first two rotations are reasonably firmed up. Since it works out that I go straight from school Friday until noon (drive for hours between) to my sibling's wedding (SQUEE!) and my first rotation the day after the wedding, my time to prepare is really short. Startlingly short.
My very first na.plex review book came yesterday (that's one of the two exams we take to get licensed, the other one being the state-specific law exam). I was cheap and bought last year's edition since I'll want the newest information to study for the real thing next year. I haven't actually gotten it out of the packaging yet. So far it's sitting where I can kick it around but studying for my exit exams starts Friday afternoon (and the exam is way too soon so I'm counting on being able to fail once so I get to study for it before the retake).
I think for now I'm going to make a list of everything that is left in the semester and another that's everything to get ready for rotations. Hopefully they are similar in length and not terrifying. After I finish the assignment due at midnight and the very last freaking paper I'm ever writing in pharmacy school that's due tomorrow. And maybe after I sleep some since I have a quiz and a zillion doctor appointments tomorrow with big things the rest of the week too. Siiiiiigh.
Tuesday, April 22, 2014
Thursday, April 17, 2014
The d word
That would be disclosure, in case you were wondering.
I'm finding myself in this interesting space where I'd like to write about something very profound happening in my life but it would make me way too identifiable. So let's tiptoe around it for a bit, shall we?
For a long time we have been trying to figure out what the deal with the kid is. She is a very quirky kid. Now we have a relatively neat answer and a label and that's exciting and terrifying. At this point it's hard to know if the label will stick but it seems like we just discovered the label had been attached to her all along and it was discovered rather than attached externally so I'm pretty comfortable with it overall. The label's big reveal is very helpful to me in how I approach parenting in that I know I'm not doing anything wrong but that what I know to do is based on a label-free child and that's not who I am parenting so my approach needs altering. It isn't that the everything we have tried was done wrong by us but that what we needed wasn't in the realm of normal "everything."
So to whom do we disclose this information? Does it matter? Should we be thinking about how a label changes the way she is perceived or is it inherently wrong to withhold information from those who might benefit from it?
Last night the spouse and I watched the movie Gataca (why yes I spelled that wrong) about a future where selection of specific genes is normal before a child is created via something like IVF. A lot of it boils down to how we discriminate against those with a certain label, whether that label is one that's visually apparent to everyone or one that is revealed by a test. The lead character really wants to be an astronaut but his genetic probability at birth says his life expectancy is only to 30 and he will have "a heart condition." He proves that he is mentally very capable despite that doom and gloom prediction of his odds of success in life as a baby. The genetic counseling session where the parents with the unordered baby protagonist in tow is really intriguing as the parents choose just how much they want to control the genetic probability of various risks.
But our world isn't just going to be like that if it changes and we order babies off a menu. It's like that now. Men and women get a different number of calls for job interviews, mentoring opportunities, and promotions with identical resumes. People with an "ethnic" name get discriminated against like there's no tomorrow (who gets called back about an apartment or a job or even the micro-aggression of having to explain where you are from to every person you meet). Fat people get their health concerns blown off and are told to lose weight as the sole solution to every problem. I got told my migraines would get better if I lost 20 lbs by a migraine specialist for example. They didn't of course.
To some degree we are people and we have to weed out people who are helpful from people who are harmful so discrimination is in our nature. I think that degree is tiny compared to the way we've structured society though. Look at who is in power and who isn't. There's a line and only a very certain set of people get to cross it. We all lose because of this narrow control of power.
So I am struggling with disclosing this label. How does the label move what people think about my kid, about my parenting of her? When do we tell her about the label? We have an appointment to look at this with her primary doctor next week and it's hard to know if she's old enough to know about the label yet, and if telling her does more harm than good, and if we should bring her to the appointment and involve her or if we should let her continue being her without the label wandering around in her psyche.
That of course is the heart of the matter - disclosure. Do we disclose what we know to her now and if not now, when? What's the age where the label will be something she can understand completely?
And who else do we let in on the label? Primary caregivers only or do we wait to see if she struggles and then clue in the primary caregivers? Teachers? We decided to see about what the school district has to offer so that cat is probably out of the bag but we need to know our options and figure out if labeled schooling matters or if she can succeed somewhere with no label beyond her name.
I'm finding myself in this interesting space where I'd like to write about something very profound happening in my life but it would make me way too identifiable. So let's tiptoe around it for a bit, shall we?
For a long time we have been trying to figure out what the deal with the kid is. She is a very quirky kid. Now we have a relatively neat answer and a label and that's exciting and terrifying. At this point it's hard to know if the label will stick but it seems like we just discovered the label had been attached to her all along and it was discovered rather than attached externally so I'm pretty comfortable with it overall. The label's big reveal is very helpful to me in how I approach parenting in that I know I'm not doing anything wrong but that what I know to do is based on a label-free child and that's not who I am parenting so my approach needs altering. It isn't that the everything we have tried was done wrong by us but that what we needed wasn't in the realm of normal "everything."
So to whom do we disclose this information? Does it matter? Should we be thinking about how a label changes the way she is perceived or is it inherently wrong to withhold information from those who might benefit from it?
Last night the spouse and I watched the movie Gataca (why yes I spelled that wrong) about a future where selection of specific genes is normal before a child is created via something like IVF. A lot of it boils down to how we discriminate against those with a certain label, whether that label is one that's visually apparent to everyone or one that is revealed by a test. The lead character really wants to be an astronaut but his genetic probability at birth says his life expectancy is only to 30 and he will have "a heart condition." He proves that he is mentally very capable despite that doom and gloom prediction of his odds of success in life as a baby. The genetic counseling session where the parents with the unordered baby protagonist in tow is really intriguing as the parents choose just how much they want to control the genetic probability of various risks.
But our world isn't just going to be like that if it changes and we order babies off a menu. It's like that now. Men and women get a different number of calls for job interviews, mentoring opportunities, and promotions with identical resumes. People with an "ethnic" name get discriminated against like there's no tomorrow (who gets called back about an apartment or a job or even the micro-aggression of having to explain where you are from to every person you meet). Fat people get their health concerns blown off and are told to lose weight as the sole solution to every problem. I got told my migraines would get better if I lost 20 lbs by a migraine specialist for example. They didn't of course.
To some degree we are people and we have to weed out people who are helpful from people who are harmful so discrimination is in our nature. I think that degree is tiny compared to the way we've structured society though. Look at who is in power and who isn't. There's a line and only a very certain set of people get to cross it. We all lose because of this narrow control of power.
So I am struggling with disclosing this label. How does the label move what people think about my kid, about my parenting of her? When do we tell her about the label? We have an appointment to look at this with her primary doctor next week and it's hard to know if she's old enough to know about the label yet, and if telling her does more harm than good, and if we should bring her to the appointment and involve her or if we should let her continue being her without the label wandering around in her psyche.
That of course is the heart of the matter - disclosure. Do we disclose what we know to her now and if not now, when? What's the age where the label will be something she can understand completely?
And who else do we let in on the label? Primary caregivers only or do we wait to see if she struggles and then clue in the primary caregivers? Teachers? We decided to see about what the school district has to offer so that cat is probably out of the bag but we need to know our options and figure out if labeled schooling matters or if she can succeed somewhere with no label beyond her name.
Monday, April 7, 2014
Transitions of care
My goal for the year was to be good and put my own mask on first. It's a reasonable goal I think, prioritizing self care over draining myself caring for others.
Of course, it hasn't happened that way as much as I'd like to. I have suddenly taken over a huge amount of childcare and household stuff and that's life and was pretty unavoidable. On the other hand I've been decent about maintaining my sanity by getting out of the house sometimes, better than ever before. It has been really good to get out to be an adult sometimes. I honestly am happy to lose 5% of my grade in some classes to have the time to be human and not just a studying machine.
But here we are, getting ready to transition from me doing lots and lots to me being gone during the week. When I was away for school in the fall I came home to a disaster area and it really bothered me. I worry. I don't want to come home every weekend and spend all my time doing dishes and laundry, but if every week is like that one, I will have no other choice. I can't in good conscience leave for the week if every dish is dirty and none of the laundry is clean.
In the healthcare arena we talk a lot about transitions of care. Lots of bad things happen when people go from the hospital back home or to a different healthcare facility. It's easy to drop the ball when someone has been providing one level of care and it's suddenly gone. The new caregiver may have no idea what is needed to maintain adequate care. I think of the little old man with heart failure who goes to the hospital, stays a few days, then gets sent home on a few new medications whose little old life partner is bewildered by the whole thing. Which medications he took before the hospital should he still take? Did the dose of any of them change? What looks so bad that he needs to go back to the hospital and what should we call the doctor about? How much do all these new medications cost? What happens if he dies? What happens if I get sick? These guys come back to the hospital pretty often because they haven't been taking medications properly and it's easy to get confused even if you are a very with-it caregiver. I've seen the little old caregiver in the pharmacy and they just look like they are in total shock. They nod and say they understand and sometimes can even repeat directions back but I don't think most of them have really understood a word of what is said.
Now we all in healthcare are looking at ways to smooth transitions of care for people so don't think we've given up on the little old caregivers completely. We do things like create detailed lists of medications and send home swaths of printed information about how things should go. We sometimes send home med lists that say specifically "stop taking medication x that you took before you were in the hospital" even. Discharge counseling for those leaving the hospital is far more than it used to be so hopefully the sick person and the caregiver(s) understand better how things work.
But sometimes no matter how prepared you pretend you are, you can't really fathom an experience with radical change.
I've been trying to ease the upcoming transition of care for my spouse, spelling out things that matter like that we need to do one load of laundry every day to keep up with things. I've been letting the mess pile up so hopefully my spouse recognizes it and deals with it without prompting. This means that a bowl that got smashed in the kitchen a week ago (by my spouse no less) is still in pieces on the floor.
I'm starting to panic honestly. I know that my rotations are what's best for my career and we as a family are in a place where it looks like it will be my career and not our careers. I get that it matters a lot that I do the rotations to the best of my ability. It's part of me putting on my own mask first. At the same time I can't believe I am really going to be gone for 10 weeks in a row. I have no idea how this is going to work. I'm scared to see how it works and that it really isn't going to work at all.
Next is my short to do list. Let me know what I've forgotten.
Figure out what dishes/pans I need to feed myself while I'm away and acquire them
Assemble work wardrobe and purchase anything I need to fill it out (new undergarments for sure, probably a few pairs of pants)
Get a proper pair of pajamas
Clean out the car
Get the car's body work done so it's presentable
Figure out the site requirements and get those accomplished before each rotation
Avoid panic if at all possible
Questions for you all: how many outfits/pieces are in your work wardrobe?
Of course, it hasn't happened that way as much as I'd like to. I have suddenly taken over a huge amount of childcare and household stuff and that's life and was pretty unavoidable. On the other hand I've been decent about maintaining my sanity by getting out of the house sometimes, better than ever before. It has been really good to get out to be an adult sometimes. I honestly am happy to lose 5% of my grade in some classes to have the time to be human and not just a studying machine.
But here we are, getting ready to transition from me doing lots and lots to me being gone during the week. When I was away for school in the fall I came home to a disaster area and it really bothered me. I worry. I don't want to come home every weekend and spend all my time doing dishes and laundry, but if every week is like that one, I will have no other choice. I can't in good conscience leave for the week if every dish is dirty and none of the laundry is clean.
In the healthcare arena we talk a lot about transitions of care. Lots of bad things happen when people go from the hospital back home or to a different healthcare facility. It's easy to drop the ball when someone has been providing one level of care and it's suddenly gone. The new caregiver may have no idea what is needed to maintain adequate care. I think of the little old man with heart failure who goes to the hospital, stays a few days, then gets sent home on a few new medications whose little old life partner is bewildered by the whole thing. Which medications he took before the hospital should he still take? Did the dose of any of them change? What looks so bad that he needs to go back to the hospital and what should we call the doctor about? How much do all these new medications cost? What happens if he dies? What happens if I get sick? These guys come back to the hospital pretty often because they haven't been taking medications properly and it's easy to get confused even if you are a very with-it caregiver. I've seen the little old caregiver in the pharmacy and they just look like they are in total shock. They nod and say they understand and sometimes can even repeat directions back but I don't think most of them have really understood a word of what is said.
Now we all in healthcare are looking at ways to smooth transitions of care for people so don't think we've given up on the little old caregivers completely. We do things like create detailed lists of medications and send home swaths of printed information about how things should go. We sometimes send home med lists that say specifically "stop taking medication x that you took before you were in the hospital" even. Discharge counseling for those leaving the hospital is far more than it used to be so hopefully the sick person and the caregiver(s) understand better how things work.
But sometimes no matter how prepared you pretend you are, you can't really fathom an experience with radical change.
I've been trying to ease the upcoming transition of care for my spouse, spelling out things that matter like that we need to do one load of laundry every day to keep up with things. I've been letting the mess pile up so hopefully my spouse recognizes it and deals with it without prompting. This means that a bowl that got smashed in the kitchen a week ago (by my spouse no less) is still in pieces on the floor.
I'm starting to panic honestly. I know that my rotations are what's best for my career and we as a family are in a place where it looks like it will be my career and not our careers. I get that it matters a lot that I do the rotations to the best of my ability. It's part of me putting on my own mask first. At the same time I can't believe I am really going to be gone for 10 weeks in a row. I have no idea how this is going to work. I'm scared to see how it works and that it really isn't going to work at all.
Next is my short to do list. Let me know what I've forgotten.
Figure out what dishes/pans I need to feed myself while I'm away and acquire them
Assemble work wardrobe and purchase anything I need to fill it out (new undergarments for sure, probably a few pairs of pants)
Get a proper pair of pajamas
Clean out the car
Get the car's body work done so it's presentable
Figure out the site requirements and get those accomplished before each rotation
Avoid panic if at all possible
Questions for you all: how many outfits/pieces are in your work wardrobe?
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