Wednesday, August 23, 2017

The Day Our Whole World Changed

We've been having a lot of difficulty with Dovid over the last few months, and after blaming so many things for his issues, we've finally figured out what was really going on...

Since about June, Dovid has been drinking as though he could never get enough water. He would sneak down in the middle of the night, parched, and get himself water, even though we told him a thousand times not to. He would also sneak down for snacks. Then the pee accidents started. During the day, over night, you could never trust him not to pee. He was soaking everything, too - his bed, the couch... We blamed his medication, we blamed him just being lazy, we blamed the water before bed causing accidents (technically true, but there's more to it than just that). He also fell off the growth chart. Not that he's ever really been on it, but his plateaued, and his pediatrician was worried enough that she was going to send us to see a gastrointestinal doctor. In the meanwhile, I was going to take him to the child development clinic to see someone about his pee accidents.

Fast forward to last Sunday evening. We had a delightful party of sorts at our next door neighbor's house as a birthday celebration for our friend, Ron, whose birthday is this week. Dovid went to the bathroom (after having no less than 4 glasses of water) and stepped on their bathroom scale. He came out and proudly announced he weighed 39 lbs. *record screech* 39 lbs...he had been over 40 lbs at some point. He was not only not gaining weight, but now losing? And I know he's eating. As I said, he was sneaking snacks even! And he'd eat plenty at dinner. There was no excuse for him losing weight.

When I got home and sat down at my computer and really started thinking about it, my nursing brain kicked in. What else could make a kid drink, pee, eat, and lose weight? I got on Facebook and asked around for a glucose meter, and luckily a friend of mine down the street had a spare. I immediately went to get it, hoping I was being a hypochondriac nurse mother. She tested it in front of me, so I knew how to work it and that it actually worked properly. I took it home and tested Dovid while he was still asleep. The screen said "high glucose > 600". My hands shook. My heart sank. I ran down the stairs, screaming for Shmuel. I showed him the meter, because I couldn't actually say it out loud. He suggested I retest, even though I knew in my heart it would show no different. I went back up and used a different finger...same result. Crap. I asked my friend if she ever got a result that high. The answer was no. Double crap. We called the pediatrician, though I knew this was an automatic straight to the ER glucose result. Shmuel carried Dovid down to the car, and I took him to a local hospital (Newton-Wellesley).


At the ER, of course Dovid feels totally fine, just thirsty as all heck and asking every living being if he could have a glass of ice water. Don't let looks fool you, of course. They tested his glucose again...same result as at home. Well done, mom. They sent his sample to the lab to get an actual value...851. Triple crap. Luckily, somehow Dovid with all of his energy and water drinking managed to keep himself out of DKA (diabetic ketoacidosis) for months with high sugars. He still had high ketones, but his blood pH was decent - just obviously compensated. After a bag of fluids and, yes, a nice glass of ice water, they gave him insulin and we were transferred via ambulance to Children's Hospital.



 One last note about Newton-Wellesley is that they have child life specialists for pediatric patients who help when any procedures are done and give them activities to do (coloring, iPad, etc). She helped to educate him and calm him, and Dovid is a kid who HATED needles. He caused a major scene at CVS getting his flu shot last year. She also gave him a REALLY nice Lego set (for keeps). They really know how to treat children there, and I was very impressed with the way they handled everything.


These two pictures above are of Dovid in the ambulance. He was entirely enthralled, as this was his first time in one. Hopefully he will never need to see the inside of one strapped to a stretcher again.


At Children's, they repeated Dovid's blood sugar and labs, and of course it was all still high. Then he was admitted, but unfortunately they didn't have any "legit" rooms, so we got put into a treatment room. :( By this time I was so exhausted I was almost not coherent. Once we were settled, Dovid, who had at least gotten a few hours sleep, enjoyed time on the iPad while I was passed out in the bed. Once the day started in earnest, all manner of doctors, nurses, educators, and dietitians came to talk to us about diabetes care and treatment. We were lucky enough to be offered a chance to participate in their day program, so we could be discharged that night (Monday) and come back the next day (Tuesday) for education for the latter part of the day.

So far we are all hanging in. Dovid is a real trooper and has given us no problems with the finger sticks and insulin shots. I am incredibly proud of him and his maturity with all of this. He doesn't really seem perturbed, even when I have to keep him from eating long enough to count his carbs and give insulin. And he doesn't mind needles now...at least not the teeny insulin ones. I also felt so loved at the outpouring of support from everyone on Facebook and especially those (like Ron, our nanny (Melissa), my amazing neighbors, and the mom of one of Dovid's friends) who visited in person, brought me food, helped with the kids, and drove us home.

I never thought I would ever need to know about diabetes at all (aside from obvious nursing/midwifery related things), let alone get a crash course in type 1. Life is going to be a whole lot different, but we'll get through as we usually do. Now we just have to get Dovid onto a regimen where his sugars are controlled and hopefully get him a continuous glucose monitor and insulin pump. That at least will take some of the weight off. Until then, I better get to sleep. 2am is finger stick time.

Sunday, May 14, 2017

Night At The Museum x3

Costco had a really great deal on the Night at the Museum trilogy - $13 for all three in a DVD set. I could not pass that up, considering I've really wanted to see them and figured the kids would enjoy. So we may have binge watched them a bit.

The kids ADORED the movies. They've been deciding which of them is which character. So far Gavriella is Sacajawea, Tzipora is Jedediah, Chana is Octavius, and Dovid is King Akhmenrah. Which, of course, leaves me to be Teddy Roosevelt. I could have done much worse. haha

Each movie has is really great points, but I have to tell you the little Jewish pieces in the third one made me smile. There's a reference to Nicky's Bar Mitzvah and an entire (little) conversation between Larry and King Merenkahre (played by the amazing Ben Kingsley) that made me crack up. Speaking of Ben Kingsley, I just about freaked out when I saw him in the Egyptian pharaoh get up. Anyone who knew me well as a child would know I had a small (huge) obsession with the biblical Joseph. It started with Joseph and the Amazing Technicolor Dreamcoat and wafted over to a made-for-TV movie called Joseph, where Ben Kingsley plays Potiphar. As I've watched him as Potiphar probably a hundred times, seeing him play the pharaoh was pretty awesome and made my teenage heart flutter.

But Ben Kingsley wasn't even the best part of the third movie. That was Dan Stevens, of course, who played Sir Lancelot. They made just enough "Dan Stevens is hot" jokes to suit me. He did a fabulous job making Lancelot believable even when I can't not picture him as Matthew Crawley.

If you haven't watched the trilogy, definitely do it. Rent them or see if your local Costco has them. You're in for a good laugh (and a good cry).

Saturday, May 13, 2017

Answers

Since at least one person expressed interest, at some point I will tell you about my interesting genealogical findings. As for now, I'll give the answers to the questions I got in comments:

First off, Dovid. He has ADHD and is a challenge all around. He still has accidents because he gets so engrossed in things that he does so he doesn't make it to the bathroom on time. He also talks a lot and has difficulty with social interaction. So he doesn't realize that the other person wants him to be quiet or just isn't interested in what he's talking about. He doesn't talk about the other kids at school much (except for one boy who I don't think is a mutual friend), so I don't know if he really has any friends. I hate thinking about how lonely he must be. But B"H he is very smart, so academically he does quite well. I'm always impressed with the things that he knows.

Right now not TTC and not planning on any more kids in the near future. I am quite content (and overwhelmed) with 4. Maybe once these guys get older and less of a handful I might have a change of heart, but I am too busy to think otherwise at this point.

As for work, I cannot get into a midwifery practice because no one wants a new graduate midwife (especially one without many years of labor & delivery experience). So I'm a bit stuck unless I want to go into a home birth practice or private practice, neither of which is a viable option for me.

I'm getting my doctor of nursing practice degree in midwifery, though at this point I'm not sure what I'm going to do with it. My end goal was to be a midwife, and now I just feel so worn out by it that I think retirement is my end point. haha

Friday, May 12, 2017

Finger Surgery

I had a small cyst removed from my finger last Tuesday, and it HURTS. I was expecting to go in, have it removed, and be sent home with a bandaid, but no... It has stitches and a HUGE dressing. Doctor also said I can't lift heavy things with that hand. So now I'm out of work for at least a week and a half. I'm not happy. My boss is not happy. And my finger hurts because this dressing is cumbersome and tight. I am seriously contemplating having one of my coworkers take out the stitches before the family reunion next week if I can't get in to see the doctor before then. It's a good thing I'm a righty.

Thursday, May 11, 2017

New Stethoscope

I probably shouldn't be typing so much since I had my finger operated on the other day, but I seriously have to tell you about my new stethoscope.

Thanks to a VERY good friend of mine, I was able to purchase a new Eko Core Digital Stethoscope. I tried it out the other day, and the magnification of the sound is unbelievable. I have a really hard time hearing breath sounds and heart sounds, and this could pick up my breath sounds through a thick sweater. Not only that, but when I used it at work, I had a nice little shock. I was trying to listen to a patient's heartbeat, but another sound kept intruding. I knew it wasn't a murmur or breath sounds or even bowel sounds. It was much too regular for any of those. It hit me that I was listening to her baby. I could hear fetal heart tones through the mom's chest. THAT IS UNREAL! Why can we not use this technology instead of cumbersome dopplers on belts that constantly need adjusting?

Also cool about it is that it connects via bluetooth to a phone app (one that I can't get because my phone is too old, but whatever). On the app you can listen to sounds in realtime or record and play back later. Quite useful for teaching or passing along sounds to other doctors who may not be available to see the patient immediately. Wish the app was compatible with my phone, but it's not 100% necessary for my job right now, so I'll just enjoy being able to hear down to someone's toenails for now.

You Miss Me?

How surprised was I today to see that someone was looking for an update and that I hadn't posted anything since last August when I became a CNM. I'm not really sure why I don't update more. I am busy - doing my DNP, working, kids - but not so busy that I can't take a few minutes to say hello to anyone who is still reading. *waves to all of my "fans"*

The nine months have not been particularly eventful. The twins are in 2nd grade and doing fairly well. Dovid is on a medication that has made him much easier to handle at school, though he still struggles with anything related to social interaction. Chana is progressing steadily and hopefully will be able to continue on to 3rd grade with Dovid next year. Tzipora has whizzed her way through kindergarten and can read! She's got a lot of sight words down, and we are all super proud of her. She also is friends with basically her entire class. Gavriella is also having fun in her first year at "school" in the 3-year-old class. She's an adorable gem, and I love it when her teachers send me photos of all of the fun things she is doing in class.

As for me, I /finally/ got a job, but not as a midwife. I was hired to work as a labor and delivery nurse (part-time nights). This is not ideal, but it is work. Meanwhile, I am plugging along with my doctoral studies and will hopefully finish in September. At that point you can all call me doc. :D

In about a week, we're going to be attending a family reunion with my grandfather and people from that side of the family that none of us have met. My mom, Uncle Ron, my sister and brother-in-law will also be there. It's going to be very exciting, and I promise to take lots of pictures and actually post about it. Maybe I'll get back into a groove or something... Feel free to leave a comment if you want me to post about something in particular. I feel as though I don't know what to talk about. I've made some pretty interesting genealogical discoveries over the past few months, but I doubt they would be interesting to anyone outside of my family.