Finding calm in the chaos

Finding calm in the chaos

Monday, April 28, 2008


I first met Jan (not her real name) in January. She had recently been discharged from the hospital for alcoholic hepatitis and was seeing me in outpatient follow up. A surly, thin-as-a-rail blonde who'd had a rough life. She had been sober for 45 days, but still had trouble walking and was still slurring her speech (long term effects of alcohol abuse). I reviewed her medications with her, reviewed the consequences of drinking with a cirrhotic liver (namely, she'd die in 6 months), and planned to see her back in a month.

Jan is a difficult patient, but for some reason, we bonded. She called the office frequently since she lived out of town and it was difficult for her to get transportation. The nurses hated talking to her. She was stubborn and hard to understand. I tried to find her a local primary care provider to help coordinate her care, but 7 providers declined, citing reports of "belligerence", "having to call security", and "nonpayment" during past experiences.

One day, she started sipping wine again and her condition rapidly declined. I told her I wanted to get her on hospice and we both came to the realization that she didn't have any insurance. We'd both thought Jan had been on Medicaid, but in reality, she had been on some discount prescription program. She had been calling her local social services office repeatedly, only to be told to call back when she wasn't drunk. Well, she sounded "drunk" whether she'd been drinking or not because of her encephalopathy.

So, I unwillingly delved into the complicated world of social services. I called her local social services staff and explained her situation. I waited on hold forever when I called our local social security office, only to be told I could call back again during business hours (that's how long I'd been on hold!).

Two weeks ago, I saw Jan and knew she was dying. She knew it, too. I couldn't help but feel like it would be the last time I'd see her. We sped up our process, although I didn't know what the heck I was doing in the social services realm. Finally, her local office called me and said, "Jan called Friday and told me she's terminal; is that true?". I felt like screaming, "YES!! That's what we've both been trying to tell you for the last 4 months." So, she got a public health nurse out there, faxed me some forms, and in a few days, Jan had started down the road to receiving hospice services.

Vindication. Finally. She's getting services. It was a difficult process. One that I didn't have any knowledge about and sometimes wanted to stop caring about. So, Jan will probably die in the next month or so, but at least she'll have a hospice nurse there with her and someone to take care of her in the meantime. It was so frustrating. Jan has worked her whole life and paid into the system, but when it came time for her to access it, she wasted the last few months of her life filling out paperwork and having doors slammed in her face because she was an alcoholic. And, I have to admit, I wasn't always very caring either. She sucked up time that I didn't have with her long, rambling phone calls and my letters and pleas to find her social services. But, in the end, I am glad we both stuck with it. It's times like these I remember the idealism with which I entered nursing and the advocacy my Jesuit education was supposed to instill in me. We don't get to be heroes very often and I'm glad I got to be a little bit of a hero for Jan before she died.

Friday, April 25, 2008

36 weeks

I had my 36 week check up yesterday:

1. Puppy's dropped 2 cm. It feels so good to be able to breathe again, although I have to pee a heck of a lot more.

2. Still head down. Heartbeat 156.

3. My doc checked my cervix and said, "It looks like that cervix is going to carry you to term. It's still closed." I sighed and then asked for a sleeping pill. If I have to make it through another 4 weeks, then I at least want to get some sleep! Ambien is a nice, nice drug.

Wednesday, April 23, 2008

pooper scooper

One must make hay while the sun shines...or, rather, scoop poop. So, yesterday, while Joe was working late, I got off work a little early and scooped poop. A lot of poop. I don't think we've been able to scoop poop since Thanksgiving because there's been too much snow. Then it was too get the idea.

So, yesterday, it was sunny and nice and I thought I'd scoop some poop. Two hours later, I cried uncle. I learned a few things:

1. Although I complain and get grossed out about it, apparently my dogs don't eat as much poop as I thought they did. Maybe I should encourage that more...

2. Six months of dog poop x 2 do the's a lot!

3. Scooping poop for 2 hours when you're 9 months pregnant is rough. I didn't realize it at the time, but afterwards, even my hair hurt. And, I had some pretty strong contractions (they didn't stick around). Today, I can hardly walk. But, our yard is now 90% poop free!

Tuesday, April 22, 2008

pregnancy is actually 10 months...

I saw a male patient yesterday and went over his test results with him. As we were leaving the exam room, he said, "So, you must be, like, 8 months pregnant by now."

Me: No, I'm 9 months pregnant.

Patient: (alarmed) Nine months pregnant? Should you even be here? What if you went into labor?

Me: I still have 4 weeks until my due date. It'll be fine.

Patient: (confused) You mean, you still have another month? I thought you said you were 9 months pregnant.'s a little known fact (apparently)...pregnancy is actually 10 months.

Wednesday, April 16, 2008

Tuesday, April 15, 2008


We did a little bit of nesting this weekend. I made some freezer dinners. It was a little rough being on my feet for 4-5 hours of cooking, but it feels good to have some meals that are ready-to-go for when the baby is born. (I couldn't stand up by myself afterwards, but that's another story). Joe spent some time working on the Puppy's room and put together our new stroller and carseat (thanks, Moms).

Oh, and if you thought April meant spring time in eastern Idaho...does this look like spring time to you? Yep, it snowed today.

35 weeks

We have a girls' name...

We've finally settled on a girl's name:

Anne Aurelia.

It's the one. It feels right. Aurelia was my great-grandmother's name. It means "golden one", which is fitting, since I call Joe my "golden boy" (he is so blonde...).

Whew! One less thing to worry about before the baby comes.

It was a JOKE, people.

Due to the confusion this blog post caused, I just have to come right out and say it:

It was an April Fool's Day joke. We are not having twins. There is only one baby in there.

For anyone who knows me, they know I can't keep a secret or pull off any sort of prank, so I was pretty proud of the "gotcha" sensation I caused. But, then we started to get phone calls and emails from readers who had not checked the comments section. Finally, when my poor Grandma called yesterday and said, "Well, were you going to tell me about your two babies?" and couldn't believe it was a joke (she'd already told her doctor that day), I thought I should just post it out in the open.

Again, no twins. Just one baby.

Thursday, April 10, 2008

34 weeks

I had my 34 week check up yesterday and here are the updates:

1. Baby's heartrate is about 160. Some people think that means we're having a girl.
2. The baby is head down. Hopefully, that means it will come sooner rather than later.
3. It kept kicking the PA throughout her entire exam...her comment? "It's a tempermental little thing, isn't it?"
4. She felt the baby and estimated it to be about 5 1/2 lbs.
5. I go back in a week and half to have my cervix checked and then start going weekly after that. It makes the baby's arrival seem all that more imminent!

As for me, I have cankles that won't go away no matter how much I elevate my legs. I have begun experiencing the joy of Braxton-Hicks contractions. I've gained one pound since last week (whoo hoo! it's slowing down). I'm feeling ready to have this baby out of my body and in my arms.

In the meantime, shower updates are available on Deanna's blog.

Wednesday, April 09, 2008

Sleep over!

After our long trip to and from Spokane, Joe began another trip to Boise, leaving his tired, pregnant wife home alone. Luckily, my "mom-friend", LeAnne, heard of my plight and offered to spend the night. So, after work for me and clinicals for her, we met for dinner, ate some delicious sushi, ran some errands, and headed back to my house for a sleep over. The cogs were super excited to have a new houseguest and I was glad to have a good friend for company.

In the middle of the night, I woke up with some contractions in my back that were pretty uncomfortable. Once I got up to get something to drink and walked around a little, they went away, but it made for a short night. And, I'm sure my bed partner woke up frequently as I jostled the bed several times. Ah, good friends...I'm sure we'll laugh about this later. In the meantime, I'm ready for this baby to decide to pop out.

I'll post some pictures later, but most of the weekend pics were taken by Deanna and Amy, so check out Deanna's blog for some weekend stories and photos.

Friday, April 04, 2008

Packin' up and headin' out

Tonight, after work, Joe and I will again take a trek up north. Our last trip was misery (just the drive, not the family time), so this time we decided we would ride in the comfort of Joe's hippie van so I could lay down easier if I needed to. (Last time, Doc and I ended up sharing the back seat and Doc wanted to snuggle...I didn't...Doc didn't understand).

So, last week, we:
1. Bought a birthday present for my Lola (she celebrates her 80th birthday on Monday!).
2. Bought some goodies for Noah and Miss Daisy.
3. Got a surprise from my old college roomies, who are throwing my baby shower this weekend.

Last night, we:
1. Bathed the dogs. (Who wants to spend 8 hours in the car with 2 stinky dogs?). They promptly rolled in pitch. Figures.
2. Packed our clothes.

Tonight, we'll:
1. Try to get off work a little early.
2. Gas up the car.
3. Grab some Starbucks and fast food and hit the road!

Thursday, April 03, 2008


Joe brought home a large beef bone (like maybe a tibia) for the dogs the other night. Both Schatzi and Doc went nuts. The bone was too big for either of them to pick up, so they demonstrated some admirable team work, dragging it around the kitchen, until it had been sufficiently chewed down to a more manageable size.

After that, Doc decided he didn't want to share the bone with Schatzi any more, so I've been giving them 30 minute turns each. One dog chews on the bone while the other one lays nearby. Staring forlornly. Whimpering intermittently.

The first night they had it, neither dog wanted to come to bed. The next morning, neither dog was in bed. And, the mammoth bone had somehow made it through the dog door and into the backyard.

It occupies their thoughts all day and all night long. If they aren't actively chewing the bone, they're thinking, whining, and dreaming about it. They are obsessed.

Tuesday, April 01, 2008

Big surprise!

I've been very worried about our baby fitting out the birth canal, so yesterday at our doctor's appointment, I asked for a second ultrasound to see how big the baby was. At first, he resisted, but when I pushed him to explain my dramatic weight gain (other than my crazy eating), he thought it might be worthwhile to get another ultrasound.

We weren't prepared for the results.

Here's a snapshot.

What's weird about this picture?? THERE ARE TWO BABIES IN THERE!! Yep, folks...we are the proud parents of twins. No wonder I'm so freakin' huge. I guess the second baby was laying at the top of my uterus during the first ultrasound, so the tech only saw the bottom baby at the 20 week ultrasound.