#200 (Take 2)

Four posts ago, I posted what I thought was my 200th post.  Turns out, I had 4 saved drafts that Blogger was counting as posts, so today's post is really #200.  I thought about writing something deep and insightful for my 200th post, something profound about my life as the single mom of an 8 month old.  But then my thought process was interrupted by a teething baby with a cold who woke up to cry inconsolably for 45 minutes before finally falling back to sleep, and now I'm tired, hot, sweaty and covered with someone else's snot.

So instead of a contemplative post, all I have the energy for is a post about my latest news:  I've decided to move.  After all that work I did on my condo last year to make it ready for baby, it's just not big enough.  There's no way I can sell in this market, and I can't rent it for what I pay on my mortgage every month, so I was pretty sure I was stuck.  Until I had the (very belated) brilliant idea that I could rent out my place for the same amount that I could rent a decent house for.  Last week I contacted my relator friend to ask her if this was even a possibility, and today we went to look at houses!

The first house was one I was already in love with after looking at it online, and when I walked in, I knew it was perfect.  An open floor plan, bright and sunny with lots of storage space, a tiny yard and a huge porch off the master bedroom.  Which means, of course, that when we called the listing agent she said, "Oh, we already have two very qualified applicants, so sorry."

The other place we looked at was horrible, and we couldn't look at the third place I wanted to see.  I've spent the past hour looking online at homes to rent, and while there are plenty out there, I don't really like any of them, but there are a few for sale that I love.  Stupid economy.

I have picked out a few houses I might want to look at next weekend, and I'm hoping there will be some new places listed this week. I've also spent a lot of time the past week decluttering as much as possible, getting my place ready for showing.  My relator thinks I could have the place rented out within the next 30-45 days.  Let's hope I find somewhere to live before then!

A part of me wonders if I'm crazy, adding more stress and work to my life.  But I really think this is something I have to do, especially since I'm planning on TTC #2 this year.

Because despite the crying and the snot and the exhaustion, it's all worth it.

ETA:  I just talked to my sister.  She told me that in his prayers tonight, my nephew D asked, "Please send Aunt Shannon a big house with plenty of good food."  I love that boy.

The Start of The End?

Not Finn (and not me!)

I am so lucky that Finn has never once had to have formula.  While my delivery didn't go how I wanted (and even now I sometimes think about how great it would have been to have delivered him naturally, like I wanted), at least breast feeding has been relatively easy for us.  But pumping is hard work, and I'm running out of space to store my milk.

My schedule at work is set up so I pump for the first time of the day at lunch time.  That means I'm always late for lunch, but it's also nice because I use that time while I'm pumping to catch up on messages and do a little paperwork.  The second pump session of the day is around 3, but sometimes, if I'm really busy, I end up running really behind because I need that time I set aside for pumping to see patients.  That second session of the day is really just a pain in the butt.  When I first went back to work, I was pumping 18 ounces a day on average, while Finn was only eating about 10-12.  After Christmas, when I didn't pump at all, my supply dropped a little, and I've been pumping around 10-14 ounces a day.  Finn is still eating about the same amount every day (even though he's bigger, he's not growing as quickly, and he's eating solids), so my supply keeps building up.

It makes me feel secure, having that supply.  I have about 110 bags frozen, each containing 4-5 ounces (mostly 4).  And while that takes up a lot of space in my freezer, it really isn't all that much, when you think about how short a time it would last him if I stopped being able to nurse tomorrow.

Which brings me to my dilema.  I'm considering dropping that second pump session of the day.  I usually get the most milk pumped at my first session anyway; at today's second pump session I only pumped about 5 ounces total.  By dropping that second session, I'd start to use up some of my supply - and since I've pretty much run out of room in my freezer, anyway, that wouldn't be a bad thing.

But then I worry if doing that might cause my supply to drop too much.  What if I ended up not being able to make enough milk to keep him fed?  After all this time, I really don't want to have to start using formula.  I probably shouldn't worry, dropping a feeding is the natural first step of weaning. Weaning  - oh that word makes me sad. Breastfeeding has been something I'm happy to do, but it's not really a time of significant bonding for us.  So why does it hurt me so much to think of weaning him?

The good thing about weaning is that it puts me on the path of trying for #2. Maybe that's how I need to think of each step of this process - not thinking about what I'm giving up, but what I'm going to (hopefully) get.

I was thinking of dropping that second session when Finn turns 9 months, but the current crowded state of my freezer has me thinking I might need to do it sooner.  Like Monday.  I don't know if I'm ready for that!

Post MRI Relief

This weekend was a perfect weekend.

Getting festive with a party hat

Wait, let me back up a bit.  I had thought that after the MRI in October that most of my worry and stress was gone, but judging from the degree of relief I felt after Friday's MRI, I think I was fooling myself.  I know I'll never stop worrying, but every single MRI is going to make me feel better.  And now, here we are, 5 months out and that tumor just keeps on getting smaller and less defined.  I have noticed since August that Finn's right hand is always cooler than his left. I've been worried that this meant something bad, but when I remembered to mention it to Dr. B on Friday, she thought that maybe it was because he was born with the tumor, and it might have been compressing one of the arteries to the arm.  During gestation he had plenty of time to grow more vessels to supply the arm, but because they don't come the normal route, that might be why his hand is cold.  I then went back and looked at all my notes from when he was in the hospital, and saw that the surgeon had mentioned the tumor wrapped around the subclavian artery. So her hypothesis makes sense - and since nothing new has shown up on the MRI,  I'm feeling less worried about that.

So the relief I felt over the weekend put me in a great mood.  And Finn was in a good mood, too.  Saturday we had plans to run errands, and ended up meeting my friend Liz and her older two daughters for lunch.  Finn smiled and giggled and loved Liz's daughter Erin.  We did some shopping, and Finn laughed his way through the grocery store, entertaining me and all the other shoppers while he did.  We played at home, he ate well, he napped well and was sweet and cuddly.  He even sat on the floor and played in the kitchen while I made dinner.

We had Lillian's first birthday party to attend yesterday, and aside from a bad moment with some birthday horns, he had a great time there, too.  I had a wonderful time, too.  It's hard to believe it was a year ago that I held little 4 pound Lillian on my pregnant belly while Finn kicked away like he was saying hi to her.

Lillian 1 year, Finn 8 months

But really, overall there was nothing amazingly special about this weekend.  But somehow everything worked so well, it was just perfect.

Too bad I had to go to work today and that ruined all my good energy from the weekend.  I hate coming home in a bad mood.  I'm going to have to find a way to avoid that in the future.

MRI #5!

We're finally home from the MRI, and everything looks great! 

This was a loooooong morning.  It started around 5:30 this morning when I got up to get ready. (Well, it really started at 3:30 when Finn woke up and stayed awake for over an hour - sigh.)  Finn was up (again) at 6:20, and I lucked out with collecting the urine specimen when he peed while I had the specimen cup in my hand - I caught it midstream and didn't have to mess with squeezing urine out of the cotton balls that had been stuffed in his diaper last night.  I felt like such a bad ass.  LOL

We got to the hospital at 7am, and for the first time had to wait because the anesthesiologist was caught up in another case.  It was after 8 before he went back - and while he didn't smile, he didn't cry, which was good.  He was smiling and flirting with the nurses again when I went back to get him in a recovery a few hours later, and was fairly happy (but hungry) during his abdominal ultrasound.  I fed him after his ultrasound and then we headed over to Dr. Bolen's office.

We didn't make it there until after 11, so we had a little wait, but he did great.  They had balloons in the waiting room, so he was well entertained, and when we went back to the exam room, there were bubbles and toys and a wonderful child life specialist that kept him entertained while they got his vitals and drew his blood.

Finally Dr. Bolen came in and gave us the good news - the tumor is the same size, but actually looks different.  It's less defined, like you would expect if the body was breaking it down.  She didn't see anything at all to be worried about, so we're free of scans for the next 3 months!  Yay!

Thanks again to you all for all your thoughts and prayers.  Lots of love from me and Finn!

The Amazing Goodness of Children

A few of you might remember Miss - she is a SMC who blogged for a short period of time while TTC (and is now the mom to a beautiful little boy!), and someone who I've corresponded with since our miscarriages in 2010.  Not long ago she sent me the most wonderful email, one that I have to share here.  I've been saving this story for my 200th blog post - and then almost forgot to even mention that this is my 200th blog post!  Ok, back to the story...

Miss is the aunt to some amazing children.  And by amazing, I mean A.MA.ZING.   Shortly after the earthquake in Haiti, her nephew Eric was watching a special about it, and asked his mom if they could send some money to help the children in Haiti.  When she said yes, he then asked if it would be alright if he asked for money for his birthday to donate to Haiti.  She thought he meant asking for money from the family, but what he meant was asking for donations from his friends instead of presents at his birthday party.  That started a tradition amongst the children in the family, with his sisters following in his footsteps.

This year Leah wasn't sure what she wanted her cause to be for her 7th birthday.  And then she heard Miss telling her mom about Finn and his cancer diagnosis, and decided she wanted to raise money to help Finn and children like him.  She sent out invitations for her birthday party with a note about Baby Finn and his fight against neuroblastoma, and asked for donations to benefit Alex's Lemonade Stand, an organization that not only funds cancer research, it also helps families with children who have cancer.

Here's what Miss said about the party:

The kids had a great time, and there was lots of applause after the cards were opened. The parents were also very interested in what Leah was doing, and many took the time to read the small info sheet we had set out and to comment on how blessed it made them feel - not only to have healthy children, but to be able to help others. One little girl has asked her Mom if she can pick a cause for her next birthday, and help someone else instead of getting gifts. Her Mom was very pleased to hear that :) Another little girl excitedly told her parents that with "so much money raised, Baby Finn will be all better in no time now!" It was sweet. 

Isn't she beautiful - inside and out!

For her 7th birthday Leah raised $465 for Alex's Lemonade Stand.  An amazing total, but even more amazing is the fact that she did this instead of asking for presents for her 7th birthday.  I honestly couldn't imagine anything good coming out of Finn's diagnosis, but Leah (and her siblings) generosity proved me wrong.

I'm going to make sure that Finn grows up knowing about Leah and her birthday party and I hope he learns to have the same giving spirit that she does.

Oh, in case you were wondering what's the latest with Finn's neuroblastoma, his next MRI is this Friday.  I'm hoping for nothing but more good news to share on Friday afternoon!

Whiny Post about Work

Surrounded by charts right after our move last year (10dpIUI #4)

Warning:  the following post is just me complaining about my job.  I try to limit my work talk on here as much as possible, but things have gotten so bad, I have to write about it today.

I have a love/hate relationship with my job.  And these days, the hate is winning over the love.

I love the complexities of a difficult clinical case.  I love meeting someone who feels hopeless with their medical problems and giving them the keys to a solution.  I love the challenge of figuring out how to get someone motivated and involved in managing their own medical problems.  I love it when I know I’ve made a difference in someone’s life, even if it’s just because I did something as simple as listen to them when they needed it.  I love it.

There are the patients who don’t care.  The ones who blame me (or the entire healthcare system) for their problems.  The ones who say things like, “If you want to pay for my meds, I’ll take them, but otherwise I’m not going to,” as their breath reeks of tobacco.  But I knew I’d have those challenges when I signed up for this job.  And I have gotten better at being able to distance myself from those patients.  I no longer find myself getting upset because I care more about their health than they do, and that makes it much easier to see these patients and not have it ruin my entire day. 

What I didn’t expect was the fact that it’s getting harder and harder to practice medicine.  I’m scheduled to see a patient every 15 minutes.  My job isn’t just to prescribe a couple of pills and move on – there’s a lot to talk about, and sometimes 15 minutes just isn’t enough.  I usually can make up the time when someone doesn’t show up for their appointment, but I never have time to write notes during the day to document each visit.  As someone who bills Medic.are, I have to follow their rules for billing.  Which means that I have to have all this stuff in my notes from each visit that has nothing to do with the care I gave, but I have to have it in there to support the level of service I bill.  So in addition to the 15 minutes of direct patient contact, I have about 5-10 minutes of documentation for each patient.  And then there’s the paperwork outside of the patient contact – I have anywhere from 30-60 minutes worth of “nonrevenue generating” paperwork to do every day.  If your insurance company doesn’t want to pay for the drug or test your doctor thinks you need, your doctor has to spend 5-10 minutes filling out a form, or even longer waiting on hold to talk to someone with your insurance company, to try to convince them otherwise.  And we have to do that for free.  What other profession that bills for services does that? Why is it that doctors are supposed to do so much work for free, and why is it poor form for us to talk about that?  I or one of my partners have to be available at all hours for calls.  If you’re my patient, you can reach me at 2am to talk about anything, even if it’s not an emergency.  And I can’t charge you for it, even if it was a frivolous call that could have waited until normal business hours.  Again – can you imagine how much your attorney would charge if you called her at 2am?  Add in the fact that our crappy electronic medical records system – that was supposed to make things faster – has made things even slower.  (For those of you in the medical field – I’ve done EMR before.  I love it.  I couldn’t wait to get it again.  We’ve been on it now for over 5 months and I still hate our system.) 

I have more paperwork to do in a day than I can possibly get done.  And now the administrators are telling us we need to see more patients, we need to get our paperwork done more quickly, and we also need to serve on committees, and do volunteer work, and complete more after hours training.  In the meantime, I have no time to do any reading that might be relevant to my job.  I get weekly emails with updates on the latest journal articles; I used to read these every day, and then do extra reading on top of that to stay up to date.  I currently have over 45 of those emails unread in my inbox, so who knows what I’m missing.  I know I’m not as good a doctor as I could be, because things fall through the cracks because I’m trying to do too much.  And it’s not because of Finn – he’s almost always asleep by 8pm these days.  It’s because all my downtime has to be spent doing paperwork.  Paperwork that, for the most part, has absolutely nothing to do with the actual business of caring for patients and everything to do with business of health insurance.

Last year we ran our numbers against a national databank and discovered that I’m more productive (I see more patients on a daily basis) than 95% of the doctors in my field in the country do.  And yet I make less than 75% of them.  My salary is the same now as it was when I started over 7 years ago.  Exactly the same.  And yet I’m being told I don’t see enough patients, I don’t bill enough, and I need to do more, more, more.

Recently it’s just gotten to be too much.  Our current way of doing things can’t continue.  And so, at our monthly meeting Wednesday, I let our office administrators have it.  As one of my partners pointed out, the fact that we’ve stayed here as long as we have shows that we want to be here.  But at some point, wanting to be here isn’t enough.  And while I know that the state of medicine is similar everywhere in the country these days, and I’d just be trading one set of problems for another if I left, at least I’d be paid more and work less if I joined a different practice. 

When I used to dream of being a doctor, I never dreamed of the work life I have now.  The older doctors, the ones who were around before all the regulations, say it didn’t used to be this way.  My particular practice has it worse than others, just because of the type of medicine we practice, but it’s getting worse for everyone. 

I can’t imagine what else I would do if I hadn’t become a doctor, but I would urge anyone thinking of medicine as a career to look elsewhere.  I’ve actually contacted the manager of a drug company to ask if they’re hiring physicians.  I’d hate that job.  But at least I’d have a life outside of work.

And that’s just sad. 

After over a year of promising to get a meeting scheduled with the head administrator, it’s finally being scheduled (I tend to be the driving force in our office, and while I was distracted with being pregnant and then being a new mom, not much got done).  I’m in the process of drafting an email to the administrator outlining our specific problems.  And making it clear that while we don’t want to leave, it’s getting to the point where it would be crazy to stay.  It’s possible that they might be able to do something to make things better.  I’m willing to give them a little time to try. 

In them meantime, I’m just trying to stay afloat at work and trying to be fully present with Finn when we’re together so he'll never realize how stressed out I am.  Exercise is pretty much out of the picture.  Reading for pleasure?  Not so much.  I do get to watch tv, but usually while I'm doing paperwork, so I can only really watch things I've seen before, since I really can't pay close attention.  I anticipated I might go 6 months between hair cuts when I had Finn.  I never anticipated I'd have such little free time with just one baby. Especially one baby who is such a good sleeper.

 If you’re still reading – thanks for listening.  It felt good to get it out of my system.  Maybe tonight insomnia and headaches will leave me alone so I can finally get a good night's sleep for the first time in weeks.

Hello 2012!

New Year's Eve at the Beach

2011 had some amazing highs and some amazing lows, but in the end, the highs have outweighed the lows.  For the last day of 2011, we took Finn to the beach where he ate sand (and apparently ate some of that weed that's in his hand in this picture, if what I found in his poop this morning is any indication).  We had dinner at 5:30, so Finn could be home in time for bed by 7, and I was in bed by 10:30.  I did wake up just before midnight, and welcomed in the new year watching my boy sleep.

I'm lucky in so many ways, and yet I still find myself feeling stressed and overwhelmed not because of motherhood, but because of my job.  I love my job and I can't imagine doing anything else.  And yet my job is making me miserable.  I have no idea how to fix it, but I'm going to figure out a way to make it better.  I have plenty of time with Finn, but I need time for myself, too.  I want to be able to blog and read and watch movies without feeling guilty (like I am now) for not doing paperwork instead.  If I could leave work every day with just 30 minutes of paperwork to do in the evening, instead of 3 hours, I would be in heaven.  I really have no idea how I'm going to do it, but I'm going to find a way.

A much easier resolution to keep for 2012 is eating healthier.  I lost back to my pre-pregnancy weight within 2 weeks of having Finn.  After his surgery, I was on my way to losing my TTC weight as well.  And then something went wrong (namely my diet) and now I'm back to where I was in June, or maybe even worse.  I've been eating horribly, so just going back to healthy eating is likely to help me lose the weight. I'm not going to stress the pounds, or even think of it as a weight loss diet, I don't think I'm capable of that right now.  But I can choose fruits and veggies over junk food, and skip the desserts at lunch most days, and stop eating entire boxes of Peeps in one sitting.  That I can do.

As part of their New Year's reflections and resolutions, a lot of SMC bloggers were posting today about living in the moment.  We try so hard to have children, but then it's easy to get caught up in the stress of daily life and forget to stop and appreciate our miracles.  That's what I thought about at midnight last night, was what a miracle Finn is, in so many ways, and I'm so lucky.  Claire's resolution is my favorite, and one that I'm going to try to keep too: "To face each and every day with joy and an open heart."

Happy New Year!