I am not ashamed to admit I have not left my bedroom today except to help get the bald kid in bed at 9:30 this evening! And it felt good. So good.
Since coming home from the hospital, I feel like we've run around a lot. Bald kid appointments, my appointments, pick up meds and diapers and drop off scripts and copies of Ethan's new MO Health Net card, etc, etc. I needed a break.
Wednesday We took E to GI to visit Ms Beth and he got a new MicKey button-gastric feeds only now-rock on! He was sized down a whole size from his GJ-he's a 14F 1.2 cm. his GJ was a 16F.
We were finally able to send him back to school today with correct orders for g-feeds now and he was so happy to go back-And so were we! We are able to get all his nutritional needs in him in a day with the bolus feeds in just 5 feeds per day. Which is very nice because now he doesn't eat overnight, and we don't have to worry about feeding pump alarms in the wee hours of the morning-which miraculously I'm the only one in the household that hears anyway....
I saw Dr B at KU and she said everything looks great. They pulled my pain catheters-I asked for a refill, but no go. My drains are still putting too much out. So I'm scheduled for next Wednesday for my first fill and drain pull then. Pain not too bad still. I will have moments of complete paralysis in pain when my muscles spasm and I just have to tell myself to breathe and relax. Easier said than done when it feels like someone has a band around your chest pulling it as tight as they can. And when I do too much in a day, like dishes and laundry and stuff I'm not supposed to anyway, I really get sore. But it's better every day. I hate the drains and will be thrilled when they get pulled.
I do have to leave my bedroom tomorrow because we are meeting with a potential care assistant for Ethan in the morning. Woo-hoo! I don't want to scare her away right off, so I am going to shower and fix my crazy hair. The one we are meeting tomorrow has day and some evening availability, and could start next week! Then we have the name of another gal who can do later evenings for nights Brian and I are both at work. We are going to try to meet with her next week. We are so excited to have some help. It takes a lot of pressure off of Brian during my down time having to take care of me and Ethan. And it will allow us to attend the older kids events Ethan can't go to-like the freezing cold track meet of Parker's the other day. Or 12 hour long volleyball tournaments. And like the random day off school E has next Thursday, and I still can't lift him.
Going to try to hit the movies this weekend-got a few I want to see, so if anybody wants to see some flicks-give me a call!
We have my nephew's first communion this weekend, and I'm hoping to feel good enough to go to Saturdays mass for it since I won't have Brian to help me with the bald kid. And I move around pretty slow still. Oh dear, and Hailey will have to drive us all.....maybe I will rethink that.
Thursday, April 18, 2013
Wednesday, April 17, 2013
5 days post-op
And not feeling too shabby.
I have an appointment with Dr Buescher tomorrow, and my On-Q pain catheters will be pulled, as the pain ball is empty-boo. Not sure if my drains will get pulled yet or not, as I still have about 80cc total output in a 24 hour period. I don't really have pain, as much as soreness. Sore like after a really kick ass chest, arms and back work-out where you can't lift your arms up afterwards! The muscles in my chest and under my arms around to my back will spasm terrible, and when it does that it hurts to even breathe normally. I end up doing my yoga deep breathing to get through it. And pop a Valium if it doesn't pass. I'm down to only a few pain pills a day and 2 Valium-one to sleep and one to get up and get ready with. I can't take any aspirin or ibuprofen or NSAIDs yet because of the increased risk of bleeding, so I pop an occasional Tylenol during the day to help.
I'm moving around really well, and being able to shower makes it so much better! I got to shower when I got home Saturday night and try to wash all the hospital funk and stickiness off me-thanks to my friend Jody. She brought me home, picked up my scripts, made me take my meds, and made me laugh. It helps she's a nurse, as she undressed and re-dressed my drain sites after my shower, and helped put the bald kid in bed. It's quite an ordeal getting both of us in bed right now, I'm so glad she was here to help.
We have been having a host of issues with Ethan's feeds, as his j port is clogged, again! We started feeding him through his gastric port last week, and trying to advance to his nutritional needs during waking hours. It's been tough, and slow. We have to be very careful to monitor his respiratory status, as he was switched to j feeds because he used to aspirate on his g feeds. Kind of scary putting him in bed after a feed in his tummy and hoping he doesn't aspirate. I end up asking Brian to go check on him a dozen times since I can't just jump out of bed right now. Tomorrow we are headed to GI to get his GJ switched out for a regular MicKey gastrostomy tube and hopefully just be done with J feeds all together!
Monday Brian took him to his first OT Vital Stim appointment to work on swallowing. This is where they place electrodes on the neck and increase electrical impulses to initiate a swallow. As we work on oral feeds with him, he has to have a better, more consistent swallow, or he could aspirate. He did awesome, and his OT is the Aunt of one of Hailey's best friends! He was on the machine for 32 minutes-which she said was awesome for his first time. He ate frozen applesauce and lemon juice. I'm going to stock up on some gummy bears, sour patch kids, hot tamales and other strong flavored foods to take to work on with him.
Ethan also got to get back in the Therapy pool today! We were so excited and nervous, as his past experiences with warm water have ended up with him in the ER due to episodes of not breathing. I got very anxious as Brian lifted him out, but he did just fine. Won't means I won't hold my breath every time. At least we are super close to the ER if needed....
E also got his new glasses and hearing aides this week. He looks so sharp! And it's funny to see him look around with his glasses on-he was really, really nearsighted! And he's been talking like a crazy man since he's had his new aides. I'm sure he will get tired of hearing my voice loud and clear real quick!
Parker ran his best 200M at his track meet on Monday-2 seconds faster! He shaved a little time off his 100M and threw a foot and half farther than his longest discus throw! We are so proud of him. Now if we can just get him to do his homework and turn it in, the world would be perfect.
Hailey had a great time at Jonny's Prom in Wichita-thank you everyone who made it possible-Dad and Teresa for getting her to Emporia and Jonny's parents for getting her back to KC Sunday. She wouldn't have been able to go without all of your help! She has one more volleyball tourney, Regionals, not this weekend, but next. Fortunately it's local.
I may need some driving help next week. Definitely some lifting help with the bald kid. Brian is back to work this weekend, and E has a few appts next week. I can't lift him at all yet and will need someone to accompany me to get him from school and take him to his OT and PT appointments. One is up North at CMH, and one is downtown. If anyone can help-shoot Brian or I a message or text. Thanks so much for everyone's help and for the dinners! Tonight was chicken and rice from Kathi Clapp-and it was delish! Not a morsel left!
Off to sleep for a few hours before appointments!
I have an appointment with Dr Buescher tomorrow, and my On-Q pain catheters will be pulled, as the pain ball is empty-boo. Not sure if my drains will get pulled yet or not, as I still have about 80cc total output in a 24 hour period. I don't really have pain, as much as soreness. Sore like after a really kick ass chest, arms and back work-out where you can't lift your arms up afterwards! The muscles in my chest and under my arms around to my back will spasm terrible, and when it does that it hurts to even breathe normally. I end up doing my yoga deep breathing to get through it. And pop a Valium if it doesn't pass. I'm down to only a few pain pills a day and 2 Valium-one to sleep and one to get up and get ready with. I can't take any aspirin or ibuprofen or NSAIDs yet because of the increased risk of bleeding, so I pop an occasional Tylenol during the day to help.
I'm moving around really well, and being able to shower makes it so much better! I got to shower when I got home Saturday night and try to wash all the hospital funk and stickiness off me-thanks to my friend Jody. She brought me home, picked up my scripts, made me take my meds, and made me laugh. It helps she's a nurse, as she undressed and re-dressed my drain sites after my shower, and helped put the bald kid in bed. It's quite an ordeal getting both of us in bed right now, I'm so glad she was here to help.
We have been having a host of issues with Ethan's feeds, as his j port is clogged, again! We started feeding him through his gastric port last week, and trying to advance to his nutritional needs during waking hours. It's been tough, and slow. We have to be very careful to monitor his respiratory status, as he was switched to j feeds because he used to aspirate on his g feeds. Kind of scary putting him in bed after a feed in his tummy and hoping he doesn't aspirate. I end up asking Brian to go check on him a dozen times since I can't just jump out of bed right now. Tomorrow we are headed to GI to get his GJ switched out for a regular MicKey gastrostomy tube and hopefully just be done with J feeds all together!
Monday Brian took him to his first OT Vital Stim appointment to work on swallowing. This is where they place electrodes on the neck and increase electrical impulses to initiate a swallow. As we work on oral feeds with him, he has to have a better, more consistent swallow, or he could aspirate. He did awesome, and his OT is the Aunt of one of Hailey's best friends! He was on the machine for 32 minutes-which she said was awesome for his first time. He ate frozen applesauce and lemon juice. I'm going to stock up on some gummy bears, sour patch kids, hot tamales and other strong flavored foods to take to work on with him.
Ethan also got to get back in the Therapy pool today! We were so excited and nervous, as his past experiences with warm water have ended up with him in the ER due to episodes of not breathing. I got very anxious as Brian lifted him out, but he did just fine. Won't means I won't hold my breath every time. At least we are super close to the ER if needed....
E also got his new glasses and hearing aides this week. He looks so sharp! And it's funny to see him look around with his glasses on-he was really, really nearsighted! And he's been talking like a crazy man since he's had his new aides. I'm sure he will get tired of hearing my voice loud and clear real quick!
Parker ran his best 200M at his track meet on Monday-2 seconds faster! He shaved a little time off his 100M and threw a foot and half farther than his longest discus throw! We are so proud of him. Now if we can just get him to do his homework and turn it in, the world would be perfect.
Hailey had a great time at Jonny's Prom in Wichita-thank you everyone who made it possible-Dad and Teresa for getting her to Emporia and Jonny's parents for getting her back to KC Sunday. She wouldn't have been able to go without all of your help! She has one more volleyball tourney, Regionals, not this weekend, but next. Fortunately it's local.
I may need some driving help next week. Definitely some lifting help with the bald kid. Brian is back to work this weekend, and E has a few appts next week. I can't lift him at all yet and will need someone to accompany me to get him from school and take him to his OT and PT appointments. One is up North at CMH, and one is downtown. If anyone can help-shoot Brian or I a message or text. Thanks so much for everyone's help and for the dinners! Tonight was chicken and rice from Kathi Clapp-and it was delish! Not a morsel left!
Off to sleep for a few hours before appointments!
Saturday, April 13, 2013
Surgery Step One, Done.
The surgery process at KU is much different than that of NKCH.
Not better. Not worse. Different.
I was Patient #30-ya know so as not to violate anyone's privacy by using their name -that HIPPA thing and all. Which I suppose might actually work had they not come right out into the waiting room of fellow surgery patient family members and given updates in front of them all. Don't get me wrong, I could care less what the person sitting next to my husband hears about me, otherwise I probably wouldn't blog to the whole world. But it seems kind of contradictory???
Anywho, pt #30 gets called back to pre-op-that's me- and imagine my surprise when standing there waiting for me is one of my oldest, dearest, best friends from X-ray school! My friend Keely, whom I can only describe as one of the most upbeat, fun, loveliest people I know was standing there with a big hug for me! I haven't seen Keely in years, though we've somewhat kept in touch through FB. She and I go waaaaay back-like 23 years back-and have our fair share of crazy Westport, Lakeside, Bethany Medical Center memories. It really made my morning to see her and chat with her about our lives and kids while being worked up for my surgery. Love you Keely Rae-we have to get together now, and I don't mean while I'm all hopped up pain meds!!
So, change into gown, get IV started-one stick yeah, chat with nurse anesthetist, anesthesiologist, get marked on by Dr Buescher, get my lovely surgical cap on and away I go. The pre-op area was full of hustle and bustle, lots of chatting and smiling and so many people. I wonder if I often forget how many people actually work on the day shift since I'm so accustomed to a skeleton crew at night. It was nice, kept my mind off the pounding headache I had and helped me to ignore my rumbling, hungry tummy.
I got me a little Fentanyl and Versed on the way to the surgical suite, and sure thought I would go right out. But I was awake and moved over on the table and the last thing I remember was trying to move the mask off my face as the Dr was saying "take some deep breaths now Kari"
The next part was not so pretty. Apparently I did not wake from the anesthesia very well. At all.
So poorly in fact that I extubated myself, began thrashing around and upon nearly kicking the plastics Fellow, they put me right back down. Fast. My fellow CMH peeps know exactly what I'm describing. Many a times we wrestled with a little one waking from sedation. And I spent an hour wrestling with my bald kid after his ear tube removal. I vaguely remember describing him as a howler monkey on crack. And red heads are the worst. Even strawberry blondes!
So, during my exorcist-like awakening, I caused some bleeding in my surgical site and when my right drain started putting out 100+ ml every half hour, Dr Buescher was worried she may have to take me back into the OR to fix it. Fortunately she did not, it just got me 5 hours in PACU with an amazing nurse Meghann, and an overnight stay. Oh, and lots more Dilaudid. I was so schnockered, I was unable to open my eyes, but communicated to the nurse with thumbs up and thumbs down hand signals. I guess I kept asking what time it was too, like a dozen times, because Meghann said she finally asked me if I had somewhere I needed to be and I told her yes and then went right out again.
Finally the drainage slowed down and Dr Buescher and the Plastics Fellow-wish I could remember her name-she was lovely too, came to tell the finally awake me that I need to tell them how horribly I awoke for next time. And for my safety. And theirs. Dr B is military trained, and said she saw lots of young soldiers come out of anesthesia the same way. Something to do with a fighting, feisty attitude when personal control is taken away. Oh and stubbornness. Hmmmm.......
So, I'm of course awake in room 5114 because this is my normal awake time. Oh, no because I got a roommate at 11pm! Yep, shared, small room. And bathroom. A least I'm the only one getting up to pee-my roommate is snoozing marvelously while I listen to her IV beeping, breathing machine, RT checks, lab draws, vitals checks every two hours, drain emptying and foley emptying noise all while divided by that privacy ensuring paper curtain. Again with the HIPPA thing? Defeating the purpose, maybe?
Sarah Mills, I thought you were gonna hook me up with private penthouse suite, complete with mini-bar and personal masseuse?? And for some reason I didn't get a wine list with my food service menu. What's that all about?
But, I hear the Plastics Team rounds pretty darn early around here. And since my drain output is down to about 10ml on the left and 30ml on the right every 4 hours, I ought to get cut loose! They are being a little stingy with the pain meds, I only get 2mg of Dilaudid every 2 hours, they held the Toradol for now until the bleeding was controlled so as not to make it any worse. I don't have much swelling, which is surprising because Dr B said I had almost no scar tissue, but that also meant very little stretchy skin. She said she hurt me pretty good getting the expander under my pectoral muscle, and was only able to get 50cc's of saline in each one. And I feel it. Like an elephant standing on my chest. Hurts to take a deep breath, but not unbearable-the worst I've been was a 7 out of 10. Most often a 4, and can easily tolerate a 4. I do have the On-Q pain catheters in, one on each side connecting to a pain ball distributing 4ml/hour of Bupivacaine-numbing medicine. I don't want to imagine how I would feel without the On-Q. Pretty fancy, schmancy device.
Brian and my Mom hung out with me all day, then Brian went home to check on the boys and go to his Fraternity get together. So Mom and Carissa hung with me later, even while I napped! Funny thing, the night nurse asked if Carissa and I are sisters! We used to get that a lot when we worked together at Mercy. Even though she's not, she's been like a sister to me for years, and I wouldn't trade her for the world. She's been there for me and my family without missing a beat! Love you sister friend! Ooh, makes me think of sister wives, maybe sister bestie is better.
Oh, and the bald kid's GJ clogged off again last night! Argh! I am so damn frustrated with this thing. He went all day with almost no food, because although his feeding pump never beeped off, it was flowing extremely slow. He should have received 770ml but only got about 100ml. Looks like these next three weeks I'm off we are going to be trying to go back to bolus gastric feeds again. He needs to start developing a hunger sensation anyway since we are going to be starting with OT this week working on swallowing and taking foods orally. Oh, and he has an ABR test-special hearing test- and gets his new hearing aides this week. AND he gets to get back in the pool Tuesday for pool therapy! His new glasses should be in this week, AND we got bumped to three years for his next Orthopedic visit with Dr Schwend! His scoliosis is gone-yep gone! His spinal curve that was 20 degrees is now 13-so no longer considered scoliosis. However, his kyphotic curve, the curve of your upper back that little old ladies get causing them to slouch, is drastically worse at 56 degrees. Dr S was worried he had tight hamstrings pulling him over, but I laid Ethan down on the table and when he immediately raised his legs straight up in the air, back almost to his head, Dr S was convinced that was not the problem. Probably just his poor trunk muscle tone and long body. So three years it is, as boys typically have a growth spurt at 12. Not that Ethan does anything typical. But we will take the three year break!
He is doing well being home, I've been sneaking in and checking his sats while he's asleep and they've been holding steady at 98 with a sleeping heart rate in the 70's!!
Hailey is in Wichita for Jonny's Prom tonight, I can't wait to see the pics-I will share as soon as I get them!
Brian and Parker are going to see "42" on Sunday, which I would love to, just not gonna be ready to sit through a movie theater movie by then.
One of my other besties, Jody, is coming to take care of me today and tomorrow. Jody and I are pretty warped together, so I'm sure I will spend most of my waking hours laughing my ass off. I just wish it were going to be our 'drunk lunch' rather than nurse and patient!
My Mom is coming up to help me out too. I will definitely need my hair washed and fixed sometime today!
I'm about to doze off now in sleepy narcotic haze, and just realized how long this post was, but want to leave you with a funny story. As Brian was putting E in bed, I asked him to Face Time me so I could tell him goodnight. He was holding his iPad over the bald kid's head, and I was talking to him watching him look around for me in his room, not realizing I was the huge face in the screen in front of him, and Brian dropped the iPad right. on. his. head! Yep, he did.
Ethan looked rather shocked and just about started crying, but stopped when he realized we were laughing at him.
Parents of the century we are....
Not better. Not worse. Different.
I was Patient #30-ya know so as not to violate anyone's privacy by using their name -that HIPPA thing and all. Which I suppose might actually work had they not come right out into the waiting room of fellow surgery patient family members and given updates in front of them all. Don't get me wrong, I could care less what the person sitting next to my husband hears about me, otherwise I probably wouldn't blog to the whole world. But it seems kind of contradictory???
Anywho, pt #30 gets called back to pre-op-that's me- and imagine my surprise when standing there waiting for me is one of my oldest, dearest, best friends from X-ray school! My friend Keely, whom I can only describe as one of the most upbeat, fun, loveliest people I know was standing there with a big hug for me! I haven't seen Keely in years, though we've somewhat kept in touch through FB. She and I go waaaaay back-like 23 years back-and have our fair share of crazy Westport, Lakeside, Bethany Medical Center memories. It really made my morning to see her and chat with her about our lives and kids while being worked up for my surgery. Love you Keely Rae-we have to get together now, and I don't mean while I'm all hopped up pain meds!!
So, change into gown, get IV started-one stick yeah, chat with nurse anesthetist, anesthesiologist, get marked on by Dr Buescher, get my lovely surgical cap on and away I go. The pre-op area was full of hustle and bustle, lots of chatting and smiling and so many people. I wonder if I often forget how many people actually work on the day shift since I'm so accustomed to a skeleton crew at night. It was nice, kept my mind off the pounding headache I had and helped me to ignore my rumbling, hungry tummy.
I got me a little Fentanyl and Versed on the way to the surgical suite, and sure thought I would go right out. But I was awake and moved over on the table and the last thing I remember was trying to move the mask off my face as the Dr was saying "take some deep breaths now Kari"
The next part was not so pretty. Apparently I did not wake from the anesthesia very well. At all.
So poorly in fact that I extubated myself, began thrashing around and upon nearly kicking the plastics Fellow, they put me right back down. Fast. My fellow CMH peeps know exactly what I'm describing. Many a times we wrestled with a little one waking from sedation. And I spent an hour wrestling with my bald kid after his ear tube removal. I vaguely remember describing him as a howler monkey on crack. And red heads are the worst. Even strawberry blondes!
So, during my exorcist-like awakening, I caused some bleeding in my surgical site and when my right drain started putting out 100+ ml every half hour, Dr Buescher was worried she may have to take me back into the OR to fix it. Fortunately she did not, it just got me 5 hours in PACU with an amazing nurse Meghann, and an overnight stay. Oh, and lots more Dilaudid. I was so schnockered, I was unable to open my eyes, but communicated to the nurse with thumbs up and thumbs down hand signals. I guess I kept asking what time it was too, like a dozen times, because Meghann said she finally asked me if I had somewhere I needed to be and I told her yes and then went right out again.
Finally the drainage slowed down and Dr Buescher and the Plastics Fellow-wish I could remember her name-she was lovely too, came to tell the finally awake me that I need to tell them how horribly I awoke for next time. And for my safety. And theirs. Dr B is military trained, and said she saw lots of young soldiers come out of anesthesia the same way. Something to do with a fighting, feisty attitude when personal control is taken away. Oh and stubbornness. Hmmmm.......
So, I'm of course awake in room 5114 because this is my normal awake time. Oh, no because I got a roommate at 11pm! Yep, shared, small room. And bathroom. A least I'm the only one getting up to pee-my roommate is snoozing marvelously while I listen to her IV beeping, breathing machine, RT checks, lab draws, vitals checks every two hours, drain emptying and foley emptying noise all while divided by that privacy ensuring paper curtain. Again with the HIPPA thing? Defeating the purpose, maybe?
Sarah Mills, I thought you were gonna hook me up with private penthouse suite, complete with mini-bar and personal masseuse?? And for some reason I didn't get a wine list with my food service menu. What's that all about?
But, I hear the Plastics Team rounds pretty darn early around here. And since my drain output is down to about 10ml on the left and 30ml on the right every 4 hours, I ought to get cut loose! They are being a little stingy with the pain meds, I only get 2mg of Dilaudid every 2 hours, they held the Toradol for now until the bleeding was controlled so as not to make it any worse. I don't have much swelling, which is surprising because Dr B said I had almost no scar tissue, but that also meant very little stretchy skin. She said she hurt me pretty good getting the expander under my pectoral muscle, and was only able to get 50cc's of saline in each one. And I feel it. Like an elephant standing on my chest. Hurts to take a deep breath, but not unbearable-the worst I've been was a 7 out of 10. Most often a 4, and can easily tolerate a 4. I do have the On-Q pain catheters in, one on each side connecting to a pain ball distributing 4ml/hour of Bupivacaine-numbing medicine. I don't want to imagine how I would feel without the On-Q. Pretty fancy, schmancy device.
Brian and my Mom hung out with me all day, then Brian went home to check on the boys and go to his Fraternity get together. So Mom and Carissa hung with me later, even while I napped! Funny thing, the night nurse asked if Carissa and I are sisters! We used to get that a lot when we worked together at Mercy. Even though she's not, she's been like a sister to me for years, and I wouldn't trade her for the world. She's been there for me and my family without missing a beat! Love you sister friend! Ooh, makes me think of sister wives, maybe sister bestie is better.
Oh, and the bald kid's GJ clogged off again last night! Argh! I am so damn frustrated with this thing. He went all day with almost no food, because although his feeding pump never beeped off, it was flowing extremely slow. He should have received 770ml but only got about 100ml. Looks like these next three weeks I'm off we are going to be trying to go back to bolus gastric feeds again. He needs to start developing a hunger sensation anyway since we are going to be starting with OT this week working on swallowing and taking foods orally. Oh, and he has an ABR test-special hearing test- and gets his new hearing aides this week. AND he gets to get back in the pool Tuesday for pool therapy! His new glasses should be in this week, AND we got bumped to three years for his next Orthopedic visit with Dr Schwend! His scoliosis is gone-yep gone! His spinal curve that was 20 degrees is now 13-so no longer considered scoliosis. However, his kyphotic curve, the curve of your upper back that little old ladies get causing them to slouch, is drastically worse at 56 degrees. Dr S was worried he had tight hamstrings pulling him over, but I laid Ethan down on the table and when he immediately raised his legs straight up in the air, back almost to his head, Dr S was convinced that was not the problem. Probably just his poor trunk muscle tone and long body. So three years it is, as boys typically have a growth spurt at 12. Not that Ethan does anything typical. But we will take the three year break!
He is doing well being home, I've been sneaking in and checking his sats while he's asleep and they've been holding steady at 98 with a sleeping heart rate in the 70's!!
Hailey is in Wichita for Jonny's Prom tonight, I can't wait to see the pics-I will share as soon as I get them!
Brian and Parker are going to see "42" on Sunday, which I would love to, just not gonna be ready to sit through a movie theater movie by then.
One of my other besties, Jody, is coming to take care of me today and tomorrow. Jody and I are pretty warped together, so I'm sure I will spend most of my waking hours laughing my ass off. I just wish it were going to be our 'drunk lunch' rather than nurse and patient!
My Mom is coming up to help me out too. I will definitely need my hair washed and fixed sometime today!
I'm about to doze off now in sleepy narcotic haze, and just realized how long this post was, but want to leave you with a funny story. As Brian was putting E in bed, I asked him to Face Time me so I could tell him goodnight. He was holding his iPad over the bald kid's head, and I was talking to him watching him look around for me in his room, not realizing I was the huge face in the screen in front of him, and Brian dropped the iPad right. on. his. head! Yep, he did.
Ethan looked rather shocked and just about started crying, but stopped when he realized we were laughing at him.
Parents of the century we are....
Thursday, April 11, 2013
T minus 24....
In about 24 hours from now I will be arriving at KU Med getting ready for my tissue expander surgery, IF I don't go crazy between now and then.
Let's see, first I leave work in about one hour, go home and try to sleep before coming back to work at 1pm this afternoon. Then home at 11:30pm to drink a big glass of water before midnight, cause then it's nothing by mouth until well after 3 pm on Friday!!
Doesn't sound like a big deal, except Ethan's G-J tube is starting to become difficult to flush-AGAIN! If we have to go trade this one out, it will be 5 visits to Interventional Radiology at CMH in 4 weeks with 4 tube changes. They know us well, and I'm pretty sure like us, but I think even we are pushing our luck!!!
This is getting ridiculous! We aren't doing anything differently than we have for say, the last 4 years, other than formula change. And the formula we are using he has been on for over a year, so we are really baffled. So if any of my J tube Moms have any advice, please share! We've done Coke, meat tenderizer, going to try seltzer water today, and we flush all the time!
Umm, add to that we planned to have him at school today and tomorrow, not running him down to the Mercy either of those days!
Hailey needs some last minute prom stuff and since I'm working tonight, I'm not sure how we are gonna get that done.
I need to pack and coordinate what comfy jammys I will be living in for the next week.
And, what to do with my hair??
Now that it's come in curly, it's kinda crazy looking after it's slept on. Gives a whole new meaning to 'bed head' for sure.
Since I won't be showering for a week or so, I may need some hair washing volunteers again!
Oh, and my biggest dilemma?
Don't laugh....
I really needed to get my eyebrows waxed before surgery. I don't want some anesthesiologist staring at these overgrown things for two hours completely disgusted! Unfortunately that's not in the time schedule, so plucking in the bathroom mirror will have to suffice!
Thanks to all my wonderful family and friends helping us out this weekend;
mom coming to stay with the boys and dogs
Dad and Teresa getting Hailey to Emporia to meet Jonny for Prom
Kate coming to get the bald kid on the bus tomorrow morning
Jody and Carissa for being my hospital babysitters
Ashley for trading shifts with me so I'm getting my hours in this week
Andrea for setting up the Meal Train again while I'm off
And all of your thoughts and prayers!
The Meal Train Andrea set up can be accessed through this link:
http://www.mealtrain.com/?id=mo2wq3v17wjt
We greatly appreciate the meals, and are not picky at all! Don't need any five course, gourmet meals to please my kids. Just won't be lifting my arms higher than mid chest for the first two weeks makes it really hard to cook. That and the Dilaudid.
If there is a day that you want to bring something and the date isn't listed, just email Andrea and she will add the day. We didn't list every day, just every few.
Andrea.Phillips@NKCH.org
Thanks again everyone.
Brian will update from the hospital.
Time to get some new boobs!
Let's see, first I leave work in about one hour, go home and try to sleep before coming back to work at 1pm this afternoon. Then home at 11:30pm to drink a big glass of water before midnight, cause then it's nothing by mouth until well after 3 pm on Friday!!
Doesn't sound like a big deal, except Ethan's G-J tube is starting to become difficult to flush-AGAIN! If we have to go trade this one out, it will be 5 visits to Interventional Radiology at CMH in 4 weeks with 4 tube changes. They know us well, and I'm pretty sure like us, but I think even we are pushing our luck!!!
This is getting ridiculous! We aren't doing anything differently than we have for say, the last 4 years, other than formula change. And the formula we are using he has been on for over a year, so we are really baffled. So if any of my J tube Moms have any advice, please share! We've done Coke, meat tenderizer, going to try seltzer water today, and we flush all the time!
Umm, add to that we planned to have him at school today and tomorrow, not running him down to the Mercy either of those days!
Hailey needs some last minute prom stuff and since I'm working tonight, I'm not sure how we are gonna get that done.
I need to pack and coordinate what comfy jammys I will be living in for the next week.
And, what to do with my hair??
Now that it's come in curly, it's kinda crazy looking after it's slept on. Gives a whole new meaning to 'bed head' for sure.
Since I won't be showering for a week or so, I may need some hair washing volunteers again!
Oh, and my biggest dilemma?
Don't laugh....
I really needed to get my eyebrows waxed before surgery. I don't want some anesthesiologist staring at these overgrown things for two hours completely disgusted! Unfortunately that's not in the time schedule, so plucking in the bathroom mirror will have to suffice!
Thanks to all my wonderful family and friends helping us out this weekend;
mom coming to stay with the boys and dogs
Dad and Teresa getting Hailey to Emporia to meet Jonny for Prom
Kate coming to get the bald kid on the bus tomorrow morning
Jody and Carissa for being my hospital babysitters
Ashley for trading shifts with me so I'm getting my hours in this week
Andrea for setting up the Meal Train again while I'm off
And all of your thoughts and prayers!
The Meal Train Andrea set up can be accessed through this link:
http://www.mealtrain.com/?id=mo2wq3v17wjt
We greatly appreciate the meals, and are not picky at all! Don't need any five course, gourmet meals to please my kids. Just won't be lifting my arms higher than mid chest for the first two weeks makes it really hard to cook. That and the Dilaudid.
If there is a day that you want to bring something and the date isn't listed, just email Andrea and she will add the day. We didn't list every day, just every few.
Andrea.Phillips@NKCH.org
Thanks again everyone.
Brian will update from the hospital.
Time to get some new boobs!
Monday, April 8, 2013
Home it is!
Brian just texted me at work-he is packing up the bald kid right now to head home!
Sats have been 90-92 on room air.
Heart rate has been mid to high 40's.
The Purple Team is not completely comfortable sending him home, but deferred to Cardiology and Dr Kaine said to cut him loose, and we trust that man!
Digoxin is to be stopped completely, and we are to follow up with Cardiology in 4-6 weeks about his heart rate.
He's ready to be home and we are ready for him to be in his own bed tonight!
Happy Monday!
Sats have been 90-92 on room air.
Heart rate has been mid to high 40's.
The Purple Team is not completely comfortable sending him home, but deferred to Cardiology and Dr Kaine said to cut him loose, and we trust that man!
Digoxin is to be stopped completely, and we are to follow up with Cardiology in 4-6 weeks about his heart rate.
He's ready to be home and we are ready for him to be in his own bed tonight!
Happy Monday!
The "H" word....and lots of other crap
I won't say it. Or even type it.
But it could happen tomorrow.
Ethan has been back on full feeds since Friday.
His heart rate is back up to high 50's low 60's.
He is tired of hanging out at the CMH, but off oxygen he was only at 87-88, so that has been the only thing keeping him there. They want him to be without oxygen while sleeping and keep his sats above 90. Not sure how soon that's gonna happen. Since we've done the oxygen at home thing before, I'm ready to pack his skinny butt up and head home with some O's rather than wait for him to come down with something else!
They think his seasonal allergies and asthma are what set all of this off, and warned us they expect this to be a bad, bad, very bad spring allergy season! Woo-hoo! Back on an asthma action plan we go. I am going to ask about increasing his Robinul though. Pulmonology was trying to wean him off it, but with the increased secretions, I think he needs it full strength again. The Robinul is used off label to help control secretions-Ethan's drooling-and it really helps.
Whenever he has a little virus or allergy flare up, his skin gets crazy. His eczema acts up and the skin around his GJ gets red and angry. So wound care came by and hooked us up with some fabulous products! Mepilex and Stomahesive powder and Cavilon No-Sting barrier cream. Oh, and a Flexi-trak device to hold his tubing in place and keep it from moving around his stoma and irritating it. We haven't been in the hospital for so long we didn't know about all these new fancy tools and gadgets! Time to make more room in the bald kid's supply cabinet!
I expressed my concern about his heart rate, so Dr Kaine came by Friday afternoon. I was crashed out from working the night before, and the one time my husband didn't wake me up was this time! Dr Kaine is not concerned about the bald kids heart rate, but still hasn't decided whether we are keeping him on the Digoxin or not. What I did not get a chance to ask, and my husband didn't think to, was when do we need to be concerned? They have moved his follow up Cardiology appt from 6 months to 3 months, so if nothing else, I will ask then!
These last two weeks everyone in our house has had a run of illness. It started with me week before last-sinus infection, upper respiratory infection, the start of a little pneumonia. Then Brian two days later, then the bald kid, and finally Hailey and Parker missed school Thursday and Friday. So, as I am taking one kid to the hospital, nursing two other kids, a husband and my own illness, I also worked full time-nights no less-minus the 3 hours late I went in the night E was admitted since my husband was at home sick and I needed to get him settled in the big house before going in to work. But we managed, as we always do. And our older kids stepped up, took care of themselves, and their responsibilities.
Hailey missed VB practice Thursday evening because of this illness that spread through all five of us in our house in 7 days. We kept her home in the thought we did not want to expose her whole team to the illness. She had a tournament on Saturday and we felt missing one practice to rest and get better for her tournament was the best thing to do.
Well, apparently her coach thought she was either playing hooky or that she should have come anyway based on the shitty text she sent her, not sending her a pre-tourney text about arrival time and jersey color, and the way she treated her at the tournament itself. I don't post about certain incidents because I don't know who all reads this, and I don't want to call anyone out or hurt anyone's feelings. This time, I'm done being nice while someone treats my kids poorly. Gloves are off. And whatever I say on here, my husband I will be sharing with her coach, in person. This is not an email or text convo. So you might be asking why I'm posting? Because with all the focus on the way some coaches treat kids badly, I want people to know it can happen in any sport, at any age and we as parents can't keep allowing it. Hailey has missed 3 practices of club ball all season-two for illness-this being one, and one for a visitation. Less than all her teammates. And she's never missed a tournament-never a minute. She made the commitment and she takes it seriously. Hailey went to her tourney by herself Saturday morning because Brian was at the hospital with E and I worked until 0530 and went home to sleep. Yep, she set her alarm, got up, got there at the time she had to text and ask her coach what time to be there, all by herself. Her coach was 10 minutes late.
They had to ref the first game, which Hailey always willingly helps. She line judged. Between games she and another girl agreed to switch, so she went to the bathroom because her nose was running and she needed to pee. Upon arriving back to the bench, her coach attacked her and accused her of shirking her responsibilities. I'm more than a little disappointed the girl whom she had switched line judging with didn't speak up during this. Of course Hailey didn't drop the dime on her, because she's not like that. But wow-awesome team mate! The coach accused her of not having her head in it-in what exactly? Their game hadn't even started. So Hailey, who would never back talk an adult, except her dad or I, apologized and told her that her allergies were bothering her and her brother was in the hospital. At this point her coach told her maybe then she didn't even need to be there. And not because she was worried about her state of mind. Well, for a 16 year old to get herself to her tournament without parents, and while her brother is in the hospital, and with a coach who couldn't be bothered to send her the tourney info, I'd say that says something about that kid's character. So I will be damned if that coach gets to make her feel bad about it. How about you address the tardiness of girls to tournaments, the attitude and arguing with refs which resulted in one girl getting a yellow card from HOA or the general lackadaisical, 'don't want to be there' attitude others have had. So much for believing this coach who told us from day one she doesn't put up with drama. We've got enough real life drama, don't need it from a coach with her own. And I really wonder if she would have treated Hailey that way had one of us been there.
We hate missing any of the kids events, but sometimes that's life. They know it and understand it. It's not fair and neither is life. And if Hailey was shirking her responsibilities, I expect it to be addressed, but those of you who know our girl-know that's probably not likely! And I expect it to be done respectfully, at least that's what we expect from our kids, so it's not too much to ask for it in return.
Sorry for the rant, but I am trying to keep it all together after the shitty month I've had, and this incident just about pushed me over the edge. Me, the one who never lets shit get to her, cried the whole way home from the hospital. I'm done letting people attack my kids. I let it slide in the name of a friendship of my husbands many years ago-and I never should have. I should have gone right across the street and punched her in her big nose and fake mole. Sorry-story for another time.
But between my work comp knee injury-which BTW is better and even if it wasn't I wouldn't act any different because work comp is a joke. I just ended up burning my own time-like I had any to spare! Then me getting sick and using more time I don't have, my blow dryer catching fire (trivial, I know, but I loved my blow dryer and now that I have hair to use it on....) our TV going out, Ethan getting admitted, Brian getting sick, Hailey and Parker getting sick, the little dog having diarrhea all over the house, the big dogs jumping on the table and eating all of the leftover birthday cake-yep chocolate-and some old lady backing into my husband's car while he was getting food on his way to the hospital, is it any wonder my blood pressure is high???
So beware.
I may be a little quick to overreact right now.
So think before you piss me off.
Because I will punch you in the face.
And enjoy it.
Ps-a little packing tape can fix anything. Even when your diffuser won't fit on your daughter's blow dryer.
But it could happen tomorrow.
Ethan has been back on full feeds since Friday.
His heart rate is back up to high 50's low 60's.
He is tired of hanging out at the CMH, but off oxygen he was only at 87-88, so that has been the only thing keeping him there. They want him to be without oxygen while sleeping and keep his sats above 90. Not sure how soon that's gonna happen. Since we've done the oxygen at home thing before, I'm ready to pack his skinny butt up and head home with some O's rather than wait for him to come down with something else!
They think his seasonal allergies and asthma are what set all of this off, and warned us they expect this to be a bad, bad, very bad spring allergy season! Woo-hoo! Back on an asthma action plan we go. I am going to ask about increasing his Robinul though. Pulmonology was trying to wean him off it, but with the increased secretions, I think he needs it full strength again. The Robinul is used off label to help control secretions-Ethan's drooling-and it really helps.
Whenever he has a little virus or allergy flare up, his skin gets crazy. His eczema acts up and the skin around his GJ gets red and angry. So wound care came by and hooked us up with some fabulous products! Mepilex and Stomahesive powder and Cavilon No-Sting barrier cream. Oh, and a Flexi-trak device to hold his tubing in place and keep it from moving around his stoma and irritating it. We haven't been in the hospital for so long we didn't know about all these new fancy tools and gadgets! Time to make more room in the bald kid's supply cabinet!
I expressed my concern about his heart rate, so Dr Kaine came by Friday afternoon. I was crashed out from working the night before, and the one time my husband didn't wake me up was this time! Dr Kaine is not concerned about the bald kids heart rate, but still hasn't decided whether we are keeping him on the Digoxin or not. What I did not get a chance to ask, and my husband didn't think to, was when do we need to be concerned? They have moved his follow up Cardiology appt from 6 months to 3 months, so if nothing else, I will ask then!
These last two weeks everyone in our house has had a run of illness. It started with me week before last-sinus infection, upper respiratory infection, the start of a little pneumonia. Then Brian two days later, then the bald kid, and finally Hailey and Parker missed school Thursday and Friday. So, as I am taking one kid to the hospital, nursing two other kids, a husband and my own illness, I also worked full time-nights no less-minus the 3 hours late I went in the night E was admitted since my husband was at home sick and I needed to get him settled in the big house before going in to work. But we managed, as we always do. And our older kids stepped up, took care of themselves, and their responsibilities.
Hailey missed VB practice Thursday evening because of this illness that spread through all five of us in our house in 7 days. We kept her home in the thought we did not want to expose her whole team to the illness. She had a tournament on Saturday and we felt missing one practice to rest and get better for her tournament was the best thing to do.
Well, apparently her coach thought she was either playing hooky or that she should have come anyway based on the shitty text she sent her, not sending her a pre-tourney text about arrival time and jersey color, and the way she treated her at the tournament itself. I don't post about certain incidents because I don't know who all reads this, and I don't want to call anyone out or hurt anyone's feelings. This time, I'm done being nice while someone treats my kids poorly. Gloves are off. And whatever I say on here, my husband I will be sharing with her coach, in person. This is not an email or text convo. So you might be asking why I'm posting? Because with all the focus on the way some coaches treat kids badly, I want people to know it can happen in any sport, at any age and we as parents can't keep allowing it. Hailey has missed 3 practices of club ball all season-two for illness-this being one, and one for a visitation. Less than all her teammates. And she's never missed a tournament-never a minute. She made the commitment and she takes it seriously. Hailey went to her tourney by herself Saturday morning because Brian was at the hospital with E and I worked until 0530 and went home to sleep. Yep, she set her alarm, got up, got there at the time she had to text and ask her coach what time to be there, all by herself. Her coach was 10 minutes late.
They had to ref the first game, which Hailey always willingly helps. She line judged. Between games she and another girl agreed to switch, so she went to the bathroom because her nose was running and she needed to pee. Upon arriving back to the bench, her coach attacked her and accused her of shirking her responsibilities. I'm more than a little disappointed the girl whom she had switched line judging with didn't speak up during this. Of course Hailey didn't drop the dime on her, because she's not like that. But wow-awesome team mate! The coach accused her of not having her head in it-in what exactly? Their game hadn't even started. So Hailey, who would never back talk an adult, except her dad or I, apologized and told her that her allergies were bothering her and her brother was in the hospital. At this point her coach told her maybe then she didn't even need to be there. And not because she was worried about her state of mind. Well, for a 16 year old to get herself to her tournament without parents, and while her brother is in the hospital, and with a coach who couldn't be bothered to send her the tourney info, I'd say that says something about that kid's character. So I will be damned if that coach gets to make her feel bad about it. How about you address the tardiness of girls to tournaments, the attitude and arguing with refs which resulted in one girl getting a yellow card from HOA or the general lackadaisical, 'don't want to be there' attitude others have had. So much for believing this coach who told us from day one she doesn't put up with drama. We've got enough real life drama, don't need it from a coach with her own. And I really wonder if she would have treated Hailey that way had one of us been there.
We hate missing any of the kids events, but sometimes that's life. They know it and understand it. It's not fair and neither is life. And if Hailey was shirking her responsibilities, I expect it to be addressed, but those of you who know our girl-know that's probably not likely! And I expect it to be done respectfully, at least that's what we expect from our kids, so it's not too much to ask for it in return.
Sorry for the rant, but I am trying to keep it all together after the shitty month I've had, and this incident just about pushed me over the edge. Me, the one who never lets shit get to her, cried the whole way home from the hospital. I'm done letting people attack my kids. I let it slide in the name of a friendship of my husbands many years ago-and I never should have. I should have gone right across the street and punched her in her big nose and fake mole. Sorry-story for another time.
But between my work comp knee injury-which BTW is better and even if it wasn't I wouldn't act any different because work comp is a joke. I just ended up burning my own time-like I had any to spare! Then me getting sick and using more time I don't have, my blow dryer catching fire (trivial, I know, but I loved my blow dryer and now that I have hair to use it on....) our TV going out, Ethan getting admitted, Brian getting sick, Hailey and Parker getting sick, the little dog having diarrhea all over the house, the big dogs jumping on the table and eating all of the leftover birthday cake-yep chocolate-and some old lady backing into my husband's car while he was getting food on his way to the hospital, is it any wonder my blood pressure is high???
So beware.
I may be a little quick to overreact right now.
So think before you piss me off.
Because I will punch you in the face.
And enjoy it.
Ps-a little packing tape can fix anything. Even when your diffuser won't fit on your daughter's blow dryer.
Thursday, April 4, 2013
Hanging out at the Mercy.
It has been a whirlwind of a week around our house, as usual.
Ethan and I took a trip to Urgent Care on Wednesday afternoon for what I felt was definitely not admission worthy crumminess, but alas, I was wrong. Ethan's virus panel came back positive for only one virus; Coronavirus. Or a freight train version of the common cold. The hangover results without the fun! It causes upper respiratory issues-thus the oxygen needed for sats in the 80's, and gastroenteritis, thus the inability for him to tolerate anything more than Pedialyte right now.
What is really kind of freaking everyone out is that fact that Ethan continues to Brady down, or drop his heart rate. To the 30's. and not just while sleeping. It was pretty chaotic when he got down to 37 and hung there for a while. That low a heart rate gets a lot of people in your room. Fast. While awake he hangs in the low 40's-still pretty concerning. Cardiology was called and they recommended to stop his Digoxin and check a Dig level for toxicity. It's not back yet, but I'm pretty comfortable that's not it. *update: not the Digoxin.
His admission last fall he showed a new 'normal' sinus bradycardia in the low 50's. Now we are even lower than that consistently. I won't lie, it kind of scares me a little.
Is it the illness? Is this his new normal?
What happens when his new normal is in the 20's? Teens?
We don't get really excited about Ethan's illnesses, or we would be crazy. When the time warrants, we react appropriately. But I was chastised by the Urgent Care Dr yesterday for taking him there vs. the ER. She asked what our criteria were for deciding which place to take him. I told her I didn't feel he was sick enough that an admission was in the cards so we chose the UC route. Her concern was -mind you, she has taken care of the bald kid before in the hospital-her concern was us taking him to Urgent Care for a seemingly minor issue and him crump there. Should they have to code him or provide care for him that was more advanced than they are accustomed to, is Urgent Care the right place for him? She admittedly told us Ethan scares her. She's seen him go bad before and did not feel they could safely take care of him in Urgent Care.
Looks like we'll be heading down to the big house from here on out. I get that he makes people nervous, and I sure don't want someone treating him that is afraid of him. He keeps Dr's on their toes, that's for sure, and many have learned you can't take for granted he will follow the norm of any course of treatment. But come on, you're a pediatric urgent care Dr.
Coughs , colds, tummy aches, earaches and sprains may not be all that walks through your doors. Sometimes a really crappy sick kid might. And this time I didn't feel he was that kid. Yet.
It's frustrating, because I feel like maybe I'm reading him wrong, or have become too complacent with Ethan's new norms, that I don't get more excited when I should.
I'm going to talk to his regular pediatrician about her thoughts, and I guess in the meantime all our trips will be to the Emergency Room rather than the Urgent Care.
On the flip side, we sit here and watch his heart rate hang in the low 40's, and his oxygen levels hang in the mid 80's unless he's on a liter of oxygen. All the while one group of Dr's getting excited and another group of Dr's with little to no concerns about these changes.
When should we get concerned? Or when will they?
Ethan and I took a trip to Urgent Care on Wednesday afternoon for what I felt was definitely not admission worthy crumminess, but alas, I was wrong. Ethan's virus panel came back positive for only one virus; Coronavirus. Or a freight train version of the common cold. The hangover results without the fun! It causes upper respiratory issues-thus the oxygen needed for sats in the 80's, and gastroenteritis, thus the inability for him to tolerate anything more than Pedialyte right now.
What is really kind of freaking everyone out is that fact that Ethan continues to Brady down, or drop his heart rate. To the 30's. and not just while sleeping. It was pretty chaotic when he got down to 37 and hung there for a while. That low a heart rate gets a lot of people in your room. Fast. While awake he hangs in the low 40's-still pretty concerning. Cardiology was called and they recommended to stop his Digoxin and check a Dig level for toxicity. It's not back yet, but I'm pretty comfortable that's not it. *update: not the Digoxin.
His admission last fall he showed a new 'normal' sinus bradycardia in the low 50's. Now we are even lower than that consistently. I won't lie, it kind of scares me a little.
Is it the illness? Is this his new normal?
What happens when his new normal is in the 20's? Teens?
We don't get really excited about Ethan's illnesses, or we would be crazy. When the time warrants, we react appropriately. But I was chastised by the Urgent Care Dr yesterday for taking him there vs. the ER. She asked what our criteria were for deciding which place to take him. I told her I didn't feel he was sick enough that an admission was in the cards so we chose the UC route. Her concern was -mind you, she has taken care of the bald kid before in the hospital-her concern was us taking him to Urgent Care for a seemingly minor issue and him crump there. Should they have to code him or provide care for him that was more advanced than they are accustomed to, is Urgent Care the right place for him? She admittedly told us Ethan scares her. She's seen him go bad before and did not feel they could safely take care of him in Urgent Care.
Looks like we'll be heading down to the big house from here on out. I get that he makes people nervous, and I sure don't want someone treating him that is afraid of him. He keeps Dr's on their toes, that's for sure, and many have learned you can't take for granted he will follow the norm of any course of treatment. But come on, you're a pediatric urgent care Dr.
Coughs , colds, tummy aches, earaches and sprains may not be all that walks through your doors. Sometimes a really crappy sick kid might. And this time I didn't feel he was that kid. Yet.
It's frustrating, because I feel like maybe I'm reading him wrong, or have become too complacent with Ethan's new norms, that I don't get more excited when I should.
I'm going to talk to his regular pediatrician about her thoughts, and I guess in the meantime all our trips will be to the Emergency Room rather than the Urgent Care.
On the flip side, we sit here and watch his heart rate hang in the low 40's, and his oxygen levels hang in the mid 80's unless he's on a liter of oxygen. All the while one group of Dr's getting excited and another group of Dr's with little to no concerns about these changes.
When should we get concerned? Or when will they?
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