Thyroid

My Doctor called me the morning after my postpartum checkup.  I asked him how he was doing, and he answered,

"I am great.  My thyroid levels are not low like yours."

He was trying to be witty.  I laughed.  What I really wanted to do was get up and start dancing!

It turns out that the reason I am so freaking exhausted day in and day out, is not because I have 5 kids.  I am exhausted all the time because my thyroid gland is not working very well.

There is no treatment for exhaustion from 5 children.

There is treatment for an under-active thyroid!  Hallelujah!!!!

My self-medication method of treatment for the past 7 years has been Mountain Dew.  Tons of sugar and caffeine.  Not healthy.  Mountain Dew contributes to weight gain, which is another symptom of the sluggish thyroid.  I just assumed my weight struggles were because I could not give up the Mountain Dew  without falling to the floor in a puddle of tears, and feeling as though I needed to spend the whole day in bed.  

It is a self-defeating cycle.  I woke up tired every morning.  I depended on Mountain Dew to wake me up, and give me the energy to keep going throughout my day.  I told myself that my exhaustion was from raising young kids, and my weight gain was from drinking Mountain Dew all day.

It never dawned on me that I might be dealing with a health issue instead.  

When I was being discharged from the hospital after delivering Titus, the doctor informed me that my blood work showed that my thyroid levels were low. The first thought inside my head was, "is this why I have so much trouble losing weight?"  The doctor explained that since I was not complaining of any of the symptoms, they were not going to start treatment that day, but that they wanted me to tell my family doctor so he could follow up on it.  

I have friends who fight Grave's disease, and have various battles with their thyroid gland.  Their symptoms are rough, and I would not want to travel that road.  This information is really not good news. 

I mentioned the details to my family doctor, and he explained that thyroid levels vary quite a bit during and around pregnancy.  He suggested that we test it again at my postpartum checkup, and see where I was then.

At home, I did some research on the symptoms of a low thyroid, and that is when I had my eye-opening realization that this is probably something I have been dealing with for a while, and certainly recently.  I have always blamed my exhaustion on the stresses of life.  I have always assumed my weight struggles were due to soda pop and poor genetics.  A friend recently commented to me that she could not understand why I was overweight, considering how active I am.  Her comment really came to mind when I was researching thyroid function.

By the time I went in for my postpartum appointment, I was expecting the levels to still be low, and treatment to be advised.  It all made sense after I studied it, and put the pieces together.  The part of my research that I liked the most was the part where the effects of low thyroid (exhaustion and weight gain) would start to reverse about 2 weeks after treatment was started.  That sounded so promising to me, which is why I was rather excited to get that call from my Doctor.

My Doctor called in a prescription for me and I picked it up at the pharmacy on my way to the gym that evening.  In conversation with a friend at the gym, I received some great advice about how to take the medication.  It has to be taken on an empty stomach, with a full glass of water, and then do not eat for at least 30 minutes.  My friend suggested I keep the medication and water in my bedroom, and take them in the wee hours of morning when I get up to use the restroom, before returning to bed.  Then, by the time I wake up for the day, I will be able to eat breakfast and go through my day.  

I followed that advice.  The first day, I took the med and drank an entire water bottle of water at 6am.  I was not expecting much to happen at first.  The medication information says it takes 2 weeks to have a noticeable effect.  Well, I know that I am really lucky that medication works very well and exactly as intended in my body.  But, I had no idea that I would see results as fast as I did.  

By 7:30am, I had to get out of bed because I was SO alert!  Only an hour and a half after taking the first dose of this medication, and I was ready to tackle the day with gusto!  I texted my friend and told her that I hoped this was not a placebo affect, or that the med would taper down over time, because I was already feeling so good!  I was not exhausted at all.  It was quite a shock to go through my whole day and not feel the desire to take a nap.  I actually researched the medication again, to make sure the pharmacy gave me the right thing, and didn't give me speed by mistake!  It was just that big of a difference!

The absolute best part of this thyroid treatment medication is how alert I feel each day.  It is as if my brain has been turned back on.  I can fully function in my life.  I can go about my business all day long, and not need a nap.  I will joyfully take this medication every day for the rest of my life, just to continue this feeling of being awake and capable.  

The second best part of this treatment is the weight loss.  I dropped 4 pounds in the first 8 days of treatment!  I imagine that my body's metabolism is ramping back up to normal, which makes a big difference.  Another big difference is that I do not feel the need for soda pop, since I am so alert.  I am certain that not adding those empty calories is also helping encourage weight loss.  

I decided to use this to my advantage, and began cutting back on my Mountain Dew intake immediately.  I used the method of cutting my intake by half, every few days.  It ended up that I did not suffer with caffeine withdrawal at all.  Sugar was my addiction, and I had to be careful to not replace the sugar decrease with other sweets.  I am very pleased to report that I have not had any soda pop at all for the past 3 days.  I am still a bit surprised by that, myself.  Soda has been such a big part of my life for so many years now, and all of a sudden it has become completely irrelevant.  

I am hoping that this treatment will continue to work wonders.  I am so pleased with its effect so far.  

Visiting the Good Doctor

I took my thundering herd to see the good Doctor yesterday.  

Dr. S has been our Family Physician for the past 13 years.  He is the best.

Today's visit was scheduled to be a well-child check-up for Jersey #5.  Normally, I try to schedule the kids' well-child appointments within a month of their birthday.  It is easier for me to keep track of them that way.  Well, last Fall, life was a bit crazy, so I got behind on appointments, and now I am trying to catch up.  

I have learned my lesson!  It has been a challenge to catch up the missed well-child check-ups for my late summer babies, at the same time that my winter and spring babies are having more birthdays.  It seems like we are visiting the doctor's clinic a lot lately.

Today, I took full advantage of the scheduled appointment.

In addition to going through the well-child routine for Jersey #5, I lines up all of the kids and asked Dr. S to scan their current ailments.  He is real good about that.

We addressed Jersey #5's little, crooked toes.  Poor kid has toes that are various lengths, and overlap each other.  It doesn't appear to inhibit his motion, running and playing, so there is nothing to do but wait it out and see how his feet grow.

Jersey #1 sprained her ankle.  I dismissed her complaints at first, because she tends to be over-dramatic about every bump.  But, this time she was serious.  Her instep is showing the bruising discoloration.  The doctor examined it (or made it "really hurt" by pressing all over her foot, according to Jersey #1).  She should mend well with rest and some Ibuprofen.  She should be ready to run again for her next AWANA Games practice.

Jersey #2 has had a rough time this winter with dry skin on her hands.  We've tried all kinds of lotions and grease, and could not get it to mend.  The good Doctor gave us some hydrocortisone cream to try with the lotion.  The pharmacist also agreed that it should do the trick to help with her hands.

Jersey #3 developed a sudden cough, with no prior illness.  I suspect it is his allergies, which are really terrible right now.  But, just to be safe, I asked Dr. S to listen to his lungs.  All clear!  That is good news.  We will stick with my allergy theory.

Jersey #4 has a terrible wart problem on her hands.  Warts are caused by a virus, and will usually go away once the immune system rises to the challenge (which can take a long time, it seems).  One wart is really bothering her, because it is on her thumb and pressing into her nail.  I started a home treatment for her  thumb wart, and it made the skin all over her thumb start to peel away.  I had Dr. S take a look at it and make sure she wasn't having a bad reaction.  We are going to continue the home treatment and hope it works.  I dread her having to have them frozen off.  That is not fun.

Jersey #5 is healthy and growing great.  At his 2-year old check-up, his height and weight measurements were completely off the top of the growth chart.  Dr. S simply wrote down "greater than 100%" and laughed it off.  He said Jersey #5 was the largest 2-year old in the USA.

Now, at age 3 1/2, Jersey #5 has returned to the growth chart.  He is 3 feet, 5 inches tall (92%), and weighs 42 pounds (97%).  He is still a BIG boy!  

BMI calculations are popular now, instead of the height and weight curves.  According to his BMI, Jersey #5 is overweight.  The Doctor and I had a fun chuckle over that.  I am not sure there are any recommendations for what to do with that information for a 3-year old.  We dismiss it.  Jersey #1 and Jersey #3 were the same way at that age.  By kindergarten, they both gained more height than weight, and completely flipped their BMI status.  We will see if Jersey #5 does the same thing.

Poor Jersey #5 had to get 2 shots today.  We do not follow the full vaccine recommendations, choosing to decline the unethical vaccines that are made from cell lines of aborted babies.  But, we vaccinate with most of the ethically-manufactured vaccines.  I did not expect Jersey #5 to need any vaccines today, but I had forgotten that he was behind on 1 that was out of stock for a while when he was younger.  We caught that one up today, in addition to permitting an additional dosing of the pneumococcal vaccine.  Normally, I am not a fan of the recommendation to add a booster to the vaccine regimen just because there is an increase in disease (I would much prefer a more calculated recommendation taking into account how recent the original vaccine was given, and the reason for the increase in disease, before a booster is also given).  This time, I approved the booster because of the source (respiratory tract) of the illness that the vaccine prevents, and the child (Jersey #5) who is known to have a weaker respiratory response to illness.  I tend to have to make these choices on a case-by-case basis with my kids.

Jersey #5 was so brave for his immunizations.  He announced, "that hurts," but he did not cry.  He was pleased to pick out a sticker, and even asked the nurse for a second sticker.  He was so sweet, that the nurse gave him 3 stickers!  That made his day, and the pain of the shots was forgotten.  

At the end of the visit, Dr. S asked me how I was doing.  I shared with him my status of having better days and worse days, and that I seem to be progressing into more better days with time.  I also told him about how folks were recommending I see him for antidepressants at 2 weeks, because I admitted to being intensely sad, and I was crying a lot.  He shook his head in disbelief, and told me that there is a trend in society to try to eliminate sadness and pain.  He encouraged me by saying that since I am usually such a positive, happy person, that if I was crying in deep sadness then folks were probably nervous that the world was coming to an end!  That made me laugh.

Our Family Doctor is so sweet.

Growth Spurt

I received some pretty exciting news when I took this dynamic duo to a doctor visit this week.

Jersey #3 was there for his well-child check-up. He is a healthy, growing boy. He did great.

Our physician is a family doctor, who treats our entire family. So, I was able to ask him for a prescription for Jersey #2's antibiotic prophylaxis, even though she did not have an appointment that day. The kids go to the dentist next month, and she needs a dose of antibiotics prior to dental visits.

So, Dr. S asked Jersey #2 to step on the scale to see how much she weighs now. The medication dose is given by weight.

50 pounds!


This is some exciting news. We knew Jersey #2 has been growing. She looks great. It is obvious she is getting taller, and her coloring is good.

In the 11 months that have passed since Jersey #2 had open-heart surgery, she has jumped 2 clothing sizes, and gained 10 pounds.

TEN!

She only weighed 40 pounds at the time of her surgery.


Plus, this 50 pound mark placed her 1 pounds above her younger brother's weight. He has outweighed her by up to 5 pounds, for the past 3 years or so. It is awesome to see her grow like this.

Praise God for such amazing healing!

Jersey #2 joins the ranks of her siblings, in the "healthy and growing" category!

This Doctor

This Doctor is the most wonderful Family Physician in the world. We claim our beloved Dr. S as part of our family.

The Referee and I met this Doctor 2 months after we were married. He has been our family physician, obstetrician, and pediatrician ever since.

I am certain that this Doctor was hand delivered to our family, by God. When The Referee and I were first married, we had to name a primary care provider for our new medical insurance. I picked the clinic right next door to my workplace, and called to get appointments to establish us as patients there. This Doctor was not suppose to be there. He was the director of a different clinic, across town. His clinic was under construction, and he had relocated temporarily. Since he had just relocated his practice, he had room to accept new patients. There was not another physician in that entire clinic who was accepting new patients. I wanted a woman doctor. There was not a single woman physician accepting new patients in that entire medical network in town. I spent hours calling clinics and our insurance company to learn this. Each time I called the clinic, I happened to get the same receptionist. He was patient with me as he looked up each and every doctor on my list, only to tell me they were not accepting new patients at that time. He repeatedly suggested Dr. S. By the 3rd phone call, he was going into great detail about how wonderful this physician really was. He even shared that Dr. S was his doctor too. Finally, at my wits end, I surrendered. I called our insurance company and learned that Dr. S was in our provider network. I called the clinic again, and scheduled appointments with him.

We liked this Doctor from the moment we met him. He smiles. He sings. He has a passion for helping people. He has a gift for guiding people through their healthcare decisions, without judgment.

Yet, when I became pregnant with our first child, I tried to seek out a female doctor at a Women's clinic. I was disappointed to learn that the obstetrics process at the clinics I called was quite lengthy. It was going to be 2 months before I could get a pregnancy test....and I would already be in the 2nd trimester before I even met an obstetrician. That was not the level of care I wanted for my first pregnancy.

Frustrated, I called the clinic and asked for guidance. Not only was I told that I could walk right into the lab that morning and get a pregnancy test on my own, but the nurse who gave me the positive result informed me that Dr. S delivers babies, so there was no need for me to find a new obstetric doctor. The icing on the cake was that he had a cancellation and was able to see me that same afternoon. He celebrated our growing family, and made the excitement of that first pregnancy even higher. From that moment on, I never considered looking for another physician.

This Doctor is open and honest with us about our health. This Doctor tells us the truth, even when it is bad news. This Doctor held our hands as we grieved the death of our firstborn. He made sure to be there for the labor and delivery, staying the entire night at the hospital, just to deliver our stillborn daughter himself. He braced us for what we may face. He admits when he does not have the answers and has to do more research. He finds joy in the routine and in the rare experiences that we bring.

This Doctor was the only physician who admitted to us that Jersey #2's heart murmur did not sound very normal to him. He was diligent to follow up with tests and specialists until we had answers. He called to ask how we were handling the shocking news of her heart condition. He advised us to "go with it" and follow the steps laid out by her Cardiologist.

This Doctor managed every one of my pregnancies. He "caught" our first 3 daughters the moment they entered the world. He claims an "assist" on Jersey #3, as he ran into the room right as Jersey #3 was flying into the world. (He had a suspicion labor was going to go fast).

This Doctor answers phone messages and emails, letting me manage our family's health needs outside of his clinic too. He is calm when I called up with bleeding scares during pregnancies. He always advised me to go to the hospital "so we can see what we are dealing with."

This Doctor came to the hospital outside his regular schedule, just to be the one to circumcise our boys. I asked him if he would be the one to do the procedure. I also asked if I could be there both times. It was funny to watch his "team" of residents scramble at the sight of him at the hospital on the weekend like that, offering to do the procedure for him. It was also funny to hear his colleagues tell me that they doubted he would arrive on his day off, just for that. He always arrived, just as he said he would.

This Doctor celebrates every time our family grows. At every postpartum check-up, I would ask him how things looked in terms of having more children. I would share with him some of the negative comments I received from others. He always answered, "Go for it. I'm ready!"

We joke that we are stalking this Doctor. He has changed clinic locations twice. We have followed him each time.

This Doctor spent hours talking with me about vaccine safety and ethics when our concerns arrived. We always said that if anyone was going to change our minds about a parenting decision, it would only be Dr. S. We respect his wisdom that much to reconsider our own position. It turns out, he respects our parenting choices as well.

This Doctor is Pro-Life. I am confident that he would do everything in his power to save the lives of our children.

This Doctor finds joy in the bold personalities of our children, much like we do. He shares stories and laughter at our parenting (mis)adventures.

This Doctor even takes the time to pose for a picture with our thundering herd.

Hot Topics: Depression

Depression is one of those illnesses that are socially uncomfortable to discuss. It reminds me a lot of the reaction to grieving. Folks just don't know what to say, and usually are not very helpful with the odd comments they come up with. Much like grieving, I find the most comfort in folks who have walked in depression footsteps before. As the saying goes, "It takes one to know one."

Unfortunately, Depression has challenged our marriage many times over.

There are many classifications of Depression. It seems that the therapy world is working to identify even more classifications, in order to specialize treatment. Working with human beings and their combination of physical and behavioral details is rather difficult. That is one reason why Depression seems so tough to conquer. I do not have any expertise in Depression. I can only share from my experiences. This post is not medical advice, as I am not a health care provider.

I'm sure that most folks understand "the blues," having a down day, or feeling slightly melancholy. I handle such days by taking a day off or taking a break from my usually busy schedule. Those are the days when ordering pizza covers dinner. I skip chores, and spend more time participating in relaxing activities. Going to bed early helps restore my mood by the next morning.

Unfortunately, I have also experienced Depression that required medical treatment. Some things require more than a day off, or a longer night's sleep.

Post-partum Depression: just over a month after giving birth to our firstborn, I started showing signs and symptoms of Post-partum Depression. The boldest symptom I had was random, unprovoked crying outbursts. I would walk across the room and just start crying, for no reason at all. I also had trouble sleeping at night. My concerns were dismissed by friends and family, because I was also grieving. So, I was assured, that it was just part of grieving. Thankfully, our family doctor knew otherwise. He understood grieving. He said I had the classic symptoms of Post-partum Depression. Thankfully, it was quickly treated with a few months of taking an antidepressant, at night, that also had a sedative side-effect. Post-partum Depression is caused by those wild hormones, and improves when the body chemistry gets back into balance.

*The difference between the grieving symptoms and the Post-partum Depression symptoms was the "random" component to the crying. During grieving, I would cry when thinking about my daughter, my experience, and my heartache. With Post-partum Depression, my body was crying on its own, without sad thoughts provoking it.

Spiritual Depression: Unfortunately, Depression is often misunderstood in Christian circles. Some folks sincerely believe depression is a matter of a lack of Faith. Their advice is to pray, and spend more time with God. Christians are suppose to understand the amazing gift of salvation we have received, so we should only have joy everlasting, right?

Most forms of Depression are related to chemical imbalances in the body. It is not a matter of Faith. It is a matter of physical health. Of course, God can heal us from all such afflictions. But, we are also stewards of these bodies and need to take care of them.

That much being said, I have also experienced a Spiritual Depression. Medical interventions may help with certain symptoms, but do not fix the core of the problem. In my case, I dove into Depression when my second pregnancy ended in an early miscarriage. I was beyond sad. I was done with grieving. I quit. I spent more time with God at that point in my life than ever before. I was in constant prayer......begging God to take me out of this world. I did not want to be a Mother who had no living children. It was way too painful for me. I thought I had served my time grieving a stillborn daughter. I could not stand to endure the grief of losing my second child to miscarriage. I lived in a very dark place, deep within me. I stayed in bed most of the time. I finally called the doctor for help, with the gentle encouraging of The Referee.

My doctor understood my need to hold a living, breathing baby in my arms. He got me. He treated me with an antidepressant that was safe enough for pregnancy. He advised me to take the med, go through the motions of my life, and not worry a bit about the med when I get pregnant again. Throughout my entire pregnancy with Jersey #1, the doctor assured me that I would be just fine as soon as that baby was in my arms. The antidepressant helped me endure the details of my life, like going to work and shopping for groceries. It helped with some of my physical symptoms. It did not restore joy. I stopped taking the antidpressant the week Jersey #1 was due. It was not safe to take for breastfeeding, so I stopped it when that bottle ran out. I knew if I needed it after her birth, the doctor could prescribe something that was safe for breastfeeding.

God restored my joy. God answered my plees to be taken Home. He said NO. Not yet. I had a greater purpose, and I needed to trust Him. So, I grudgingly went through my life, expecting to be in chronic grief. I did not instantly recover when Jersey #1 was placed in my arms. I was in shock. I did not believe she was alive. I just knew that she would be taken from me at any moment. I took her home, and took care of her every need, and braced myself for the moment I would lose her too.

I still remember the exact day that I won that spiritual battle. Jersey #1 was 4 weeks old. The Referee was at work, and I was still home on maternity leave. I looked over at that precious baby girl, napping peacefully on the bed next to me. I was hit, like a ton of bricks, with the realization that Motherhood was a calling, a RESPONSIBILITY. Not only was I given this blessing, but I was expected to follow God's instructions to train her up in the way she should go....to teach her about God and his love for us. My life was instantly changed. My heart was instantly changed. My attitude was instantly improved.

In that instant, my heart was full. Full of love. Full of purpose. Full of joy.

Thankfully, I have not suffered with Depression since.

Unfortunately, I still suffer from Depression...

The Referee battles Depression. His symptoms seemed so very different from my experiences, that we missed it for years. Sadly, the last 3 years of our life together have been most awful. We could not figure out why none of the marriage resources we sought, were helping our relationship. The Referee was suffering with undiagnosed depression, and we just did not recognize it. A year ago, when I was certain that all hope was lost for our marriage, a friend gently asked if my husband had ever been evaluated for a "chemical imbalance." She gently commented that the symptoms of depression were different in men and women. She explained that a missionary who had visited our church that summer taught her the difference, when he shared about his own battle with depression. I made the suggestion to The Referee in passing, as I was taking the baby to change his diaper. Minutes later, The Referee told me that he took the suggestion and went online to research it more. He took a quiz about depression on one of the medical websites, and after 4 questions it flashed a screen saying he should seek medical attention immediately. Yikes.

That evening, we called our Pastor & his wife over to meet with us. They explained all they understood about depression, and more about the advice of the missionary who visited. They armed us with prayers, support, and resources. For the first time in many years, we actually felt a sense of relief about the strains in our marriage. We had turned over every stone between us, so it made sense that our problem was actually outside us. It is crazy how comforting that piece of information can be.

Unfortunately, The Referee's depression battle is H.U.G.E. Thankfully, he is determined to conquer it. He desires to be healthy, and to have a healthy family. So, he is doing all he can to win. He has an incredible support network on his side. Our family physician is managing the antidepressant medications. A Christian counselor/life coach is providing therapy, literature resources, and guidance. Our Pastor & his wife are practically holding our hands each step of the way. Friends, family, and our church family continue to offer prayers and support as well. The path is uphill, but it is certainly easier to hike in a group, than alone.

The Referee suffers with Double Depression. (I tease him that he is such an over-achiever that one type of depression is just not enough for him).

Dysthymia is chronic depression. The symptoms are less severe, but linger longer. Folks can usually function adequately, but they always seem unhappy. The counselor suggested that The Referee has probably been suffering with dysthymia since adolescence. It certainly explains a lot. Dysthymia is thought to be caused by chemical changes in the brain involving serotonin, a neurotransmitter that aids in coping with emotions. Antidepressant medication in the SSRI category (selective serotonin reuptake inhibitor) have helped tremendously. The Referee shocked me one day, after taking the meds, when he announced that he didn't think he was actually a pessimist! That was life changing, for sure.

Major Depression (Clinical Depression): The Dysthymia was identified after The Referee sought treatment for his Major Depression. Unfortunately, Dysthymia complicates Clinical Depression, because when life resumes to "normal," that "normal" is still low. Men express depression differently than women. Some of the Depression symptoms that The Referee has expressed are fatigue, low mood state, grumpy/unhappy, withdrawal and isolation, angry outbursts, and insomnia. I now see clearly that when he starts to have insomnia....staying up all night, or gets very little sleep for multiple nights in a row, he is on a downhill turn in his depression. The withdrawal and angry outbursts have been most damaging to our marriage. The behavior itself is bad enough, but the fact that it is so random, irrational, and out-of-character, has been most damaging. Being married to a man who appears randomly angry and periodically acts like he doesn't really care, is quite tough on a sensitive gal like me. I started to question which of his changing views about me were actually the truth. Now that my eyes are open to his Depression illness, I am able to see that things really aren't has personal as they once appeared. Now that The Referee realizes that those symptoms are related to his Depression, he is much more careful to turn to Depression help, instead of taking his emotions out on me.

We have noticed that The Referee appears to have episodes of Major Depression due to job stress. Job lay-offs, and the instability of some of the funding of his jobs has been a major source of stress for him for years. Some situations cannot be prevented. But, now that we realize how important it is for him to identify himself with his career, The Referee is being much wiser in his career path and employer selections. I am pleased to report that it looks like he chose a good company recently, resulting in his work situation starting to stabilize. I predict that as he settles into a stable job, his stress will begin to decrease, hopefully helping his depression become more manageable.

Managing Double Depression requires a lifestyle change. The Referee has to set strict boundaries for himself for a sleep routine, and making sure he is eating regularly. Daily exercise is very helpful. He makes himself go through the motions of things he knows is important in his life, even if he doesn't feel like it. He gets up and showers, goes to work, goes to church, teaches Tae Kwon Do class, and participates in family activities, whether he wants to or not. Emotions can be deceiving. So, he is learning that moving forward through the tasks that are previously deemed important, helps him stay afloat. He is also learning to give himself regular breaks to withdrawal. Right now, he gets an evening off, when I take the kids to AWANA, where he has no responsibilities for a few hours.

Finding the right balance of medications and therapy is a great challenge when battling depression. There are many classes of meds. There are many types of therapy. There are tons of books and websites filled with information. It can be overwhelming. But, finding something to help with the battle is SO much better than doing nothing at all. In addition to finding a medical provider and counselor you trust, finding a friend who has walked through the valley of depression can make a world of difference in the support you need to win the battle.

For the sake of yourself and your loved ones, I beg you to seek help if you suffer with Depression. Ignore the comments from people who know nothing about the illness. Find support from folks who do know. There is hope. Life really is better outside of the pit of despair.

Hot Topics: Vaccines

When I was a kid, I do not recall childhood vaccines being much of a hot topic. They seemed standard issue. I only knew of a few families in school who chose to not vaccinate, usually based on religious practice. I did not notice any problems with either side of the topic.

Now that I am raising my own children, I see all kinds of issues being exposed in the vaccination debate. There are so many advantages to vaccines, and so many concerns about them, that it is enough to make a parent's head spin.

Scientifically, I think vaccines are one of the most amazing medical discoveries of all time. I find immunology to be fascinating anyway. So, a means to combat virus attack, is just awesome.

Unfortunately, some of the business practices and ethics in developing the vaccines has been called into question, especially in recent years. Parents are starting to question if all of these vaccines are even necessary. Unethical research practices have damaged trust in the companies who manufacture the vaccines. The marketing tactics cause us to question if the government thinks vaccines are a public health benefit, or just a money-making business? With the increased focus on allergies, the contents and side effects of vaccines are being questioned.

From a public health standpoint, vaccinations are a wonderful thing to the health and well-being of the public at large. They prevent the spread of deadly viruses across the masses. Public health looks at a benefit versus cost comparison. The benefit is the number of lives protected/saved, compared to death by disease. The cost is the number of lives harmed or lost by side effects of the vaccine. From a public health standpoint, the benefits of the vaccines are huge for the majority of the population. The negative outcomes of vaccines affect only a small minority of the population.

Parents do not always appreciate recommendations from a public health standpoint. I for one, find those statistics to be very frustrating when I am trying to figure out what is the best medical choice for our family. Even though negative outcomes are low for the public at large, if those negative outcomes are happening to MY family, they are HUGE!

For the most part, the vaccine debate appears to be centered around public health versus family health. Some families do not want to risk any negative outcomes, regardless of what is best for the general public. Folks pushing for the best public health outcome, seldom respect the position of families who are looking at their own specific situation first.

I respect both ends of the polarized debate, and I am thankful for the freedom to make informed decisions. I see where folks are getting their information and why they are choosing the side they are on. I just don't agree much.

I really do not understand how folks can dismiss the benefits of the Pertussis or Polio vaccines. There are people who are not quite to retirement age who live with paralysis or crippling due to polio. Its damaging effects are still active in our communities. The Referee and I have had a mild case of Whooping Cough (Pertussis), and I would not wish that on anyone. It was so awful and ruined more than 6 weeks of our life. The fever and coughing eliminated my ability to breastfeed Jersey #4, so she weaned much younger than desired. The Referee had his work ethic called into question, as he was missing work and not performing well during that time. It is hard to look professional when you are coughing and miserable like that. I can completely understand why infants die from that disease, as you cough so deeply that you stop breathing and can't catch a breath. It is a scary feeling. I was not certain we would survive.....and that was the *mild* case. I thank God that my children were vaccinated against Whooping Cough at the time that it hit our household. Thankfully, they remained healthy.

I do not think there is a need for a Chicken Pox vaccine. That vaccine appears to have been created so that parents would not have to be inconvenienced/home from work because their children are home sick for the week it takes to endure the disease. There have been so many complications with that vaccine. Now, there is an increase in the number of folks fighting Shingles, which comes from the same virus. It seems we have just traded a childhood illness for an elderly adulthood version.

The new Rotavirus vaccine is another one that strikes me as bizarre. Rota virus causes some nasty diarrhea that in turn causes profound dehydration. It is one of the common reasons infants and toddlers are hospitalized. From a public health standpoint, it makes sense to vaccinate against it and cut down on the need for so much hospital care. From a family standpoint, if I am home, caring for my own children, then I have the ability to assess my child's hydration needs, in addition to needs for baths, cuddling, and rest. It seems unnecessary to put my child through the risks of vaccine side effects (which an older version of the vaccine had a pretty dangerous one of twisting the bowels, so it was removed from the market), for an illness that simply requires focused mothering until the body can fight it off.

The feud about whether or not vaccines cause autism is a big one. The number of recommended childhood vaccines have greatly increased in the past couple decades. The number of children diagnosed with autism has simultaneously increased. Some parents are adamant that their child did not start exhibiting autism traits until vaccines were administered. Research studies continue to report that there is no link. So, the heated debate continues.

One of the things that I appreciate most about the vaccine/autism debate is that it is getting a lot of attention. Parents are becoming more aware of the business practice of vaccinations, and are starting to study and research the vaccine benefits, costs, and contents. I am hoping that the autism voices will one day grow loud enough to encourage alternate vaccine options. The specific vaccine in question in the autism debate is the MMR vaccine (measles, mumps, rubella). I personally, would like to have an ethical alternative to this exact vaccine.

The R (rubella) portion of the MMR vaccine is derived from the cell line of aborted babies. This practice goes against my core values. Abortion is murder of an innocent life. I value life. As much as I appreciate the benefits of vaccinations, I cannot support giving my children a vaccine that involved the murder of other children.

I would like to vaccinate my children against measles, as that is another big disease that I would like to prevent. I am on the fence about Mumps. I am not convinced the Rubella vaccine is necessary, and I certainly despise its unethical origin. Unfortunately, the company who produces the MMR vaccine in the USA does not currently sell the 3 parts individually. It is all or nothing. Plus, they are increasing marketing 4 parts to that vaccine, by including the Chicken Pox vaccine with it. (Right now, it is still possible to get the Chicken pox version separate).

It is the unethical practice of using cell lines from aborted babies that helps me understand and respect families who choose alternative vaccination schedules, or even refuse to vaccinate at all. It is wrong that my pro-life value is trampled in order to protect the health of my children. The Rubella vaccine, the Chicken Pox vaccine (Vericella), and the Hepatitis A vaccine are all derived from cell lines of aborted babies. So, I want nothing to do with those vaccines. In addition, I have lost respect and trust for the developers and manufacturers of those vaccines, which makes me want to question any other vaccine they offer. So, I am hoping that the autism advocates will create a big enough voice to force the vaccine company to make some changes....hopefully in a more ethical direction.

Every family is different in their values and priorities for their health. The Referee and I laugh at ourselves for the ways our choices have changed through the years, based on the needs of our family. Prior to Jersey #2's birth, neither of us had ever received a flu shot, and neither of us had ever had the flu. Our family rolled up our sleeves, and immediately took a flu shot that winter...when our family physician recommended it....as a means to help prevent Jersey #2 from catching the flu while she was also recovering from her first open-heart surgery. We made certain to get a flu shot every year, at the start of the winter, to help give her some "herd" protection.

Two years ago, Jersey #2 and Jersey #4 both caught the flu, in spite of our vaccine efforts. Healthy Jersey #4 progressed through the flu illness at the textbook rate. Jersey #2, on the other hand, gave us quite a scare that the flu could take her life. She kept a fever longer. She fought the upper respiratory symptoms longer. She dropped 10% of her body weight. I took her to see a doctor 3 times during that 1 illness. It was a scary experience, that clarified exactly why her medical team did not want her to catch the flu. We did not regret a single flu vaccine.

When the H1N1 (swine) flu took the world by media storm, I was really torn about whether or not to trust that vaccine. Thankfully, I did not have to make a choice in the matter. The virus reached our state long before the vaccine did....and then it swept through our family like wildfire. Thankfully, it was a very mild form of the flu. It was no where near as difficult to endure as the seasonal flu the girls had experienced a couple years prior. Since Jersey #2 was facing her next open-heart surgery, we did take the risk of giving her the Tamiflu antivirulent after her first symptoms emerged. The irony is that after questioning the safety of the vaccine, we turned around and readily tried the experimental antivirulent medication for her. (Yes, parenting is full of tough choices). The medicine worked wonders, and her flu experience was much easier than the rest of the family, and tremendously better than her past illness.

With her new, fully-functioning heart valve, Jersey #2 is no longer in the high-risk category for flu complications. This year is the first year of her life where our family can pass on the seasonal flu vaccine. It is a wonderful milestone. It is also temporary, so our choices will change as that valve wears out.

Looking at the great vaccine debate, I can take sides with both sides: I am in awe of the miraculous power of vaccines to fight viruses and keep our population alive. Yet, one of the greatest privelages of being a healthy individual is to be able to choose to decline recommended vaccines, and trust our body's immune system to go to work for us instead.

Down for the Count

I am almost semi-functional again.

Almost.

A terrible sinus infection came out of the blue and knocked me off my feet. I was down for the count for 3 days. It was wild. And crazy. And restful?

It was restful because I was in bed, heavily medicated to manage the pain. I have had a few sinus infections in my life. But, I have not faced sinus pain like that before. There were points when I wondered if I was really dealing with a sinus infection, or a dental emergency. Ouch!

I did get a lot of sleep all weekend.

I went to the doctor yesterday and got a prescription for an antibiotic. Two doses later, and I am noticing a big improvement already. I am out of bed, for one thing. My nose is running again, which is another good thing.

The lesson I learned from this experience is that when a head cold seems like it suddenly went away quickly and easily....it really did not. Here I thought I was just healthier. It turns out everything stopped flowing because it was settling up in my sinus cavity. Building a cement foundation. And when that foundation was set, it was quite a fortress to attack.

I ignored the early warning signs: feeling tired and run down, and pain in my upper jaw teeth. I took Tylenol for my headache, and went about my days. Maybe if I had intervened with some home treatments earlier, I could have stopped the full-blown war in my face.

I went from feeling achy and run down one morning, to in-bed and non-functional by late afternoon....along with intense face pain and fever. Ugh. Thankfully, there were no activities scheduled for the weekend. The Referee worked on his car. The kids ran wild, but he was there to supervise them and feed them regularly. So, my family let me sleep.

Sleep helped. Pain medication helped. Drinking lots of fluids helped. Shower steam helped. But, this time around, antibiotics are my favorite resource right now. I was just not bouncing back on my own.

Next time, I think I will take that common cold a little more seriously.

Take Two

So much for decompression....just over an hour after this morning's post, I dove into another adrenaline rush!

I had just woken up, sent my husband off to work, changed the baby's diaper, greeted the kids, and sat down to the computer to check my email, when I was approached by Jersey #2.

"Mom, my tummy hurts."

I barely get her to point to the location of the pain (which happens to be where her stomach is actually located in the abdomen), before she starts to gag. I suggest she run to the bathroom to puke....she makes it half-way there. I inspect the spewed contents while she washes her hands at the sink. I clean up the mess, while I explain to her what was in her stomach: apple juice and mucous. Yuck. I feel her forehead. She's warm.

OH NO! BEGIN PANIC MODE!

I take her temperature with both the ear thermometer and the forehead thermometer. Either way I look at it, she has a low fever. 100.2 Ugh. This is not good.

This is SO not good.

10 days after surgery, and she is at an incredibly high risk for infection.

5 out of 5 cardiologists (not 4 out of 5 like you hear on drug commercials on TV) have instilled in me last week that Jersey #2 is NOT to be running a fever of unknown origin. She must be checked out by our family doctor...and he is suppose to go through an entire checklist of clinic symptoms, in order to rule out various infections and heart failure.

Try explaining THAT to the new receptionist who hasn't met us yet! She insisted that Dr. S was completely booked today, but she could get us in to see someone else in the clinic.

Um, no. That will not do. This situation is critical enough to require the doctor who literally caught Jersey #2 when she entered this world. He is the one who picked up on her heart problem in the first place. He is the one who needs to assess her today. He knows her. Please have the nurse call me. I would prefer a person who has actually taken an anatomy class to decide whether this situation needs Dr. S specifically. Did you hear the words open-heart surgery on a 6-year old??? I am not sure when receptionists started dishing out medical advice, but there is no way I am leaving my daughter's health in such untrained hands.

The nurse calls me back within 15 minutes, listens to half of my story, and promptly tells me that Dr. S will want to fit us in today, under the circumstances. Yes, that is what I was thinking too.

In the meantime, Jersey #2 holds down her heart meds, Tylenol, and a cracker. She starts drinking water again and tells me she is fine. She tells me that the entire trip to the clinic. She naps on the way, which is another bad sign.

We get right in almost immediately. I semi-apologize for being such a panicked Mom like this. The medical assistant taking vital signs tells me she would have panicked too. Apparently my panic is very understandable, because Dr. S doesn't joke or tease. He greets us and tells me immediately that Jersey #2's Cardiologist called him on Friday. That let me know that he knows exactly what is expected from him, so I do not have to try to relay all of that information. This could be nothing. This could be serious.

He tries to make small talk with Jersey #2 about her surgery adventure, while he steadily goes through the various clinical signs of infection. He smiles more and more as he rules things out. Her throat is clear. Her ears are clear. He is almost surprised to report that her lungs sound real good (because she has been dealing with some collapsed lung tissue on her left side). Her abdomen is soft, and not in any pain. He says he is going to run a urinalysis too. I expect that, because it was one of the "extra" tests that her cardiologist wants run at times like this.

Her liver is not enlarged! HALLELUJAH! One of the scariest risks Jersey #2 has right now is infection to her pericardium, the tissue lining around her heart. One of the clinical signs of pericarditis...and also heart failure....is an enlarged liver. If her valve starts to have trouble, her liver will tattle. So, it is really good news to hear that her liver is its normal size.

Dr. S jokes that Jersey #2's heart is very musical. He is joking again, this is a good sign.

He sends us off to the restroom to get a urine sample. He walks back in the room a few minutes later and shows me the lab result: Negative. There is no increase in white blood cells. Her urine is not showing any signs of infection. This is good.

He assures me that Jersey #2 is not showing any clinical signs of infection. He jokes with her that it must have been her Mama's cooking! He's teasing again.....this is a good sign that all is well. He offers her a sticker.

He tells us to have a good day, asks about the siblings and The Referee's job, and reminds me to call him immediately if Jersey #2 spikes a fever.

I leave the clinic so relieved that I am practically shaking and ready to cry. Crisis averted.....for now. The window of the highest risk for infection are the first 3 months after surgery. Here's hoping I can keep my wits about me that long.

Now, let me go re-read my earlier post on decompressing, because I have already forgotten how....

Food & Finances Friday--Medical Expenses

Now that I am intensely focused on budgeting income and expenses, I am paying much more attention to what things cost. I double check medical bills to make sure that our insurance was billed accurately, and to check for accounting errors. I am amazed by how many errors are made on a regular basis in the medical billing profession. One time I was sent the full bill for a clinic visit, just because someone forgot to bill the insurance company at all. Another time, I was sent a bill for a copay that was paid by check. The check was cashed and cleared my account, and I had record of it! For the most part, folks have been friendly when I call to report an error. They usually apologize for the oversight and assure me that they are submitting the correct paperwork immediately.

I have also noticed a trend of folks blaming the insurance company first, and suggesting I call the insurance company before they are even willing to take a look at the error. I know that medical insurance companies are not favored these days, so it is easy to be mad at them and speak poorly of them, and no one will disagree. My experiences so far pile up the most billing errors in the hands of the person who received our file immediately after the doctor is finished. I am not yet clear who that person is, but he/she is not very diligent in their job. I am sure it involves a lot of data entry, which is very boring. But, it so important for that person to enter the data correctly, so that the insurance company will have all of the necessary information to process and pay the claim.

The folks I am most suspicious of recently are in the pharmacy. I've noticed that the only financial information I receive from them is listing the cost of the prescription co-pay. I do not receive any information listing the original cost of the medication, the percent my insurance company pays, or anything that I can use to check their math and make sure calculations are correct. I have also noticed that different pharmacies in town charge me different copay amounts for the same medication. That seems suspicious.

Last week, I had a run-in with a pharmacy tech that wasn't very cordial. The pharmacy gave me a half-filled prescription, because they did not have enough in stock. I was irritated that they did not tell me this in advance, so that I could choose to go elsewhere to get my prescription filled, so they received my feedback on that. Then, when I went back to get the second half of my prescription, I was told I had an additional copay for the medication. Even though I was picking up half of the medication each time, the two copays were not equal.

When I asked why I was not charged in full the first time, I was told that it was illegal to charge me for medication I did not receive. Hmm? Well, then why is it legal to charge me 80% of the cost of the medication, but only give me 50% of the medication? Then, when I return, charge me the remaining 20% of the cost to receive the remaining 50% of the medication???

Since Jersey #5 is allergic to the medicine, I did not need to pick up the remaining half of his prescription. So, in the end, I was charged 80% of the cost, but only received 50% of the medicine. The pharmacy simply re-shelved that med and will sell it to someone else for its value. By my calculation, that gives them the 30% as profit, because they are able to double charge for that same bottle of medication.

The pharmacy tech was more than willing to blame my insurance company by telling me that she can only enter the information into the computer, and the computer spits out the copay amount that the insurance company says I have to pay. She suggested if I had a problem with that, I should take it up with my insurance company!

Um, yeah. MY solution was to request that the tech place a note in my file that states I do not want partially filled prescriptions. I want to be notified in advance when they do not have my prescription in stock, so that I may take my business elsewhere. I live in a big enough town to have plenty of pharmacy options. I can exercise my consumer privilege in order to cut down on such pharmaceutical embezzlement!

Realizing my own advice, I see that it is time I shop around for better pharmacy prices and service if both can vary that much from store to store.

It is amazing what I learn when I start telling my money where to go, instead of asking where it went!

Mental Math

Jersey #2 has a gift for mental math. We learned this when she was in preschool, listening in on Jersey #1's math lessons, and shouting out the answer before her older sister could work the problems. She liked adding 3 single digits in her head, and really enjoyed the positive reaction she got from adults when she demonstrated this ability at 4 years old.

Since The Referee has a love for all things mathematical, he started playing math games with her. He would list out numbers for her to add while they were driving down the street. They moved on to series of numbers to calculate that were part of a pattern. In our nerdy family, we call this fun!

Dr. S, who has been our family doctor from the time that The Referee and I were married, is also gifted in mental math. It is fun to listen to him calculate prescription doses, out loud, instead of using a calculator or reference manual. I have double checked his math on prescriptions before, and it has always been correct.

It turns out that Dr. S took 2nd place for the entire state of New York, in a mental math competition when he was in 8th grade. After we admired his mental math skills recently, he shared more details with us. He said that to this day, he can still remember the 1 question that he missed, that the other kid answered correctly. He said he was rushing, and missed a simple one.

What positive integer multiplied by 2 is less than that same integer added to 2?

I was standing next to Jersey #1 at the time, and we both tried to figure it out. In my head, I was thinking.... 2x3=6. 2+3=5. Nope, that is not it.

That is as far as I got in my thought process before Jersey #2 shouted out the answer...

ONE!

We all turned to look at her. I didn't realize she was even listening to the conversation, let alone calculating the answer to the problem. Jersey #1 commented, "She is really good at doing math in her head." I agreed. Jersey #2 just smiled. Dr. S smiled at her as if they were part of the same club. The mental math club.

He went on to explain that he had answered zero. Even though zero works for the equation, it does not qualify as a positive integer. Dr. S said it was funny that he could remember that question that he missed after all these years.

I think it is funny that we have a nerdy family doctor who likes to play mental math games too!

HIVES

It has been a hive-filled week at our house. Jersey #5 had an allergic reaction to the antibiotics he was given for his sinus infection. He started a series of Amoxicillin last Wednesday. When I gave him his morning dose on Saturday, within 20 minutes, he looked like this.....

I knew it was hives right away. What I did not know is that it was an allergic reaction. Sure, the thought crossed my mind. But, I quickly ruled it out for a few reasons. First, he has taken Amoxicillin at least once (possibly twice) before, with no problems. Plus, no one in our immediate family has any food or medicine allergies, so this is not a common issue for us. Considering he has been sick for nearly 3 weeks, and considering he had been running a fever for the better part of the past 3 days, I really thought he was just having a skin issue from all the illness.

So, I gave him his mid-day dose on schedule.

We then loaded up in the car and spent the day at basketball functions. I watched a new set of hives appear and merge with the older set all throughout the afternoon. He was certainly allergic to Amoxicillin, no doubt about it!

This is what his hives looked like at bedtime. He even had some on his forehead. Most were on his torso and legs.

I knew he was having an allergic reaction. I knew that any more exposure to the allergen would cause an even bigger reaction. So, I knew we had to immediately stop giving him the medication. I did not know if or when he needed to see a doctor to verify and document this medication allergy. I called a friend who has children with allergies, to get some wisdom from her experiences. I then called the nurse hotline to inquire about when to see the doctor, and also to get the correct dose of Benedryl for his weight.

The nurse who answered was very friendly. She took down all of his information and the details of his hive situation. She entered all that I told her into a medical database and out popped a recommendation.

To my shock, the recommendation was to continue giving him the medicine until he could be seen by a doctor. The suggested timeline was to see a doctor within 24 hours.

I could not contain my shock, and actually blurted out, "You've got to be kidding me!" Even the nurse seemed a bit surprised. She carefully read every word on her computer screen, which said that because his hives did not itch, it should be assumed that the rash he has is actually a non-allergic Amoxicillin rash that 5-10% of children get. I argued that he did not have a rash, but indeed had hives. She argued that hives itch, so it must not be hives. She also told me to not give him Benedryl, since it was not an allergic reaction. I could not contain my disbelief. To add comfort, she assured me that a doctor may later tell me it was an allergic reaction, but until then, I should assume it was not.

Before becoming a stay-at-home-Mom, I worked for 4 years in biomedical research.....in an immunology laboratory! I understood the basics of an allergic response. More exposure to an allergen yields a larger allergic response! I attempted to explain to the nurse that if my son was allergic to the medication, then giving him more doses will cause a larger reaction in him, which could even be fatal. She agreed with me, and suggested that I watch him closely for signs of swelling and trouble breathing.....and if that happened to rush him to the Emergency room!

I was nearly speechless, so I quickly thanked her and got off the phone. I then attempted to process this horrible advice. On a Saturday night, when there were no doctor clinics available, I was advised to continue giving my son a potential allergen, and watch for signs of emergency. And the only reason I was told to do this is because a nurse did not believe I could identify hives, and a computer database states that hives must itch.

I marveled at the stupidity of it all. I decided that there was no reason to err on the side of creating an emergency. Instead, I halted the medication, looked up the benedryl dose on a pediatric site on the internet, and resolved to wait until Monday to try to get an appointment with our family doctor. If the hives were gone by Monday, and a doctor needed to see them in order to verify an allergy, then that experiment would have to be done during business hours at a medical facility.

This is what the hives looked like on Sunday morning. Many had grown together in large blotches, and were warm to the touch.

By Monday morning, the hives were disappearing rather nicely. They were much lighter in color, and much smaller in size.

I managed to get an appointment with our family doctor for the early afternoon. I decided to email the earlier pictures to him in advance, so that he could see how things looked during the weekend, for comparison.

He did not have a chance to check his email before our visit. He walked into the room, looked at Jersey #5 sitting on the exam table in a diaper, and exclaimed, "Boy! Look at those hives!"

Well, that settles it. I really do know what hives are! I was all prepared to defend my case, and there was no reason to do so. I gave Dr. S the brief run-down of events that lead up to our clinic visit that day. He chuckled at my initial disbelief about the allergic response and giving a 2nd dose. He nodded about the hives getting worse due to that 2nd dose. He gasped at the advice I was given from the nurse hotline. After I told him what I chose to do instead, he very seriously said, "You did the right thing." Then, he shook his head as he processed it all. He told me that hives are pretty distinguished so there was no reason to assume I could not identify them. He said they do not always itch. He said the medical database that the nurse line uses must have an algorithm that declares hives must itch in order for them to give such illogical advice. He then examined Jersey #5 and discovered that in addition to his sinus infection that started this whole adventure, he also has an ear infection and bronchiolitis (which was causing wheezing in his upper chest).

Dr. S explained that Jersey #5 can no longer have Amoxicillin. And, since we will tell everyone that he is allergic to Amoxicillin, odds are high that no provider will give him Penicillin either. But, rest assured, there are many antibiotics available, so all should be well. He prescribed a new antibiotic that was not from the Penicillin family.


Jersey #5 woke up with hives the very next morning following that first dose of the new antibiotic.....

So, it is back to the drawing board we go...

The Good Doctor

I am flat-out exhausted from our trip to the doctor this morning. Two of the children had well-child check-ups scheduled. I do not think I will schedule that way again. I have scheduled 2 kids many times in the past, or have scheduled a well-child along with a prenatal appointment, and it seemed fine. Today was different. Today I realized just how much information is transferred between me and the doctor in such a short amount of time. It is A LOT! I have information overload right now.

Part of the problem is that a 1-year-old well-child is rather extensive. That is a big vaccine age. It is also a big age for developmental milestones and nutritional changes. There is much to discuss. In addition, the other well-child was for Jersey #2, and her appointments are just extensive no matter what the age.

Our family doctor is the father of 4 children, so he is accustomed to multitasking and can chat well while the kids play around us. He and I can pass back tons of information to each other while he is conducting his exam, while I am changing diapers, and while we are both making notes about the next level of care.

There once was a time when well-child check-ups were simple. Height and weight measurements were charted and the major developmental milestones were tracked. We would share a few entertaining parenting stories and depart chuckling and smiling.

Today, we discussed the latest cardiology report, MRI, surgical plan, food & nutrition, regular vaccines, ethical versus non-ethical vaccines, flu vaccines (including the swine flu vaccine), tendon/ligament stiffness, physical therapy, anemia, height and weight trends in all of the children, homeschooling, sports and activities, babies eating foreign objects, breastmilk and whole milk, God is in control, whether a dip in the chest (pectus excavatum) is a cosmetic versus a cardiology concern, dental care, limits in the volume Amoxicillin that can be dispensed in one prescription, sleep (or lack of), and how the Referee finds peace & quiet in his job when his home is a circus!

Looking back, it is easy to see why I am so mentally exhausted! Thankfully, after swapping a couple parenting stories, we still left chuckling and smiling...