Frozen February

Winter is here, finally. After a December with nere a flake of snow, and a January where it rained as much as it was cold, we now have some winter weather. We have about 4 inches of snow on the ground, that blows around, and for the next 3-4 days it is forcasted to be well below 20 degrees F.
We now have carpet picked out for the office downstairs, someone to come out next week for to tear up our bathroom (they laid linoleum down on top of carpet and now it stinks and will come up) and put down some new linoleum. So, maybe next weekend I will be able to put the office back together and have a place to hide and study and pay bills and such.

From January 07

While we were at Home Depot picking out carpet last night, the lady in the carpet section told us that Home Depot has a craft day every Saturday from 9-11:45, so I took the three older kids to Home Depot and we put together race cars, visited their bathroom, and then made it out of there, but not before they hooked me with their discounted snow sleds. Jan wanted the Red one, and was nearly in tears when I said "no." She got over it. Alec really wanted the Orange one and was in tears because he said "I don't know how to use the other one." Actually, he doesn't know how to use any of them, but he got over the answer I gave Jan just a few seconds earlier.
I got the fancy one that looks like a wakeboard, and we went to the park just past our house, where there is a sledding hill. Actually, it is a pretty nice sledding hill, and is sort of like a bowl, so they sled down and then sort of slide around in the bottow until friction overtakes gravity, or big slow kid doesn't get out of the way fast enough. I decided to take them down with me, and that worked well until about 3 times into it Jan says to me, "can I go by myself?" I started to say no, but I thought about that turtle Crush on Finding Nemo who says "it's time to see how Squirt does flying solo," and I said "uh, sure."
After some instruction which mostly included repetitions of "hand on tight" in various flavors, Squirt flew solo, and actually did very well, except I forgot to tell her not to walk back up the middle of the hill, where everyone else slides down. Oh well, that's how you learn, I guess. Next, Alec wanted to go down by himself too, and so both Squirts did very well flying solo. So much so that by the end of the time I decided to add some speed and put them on together. I almost bowled a perfect strike, where they nearly took out a pack of about 8 14-year old girls at the bottom, who were talking and joking until Jan and Alec came blasting through the pack.
We will have to go back and bowl again, and maybe I will bring my camera, so I can share it with you all.
At many of these parks here, there are ponds that are converted into ice rinks... Which we decided maybe we will plan on doing next year, after a year of solid shopping for ice skates for the family. I had some old russian hockey skates, but gave them up a while back. Actually, we could most likely find some skates quite easily, but I need a good year to get stretched out so I don't pull something trying to help the kids learn to skate. I have visions of my dear Father, trying to avoid a wild 4 year old, as well as a hazard marked with cones, and then slipping on a "slippery spot on the ice" nearly made himself a wish bone. Actually, maybe kids learn faster if they just go out there by themselves and figure it out. That sounds good, maybe I can watch the baby and keep the hot chocolate company or something.
This month I am back to the land of general surgery, which is nice, actually. My first day on was Thursday, and I was on call. I got to take out two gallbladders with an attending I have barely met, and the second one he let me do practically the entire thing. I helped put in the gas port and then put in two ports on my own, and held the gall bladder for him while we did cholangiograms (injecting the cystic duct to image the bile ducts and confirm we have the correct duct, as well as look at the specific anatomy (there are plenty of variations to the "normal" bile duct anatomy).
After this point, we started the actual operation and he let me operate the camera as well as do the dissection, isolate and clip off the duct and artery, cut them, and then use cautery to dissect out the gallbladder itself and then put it in a bag and pull it out, followed by careful inspection for bleeding or oozing and then irrigation and quick inspection of the bowel and then taking out and suturing up the port holes.
It was my first real abdominal operation where I was the primary operator, and it was great. Helps to confirm to me why I am here and what I am trying to get out of it.
Well, that is about it for this time. We left the sledding hill just perfectly: everyone had a good time and was upset to leave. Maybe we will let mom go back with them tonight and sled again while I keep the baby and Anne company here in the warm house.

I looked up the park website and there are at least 4 parks here that have sledding hills, and 3 that have ice skating ponds. Fun times.

Dr. Meat

From February 2007

January

From January 07

January was busy.

Starting off we had vacation the first week of January, where my dad and Maria came out for two weeks and were a tremendous asset to us with a new baby and three other children. God knew we needed them here, because one of the first days back to work, my dad came and told me at about 6am that the basement was flooded. Seems the roots are growing into our sewer and with the extra rain we had, our drain couldn't keep up and we backed up. Had to tear out half of the carpet, rip up the pad and then my dad bleached everything and we set it out to dry.
Insurance had a carpet guy come out and he sprayed some cleaner into everything and then re-laid the carpet. Next, a cleaner service comes to actually clean the stuff, and then I have to figure out what to do in the office as we threw that carpet out and are not sure what to replace it with...

So, I have no office to work from or be inspired to blog from, which is fine because we have been busy this month with work (I have been on Urology) and sickness. All of the kids have been sick this month, Kristi included. Mary Beth is now out here with us for two weeks and she is sick too. She was well on her way to recovering from a nasty bug when she arrived and I think that we have succeded in giving her a little too much to do. More than we intended, anyway. Last weekend we were in the Children's Hospital for Friday night through Sunday afternoon with Pati, who had RSV bronchiolitis and was having a very difficult time managing secretions. Mary Beth held down the fort with the three sick bigger kids for the whole weekend while we parents were at the hospital. We don't know what we would have done without her.

All is now well, and we even have our recycling trash bin here. The city just distributed new trash cans to us, well, about 4 months ago, and we finally have the special one for recycling so we can save the planet. Phew! sure feels better now.

Urology has been pretty fun. If you like genitals and their pathology. Actually, I like the bladder scopes, and after the second week I was doing scoping people's bladders and shooting dye in their ureters and laser blasting kidney stones with a vengence. Pretty fun, and they make a killing and have a good life, to boot, but there is something that tells me I would grow to hate it, and being so focused on a single organ system would drive me nuts and make me wonder why in the world I got into medicine, anyway. Nice to know that.

Actually, one of the residents a year ahead of me just switched to Urology, so next year he will be an intern again and start all over. Good for him, but bad for us because he is such a good surgeon and guy. Oh well, I hope they find a good replacement, since he and I were supposed to be senior and chief residents together. I am just trusting God for the replacement.

No new pictures at the moment, since my hard drive is tucked away out of water's reach and all of my pictures are on that drive... .Also because I just finished taking my annual American Board of Surgery In Training Examination today. This is a yearly exam we take which is sort of like a "see where you compare with all of the other surgery residents in the country" as well as a "better study more or else we won't let you pass on to the next level" whip.

I will see if I get a chance to throw some pictures up for you all. Since it has been colder and snowy lately, we have not been taking that many pictures, but we will see what we can do.

Hope all is well with you and the new year brings closeness with Him.

David

When you were born...

From Patagonia Ele...

When you were born...



Starting on December 21, I was on call every other day through the 25th, which means I was at home from about Noon until 5am the following morning on the 22nd, 24th, and 26th. I had it all worked out: work straight until the 28th and then I would have five days off, followed by 7 more days of vacation. During these 12 days I was hoping would bring the fourth child of ours. If her respect of my schedule is any indication, Pati will be a most compliant and obliging daughter. There was a crossover date where I had coverage at the hospital, but was expected to be there. Kristi started having contractions starting somewhere around 7pm on the 26th, a day where I got off around noon from a 30-hour shift of being on call at the hospital. I was able to nap some from 11 or so until about 3am when the groaning next to me became a bit more intense and closer together.



The plan was to take the three kids next door to our wonderful neighbor's place (Dana and Nancy Ewing) as soon as we needed to, but we had some backup just in case. On around 6:00 on the morning of the 27th I realized that I needed to get in gear and make sure the kids were breakfasted, clothed, pottied and had a change of clothing in preparation for a quick trip next door to the neighbor's place. Somewhere after the oatmeal was ready (yes, I can cook when I have to, but the trick is to make it edible but not too close to savory that you are asked upon to perform the culinary art during non-emergent states) and the bags were nearly packed our lovely midwife Heather Judson decided to see how things were progressing. Feel, rather, is more like it, I guess. Anyhow, I didn't hear any words of the conversation that was going on in the "exam" room except for the word "COMPLETE."



Now, maybe to the lay person that doesn't mean anything, but I suppose it would be like telling a cook that their oatmeal was either about to boil over or had run out of water. In the next few minutes the children were up, dressed, hastily fed, and packaged and delivered next door after a call to the neighbor at 7am. Fortunately for us, our midwife is no lay person either, and the word "COMPLETE" meant that in the time I had packaged and delivered the bewildered children next door, our bedroom had been transformed into a birthing suite, and before long we were full into it, with pushing, a bag of water that broke and showed us the GI tract was working in the new one as there was some meconium staining in the fluid (this can indicate fetal distress and is a problem if the little tot inhales some with the first breath of cool, fresh air). She was pretty efficient after that and before more than 10 minutes had passed, maybe only 5 since the water broke, a crowning head was clearly visible. One push after that we were trying to find the orifices to suction before the rest of the monster was delivered (the baby, of course is the one I mean is being delivered, although I know it is mutual deliverance). It was difficult to suction because she was facing behind mommy, so suctioning was a bit like attempting to find a hole with a screw on the end of a bit on the back side of an ottoman that you are seated in front of. In no way is my lovely wife similar to an ottoman, but that seems the best description I could think up.



Anyhow, there she was and next thing I know we were sitting there wrapping the little sausage in a blanket and working the clamps on a cord after a minute or two. Pati was discovered to be a Pati and not a Mark, or James, or John, or whatever we would have named her if she was a boy at this point, and was noticed to be incredibly quiet, blue, and nealy inactive except for large blinking eyes. We finally rubbed her down and got a little hoarse cry out of her before we clamped and cut the cord. Then we worked on getting Pati pinked up and suctioned out and dried off and wrapped up while waiting for the twin to be born (the placenta that is). This took a bit of time, and I was a bit too close because this placenta was sort of it's own plug, holding back about a quart of blood and fluid that came out all at once and hit me right in the leg and foot. That being over, we had an issue with mom bleeding for about 45 or more minutes after the placenta was delivered, which involved massaging the fundus, giving some shepherd's purse (some herbal thingy), metherjin (that is how you pronounce it anyway), and pitocin that was intermixed with prayer of course.



The bleeding stopped, the baby nursed, we all felt a bit better and then got a nap or two before our first night together as 6. Pati seemed to be quite pleasant, and has continued to seem so. I don't know if this will continue, but we are sure grateful for her quiet voice and calm demeanor. Takes most everything either asleep or quietly gazing into the still winter air as if she is waiting for spring to come before she really wakes up and becomes who she is going to be.



Heather, the aforementioned midwife and long-time family friend, was escorted by 4 of us this morning to the airport, so it is just dad and the three older kids doing their best to stay out of mom's hair and keep everyone fed, in clean clothes, and the house in good walking order (paths clearly marked). I have no idea how my wife does it. I think I would go insane after a week or two dealing with this crew. Not that they are bad kids at all, just that so much is going on and nobody really is that much of a help, yet. I was able to get some help organizing the lincoln logs and such today, and I can warm up a mean frozen pizza and make some pretty sweet hot chocolate. Really, the older kids and I went to the towpath this afternoon while mom and baby and Anne were napping. We made it a good four miles before the girl had to go potty, and it was right next to a latrine, so I consider it a pretty good day, in all. I still am figuring out how I am going to go to the store and get some necessities. Duct tape seems like it would sure come in handy if it weren't for those bothersome CSD people and their spies. I guess it will be discrete pinches in sensitive locations for now.



Well, this was meant to be both a blog entry for you all, as well as an accounting for Patagonia when she gets older and asks about what her birth was like. Actually, it will be for me because by then I will most likely have some form of dementia or memory loss or something, and will need a crutch like this to help me out.



Thanks for the prayers and for not making fun of Pati's name. We figured she could always go by Pati or Elena or Elen or something if she really doesn't like it. If you don't like it, well that's just too bad.



David

Pictures of December

From December 2006

You don't hear from me (Kristi) much because every time I sit down to write a new posting I get distracted with trying to put a picture in it. I usually just give up after I have used up my 30 minutes of kids nap time trying to get a picture to configure and post it on the site (it must be done before anything can be written). I thought that I must be very inept since I know others who fill their blogs with multiple pictures and it never seems to give them a problem. I feel a bit better to know that the pictures give David trouble too, in fact, posting pictures gives trouble to most everyone who uses beta blogger instead of just plain blogger. Unfortunately we didn't know that there was difference between the two and to change from one to the other now would be a royal pain - so I guess I will keep trying to post pictures with minimal success, althuogh I do hear that beta blogger is working on fixing the problem since no one is happy about it!. [I added the above picture after the fact, DC]

If I could have put pictures in I would have put in Kaytra Copper and Sarah Coder playing with my kids. They came out to Ohio for a week and made cookies and bread and freezer meals, took care of my children, cleaned bathrooms, mopped floors, folded laundry, wrapped Christmas presents, and took about 500 pictures on our digital camera. We sure miss them. They were also here for 3 of the days this month that David worked 30 hour shifts and were great company for me.

The one picture that we almost took but didn't was of Jan, early this last Sunday morning. She had gotten up before anyone else because she needed to use the bathroom. While sitting on the toilet, in the dark with no one to talk to she noticed that there was no toilet paper on the roll. The most natural thing to do was to take off the rod that usually holds toilet paper, take it apart and pretend that it was jewelry. When she finally hollered for me to come and help her one of the ends of the toilet paper roll was good and stuck on her pinky. Of course, David had left several hours earlier and would not be home until the next afternoon. I tried greasing it up with several things, then cutting with tin snips and wire cutters. Nothing worked. It was off to the emergency room. I was so grateful that I didn't have to haul the other two kids out of bed and take them with us too. Kaytra and Sarah stayed with them while Jan and I headed to Akron Children's Hospital. The doctors and nurses down there couldn't figure out how to get it off either. They finally called up a big brawny janitor from maitenance to bring a large pair of tin/wire cutters. About an hour and fifteen minutes after she first put it on it finally came off. Her finger was swollen, cut and gray but she could feel it. (And they gave her a pretty white bear for being so good...she was so pleased with it that I worried a little about a repeat performance.)

It has been snowing for most of this week and it is beautiful outside. We have a few pictures of kids with red cheeks making snowangels. Anne Pilar is so bundled that she can hardly walk, looking like a cross between a boy and a girl in Alec's hand-me-down blue snowsuit and a powder pink hat. Pretty cold, but we make it out a couple of times a day to pull the sled around and try to make snowballs. The first day Jan rolled snowballs around for twenty minutes trying to make a snowman. She kept saying "I think it is getting bigger Mom!" But it wasn't and she finally gave up. I guess wet Oregon snow is just better for snowpeople. David even made it out to pull kids around the house in the sled a few times before he had to go to bed. (His overall schelule this month is pretty awful and he goes alot of nights with no sleep at all..I guess that it will make having a newborn look easy!)

The house is half decorated for Christmas - we hope to make it out to get a tree next week (along with some new PLASTIC toilet paper holders). We don't have pictures of doing advent, but it would be fun to post a few since it really is the best time of day. It is most fun when David gets to be home for it. The kids are relearning some of Luke 2 and are starting to be able to sing the real words to "O Come O Come Emmanuel" (which is good since David and I can't help getting the giggles when they are singing along earnestly, but don't really know the tune or the words.).

I started this month fretting about the upcoming birth, about David's schedule, about lack of childcare options during the birth. Several people have mentioned that they are praying for for all of that. This week I have had peace about God's control over all of those things. I am interested to see how He works it all out...and I can't help wishing that it were over!

Maybe our next post will have real pictures - of a new baby!

Hope you all have a good December.
Kristi for the Carnes