Definitely back

I'm definitely back in the PICU. This time around, I feel that some of the kids I'm taking care of are even sicker than the ones I had last year. One of my patients is on both ECMO and CVVH and is hanging in the balance, so I have had a crash course in both of these over the last two days. Both of these are largely run by the fellows and attendings, but I'm doing my best to keep up with what's going on. I spent thirteen hours in the PICU yesterday and another seven and a half today plus an additional four in clinic; I'm tired of being at the hospital! I have another thirteen to fourteen tomorrow and at least ten on Thursday, and then I'll be there thirty hours straight Friday through Saturday. I will work again Sunday through Friday (no more overnight call during that period though) and then will have two glorious days in a row off. :)

Being the most senior resident on the team has been a very interesting experience. I have a sub-intern (4th year medical student) on the team, two second year residents, and one second year outside rotator, and since none of them have been in the PICU before Monday, they have been looking to me for guidance. I've actually surprised myself at times when I give answers I didn't even know that I knew. We had a new admission early this morning right before rounds, so with the help of the night float team, I did a quick history and physical in addition to seeing my regular patients. I didn't have time to print up my history, so I apologized to my attending that I was going to present off memory. When I was done, he gave me a huge compliment in front of the team by telling the med student, "Now that was a perfect history; Sarah told a story with that one -- something that tends to get lost when people have their papers in front of them ... great job, Sarah." I actually felt not on top of my game since I had been so rushed that morning, so when my attending complimented me like that, I got a much needed boost. Being that I'm back in the PICU, I'm a little more emotional than normal, so I'm surprised I didn't start crying in front of the team!

Knowing that Hubby will be back in town in two days for two months (yay!!) makes this month easier to bear. I also love having Sebastian home to greet me at the end of the long day; his little tail wags a mile a minute every time I walk through the door, and he makes me laugh with his silly puppy antics. My little family is my escape from the stress of the PICU, and I am so thankful for them!

Travel Size Comfort

My hubby is a frequent traveler, and before we got married, it became a joke among my family that everything in his life is travel size including his wife (we have a 12 inch height difference between us). A little over a year into our marriage, we adopted Sebastian, the best Yorkie ever, so we now have a travel size dog. Prior to getting our dog, I had done a lot of research on breeds and decided that I wanted a terrier; I was scared of having a big dog pulling me behind him down the street, and the terriers seemed to have such great personalities. I had originally selected a Norwich terrier but then found out that these dogs are ridiculously expensive, so our plan changed to a more easily accessible Yorkshire terrier.

Sebastian turned out even smaller than we expected; he still only weighs about four pounds and is small enough to pick up with one hand. Don't let the size fool you though; he is all dog! He loves to hide his puppy treats, and when he thinks someone is intruding on his home turf, he is quick to jump to my defense and growls up a storm. That being said, he's one of the sweetest dogs I've ever met. We have 2400 square feet in this house, and he typically wants to be in the two square feet that is my lap. Unless he gets extremely fired up, he almost never barks (no yappy dog for me!), and he somehow always seems to know when I am upset or sad and sticks extra close during those times.

I started getting migraines on my thirteenth birthday. My worst experience with them was a period during the winter of third year of medical school when I got into a bad cycle of headaches and had to take some pretty strong medicine to break them. Since then, I've been blessed to have had the headaches space out, and when they come, they have been easily controlled. Today I worked from home, and this afternoon I was hit with a horrible migraine out of the blue. Many times I have auras before my migraines (vision changes are my normal auras), but I had no warning with today's headache. I put Sebastian outside for a bit and retreated to our dark, quiet bedroom. After about 45 minutes, the worst passed, and I was able to get up and leave the bedroom.

I think Sebastian knew something was wrong when I let him back inside. He's been extra sweet and has been glued to my side ever since I let him inside. Hubby's out of town this week, so it's just me and the puppy tonight. I remember our first year of marriage when I would be all alone during the week when he traveled, but now I have Sebastian. :) He may be just a puppy, but he provides 4 pounds of warm snuggly comfort and keeps me from feeling alone when Hubby is gone. Other dog lovers will understand; he is more than just a dog to me!

I am thankful ...

... that I'm incapable ... of doin' any good on my own.

Seriously, the tragedy I have been watching around me makes me stop and reflect how many things for which I have to be thankful. Let me give an abbreviated list:

• My beloved husband
• My family
• The best dog in the world
• My home
• Indoor plumbing :)
• Delicious food that is readily and easily accessible (and often somewhat nutritious)
• Clean, drinkable water
• My overall good health
• A supportive work environment
• Freedom of speech and of worship
• Easy access to medicine
• Laughter
• My new Barista and the delicious coffee that Hubby makes for me before I go to work
• Christmas CDs that arrive early (yay Amazon.com!)
• A baby's laugh
• Seeing miracles everyday with my own eyes
• Most of all ... my Savior

Puppy drama!

Oh my goodness, what a day! The day started off shortly after 5:45 with my hubby rolling out of bed. I lazily dragged myself out of bed a few minutes later and started getting ready. At 6:30, Hubby was loading up the car with his suitcases when I noticed that Sebastian had something in his mouth. I was able to see that it was one of my soft foam ear plugs ... right before he swallowed it. I immediately went into panic mode and let Hubby know what had happened. Of course this event didn't change the fact that his plane was leaving in an hour and a half, so he was forced to leave while I stayed with the puppy. Sebastian was acting pretty normally, but since he weighs less than 3 pounds, I wasn't sure if he could handle the ear plug in his gut.

I called his vet as soon as the office opened at 7. The girl answering the phone said that she thought he would be okay but to call back in an hour to talk to someone else. I called at 8, and the nurse I spoke with asked me to go ahead and bring him in. We arrived at the office at 9 and were seen around 9:45. The vet (not our normal vet but still great -- I love this office) told me that if Sebastian had been a Labrador, she wouldn't be worried about the ear plug, but since he was so little, she thought it would be best to induce vomiting in the hope of retrieving the ear plug. She anticipated that the process could take two to three hours, so I left him at the office and ran some errands. When I showed back up around 11:45, she told me that he hadn't thrown up the ear plug yet but that she wanted to give him another round of vomiting before giving up. She let me come behind the desk to the room where the pets were being treated, and my heart melted.

Sebastian was in a row of cages that looked like horizontal lockers with grates instead of doors at the front. He had a towel he was resting on, and I could see little puddles of white phlegm that he'd been throwing up. His little beard was all wet, and his little ears were pulled back. When he saw me, he slowly tiptoed over to the front of the cage and licked my fingers as I stuck them through the grate. The vet let me open his cage, and he slid into my arms. He quickly found his favorite spot, nestled up on my chest with his head tucked over my shoulder next to my neck; then he turned and started to lick my cheeks. He was so docile, and I could tell he felt horrible. As I talked to him, he cuddled into me as deeply as he could as if to say, "Mom, please make all this stop." The vet told me to take all the time I wanted with him, but I couldn't stay much longer because I started crying right there in the vet's office. I felt so silly; Sebastian is only a dog after all, so why was I crying?

I left and called Hubby immediately upon getting into the car. I broke into tears again as I related to him everything that had happened since we talked last. I also told him that I felt responsible since it was my ear plug that Sebastian had eaten. He reassured me that he didn't blame me for any of this and that I hadn't forced the ear plug down Sebastian's throat (I'm guessing it had fallen off the nightstand in the middle of the night, but I don't know for sure). I felt a little better after talking with him, but I still didn't feel great about leaving Sebastian behind without a good solution. At home, I scoured the entire ground floor, hoping against hope that I had just missed the ear plug and that he hadn't really swallowed it, but no such luck belonged to me!

I still hadn't heard from the vet, so I left to pick my puppy up around 2 PM. When I got there, she saw me coming in and brought him out to me. He still hadn't thrown up the ear plug, so she discussed the options with me, and together we decided that I would take him home to watch and see how he did. Armed with the number of an emergency vet nearby, I returned home with my sleepy Yorkie baby.

We got home, and I could tell he immediately felt better knowing that he was back in his own domain. I got him to eat about twelve bites of his puppy kibble (how do I know twelve? I counted!), and we went upstairs to watch TV. About five to ten minutes later, all of a sudden, I saw him start to make gagging motions. I swooped him up with my right hand, and with my best mommy-to-be-one-day motion, I used my left hand to catch his throw up. To my (great) surprise, along with his kibbles was an intact ear plug!

I am so thankful that this has all turned out okay. I was very nervous about leaving him alone even for a few hours for me to go to work tomorrow (luckily for me I am on a rotation where I could take today off as I wasn't essential to the team today), but now I feel much easier about going to work. He is curled up next to me on one of his favorite towels right now, and he looks comfortable for the first time since early this morning. I couldn't imagine a better ending to this day!

Job title

Add dog groomer to my resume. Yesterday evening I was pulling grass out of the flower beds, and Sebastian was keeping me company. Being his usual inquisitive self, he wandered over to our neighbor's wilderness of a front yard when all of a sudden I heard him scream. He's typically a very quiet dog and usually doesn't even bark, but the only thing I can compare the noise he made to is a loud puppy scream. I called him over, and he continued to yelp the 10 seconds it took to get him to me. When he reached me, I saw that he was covered in little cockle burrs (those dry little sticker things that HURT). I tried to pick him up, but I couldn't find a single position in which to hold him that didn't cause him pain. I ran inside the house (carrying him as he continued to scream) to get scissors. I took him back outside, and after about 3 or 4 minutes, he finally calmed down enough to let me pull the burrs out. I spent over 30 minutes on the front porch, gingerly picking out the ones I could and cutting out the ones that were too tangled up in his fur. I lost count after 30. Extracting the burrs was one of the hardest jobs I think I've ever done because he would cry and look at me with his big brown eyes whenever I would get to one that hurt too much. When all was said and done, he was missing a few large chunks of fur, but at least he was free to walk around without yelping in pain.


After this incident, I stopped at Target this afternoon to purchase a dog grooming kit. The main piece looks quite similar to a man's beard trimmer. I'd never used a trimmer before, so it took a few minutes of experimenting to get it right, but now the little guy's coat is shorter and hopefully less prone to attracting painful objects of nature. My mom told me she almost cried the first time my brother got a haircut and lost his beautiful blond curls, and I have to admit that I felt a little twinge of sadness as I gave Sebastian his trim. His little black coat is starting to turn into a mature silver coat, and the trim made it more obvious today. My little guy is growing up! Don't worry; I didn't save any of the trimmed fur (I haven't gone totally crazy yet).

Contemplative

Today I took our yearly in-training exam that we'll take 3 times throughout residency as prep for our real Pediatrics boards that we take the fall after we finish. 170 questions in, I had enough and lost my drive to keep going (for the record, I did answer all 200 questions). I just wanted to finish and go home! I had good intentions of making a Target run since I was near my favorite Target, but that test sucked all the life out of me, so I *gasp* skipped Target and headed home. After giving my sweet puppy kisses and taking him outside, I immediately headed for the kitchen and whipped up my casserole version of my mom's chicken enchiladas. I made a sour cream-Monterrey Jack cheese sauce from scratch, grilled some chicken breasts that I then shredded, caramelized 2 chopped Vidalia onions, and sliced up some flour tortillas. Then I mixed everything together with the remainder of the MJ cheese and baked in a casserole dish for about 30 minutes. With a side of refried black beans, the meal was perfect, and cooking for over an hour at my own pace without any pressure was amazingly therapeutic.

I'm struggling right now. Hubby's job has taken him out of town for 5 weeks in a row again. He gets the weekends back here, but this is the longest stretch we've done with him being gone for a while. I have Sebastian here to keep me company, but obviously it's not the same. I'm such a quality time person that being apart just hurts. I saw him this morning, but coming home and knowing that it would be dinner for 1 was a sad moment.

On the bright side, the cutest dog ever is staring at me right now ... think he wants to go play outside for a little bit before it gets dark. This Yorkie thinks that he's a Labrador! Seeing him approach other dogs is hilarious because he doesn't realize how small he is. He is a truly wonderful addition to our little family (and a perfect reminder of why I'm not ready to be a mom yet!).

No More Driving

This has been by far not my best week ever in the driving realm. On Tuesday I managed to get myself broad-sided by a woman who called me a "f---in' b----" several times even after I apologized for pulling out in front of her. C'mon, it's not like I meant to cause the accident!! I think the police officer actually felt sorry for me because he didn't give me a ticket or anything (which I am very thankful for), but I still feel really horrible about the whole thing. My neck and back are still pretty sore, but they're getting a little better every day. I'm just thankful nobody was seriously injured. Her car was pretty messed up and required a tow (she wouldn't attempt to start it because she was afraid of messing up the engine -- the cop just rolled his eyes at me when that happened), but the trusty old 4Runner is still plodding along with not much more than a bent-up running board an some minor damage to the doors. This baby is a gas-guzzling tank!

I'm spending this block doing a developmental pediatrics rotation at an outside facility, so I usually arrive there between 7 and 8:30 AM, return to my main hospital 15 minutes away for our noon conferences, and then return to the other facility for an afternoon clinic before heading home. Today when I arrived to the hospital for noon conference, I made a special point of putting my keys into my purse so that I wouldn't forget them. I then promptly locked my purse in the car! Our security offered me a coat hanger but nothing else. The locksmith that services the hospital would have unlocked my car for approximately $40 cash only (which I typically don't carry -- I think I only have about $20 or $25 in there right now, and I'm lucky to have that), and all the other places I called would be happy to open my car for the low starting fees of $50 - $75 plus labor in some cases. Being the tight-fisted woman that I am (plus the fact that our electricity bill was through the roof), I knew my hubby was scheduled to be back in Dallas at 5:45 from his jaunt to Houston, so I opted to wait for him to bring me the extra key. Unfortunately thanks to the continued bad weather, his flight has been delayed. I finished my work around 3:30, so I've just been hanging out at the hospital since then. I managed to get in some studying, so that was a positive, but my mind has now officially gone blank. Any further studying is useless at this point, so I'm now just killing time. The website has his plane scheduled to arrive at 6:29, so I figure that he might make it here by 7:15 or so.

In other news, Sebastian is cuter than ever. He is still a handful, but we love him. He's getting better at learning to potty outside but still has occasional accidents. It's been a real challenge to help him want to go outside when it's pouring buckets, but he's getting better. We've had up to 5.5" inches of rain in a single day here, and I've lost count of the cumulative total for June. Today has been drier (at least the hospital), so maybe we'll have a chance to work on the flowerbeds soon. Sebastian is fascinated with the large pieces of bark in the mulch and has taken to running around the yard with bark in his mouth to entertain us.

Did I mention that intern year is over? Life has been pretty swell ever since I danced my way out of the hospital the afternoon of June 23rd. I had eight days in a row off, and we were visited both by my hubby's mom and by my younger sister during our week off. We got the house closer to being unpacked and organized, and we went on my birthday shopping spree with my mom-in-law. During her 2 1/2 days with us, she bought me 2 pairs of Gap jeans and 1 pair of khaki capris, a wrap dress from Ann Taylor Loft (it pains me how much cheaper this dress is now even if I didn't pay for it myself), 2 adorable shirts from Ann Taylor (I can only find one online), a personal bra fitting at Nordstrom with 2 very cute bras (I had no idea what my true size was!), one of the best smelling candles ever, a fun pair of red Nine West shoes, a cute yet practical pair of brown pumps from Dillards, more Fiestaware, and Godiva truffles among other things I'm sure I forgot to name. She also bought the hubby several nice dress shirts, so I wasn't the only one to be spoiled. :) I seriously had never had anyone take me out and say "have fun!" so this was a very new experience. I had to receive encouragement from them throughout the course of the day that I was not being excessive; in fact, my MIL had to steer me away from just the sale racks so that I would open my eyes to other things. We had a great time with her and look forward to seeing her again soon.

To have one of our family members finally at our new house was so cool. We got another treat later in the week when my younger sister came up to visit for a few days. Having room to host guests without stepping on each other every time we move is great!

Well, the hubby just called ... it's 6:45, and he's on his way to get me. Looks like I better get things wrapped up soon so that we can head home! I know Sebastian will be very happy to see us, and I'll be happy not to see the hospital all weekend! :)

Surprise!!

I wrote the last entry half asleep ... I should have had some caffeine before I blogged. That entry was extremely disjointed.



In other news, we got an extremely pleasant surprise today -- Sebastian got to come home. We are both enamored with him.

Happy birthday to me!

I am officially exhausted. Yesterday was my birthday, and what was the best present I got? Ten and a half hours of sleep! I was in bed before ten and didn't get up til after eight (my first day off in twelve days). It was amazing.

In addition to the sleep, I also had some nice and one not-so-nice surprises. I got an awesome haircut on Thursday (nice!), but as I was leaving the salon, I found out that Sebastian has yet another cough and won't get to come home this weekend (not-so-nice). Friday I went to work knowing that I would have to stay later than usual to cover for someone til she got back from clinic to be on call, so I was prepared for a long, busy day.

One of my big pet peeves from work is when people page me with just a call back number. We carry text pagers, so why not make use of the 120 characters you have to give me a heads up on what you want instead of typing in just 4 numbers? Even worse, I got paged about 30 minutes into rounds when I was meeting with the other doctors including my boss to discuss all of our patients; I hate leaving rounds to return pages because I tend to miss out on something important that's being discussed. I called the number back only to rind out that my sweetie had ordered a dozen roses to be delivered to my hospital as a birthday surprise. Doh! What a great surprise! Then the girl I was covering got back to the floor around 4:45 when I hadn't expected her to arrive until 6 or so -- I got to leave earlier than I thought!!

After I got home, I got to open my presents from my parents. They are in Sweden right now, so my mom shipped my presents right before they left so that they would arrive on my birthday -- so thoughtful! I love to open presents ... no idea why it's so exciting, but it's one of my favorite parts of Christmas or birthdays (watching other people open theirs is actually even more exciting!). I ended the day with a delicious dinner of sushi (mmmmm, tuna sashimi and firecracker rolls) followed by me crashing as soon as we got home. My sweet husband just laughed because he knew how tired I was.

Now the hubby is off taking some exam for work, so I slept in and am now spending the morning lounging around and watching the Food Network. I'm unsure when he will be done, so until then, it's lazy Saturday for Sarah. After he gets back, I want to grab some food, run errands, and hopefully go see Shrek the Third either tonight or tomorrow after church. Oh yeah, church! Another exciting part of the weekend, I actually get to attend church twice in one month. That's a rare blessing with my schedule, so I'm really looking forward to being back.

Sad news

Sad news ... Sebastian caught a little puppy cold, so we didn't get to pick him up this weekend. I didn't realize how much i wanted him until I couldn't get him. It's going to be a long five days ... no Scott, no Sebastian, and I have to work late on my birthday on Friday. Can't wait for Saturday to get here! Scott will be back, he'll be done with his test by Saturday afternoon, and we can go pick up our little man. :)

My new love

Isn't he gorgeous?

I think he would definitely be happier on the ground.

Mom's little jailbird

We're here!!!

Countless hours, 1 scratched wood floor, 3 gashed pieces of adored mahogany bedroom furniture, 2 non-working toilets, 2 broken electrical outlets, and 1 defective refrigerator later ... WE ARE MOVED IN!!! :) We have no blinds yet (those come Friday), so we have some old curtains hung up over the windows towards the street and towards the neighbor's kitchen. We got a working, non-damaged refrigerator today, and the hubby used his new tools to hang up a pot rack tonight so that our pots we got for our wedding will FINALLY be used on a regular basis. We have internet and cable now (obviously), and while we are only about 1/3 of the way unpacked and our house looks like a tornado hit it, I don't know if I could be happier. I love our house, imperfections and all.

In other news, I had my 3rd migraine in 12 days today. Ugh. I went a year without one, and now 3 in less than 2 weeks? Double ugh. At least I can finally think straight without feeling like a sledgehammer is pounding the right side of my head.

My puppy is 5 weeks old! It should only be about a month or so til we pick him up. That means 1 more month til everything in the house gets chewed to shreds. Yes, I know we are insane for getting the little guy, but I'm just a sucker for canines.

Okay, I know this post is totally incoherent, but I still have a small residual headache and can't think fully straight yet. More to come when the house gets cleaned up and we take pictures!

Picture of my little one

Sebastian is one of these little fellas; I'm just not sure which one yet. Aren't they adorable?

It's here!

We're closing on the house WAY sooner than we planned! We leave for Napa next Friday and get back on Tuesday. If everything goes as planned, we close on the house on Wednesday and move in Thursday. CRAZINESS!! The hubby and I started packing today. I forgot how much I dislike moving! It's worth it though.

Oh yeah, and we put a deposit down on a Yorkie puppy last week. He's 3 weeks old today. Last Saturday he was so little that he fit in one hand! Sebastian is on his way.

I am so exhausted. I haven't had a week off since last July. Last month I worked 19 days in a row. I cannot wait to sit on my bootie and sip some vina rosa while enjoying the fresh air in California. It's going to be such good times.