Sunday, August 31, 2008

Myra's blessing

Since the whole family was able to come for the weekend, we also took the opportunity to give Myra a name and a blessing. For those who are reading this who may not be LDS, this is analogous to the Christian christening ceremony. It is NOT an infant baptism, which we don't believe in. It is a blessing given to a baby by a man who holds the higher (Melchizedek) Priesthood - in our case, Mitch - and basically is an opportunity to give a blessing from God to a new baby and also to give the baby a name by which she is known in this earthly life, and in the records of the church. Unfortunately, Logan wasn't terribly cooperative during the blessing itself, so I missed all but the last few moments of it. Still, she was beautiful in the dress my mother made her. It was made out of scraps left over from my wedding dress. Here she is, on her own, and with family.The guys - My brother, Dan, my father, Mitch and my brother, JamesThe ladies - James's fiancee, Lindsay, my Mom, and meThe proud parents and our beautiful princess

Mitch's parents were able to be here as well, but had to head out to the airport before we took pictures. We were so glad that so much of our family was able to be here for this special time in the life of our precious girl.

Logan is 2!!

Logan had his 2nd birthday on Saturday. We had lots of fun!! Most of the family was able to be there, which was awesome. Both sets of Grandparents and Uncle Dan were able to be here in Temple for the celebration. We started out on Friday really, since that is when Mitch and Alan finished constructing the swing set that was Logan's big present from Mitch and I. Here they are working on it. I though they were too cute in their matching hats!!

Of course, there was no way to hide the enormous swing set in the back yard, so we let Logan "open" it a little early. And he LOVES it!On Saturday, we had the real celebration. First we made cake - Logan "helped" with the frosting.

Here is the finished product. I am not good at cake decorating, but I thought I'd give a monkey face a try. It is a little lopsided, and I had big problems getting the frosting to stick to the ears, but Logan loved it, and it sure did taste good!

Here's Logan enjoying his cake. I'm not really sure why he has his foot on the table, but he was the birthday boy, so we let him get away with it today.All in all, a birthday success!

Tuesday, August 26, 2008

2 week checkup

Myra had her two week well child check today, and of course, all was well. She now weighs in at 6 lbs. 14 ozs, so she's growing! Mommy makes good milk. :-) She is also an inch taller than at birth. Maybe she'll grow out of preemie sized clothes soon... She's so little that I had to make her a wee skirt so that she would have something to wear to church on Sunday. We went to church for the first time this last Sunday, and here is what she wore. I think she's pretty cute in her makeshift skirt and onesie.
Church went fairly well. Mitch was at work so it was just the kids and me. Logan was remarkably well behaved, thank goodness! He loves going to church, especially Nursery, where he gets to play with all of his friends.
Logan has also discovered showers lately. Here he is having a bit of a shower himself. He is a little bit scared of the rushing water, but still had fun.Last night we had our first Family Home Evening with Myra. She was riveted by the lesson on families, as you can see...
Logan paid attention to the lesson for about 3 minutes, which is pretty good for him. He had fun coloring pictures of families for activity, but the highlight of the evening was the treat that Daddy made. Chocolate pudding with Nilla Wafers for dipping! Yum! Between the shaggy hair and the chocolate mustache, we think he looks a bit like one of the 3 Musketeers.

Friday, August 22, 2008

Settling in...

Well, it's almost been two weeks with Myra home, and we are all starting to get used to the idea. I admit that I was completely terrified at the thought of being a mom to 2 kiddos. Logan keeps me pretty busy all by himself, so I was already preparing for the nervous breakdown I should be having about now. So far, no breakdown, but I think that may be because Myra is the perfect baby. She is so easy going and laid back. Thank goodness, since her big brother is anything but!! Logan has been taking the whole baby thing with fairly good graces as well. He has been a little more temperamental lately, but nothing too crazy. Just an escalation in number of daily tantrums. I'm getting pretty good at ignoring them. He does seem to like his little sister. He calls her "Ra", pats her head and gives her kisses. He has a little trouble keeping his pats gentle, but I don't think he intentionally hurts her. I do have to keep a close eye on them together, as he keeps trying to feed her fish crackers and fruit snacks, which are not my idea of the ideal diet for my newborn. He also has taken it upon himself to test out all of her toys. I know, what a good big brother...

Here they are playing together in her gym.

Nursing is also going well. She is a natural, which is great. Here is her "feed me" face. She also has the cutest "smile", but I haven't caught it on camera.

But she also likes her thumb, which she has already found on her own.

Mitch has been back at work this week, which has been interesting. I really appreciated the time off that his fellow managed to get for him - we had him home with us the entire first week, which was awesome!! Now that I'm solo, it has been an interesting juggling act at times, but not as impossible as I feared. I am really grateful for all of the amazing mommies that I know and can look up to! I am getting back into the swing of things though, and even managed some sewing, and made a real dinner night before last. Thanks to the awesome ladies in the ward, we had really great meals the first week back. I am inspired to attempt some new culinary experiments. It is so cool to get a chance to see what comes out of kitchens other than mine. I get so bored with the same old thing that I make all the time, so it was really great to try some new things. Everything was so good!

Well, now that we are settling in to a daytime routine, I am hoping to see some nighttime sleep... Maybe that is just too much to ask. That said, as both my babies are currently asleep - I think I will follow their excellent examples. Night, all.

Tuesday, August 12, 2008

Myra Elaine

She has arrived! Myra Elaine Deshazer came into the world on Sunday the 10th at 8:39 PM. She is 6 lbs. 3 ozs and just perfect! We came home today and are enjoying getting to know her. Initially Logan wasn't so sure about this little thing, but I think he's getting used to the idea, and even tried to share a fishie cracker with her this morning. With him, there is no greater love than sharing food! The kiddos are sleeping, so Mitch and I are going to try to get some much needed shut eye, but here are a few pictures before we go.

Saturday, August 9, 2008

Residency

I've been thinking about this a lot lately, so I am writing this mostly to work it all out in my head. Most of you will find it utterly boring, unless you are applying for residency this year, then maybe it could be helpful, but otherwise, feel free to just skip it. Hopefully our next post will mostly be cute baby pictures - much more fun.
The background - As most of you know, Mitch and I are both doctors, at very different stages in our careers. I am a Pediatrician, not currently practicing. I finished my Residency (at UT-Houston) in 2006, did a Chief Residency, and now stay home with my kid(s). Mitch is currently an Internal Medicine Resident (at Scott & White) in his 2nd year, and contemplating fellowship options. During the year that I was a Chief Resident, I had many opportunities to learn about the behind the scenes parts of running a residency program and a hospital. It was really enlightening and has impacted some of my opinions about "the way things should be". With that fundamental bias in mind - here we go.
Of late, it seems that the differences between UT/Hermann and Scott & White have been really making themselves felt to me. I'm not talking about the obvious - big hospital in a major medical center vs. smaller hospital in a small TX town, although I think that underlies many of the differences, but rather the smaller, day-to-day things that make life more or less comfortable. We're talking perks here. I know that seems like a "whatever, get over it" kind of thing, but I think that the way that you treat the people who do the greatest majority of patient care work in your institution says something about your institution and what it values. Residents work 80+ hours per week, cover the hospital nights and weekends, and basically do the work of 2-3 "physician extenders" and in so many cases, don't get the credit that they deserve.
So, first major difference, and this is one where I think S&W may be on the right track. At UT they have a very traditional mindset about call. As a resident myself in 36 months of residency, 29 of those months included some element of either overnight call or night shifts, mostly overnight call. We were generally on call every fourth night, so we spent two "normal" 12-14 hour days at the hospital and on the other two days worked 30 hours straight. Sounds gruelling - it is. This is pretty common practice, especially among pediatrics programs. There were some pretty compelling reasons for the amount of call that we had. We covered all of the pediatric and neonatal care for 3 major hospitals, so we needed a lot of warm bodies, but I suspect that a little creativity could have alleviated some of the burden. At S&W they are attempting to minimize the amount of overnight call that the residents take. In some ways I think this has been successful, but in other ways has created more problems. Not unexpected when attempting to change such a firmly entrenched paradigm. The residents are still working 80 (sometimes more) hour weeks, but they get to sleep at home in their own beds more of the time. There is something good to be said for this!
Another fundamental part of employment in general is the compensation package. Here is one place where most programs are fundamentally similar. Pay scales are about the same across the nation and benefits are at least similar. Not much to say here, but if you are applying to residency now, be sure not to overlook this part of the equation. It makes a difference.
On to other perks. One of the fundamental differences that I have noticed between UT-H and S&W is the lack here at S&W of a resident advocacy group. At UT we had not only our completely amazing program director, who was a huge advocate for the residents in my program, but we had a hospital wide resident advocacy committee, which was comprised of residents and faculty and which helped to advocate for the residents in cases where the hospital made decisions that effected us. One huge example is resident parking. This is actually a big issue in Houston, where space in the medical center is at a premium. For the average person, parking costs ten dollars a day, with contracts available for $200-300 monthly, depending on how close you want to be. As residents, you not only keep crazy hours, but make almost nothing, so none of us could have afforded to park close in. When I began my residency, the hospital provided parking in a lot across the street from the hospital, but as the hospital constantly was expanding, that very valuable piece of real estate was taken away to build a new clinic building, and we were left with nowhere to park. Our resident advocacy group went to work and eventually made an equitable deal that gave the residents parking close in, but didn't cost the hospital or med school a ridiculous amount. Here at S&W, there is no such advocacy group, so when the hospital decided to arbitrarily take away the money that they had been providing for resident meals (more on that later), there was no one to go to bat for them. In some cases, the programs ponied up and foot the bill, but not Internal Medicine.
Food money - another bone of contention. Most residency programs offer some sort of on call meal stipend to their residents. When you are in the hospital for 30 hours, food is not a high priority - the patient in room 316 with the brain bleed is. As such, most places to provide either monetary compensation or actual meals to the busy resident. When we came to S&W last year, this was the case. They were actually quite generous - providing daily lunches for the residents as well as on-call meal money at the S&W cafeteria. This was mostly funded by the hospital, but the funding was recently cut and nothing has taken it's place, so I spend a lot of time taking food to Mitch at the hospital.
As an aside, I think that many of these little things represent a fundamental difference between a program located at an enormous hospital in a major medical center and a smaller community hospital in a little town. I know S&W likes to think of themselves as a major player in the health care scene, but we call that delusions of grandeur. I think that as the hospital and supporting community get bigger, there are just more resources available for utilization. I am not making a value judgement about the program itself, or the quality of education. Just the perks. I also think that my situation was a fairly unique one, as we had a competing institution (Baylor College of Medicine) literally right across the street. As a result, we were able to make comparisons much more easily. Free market economy works here, too. Here at S&W, there really isn't anything like that - the closest comparison is Austin, whereas I could probably have hit Baylor with a spit wad from the window at Hermann. Some people probably did.
OK, back to the main topic - perks. Have you thought about those handsome white coats that doctors get to wear once they cross the stage and get their real MDs (or DOs)? I didn't give them a second thought. They were provided by the program, monogrammed for us, and cleaned weekly by our cleaning service. I thought that was just the way it was. Baylor did that, too. We all had nice, white snazzy coats. Made you feel like a real doctor... Here at S&W, you buy your own coats, monogram them yourselves, and get them dry-cleaned or launder them yourself. I know, it seems like another small thing, but I think it is representative of the relatively low esteem that the hospital has for it's residents. And have you ever tried to starch one of those stupid things!! What a pain!! It was also brought to my attention the other day that there could be a safety issue, as many times there are biohazard materials on the coats themselves. Mitch doesn't often make it through a code without getting blood on a sleeve, which he brings home and I clean. I never thought about it really (I mean, how many times have I gotten some kiddo's blood/pus/urine/feces on myself), but it is an issue. A corollary to this is scrubs. My hospitals all provided scrubs and cleaned them. Again, although S&W did provide three of the cheapest scrubs I have ever seen, they do not clean them.
Oh, this is getting long, and turning into a bit of a rant, so I'm going to stop (and try to catch an hour of sleep before Logan wakes up). If you are actually still reading this - wow, thanks. I'll be here all week...

Monday, August 4, 2008

OB update

I just got back from my 37 week checkup and I'm dilated to 3 and 50% effaced - sweet! Dr. Fothergill says my cervix is favorable, so if I am 5cm or more next week, we're going to break my water and have this baby!! She's coming soon!!! In an aside, I find it mildly amusing that when a woman is pregnant, it suddenly becomes socially acceptable to discuss a part of her anatomy that would otherwise be completely verboten.

Sunday, August 3, 2008

Ready? or not...

I guess that Sundays have become the day to sit back and reflect on the week - and post here... I think that is an appropriate Sunday task. Logan is napping, so this is usually my time to sew, check email, clean, read, or do whatever else I want to do without him underfoot (and all over me), but on Sunday, I'm still not sure about sewing (I mean, strictly speaking it could be defined as work, but I really enjoy it, so... the jury is still out), and today the next step on my current project (a white button down shirt for Logan) is the sleeves, which are not my favorite thing to do. So, here I sit. I have of late been thinking a lot about how ready I am for Myra to come. As you can see, we are getting close. In the picture, she had just dropped, so I am looking a little smaller, but only because more of her is in my pelvis. Ouch.
On Wednesday we'll be 37 weeks, which is exciting, and a little terrifying. I don't think you can ever be TRULY ready for a new addition to the family, although since this is the second I am a little less anxious than last time about some things, but more about others since I know a little better what I'm getting myself into. I am really worried about finding the time/energy to balance two busy little ones without neglecting one in favor of the other. I guess a little of that is inevitable, since I only have 2 hands (and one lap). I think Logan is starting to get a little inkling of what is coming. He's been very clingly lately, and has started calling my belly "Myra" or "baby" and giving it kisses. His world is about to be pretty seriously altered though. He's a pretty easy-going kid, so I hope he can roll with this as well as he does the other challenges in his life. I'm a lucky mom.

We are pretty much physically ready for her. Mitch put the crib together yesterday. Isn't it beautiful!
Thank you, Jim and Jennie!!! Mitch was initially a little worried about putting it together, since there weren't any directions, but it went off just fine, and was actually easier to assemble than Logan's Ikea crib. All of the other stuff is all together as well. Her little clothes are all hung, folded and arranged. Her swing is assembled and my bag is even packed for the hospital, so at least that is one less thing to worry about.

And finally, the completely adorable picture of the week -
Anna came over to play on Monday and the kids were watching a farm animal video. Anna and Logan set up their chairs and Anna put her arm around Logan. They just sat there and watched the video together, just like that. Aren't they sweet?!?