Vacation Part 3: To Grandmother's House We Go! (AKA, It Shouldn't Count As Vacation If You Get Sick)

(Yes, I realize I've skipped directly from Vacation Part 1 to Vacation Part 3. Vacation Part 2 requires some photos I don't have back yet.)

On Wednesday of my vacation, Brynna and I headed off to visit Grandma and Da in New York. When we were planning this trip, I'd decided that flying was the way to go: it would be faster and I could help entertain her, rather than driving 7 hours with an active two year old strapped into the backseat.

So we signed up to fly Southwest, a two leg trip that would take us south to the Baltimore airport before heading back to upstate New York. I carefully packed toys, books, snacks, extra iPod and diapers in the hopes of helping our flights run as smoothly as possible. Brynna's sippy cup of soymilk even passed the extra explosives test required to take liquid greater than 3 ounces onboard.

Southwest, as is so often their wont, was running well on time. Brynna happily headed down the gangway and into the plane, and I don't think I dislocated anyone's knees while walking through the aisle with our two bags or the giant carseat strapped to my back.

B was quite scared when the plane revved up for departure, exclaiming "go home! go home!" but responded well to some soothing and settled in nicely once we were in the air. We ate our peanuts and pretzels, watched a movie, and read some books.

After an hour, we arrived in Baltimore and found a departures list. Damn! We had to go to a different terminal. The bags seemed even heavier this time. I was incredibly relieved to arrive at our new gate, and then incredibly annoyed that there wasn't a bathroom anywhere in the vicinity. I had to herd Brynna and carry all of our stuff almost back to our original gate to get to the ladies' room. Luckily, there was a big family restroom with a changing table and everything. Still, it was right around this time that I swore that I'd never again do this without another adult.

In the boarding line for our next flight, a very pleasant lady took pity on me and carried one of our bags onto the plane. (Yes, people, I could have checked our bags. But I didn't think I'd have trouble carrying them. And we are about to discover just why I was having so much trouble.)

Brynna was even more of a champ during this flight, falling right asleep. The lovely lady helped me again when we were getting off the plane, carrying a bag all the way to the departure area. It was a good thing, because the carseat and the diaper bag seemed to be getting heavier and heavier.

We were happily met by Grandma Denny and mini-Elmo. I buckled Brynna into the car and then promptly fell asleep in the passenger seat. Then we got back to Art and Denny's house and I fell asleep again. Then I got up to eat supper, sat on the couch for an appetizer, and fell asleep again. When I woke up that time, I could barely get off the couch. And gee, I was awfully hot. And wow, my throat really hurt.

Denny did the "mom check" of my forehead and confirmed that I was burning up, at which point she and Art promptly shooed me upstairs and into bed.

Thursday morning I still felt crummy, with a wicked sore throat. "Stupid virus!" I thought. "I'd better just look at my throat real quick and make sure that I don't have strep or something. Then I can just take some Tylenol and carry on ignoring it." (Strep throat, which is caused by a bacteria rather than virus, has to be treated with antibiotics not so much because of the throat infection, but because it can cause rheumatic heart disease.)

I found a flashlight and a mirror and opened my mouth for a quick inspection.

Gross!!! My tonsils were covered with what you can politely refer to as "exudate." Pus on tonsils + fever + no cough or other cold symptoms pretty much cinches the diagnosis of strep throat. I needed antibiotics. Art hooked me up with a nighttime appointment at the local urgent care, and after Brynna went to bed, he took me over there for one of the most impressive health care experiences of my life.

I signed in, was immediately taken back to a room, and had my vitals checked while the nurse took a quick history and swabbed my throat (Gack!) . A moment later, the PA came in, took one look at my disgusting throat, said that she was sure I had strep, and headed out to check the results of the rapid strep test.

She came back a few minutes later, said that the test was negative but she didn't believe it (there's a certain false negative rate), and handed me an antibiotic prescription. Ahh, antibiotic bliss. I started feeling better about 12 hours later.

But seriously? Strep throat?

On my vacation?

Brynna never got sick, despite our germ-sharing on the flights. All she remembers about our travel day is "airpane! Up up in air!"

Thank goodness.

Philosophy

Me, enjoying local bread and cheese and our very own tomatoes on the porch on this gorgeous fall day, reveling in the fact that I can take surgery call from home: "What a lovely day!"

Brynna: "Who make lovely day?"

Harvest

What you see is a sample of the ongoing harvest from our garden. It's taken a lot of work, but is now (literally) bearing fruit. Geek that I am, I've been keeping stats on our yield. To date we've gotten about two dozen tomatoes, about twice as many tomatillos, and exactly two small red peppers.

The tomatillos have ranged from a few plum-sized ones at the start to much more numerous golf ball-sized ones now. It's been rainy the last day or two, otherwise I'd have another handful. These we've used almost exclusively to make salsa verde, which generally we use in a nice black bean enchilada recipe we've been making for years.

We planted four different varieties of tomato, but managed to get them a bit mixed up between the seedlings and the transplanting, so I don't know exactly what the red ones are. The orange ones, however, are Moonglow, an absolutely wonderful variety that is all tomato flavor and sweetness with very low acidity. We also have some brandywines that are very, very slowly making their way to full ripeness. If the frost holds off another few weeks, we should be able to get another dozen or two. Even though the weather has turned cooler of late, we still love to have fresh tomato and pretend it's still July.

I simply cannot explain the peppers: they have great soil, they've have abundant sunshine and hot weather, but also plenty of watering. And yet, the two peppers you see above may well be the only fully red ones we'll get this year out of eight plants. The plants themselves are stunted and stressed, not at all like our last experience with peppers, which by comparison was downright bountiful. Perhaps they got overshadowed by the voluminous tomatillos, perhaps they needed better staking and support, perhaps we should have started our seeds in March, rather than late May. Ah well. We use peppers in a lot of our cooking, so we will redouble our efforts come next spring.

Plumbing

Today I managed to pull off a bit of plumbing repair. Plumbing is something that I usually approach with some trepidation: it seems deceptively easy (just connect the pipes, dummy), yet it almost always causes me grief whenever I take it on. Plus, unlike electrical work, where a few sparks will trip a breaker and you're all set, a plumbing problem will result in a great deal of mess and possibly some real damage.

But the situation was serious: our shower was failing. Unlike our kitchen, which was a main selling point of the house, we have no great love of the bathroom on the second floor. It is cramped, it's equipment is shoddy and poorly constructed, it looks like it was finished by a 7-year old, it has no logical storage for towels and the like, and it doesn't strictly speaking even meet code (example: there are no shutoff valves accessible for either the sink nor the shower). Our ultimate desire is to gut to it the studs and rebuild it completely. However, that is no small task, and is something we plan to wrap in with other, structural, renovations that are farther down the line. So, we have resolved to live with whatever aesthetic and functional deficiencies it presently has.

But the shower was failing. The mechanism built into the tub spout that diverts water up to the showerhead was no longer sealing very well. As a result, about half the water would be diverted up, and about half would spray from the tub spout. This meant that we were using a prodigious amount of water, and yet getting very little benefit from it. What is more, the initial priming of the shower spout - that first surge of water up the pipe to the showerhead - was increasingly loud. The noise and the waste annoyed me enough that half the time for the last few weeks I've been taking navy showers.

I had poked around at the tub spout a bit in the past, but found it fairly opaque in terms of its repair options. It is one of the very particular things I dislike about this shower's construction: you can't service any of it. The pipes, joints, fittings, and all crucial workings are sealed within the stud wall separating it from the toilet, and so there is no possibility of accessing them without half-tearing the wall apart. When we do embark on our grand renovation, I shall be sure that a proper access panel or three gets added, and all of the plumbing fixtures replaced with more sensible hardware.

Today I did finally resolve to figure out what was going on. Failing at that, I'd bite the bullet and call in the plumber. After some poking around and craning my neck, and some creative work with my Gerber tool, I was able to extract the cause of the problem:


The lever you see if what gets pulled up to divert water up to the shower. As you can see, it raises a sort of gate that, presumably, shuts off the tub spout. The black gasket is what is supposed to do the shutting off. The problem is that this gasket is supposed to be a nice continuous circle, not a torn C.

Reflecting on the design of this contraption, I kept hearing over and over a line about another contraption seen in The Ghost and the Darkness:

"Are you running a high fever, man? How could you conceive of something so idiotic."

Apparently, this kind of design for a tub diversion spout is widespread. And yet to think that sliding a circular gasket like this would work as a watertight seal after the first few dozen times is ludicrous!

Unfortunately, the current state of the world is such that I would have to spend a few hours scrounging around a junkyard to be able to hope to find a matching, replacement gasket. Perhaps a plumber would have [Holy Crap! while composing this a 3.1 earthquake came rumbling through!] a drawer of them somewhere, a vast array of ten different sizes from each of a hundred different manufacturers and models, but I would have no such luck. In the end, I had to replace the whole spout assembly - a $20 part - to be able to fix a ten-cent piece of rubber. A hassle-free shower is definitely worth $20 to the family; it's not the money that irks me. Nor is it even the time it took me to fix what I hold to be a terrible design. What bugs me is that, in our modern world of mass-produced consumerism, the best way to replace the nickel-sized gasket from a cheap piece of crap was to buy...another cheap piece of crap.

And don't even get me started on the slow drain!

A Day of Pus (and also, Failure to Launch)

I am now on my surgery rotation. Yesterday-into-today was my first surgery call...yippee! The main feature of the last 30 hours was two trips to the operating room to drain abscesses. (You may wish to stop reading now if you are a non-medical person who is eating, and return later on an empty stomach.)

"Incision and drainage," the technical term for sticking a scalpel into an abscess and squeezing out the pus, is a actually a non-technical enough procedure that I actually get to handle the knife. As I poked a giant swelling last night and pus just came pouring out, the supervising surgeon exclaimed, "Isn't that just the most satisfying thing you've ever done?"

Well, maybe not the most satisfying thing ever, but pretty darn satisfying (and also downright disgusting). I was very pleased to get to repeat the experience again this morning. As far as operating room experiences go, abscess draining fits all my criteria for a favorite procedure: short, hands-on, satisfying, and very very helpful for the patient.

Following pus-drainage experience #2, I decided that it was about time for me to leave the hospital, since there were no operations to scrub in on that would be done by 1 PM, when I had to leave after 30 hours on call. It was then that I experienced perhaps the most profound failure to launch of any end-of-shift experience thus far in residency.

11:37: sign postop orders for incision and drainage patient
11:39: one last check of electronic desktop for any patient care issues
11:42: reach car, start driving off hospital campus
11:43: pager goes off while at stoplight. Pull over, answer page from post-op care area. Apparently I failed to sign a needed form. Well, at least now I know that this form exists. Turn around, return to previous parking spot, return to OR
11:53: sign the magic form
11:55: talk with one of my fellow residents to update them on the surgery and on the postop orders
11:58: another final check of electronic desktop
12:00: return to parking garage. Sit down in car. Pick up keys and start to put them into the ignition. Get paged. Curse. Realize that it is the attending surgeon on call today.
12:01: walk back into hospital, answer page. Surgeon asks if I am "in the middle of anything." I state that I am not, but that I am only available for another hour since I am post-call. But yes, of course, I am happy to see the brand new consult!
12:04: power-walk to patient care unit, interview patient, examine patient, review labs and CT scans
12:38: page on-call surgeon to discuss case
12:40: receive call back. Surgeon is in operating room. Can I come down and talk to her there?
12:41: power-walk downstairs to operating room.
12:42: Present case. Get pimped (asked lots of questions) about medical vs surgical treatment of diverticulitis, the surgery options, etc. Hold my own reasonably well.
12:53: Surgeon agrees with my assessment that pt does not seem to need surgery at this point, and can I write a note in the chart? She will see patient once out of OR.
12:54: agonized glance at the clock. Power-walk back up to patient care floor and write consult note. Curse at the fact that I am constitutionally unable to write a note that does not approach the length of a Dostoevsky novel.
1:08: Slam chart shut. Power-walk (really approaching a jog) back to car. Successfully start car, leave hospital grounds, and make it all the way home.
1:28: hear pager go off while getting lunch. Non urgent issue...ignore.
1:40: pager goes off again, another non urgent issue. Finally get smart and turn pager off.

Now for an afternoon of peace, before another day on call tomorrow.

Vacation Part 1: Lucy visits!

So, a few weeks ago, I actually had a vacation. Hurray!

It started off with a bang: a visit from my best-friend-since-we-were-six Lucy. I literally ran out of the hospital around 10 PM on Friday night, an hour after my scheduled shift end, and zoomed off to pick her up at the airport. Thus began several days of delightful girly time.

Brynna was VERY excited to hear that Lucy had come on an airplane. ("Air pane. Up up in air!") They became fast friends, and Lucy taught her how to sing lots of new songs. They were bookworms together, too:


When not playing with Brynna, Lucy and I chatted, ate yummy cheese, watched Pride and Prejudice, used Facebook to catch up on high school friends, and went through boxes of maternity and baby clothes. Yes indeed, when I packed those goodies away, I was really hoping that I'd get to pass them on to Lucy, and that time has come!

We also took some walks—this one to the farmers' market:


And we went blueberry picking at Wild Hill, where we were married, and had a wonderful lunch with Peggy and John to boot.

Brynna wasn't quite sure why we were trying to save the blueberries, instead of just eating them, but she carted around the container quite gamely, nonetheless:


And did some of her own picking:


And then settled in for the easiest munching of all!


After blueberries came the previously blogged about Panache visit.

The last day of Lucy's visit, we actually went shopping (yes, folks, Lucy is one of the very few people in the world I would willingly go shopping with) before digging into the boxes of Brynna's outgrown baby clothes. How strange to think of Brynna as such a tiny person, and how wonderful to think of meeting Lucy's own tiny person next year!

Silent Treatment

No, dear readers, we aren't giving you the silent treatment. Things have reached a certain crazed state in our house, and time for posting has been a bit short. Some brief notes:

Hilary is working nights this week and next. That means that the scant 10 hours a day that she's not at the hospital are spent playing with B, eating, showering, sleeping, eating a bit more, and getting back out the door. There's not a whole lot of time in between for long composition.

Meanwhile, I've been taking advantage of having M around helping us out to put in some longer hours at work. We are fast coming up on a big deadline in November, so everything since June has been crunch time. I haven't been getting up at 5 this week, which is a change from many morning this past month, but it's close. I was also laid low with a GI bug earlier this week that sapped me of my will to...well...just about everything.

It's not all bad, however. We had a great time this past weekend visiting my parents in New York. Hilary and B went ahead of me by airplane. It went just fine: B had no fits or breakdowns, and spoke excitedly about it afterward. Brynna rode her first carousel and went to her first zoo. There was lots of fun times with her grandparents and Aunt Kate. Brynna was also a really good sport on Sunday, when we had a seven-hour drive back to New Hampshire.

We'll post pictures of the New York happenings, and some other updates, in the next few days. We hope.

The Beginning of a Beautiful Relationship

I spent about 10 years of my life as a fairly serious equestrienne. Medical school and residency have put the temporary kibosh on that, but when in the Upper Valley, I do try to go and check in on retired mount Panache. I often dream of returning to the saddle, and hope that it's something that Brynna and I may be able to enjoy together.

Brynna has recently become fascinated with Panache, wanting to see pictures of him and remembering our visits. So while we were up blueberry picking this weekend (separate post to come), we decided to go and visit the barn. I asked her if she wanted to ride him, and she seemed game.

She started out from a safe spot outside the fence...


Where she and Dada consulted on the proper approach...


To such a large creature:


Then, once she saw that Mama was having such a good time, Dada helped her mount up...


And off we went...


I think she's a fan!