The High Tech Way

How Blues Clues paid off at Jack's family birthday party

Jack's family birthday party was last weekend and held at my mother's house since our new house is still, well, in a shambles. (No kitchen, boxes in the living room awaiting the basement offices to be built so that all the books can be put away, etc.  We both telecommute most of the time so the offices are not a minor thing).

Well, it could not have been a lovelier event.  Jack was in a great mood, and he loves a party. The weather was idyllic. The food was fabulous. And everyone was so happy to be there.

You could not imagine a more appreciative toddler.  And because he has been particularly obsessed with the "We just got a letter, we just got a letter, we just got a letter, wonder who it's from. It's from our friends!" part of Blues Clues, he did that with every card he opened.  Yet his enunciation is not so good where anyone else could tell this was what he was doing. They all just thought he was really into cards. This was not a child who dove for the gifts.  No, instead he opened his cards over and over again, acting surprised and delighted each time (and waving a few dollars in the air in the process with a giant grin on his face, as if he knew what they were and how many containers of bubbles they could buy.)

After the gifts my mother brought out the chocolate chip cake she made (I have no oven).  When Jack saw it he started jumping up and down yelling "cake! cake! cake!"  My mother put it on the table (we were out on the patio) and went back inside.  Jack could not understand why someone would just leave a CAKE on the table and not immediately consume it. He kept looking at it and trying to get to it.  Finally my mother came back out.  This time with the Jello Rainbow Cake, which was quite an extraordinary site.

My mom is a bit of a foodie snob.  She didn't think anyone would eat the Jello cake. But really, it was so strikingly beautiful.  And everyone had a piece of it.

We put two candles on the chocolate chip cake and sang happy birthday.  Initially Jack found this intimidating.  But then he warmed up to it and we had to relight the candles and re-sing the song many many times.

The only shadow cast over the day was the loss of the yellow balloon. One moment the string was in Jack's hand and he was happily pulling it down and up. The next moment the balloon was free, headed into the sky. We  all watched it get smaller and smaller until it was a barely visible dot, and it was very sad.   Jack was very distressed.  And there was the lesson of two-hood.  That sometimes things go away and you can't get them back. You just have to let them go.  Hard to do at two and hard to do at 42.

And tonight, nearly a week later, after the boy had a major tantrum at bath time, extending into the pre-bedtime ritual, we were all serious and not enjoying things.  He'd finally calmed down and I was sitting by his bed.  We both sat there quietly for a while with somber expressions.  And then I smiled at him and he smiled back, and all was OK again.  I had trouble leaving him to go to sleep tonight. I kept thinking, this baby won't be my baby for much longer. He'll be the big brother. And that's a little sad in a way, too.  I just want to treasure him and these moments with him in these last few weeks where he's the only one. My baby. My sunshine.  My special special little boy.

Meeting with Dr. M

On Wednesday morning Dr. M phoned me. He said he didn't like to talk on the phone, and would I like to come to his office at 5 to talk to him about my letter. I said I would, but noted that I had to pick up my son from daycare by 6.  He suggested I pick up my son first and then come to the office. I said that I would do that.

Of course this week has been very busy at work with lots of phone meetings extending to the very end of the day.  An interview I really needed was scheduled for 4:30 and I told them I could only talk to them until 4:45.  After which I dashed out of the house, sippy cup with milk in hand, and headed over to daycare.  I picked up Jack and got to the Dr. office by 5:17. Whew!

Dr. M was not yet ready for me.  So Jack and I sat in the waiting room and I told him not to crush crackers into the carpet. Thankfully, people at OB offices tend to like babies and toddlers...

Dr. M's office had the sun beaming in. And on a day when the heat index was unhealthy and I was eight months pregnant, I was uncomfortably hot.  Jack was not keen on being in that office either and made his dissatisfaction known. It was hard to conduct a reasonable conversation with Dr. M given the conditions.

But the sense I get is that Dr. M has no answers. He is stressed about how crazy things are but there are no solutions.  At least he doesn't know any.  But for me what he did was took me out front and made sure I got the appointments I needed.  That included all the rest of my NSTs, plus another appt. with the supremely busy Dr. P who is scheduled to do my c-section.

All my appointments are set until July 25, the designated date.

Dr. M also told me that my chart was missing information about my previous c-section. Without that information he was uncomfortable letting me do a VBAC (if labor began before the 25th).  So with that heads up, I was able to contact my previous doc and get the info today.

After my meeting I rushed home and fed Jack some yogurt, fruit, toast and other foods to make up a quick dinner at the house of the family without a kitchen.  You see, we had the hospital tour to go to that night and too wanted to get the boy into bed a little early. My brother was babysitting in a very non-active way -- by watching our HD satellite TV.

It was clear from the hospital tour that the hospital has been packed lately too with maternity patients. Dr. M had also mentioned that the local paper that day had a story about how that hospital is at over 100 percent capacity.  I think he must have meant this story.

Nevertheless, the hospital is beautiful.

I asked how soon you get your baby after a c-section. Answer: 4 hours.  That's a long time.

I'm so hoping that I can have a successful VBAC ahead of the scheduled c-section because I really don't want to wait that long, and I don't want to spend 3 to 4 days at the hospital.  I want to be home with both my boys.

The behind the scenes story

Thank you, thank you, thank you all, for all the support. It's good to know that I'm not being hysterical or crazy and that it is reasonable for me to be upset about these things.  I dropped my letter off at the doc's office when I went in for Monday's NST. I am still waiting to hear back.

When I went to the hospital for my NST last Friday afternoon I was still so upset about my scheduling problems from my regular OB exam appointment two hours before.  So much so that I confided in the nurse who was doing my test. 

I was in one of those states where I couldn't smile -- something that is unusual for me except when I'm really upset.  So I guess I was trying to explain to the nurse why I was so unfriendly.  I told her about my recent scheduling problems at the OB practice and about some of the other problems I'd had there that I mentioned in that letter. 

She was very sympathetic, and that made me feel better.  You see, when I've expressed surprise or dismay to the person at the front desk when they've told me they have no appointments for me, they look at me blankly as if they don't understand why this is upsetting.   If I felt someone understood and was working for my cause it would be less upsetting. But no one seems to get it.

Anyway, the nurse told me that the big problems at my practice started at the beginning of May when another OB practice disbanded and two of those doctors joined the practice I've been going to. One of those doctors was extremely well liked by patients and hundreds of them followed him to my new practice.   Apparently more followed him than the practice could reasonably accommodate. The nurse said that I was not the first person to express frustration with scheduling problems and communications problems at the practice.

She said that they lead doctor/partner in the practice had been receptive to hearing about the complaints. After all, the reputation of his practice was at stake.  That's what made me decide it was worth it to send the letter (and not just write it as a way of documenting the problems while at the same time venting my anger).

The nurse at the hospital also gave me a list of other doctors who she said were good.  As far as recommendations go I think that the nurse at the hospital's prenatal testing center is a good person to go to to get this kind of info.  (The current practice having been recommended by the agent who sold us the new house. Her daughter went to this practice.)

So I'm going to give the lead doc at the current practice a few days to respond, then I will call these other OB practices -- there are two, and both are half the size of the current practice -- and see if I can get a sense for how they would be.  You know, I'm looking for someone who cares.

Meanwhile, when I went into the doctor's office for my NST on Monday I also voiced my distress to the nurse who performed the test.  She recommended asking the front desk again about appointments with Dr. P and during the week of July 4.  She said I should try to be nice to them. (And, shit, I'm usually really nice.  But I've worn out nice, in this case, and am at the point where I feel like I shouldn't have to kiss up to anyone to get what is considered the standard of medical care.)

But niceness or "no nice" (as Jack now says) aside, I did ask the front desk about these appointments, and I actually GOT an appointment the week of July 4.  The week after that I got an appointment with Dr. P.  Now, granted, the appointment with Dr. P is 40 minutes away.  But, hell, it's an appointment, and the only one I will have with her before my c-section.   That is, if I don't get my current fondest wish of having NEW GUY delivered by a toll taker on the PA turnpike instead.  (So tired of all the jumping through hoops. I bet the turnpike toll taker wouldn't even charge me the toll... or take a photocopy of my insurance card...)

Letter to the lead partner at my current OB practice

Dear Dr. M,

 

I’m writing to inform you of how frustrated and disappointed I’ve been as a patient at your practice. I am 35.5 weeks pregnant and am seriously thinking about changing practices.

 

Here’s why:

 

1. I      started with the practice mid-pregnancy after moving here from

   California

   . When I started with the practice the      nurse told me I had plenty of time to see every doctor before delivery so      I would be familiar with whoever ended up performing the delivery. This has not happened. Indeed, every time      someone at the front desk looks to schedule me, she asks me “How about Dr. R?” I always ask to see someone      else so that I can meet everyone. But that has not been possible. I’ve seen Dr. R twice now and am scheduled to see him a third      time. (and almost a fourth time,      but I opted to see the nurse practitioner instead.) Meanwhile there are at least four      doctors who I have yet to see, and will not have time to see before my      delivery date.
2. Your      surgery scheduler phoned me to schedule my c-section about a week after      the doctor said she would call. I      was not at my phone when she called. So I phoned back and her voice mail said she would get back to me      in 3 to 4 business days. (compared to same day or next day if after

   4 pm

   for my old

   OB

        practice in

   California

   ). And she did indeed take that long to      call me back, and I again missed her call. This went on for a few weeks. The next time I went into the office I learned she’d actually      scheduled me WITHOUT ACTUALLY EVER SPEAKING WITH ME IN REAL TIME. I never got to talk to her about who was      on duty on the day I wanted. I      never got to talk to her at all. 
3. I am      scheduled for a c-section with Dr. P on July 25, a date I am      happy with because it is the birth date of my late sister in law. When this finally got scheduled the      nurse said I should schedule the rest of my appointments with Dr.      P. But when I got to the front      desk I’d already had appointments scheduled for the next few weeks so they      didn’t want to change them. Today      when I went to schedule appointments with Dr. P I learned she is on      vacation for the next two weeks. (They must not have known that when they      told me I couldn’t schedule with her before?) In fact, she doesn’t have any      appointments available at all before my c-section. I cannot believe that your practice is      not allowing me to see the doctor who will perform major abdominal surgery      on me even one time before the surgery is scheduled.
4. When I      was trying to schedule my c-section I called your office maybe 10 times in      a single day and NEVER GOT THROUGH. It was a busy signal all day long so I      couldn’t even leave a message on voice mail. When someone finally answered it was the      answering service after your office had closed. She said she couldn’t take a message      unless it was an emergency. She      could not help me at all. I could not get to voice mail and I could not      leave a message elsewhere. Which      is ironic because the nurses at the hospital who have been doing this      week’s NSTs for me (because the local office was too busy to do      them since so many people were on vacation [at least that’s what the front      desk people said while trying to schedule them]) said I should phone my      doctor right away if I stop feeling the baby move. If I can’t get through, what good does      that do?
5. I’ve      had one NST at your office. I waited in the waiting area for a half hour      because the front desk didn’t tell the nurse I was there. (the nurse was      very apologetic). We were both      waiting for each other, but apparently no one conveyed the message.
6. Today      Dr. M told me I needed to start coming every week. However, you only had one appointment      for next week available – and guess who it’s with? Dr. Ruiz. But that’s better than the following      week because YOU HAVE NO APPOINTMENTS AVAILABLE FOR ME. So medical standards say you need to see      me every week but you don’t have time for me, even though I tried to      schedule a few weeks in advance. So since it will be too long between appointments the front desk      offered me a Monday appointment for the following week with, guess      who? Dr. R. (nothing against Dr.      R. He seems nice. He also seems      like the least experienced doctor on staff, according to the biographies      I’ve seen. I am 42 years old and      this is an IVF pregnancy. I don’t      want to mess around here. I’m      supposed to be seeing the other doctors, according to your practice’s      custom.)

 

These are just the things I can think of off the top of my head. I’m sure if I went back over my notes, I’d have more to tell you about.

You know, the nurse at the hospital who did my NST asked me if I really wanted to switch practices so late in the pregnancy. But what difference does it make? If anyone from your practice except Dr. R saw me on the street they wouldn’t even recognize me. I feel utterly unimportant and certainly very much less important than all the people who have somehow managed to schedule appointments with the rest of the doctors who work at the practice. 

Please tell me why I should not change practices and why I should not tell everyone I know about my horrible experience at yours.

Sincerely,

Jessica

 

 

 

OB practice: the front office/back office disconnect

Nurse (at my first appointment at this practice): We will schedule you to see a different doctor at each appointment because you won't know who will deliver you. This way you'll get to meet them all.
Front desk (when I go to schedule ANY appointment): How about Dr. R?  Well he's the only one who has appointments available.

******************************

Nurse (at the appointment when my c-section finally gets scheduled): We will schedule every appointment you have coming up with Dr. P so that you can get to know her before the c-section on July 25.
Front desk (two weeks ago): Well, you already have appointments scheduled, so we'll start scheduling you with Dr. P in two weeks.
Front desk today: Dr. P is on vacation for two weeks.  She left today. When she gets back she has no office hours available before your c-section.

******************************

Doctor today: we need to start seeing you every week.
Front desk today: We have no appointments available the week of July 2.
Me: none?
Front desk: None.  But we can get you in with Dr. R on the 9th.

The tractor is cool!

 

A tale of two non-stress tests (and what UA means)

So my first non-stress test last Friday actually was a little stressful for me, as previously mentioned.  The office was disorganized, the nurse couldn't explain what the UA reading was all about, and they couldn't schedule me back into the office again right away, so I was stuck going to the hospital for my second test today.

I was dreading the hospital test but it actually turned out to be a much more pleasant experience than Friday's. They were organized, the facilities were new and nice.  The staff and the other pregnant women were really friendly and kind.  And the nurse who did the test knew what the UA reading was all about.

She said that they could do the non-stress test -- which just measures the baby's heart accelerations and decelerations -- without the UA reading.  The UA reading was indeed a measure of uterine activity (thank you Avi).  It measures contractions, but not very well.

For example, if the baby kicked at the particular spot where the monitor was sitting it would register as a big contraction. Or it might register my breathing as a contraction. Or if I moved in between contractions it would measure the first and second one very differently.  Very skinny women tend to have readings that are off the scales while those of us who maybe have had a few too many cupcakes recently might not see such a strong reading.

In other words, the UA reading is all relative. 

I preferred the hospital testing, too, because they worked off a baseline heart reading rather than requiring the baby's heart-rate to go up to 170 to count as an acceleration.

Separately, just seeing the hospital's new wing made me feel much better about delivering in an unfamiliar place.  It felt good there.

A day at the zoo, and happy to you

Because Jack's birthday this year was on a Monday, his birthday celebration is turning into a week-long celebration and festival.

Yesterday we took him to the Philadelphia Zoo for a special adventure day.  It was his first trip to the zoo here, and the first trip to any zoo that he is likely to remember. 

Really, he was terribly impressed with just the fountain and ducks in front and was very reluctant to move along even though we told him there was even cooler stuff to see.  He must have been suspicious, thinking it was all a trick to get him to go back to his car seat. 

But after the first few exhibits he started to realize that this place has a lot of cool things in it and they keep going and going.  You run out of energy before you run out of cool things to see. So when we said, let's go see the next thing he stopped protesting. Instead he grabbed our hands and started walking.

Jack especially liked the monkeys and the fountains.  We also saw giant tortoises, elephants, a rhino, the reptile house and the big cats. 

We bought an overpriced lunch from some nice ladies at one of the zoo's concession stands and sat at a table in the shade to eat it.  Jack had chicken nuggets and fries.  Stupid mommy made the mistake of giving one of the geese clustered around the lunch tables a tiny piece of bread.  Jack thought this was cool and threw a piece to the goose.   The goose got the idea then that we were a source of food and he/she stole the chicken nugget from Jack's hand.

Jack was incensed at the sheer injustice of it  for a while, long after it was clear that he would not be getting the nugget back from the goose.   Five, ten, fifteen minutes later he was still shaking his finger at the goose and yelling "chicken!"

We tried to make it to the children's zoo, but it was clear Jack was running out of energy by then.  At that point he wanted to be carried, and wanted to be carried only by mommy.  As a big sucker and mommy of the birthday boy I gritted through the pain and carried the boy the half mile back to the car in the 85 degree heat and high humidity at 8 months pregnant. Really, I didn't think I was going to make it.  And as Jack napped in the afternoon at home I had ice bags on all the joints in my legs and took as much Tylenol as a pregnant lady is allowed to take.

Today Jack took cupcakes into his school and goodie bags for all his friends. They sang "Happy Birthday to You" or as Jack knows it: "Happy to You!" 

After school he had his favorite dinner, another cake with another round of Happy to You! and got his big present from mommy and daddy and then spent a long time loading up pine cones and then dumping them out over and over.

There are many other presents to come still sitting here from grandpa who lives in Massachussetts and Grandma who lives in California and another one from mommy and daddy.  And then on Saturday there's a family party to top off the week of celebration.

And he's also very handsome, IMO

Jack is Two!

Can it be two years since our treasured FET baby was born? We've taught him to say "Two!" when we ask him how old he is.  Then he looks at how many fingers he has up and he says "Five!"   So then I put down three of his fingers and leave two up (he hasn't mastered this himself yet).  He thinks this is hysterically funny.

The other night when we were hanging out up in his room before he went to sleep, were were talking about how his baby doll was sleeping, and putting our finger to our lips and "ssshhh"-ing.  But he had his foot up by his head too.  So I put my big toe as close to my lips as I could get it and said "Shhhhhh!"  He thought that was very funny too.

And he has his own jokes as well.  He likes to call the stuffed bear "kitty" and the stuffed kitty "bear" and wait for you to correct him. Then he laughs very hard.  He has a good sense of humor.

Every night when we go up to bed he goes through an inventory list of who he knows and usually notes some interesting fact about them.  For instance, they have feet and shoes.  Nanna, feet.  Daddy, feet. Debbie, feet.  Grandpa, feet.

He can spot an airplane that is so far away that it is barely visible to the adult naked eye.  And speaking of naked, he has taken a liking to being naked lately and will often comment "Naked!" as we are getting him dressed in the morning.

Some days he climbs into his carseat without any indication that he ever objected to such a thing.  And other days the seat is apparently filled with nails.  Some nights he is anxious to get into the tub and other nights it is apparently filled with boiling acid.

After all, he is two.  And to fulfill the promise of that age, he has recently taken to flopping onto the floor to express his supreme frustration over the state of unfairness and injustice in the world.  For example, when we wouldn't let him get a two foot long pencil at the zoo gift shop yesterday.  Instead we got him a stuffed monkey that posed a smaller threat of impaling his eyeball and blinding him forever.

He is the light of our lives. Every day I am grateful beyond words for this boy who finally made me a mommy.