The more the merrier

Tomorrow it will be 4 weeks since I drove away from my parents home with my niece and 2 nephews, leaving my sister with just her 2 year old so that she will go and get help for her deep depression. I really have felt God's hand in this whole process and feel like I've been given an extra dose of patience in dealing with all 7 children (ages 9, 7 1/2, 7, 6, 4 1/2, 4, and 2). I also feel that my heart has been opened up to love each of them individually and hopefully find the time everyday to express it to them individually.
The kids have been a riot. They really get along well and there is always something fun and interesting going on. Today for example, Ian and Cade were using the metal top and bottom to a Chinese Checkers game as their shields as they threw little bombs at each other. Skyler found some paper clips and safety pins along with other ornaments that he fixed around his neck as a cool looking necklace. The necklace only proved hazardous once when it caught on a toy Heidi was taking from him and a pin came undone and pricked his neck. Scott, Skyler, and Ian all went outside in the rainstorm and came back in soaking wet. Meanwhile Heidi and Sadie were playing some dress up game that fed off of Cinderella (we just listened to the tape in the car) and later had babies that were very sick and throwing up everywhere. At one point Skyler was racing around the house with Cade packed into a cooler that has wheels on it. Apparently Skyler would stop every once in a while and give Cade treasures (some of which were Heidi's which prompted the taking of the toy and the pin stick). Later I went upstairs to find Heidi, Skyler, and Sadie playing with some pirate ships, little people, and clean new clothes strewn on the ground which I found out were islands. I didn't catch all of the goings on, but they included captured horses, pirates, and a poison dart frog. During dinner the food was hot and so ice cubes were used to cool down the chili. This started a round of getting the ice cube stuck on one's tongue and letting it stick there for a few seconds before running out of the room screaming. Skyler was stuck in the middle seat next to the wall and had to really climb over people before getting out. Tanner tried to join in, but his ice cube had too much water on it to stick. There was also a round of wrestling with all the kids which included some spitting on the hands ritual before fighting. The kids are really amusing.
Last night we had just gotten home from out trip to Idaho. Skyler was really exited about wearing his new pjs. I wanted him to talk to his dad first to make sure he needed some. After finding out he could keep them, he excitedly put them on, but then claimed they were very itchy (I had mentioned wanting to wash them first so they wouldn't be itchy.) He quickly pulled them off in the front room with several other family members there. After they started "eww gross" ing him for being naked, he ripped a Target bag and put it around him like a skinny sumo wrestler's loin cloth and started doing martial arts moves. He was so funny although I really had to put an end to it as it was so late.
Cade's quote of the day: "Aunt Kim, Aunt Kim. I'm so hungry for lunch but I don't want anything like fruit."
Assorted tasks Tanner did today: Showing me his dirty shoe, washing it in the sink, then drying it off with the kitchen towel. Emptying some of the food bag from our trip. Trying to fill up a zip lock bag of rice. Biting Heidi in Target so hard that there was an open sore (yesterday). Leaving the house with only a diaper, big mismatched flip flops, and a doll stroller. Filling up the doll stroller with rocks and dirt. Throwing a towel and clothes into the filled bath. Overflowing the bathroom sink.
Downer of the day-- Scott has a really bad cough. I think it's something Tanner had several weeks ago. He didn't go to gymnastics and sat and read for much of the day.
Daily movie I hope to remember: Heidi dancing around the store with her new brown skirt on. Skyler with his cool necklace and rubber band bracelets.

The pain of knowledge

Today I ran about 10.5 miles (according to Google maps) here in Burbank while visiting my parents. I did bursts up any hill I came to and kept my heart rate in the 140s-160s. During a recovery downhill, I reflected on the easy runs I used to take in college. I'd go run my 5 miles (I can still visualize many of the landmarks in my mind) and let my mind mull through classes and stress. I'd enjoy the run and come home, stretch, and feel good about my exercise. I was a runner.
Then came marriage to Rich and discovery about intervals, the acquisition of a heart rate monitor, the use of a power meter, training plans, etc. My efforts were no longer solely subjective. I could now measure and compare how I was doing. I became wiser in the sport, but training also became more painful. I now train harder, but recover quicker. Mentally it is tougher, but I am now competitive.
During today's run, I realized that I can never go back. Every run I do now has a purpose-- hills, distance, speed, etc. There are occasional LSD runs-- long, slow distance runs, but generally my training is more focused. With knowledge has come sacrifice, but also great blessings. I think this is true in life-- Once I received my nursing license, gone were the days I was just a medical helper and could pass off errors to the nurse I was helping. I was now responsible for my actions and the actions of those working under me. Once I made temple covenants my life has changed. I feel a great responsibility to make sure I am living up to the covenants I made. On the other hand, with knowledge and responsibility has come great opportunities and joy.

Sunrise Duathlon

Yesterday I participated in the Sunrise Duathlon benefiting the Hess Cancer Foundation which gives money to families for funeral expenses whose children have died from cancer. This is one of the logos that is on the t-shirts, and Scott asked what "cancer sucks" means. I told him that cancer does suck. I don't work on the cancer (ICS) floor very often and am glad I don't as it is a sad place to work. I feel like we give them medicines that nearly kill them and if they survive that torture, there is a chance they can overcome their cancer. The chemotherapy kills fast growing cells, so their hair falls out, their stomach lining gets eaten away, they get canker sores in their mouth, their hair falls out, etc. It is torture and so painful.
One man spoke after the race, talking about how his beautiful daughter had died from cancer and then they were stuck with a $200,000 medical bill and no way to pay for his daughter's funeral. People from the community stepped in and helped with the funeral expenses. I'm not sure, but he may have been the founder of the organization. Hearing people like him speak makes me analyze what I'm spending my money on and if I could be spending in more Christ like ways. I try to help out those I know who need help, but there are so many with needs.
By the way, I did the International length duathlon-- a 40 K (about 24 miles) bike and a 10 K (6.1 miles) run and took 9th overall (men and women) and 3rd overall for women. This was my best finish ever and I felt great. There were 4 from our team there Ralf, Sue, Chris, and me. Ralf won the over all in International, Chris (18) took 6 in the sprint, Sue took 8th in the International, and I took 9th. I was 3 1/2 minutes behind Sue at the start of the run and closed that gap to a minute ten. It was a great race day for me. Rich and the kids came and watched. Scott participated in the 2 mile fun run. It was non competitive, but for Scott everything is competitive. He had to borrow Ian's shoes as he just had his sandals, and his feet hurt during the walk, so he took them off and walked barefoot.

Undesired reward

The kids and I went to my cousin's daughter's wedding reception. It was nice to see and visit with some of my relatives. The couple cut the cake, threw the bouquet, and got ready to throw the garter. Scott lined up with the boys. Scott is extremely competitive, and when the groom flicked the garter just a short way so that it fell on the floor, Scott ran and grabbed it. He held it up in victory, and then realized what he was holding onto. He dropped it in disgust and ran and jumped on my lap and hid his face in embarrassment and stayed there for several minutes. The groom brought the garter over to see if Scott wanted it, but he did not want anything to do with something lacy. They finally gave it to the bride's brother who is an RM and dating.
I think this example can apply to life-- you've got to make sure you really want what you try hard to get. This has applied to me in my life with boys I've flirted with and jobs I've applied for where half way through the process I realize that it (or him) is not something I really want and then I have to figure out how to quickly get away from the mess.

Flat line

I worked in the PICU the other night and had a pretty stressful night. My patient was a young preteen boy who fainted on the soccer field. He was brought into the ER twice and admitted once for observation and then sent home, and the second time was admitted (he was just a bit wacky-- yelling that he was going to die, and really really acting out. The admitting diagnosis was mental instability). After some more tests, they diagnosed him with Encephalitis (swelling of the brain-- meningitis is swelling in the outer part of the brain. If it goes into the brain, it's termed encephalitis). After running the full slew of tests, none of which came back conclusive, they will probably just call it "post viral encephalitis" simply because they have not found the mechanism which infected him.
He had to be intubated and was just extubated the afternoon before I came on shift. Anyway, the stressful thing about him was that he would go into asystole, which is the absence of a heart beat. The strange thing was that he was well perfused, his O2 sats would remain above 90%, and he would be "awake" and moving, but just have no heart beat. Asystole is something I have only ever really seen on a simulator, not in real life and here my patient was having it at random times. His heart rate would also get down in the 40's and even 30's. 40's are okay for an elite athlete at rest, but not for a preteen thrashing on the bed.
The compression on the vagal nerve is what caused these as it controls part of the heartbeat. The neurologist stated that the base of his brain was destroyed, but that there are other places that we also control our heartbeat. When the pt fell asleep or coughed however, he would go into a systole, the opinion being that during these times he became more dependent on his brain stem for his heart beat. Most of the episodes were short, lasting less than 5 seconds. We would sometimes apply O2 or stimulate him, but he'd come back up on his own. However, the latter part of my shift he had a few spells where his lips went dusky and he was in asystole for 15 plus seconds. It's just hard to know how long to let him stay without a heartbeat.
I really feel badly for this patient. On the way home I cried. Not knowing this patient, I never knew who he was before this illness. They did have pictures of him on the wall showing a happy kid instead of the unresponsive babbling child with erratic motion from most of his body limbs. One time a neighbor's son who is Heidi's age was in the hospital. I stopped by to see him on my way to work. His nurse was trying to give him some Tylenol. He was crying and didn't want to take it. I was nearly in tears after seeing him. Even though his prognosis was good, it was hard to see someone I was used to seeing riding his bike or rolling down a grass hill being confined to a hospital bed. I thought about some of the boys in my neighborhood who I've had in scouts and who are the same age as this boy. It was hard to picture these things without crying. I'm hoping for a miracle for this boy. They don't really know his prognosis.

Donna Fosbinder

I recently heard that one of my nursing professors, Donna Fosbinder, had died. She was a remarkable woman. She was raised in a small LDS town and moved out into the big world where she married a non-member, raised 3 children, eventually graduated with a PhD in nursing, and became the nurse exec for Scripps hospital in San Diego.
After retirement, Donna moved to BYU and eventually headed up the MS in Health Care Administration. I worked closely with her for a few years and she was on my thesis committee. Donna was a multi-tasker. She would knit at stop lights as she drove us to Salt Lake for classes, she would read the latest research articles while riding on her bicycle. She would bring us apples from her family farm in Kanab. She knitted a hat and sweater for Scott which I still have and all my children have worn (it's a light blue, so it even looked fine on Heidi).
She moved to St George after retiring from BYU and unfortunately her program was quickly abandoned (the only MS in Nursing they offer is a nurse practitioner degree now). I told her that I would visit her down there, but it never seemed the right time-- we were often just stopping by St George for a quick break before more hours in the car, or I didn't feel like invading a peaceful quiet home with children who have been sitting in a car for 5+ hours.
Last year I went on a trip to St George with my triathlon coach and a group of athletes. I was heading down to Las Vegas after our training to go to my cousin's wedding. I thought that it would be the perfect time to stop by and see Donna.
I called the week before and asked to speak to Donna. Her husband questioned who I was and it took several minutes for her to come to the phone. That was my first hint that things weren't quite right with her. Donna had Alzheimer's-- my professor who was always so bright, so cheerful, so knowledgeable and quick witted was now still cheerful but her mind was pretty much gone. She did inform me that her husband had finally been baptized and that she now wanted him to take her to the temple. I visited with her for a few minutes and then mentioned that I was planning to go to the temple before heading down to Las Vegas. She jumped at the chance to go and we were able to go to the temple together. That was a choice experience-- going to the temple with a past professor. A pretty rare occurrence I'd think.
Another thing Donna talked about during my grad school days was about the therapeutic effects of a garden. She had one during the last several years of being a nurse exec, and wished she had done one earlier as she said it teaches you that even though you may do everything right, you still might not get a great crop. The reverse can also be true-- you may not do much and still get a crop. Management is stressful and one may expect too much of themselves and outcomes.
Monday, after hearing about Donna on Sunday, I planted a garden. A week later, most of my flowers are dead, but the herbs seem to be going strong. Donna's obituary does mention that she was sealed to her husband.

Sibling influence

The other day I put Tanner in time out. I had removed him from the kitchen sink where he was drinking water out of the sink stopper and flooding the counter. Time out is on the unfinished stairs leading to the basement with the door into the front room closed. After I set him down and went to close the door, he turned to me and said something unintelligible and then "poo-poo!" From the look on his face, I think he was trying to throw the worst insult he could think of at me. Stifling a giggle, I closed the door. I am impressed with how much he picks up from those around him. I'm sure he's heard Ian call Heidi poo-poo and has seen the reaction it gets out of her. I was impressed that he could transfer the situation so appropriately.