Sunday, August 25, 2019

Death by Charting

It's 10pm.

Seven days before Christmas.

I'm sitting at work "finishing" up some charts.

I am suddenly overcome with anger.

WHAT am I doing here right now?? At this minute? I am helping NO ONE.

This work I'm typing away at, trying so hard not to just scream, it's hoops. Fucking hoops. For insurance companies. So I can BEG them to pay me. Pay me peons for the hard, good. compassionate, humanitarian work I'm out here trying to do, but can't, because of this.

This death trap of notes.

I put quotations around "finished" because, at this moment, I know, no matter how diligently I try. No matter how much time I spend here. Typing. Instead of completing my shopping list for my 5 children. Instead of seeing my husband AT ALL today. Instead of eating a complete meal. Instead of enjoying the rest of the evening, after finishing clinic at 8pm, to provide walk-in hours for my sick patients. I will quite literally, NEVER BE FINISHED.

 I am typing away.

Clicking box after box after box after box after box after box after box.

Reading reminders on each patient. Have they gotten their mammogram? Their pap? Their flu shot? Their colonoscopy? Have you checked their labs? Their HgA1c at least twice this year? Have you talked to them about their "health care goals"?

Did you order an Xray within 30 days of their acute back pain? You did? Ok...ding...you're no longer a "quality" physician. So...we're going to actually pay you less.

As quickly as I resolve them, new results come in. New documents. From specialists. Labs. Physical therapists. Insurance.

F.U.C.K.I.N.G insurance.

Under the guise that they "care". That they are courteously reminding me of all the "missing" items for the "quality" care of my patients.

Do you know what quality care is!??

I do. It's my passion. I love speaking to people. Meeting them. Getting to know who they are. What makes them tick. What makes them enjoy life. Are they enjoying life? Are they not? What's stopping them? Is it mental? Is it physical? Is it chemical? Is it biological? I have these answers. All of them...if I just had the time to dig a little bit. The time to help them trust me. To understand their communication style. The time to really, REALLY understand their healthcare goals.

If I were allowed to do it my way, I could help all of my patients.

But, instead, I am in front of this horrid, white, glowing, screen...typing away.

As I type, I'm neglecting something.

My patients can't stand it. They confuse lack of time, with lack of compassion.

We don't care about them. We don't return their calls. We don't get their forms in on time. We don't give their lab results until 2 weeks after their drawn. Their referral wasn't sent. Their refill wasn't sent.

I hate it more than they do.

I am a problem solver. I like solutions. I like to help.

Sitting here. Typing. At now 10:24pm, is the last thing on EARTH I ever wanted to be doing.

Yet, here I am.

Drowning.

In this, slow death by charting.






Monday, January 7, 2019

Hello 2019, Farewell 2018.

I ran into one of our favorite former neighbors tonight at swim lessons tonight. She so genuinely asked, "how are you!? How have things been?" I replied, just as genuinely, "Great, actually. I mean, really, really good. Things are as crazy as ever, and we never have a chance to sit down, but I don't think I'd want it any other way." Her kid was done with his lesson, and we parted ways, but the thought lingered, have I been great? Am I one of those people that misleads everyone into thinking an actually VERY difficult life, is one that is beautiful, fun and "perfect"?

When I think of the negatives from 2018, they're pretty significant. The most recent being, the loss of Matt's uncle Martin. Just days before Christmas. The others began in March, with the rupture of my achilles tendon. An injury that resulted in, not only significant pain, large medical bills, some existential crises, a brief depression, a strained husband, and early retirement from the sport of Pickleball, but a HUGE loss in income. Like, 6 weeks worth gone...even though I didn't take more than 4 full days off, despite surgery, a cast, and no weight-bearing for weeks. Then one month, nearly to the day, when both Matt and I probably couldn't have felt any lower or more strained, his job went through a HUGE round of lay offs...including him. In the span of 4 weeks, we went from potentially planning an addition on the house, or a big, family European vacation to just trying to open our eyes in the morning and not simply give up. A bruised ankle. A bruised ego. And our savings vanishing. The Spring of 2018 has only one stint in the life of Erin & Matt that could potentially match it in lows...Spring of 2011, when I both failed a board exam and didn't match into my residency of choice...oh, and Matt got let go then as well. Can the employers suddenly sense his strain from my failures!!??

He went the whole Summer, without a job, but home with the kids! I view this as a very positive experience. If he ever wants the job of SAHD, I am ALL IN!! It was heavenly. To know your kids are taken care of by their father. Not having to coordinate anything. I would gladly work 60+ hour weeks if I knew he was home with the kids.

The kids did swim team for the first time. Curtis narrowly missing level II's on only his 3rd 25 backstroke, ever! Such a fantastic experience, we all loved it. We had true Pool rats this Summer.

We went to Bunkerhill with my family. To the lake with my dad. To the farm. Twice.

We hosted the 4th of July for the 3rd or 4th year in a row. Neighbors joined. Family joined. It was a blast.

School started. Brock plays an instrument he loves. Matt and I went on a lovely vacation to Cancun, just the 2 of us. Though, our pet bird Slushie passed away, it allowed us to welcome Ducky. A much younger, friendlier and more trainable parakeet.

And, I launched right into my injury, skipping our wonderful early Spring. We went to San Antonio. The kids' first flights! The whole trip, I have only fond memories. The kids are steamrolling into fun ages. We truly are in the sweet spot with the kids. No diapers. No naps. No hormonal teens. Just sweet, innocent, inquisitive, beautiful kids.

The 4 youngest played Soccer. Curtis making huge strides. George the high scorer. Mitch met future classmates. Diana stole the show.

Diana started dance. Formally. Who are we kidding? She's always been in "dance".

Brock, begrudgingly played tackle football. Loved seeing those adorable boys in their pads and helmets.

I went to Vegas, via PJ, with my longest and bestest friend, as well as our mothers.

All three of my boys were awarded "virtues" in school at some point this year, which makes me feel we are doing something right. But, there I go again, forgetting that we also had many a meeting about George, and even Brock. Struggling with schoolwork and participation at times.

Brock rocked it with him trombone in the Christmas program. After stressing to the point of it affecting his schoolwork for the 10 days leading up to it.

Matt did finally, get a job. He's now at KuMed. EXACTLY what he wanted. Honestly, he had started searching before getting let go...the job loss timing just couldn't have been worse.

Curtis, Brock and I snuck away to St. Louis for a little mom-son birthday trip.

We celebrated Thanksgiving in our home, with 40+ family members.

We all remained healthy for Christmas, and spent it with our closest loved ones.  Santa even visited and spoiled those children rotten.

We attended endless social events, game nights, weddings, showers, celebrations with our friends and family, new and old!

Ending the year with a nice dinner party, including a handful of our closest friends. Eating great food, and playing fun games. Brock, Curtis and George actually staying up to ring in the New Year for the first time.

I list all of these, and it's what I remember. I smile. I loved it all. But, I'm truly leaving out the part about how much money all these events cost. How much time and energy I put into hosting Thanksgiving, school parties, etc in addition to working 45 hours a week. I do have moments where I am insanely stressed. Where, perhaps, I'm even bitter. Moments where I'm not sure it's worth it. Weeks where I feel overwhelmed because I haven't been home enough to do one single load of laundry, nor make a meal, nor read my child a book. I know I this happens, but, it's not the highlight in my head.

My memories of 2018 are filled with joy. With the beauty of childhood. With a true appreciation for health. Family. Friends. Jobs. And, perhaps, more than anything, my husband. During this insane rollercoaster that was 2018, we became even closer. Respect one another just that much more. And our love and partnership has never been stronger nor more in sync.

So, you all can call me delusional. Crazy. Misleading. A liar. But, I mean it when I say, "I'm good. And things are really great."

And, let me close with these wise words: Whatever doesn't kill you, makes you stronger.

Friday, November 2, 2018

All out WARdrobe.

I'd secretly been planning it for months. Heck, maybe it's even been a year. Scheming. I'd been dropping some hints. Sending some emails. I'm pretty sure the hubs knew it was coming, eventually...but never really when. I had started collecting a small pile. An assortment of colors. But, what began in one season, finally came to fruition in a completely opposite time of year.

Spring. No, Summer. Ok, definitely Fall. Nothing was going to stop me now. Then, it started raining. Raining for days. Not that silly saying, like after Halloween when we say: we have candy for days. Literal DAYS it was raining for...weeks really! Every single weekend was ruined by rain and sports games and even the occasional adult social event.

Then, suddenly, the rain stopped. The kids had a 4 day break. The temperatures approached the 70's at times. The sun shone. The trees!! Those breath-taking, Kansas City fall trees almost seemed to glow in the sunlight. We had mountains of laundry to do, Halloween costumes to assemble, groceries to buy for the impending school and work week. The list of To-Do's just seems to accumulate and never diminish, doesn't it? But, I couldn't handle it anymore. The kids needed showers real bad anyway. (I'm not admitting how long it had been since their last bathing.) That's it! We are getting outside to perhaps the most the beautiful park in the city, just blocks away from us. The children are going to wear those clothes I had been assembling FOR. EVER. And we are simply getting an updated photo of each individual child, as well as the five of them together.

One. One photo of each child. One. One photo of the group. ONE!!!!!!!!!!!!

So. I took a deep breath. I briefly, and with no choices presented, prepared the husband for what I was about to do...and then...I did it!

I interrupted the video games. The movies. The fort building. I called all the little ones to attention. And I said, "Guys, we are all taking a shower real quick, then getting dressed to go to Loose Park to take one picture."

KABOOM!!!!! Went the bomb.

They scattered. The oldest in tears, all but actually ran away. The 2 youngest boys rolled on the floor as if they had actually been hit with shrapnel. The second child just shriveled up to die a lonely, sad, pathetic death; it must have been some sort of chemical nuclear warhead for him. And, the girl? Well, bombs apparently don't work on her, because she hopped up and raised her hand saying, "Me!!! Me! Can I shower first!?" (Perhaps, the military should have been full of women?)

After much, non-negotiations. Threats of no Trunk or Treat. No Halloween. No birthdays. No candy ever again. Then the option to stay home, alone. Oh and by the way, no more screens EVER again. Then begging. Explanation over and over about how simple this could be. That if they would just comply we could have this whole process done in under and hour and have time to actually PLAY in the park on this most beautiful day of Fall. Each of them slowly gave in. Showers were had and clothing...well...the clothing nearly killed a few of them.

Three kids would be easier to wrangle and photograph anyway.

I was already writing two of the boys' combined obituary in my head:
      October 28th, 2018 just weeks before his tenth birthday, the oldest son, succumbed to death by wool sweater and leather shoes with no socks. The texture and itchy sensation, as well as the flexibility of the material, making it momentarily difficult to free his hand from the sleeve, were just too much for his feeble mind and body to tolerate. Though attempts were made to allow for socks briefly, or an alternative pair of shoes until the actual photograph was to take place, it was too late.
      In a similar fate, his five year old brother overheated and collapsed due to an additional sweater vest atop his already much too restrictive, collared, button down dress shirt. Shortly, before his untimely death, insult to injury was added when his mother attempted to put on some ill-fitting TOMS...

Addendum to previous release:
...then, in a surprising turn of events, the two boys were begrudgingly resuscitated as the thought of no more screens for eternity acted as a defibrillator and they returned to the awful, torturous life of a child about to be photographed. In nice clothing. On a nice day. In a beautiful park. 

So, on we went. With more crying. More threats. More bribes. Car seat arrangement arguments. And finally, arrival to the park. Where, suddenly, the open air. The freshness. The release from captivity. Whatever the reason, it elated everyone's mood. The children began to venture out and scout for their special "photo spot". They forgot about the clothing on their backs and shoes upon their feet. The worries and cares about holding still for a measly, life-altering, FORTY FIVE SECONDS vanished.

We found a reasonable spot. A nice stone wall, the shade, and maybe a bit of tree and leaves. I arranged the children in what seemed a cute set up. The oldest insisting on choking his two brothers. The girl constantly moving. The oldest then doing some bizarre and incredibly awkward squat-type pose. The 5 year old trying to simply wander off. I frantically jumped up and down, pointed at the lense saying "Look here. Look RIGHT here. Guys, right here. At the camera. Please, look at the camera. Ewwwww! Daddy tooted, P.U. Hey!! The Camera. Right here. Ok, giving daddy bunny ears. Ignore the leaves. Ignore your brother. This could be over if you all would look here RIGHT NOW."

Pedestrians in the park watched the spectacle and smiled. I mean, I'm always willing to entertain, but if I'm so funny, WHY AREN'T THE KIDS {expletive} LOOKING AND SMILING!??

Voila. {At the very least} an hour later, we have our lovely {much left to be desired} photo. Peace has been restored. And we sprint home...

...for another all out WARdrobe change...into costumes.

Friday, September 28, 2018

ADHD

I've been thinking about ADHD a lot lately (can we say hyper-focus).

It's funny, I've always viewed mine as a distinct advantage over those that are "neurotypical" aka "boring" *winky face*. And, when I say mine, I mean, my suspected ADHD. Or alleged. Never formally diagnosed nor treated, because, why?

Long ago, I developed systems that work for me. I struggle(d) to sit still, so I took restroom breaks. In high school, I remember being asked, more than once, if I ever actually went to class (then in college, I simply didn't.) I read my books upside down in an attempt to make them more challenging and keep my attention. I "hid" doing word searches during class inside my desk (the teachers HAD to know I was doing this, but I'm sure they were like, "shhhh, don't poke the bear, she is still and silent, FINALLY.")

I live(d) off of To-Do lists and planners. I love to organize. I've developed some OCD out of need for functionality. I studied in loud places, because that was the only way I could tell if I was actually retaining information...I didn't hear a sound.

I always thought I was a skeptic. And that this skepticism is why I never took words at face value, nor completed tasks in the same way as my peers. Then I realized, it's because my brain does not see things in the same way. Simple questions on normal paperwork stump me. (i.e. Relationship: ummm, my relationship to them or their relationship to me!? Agh, umm, I don't know. They are my son and I'm their mother. So...do I write Mother? Or Son? Or Mother-Son?) Yet, complicated, strange, intense and difficult logic puzzles seem like common sense. For better for worse, I am ALWAYS "reading between the lines".

Clothes have never fit me correctly. In my logical brain, it doesn't make sense that I have THE MOST UNIQUE body-type to have ever existed that not one single piece of clothing fits properly. But that's what I believed, forever. Until it dawned on me. It's not the clothes...

In fact, this constant wondering and seemingly obvious reinforcement that I was in fact, THE MOST UNIQUE person around, did nothing but bolster my confidence. I misread all of my bizarre little ADHD tics and strange neuro-connections as traits!!  Like super top quality traits that could be interpreted as creative, original, innovative, imaginative, ingenious, resourceful. These words are sought after, things you want people to say about you.

I live my life in ADD wonderland. People ask me how I manage to have more hours in the day? When your mind bounces from 30 different topics, and you're able to harness any of them, it appears you're being super productive. I can come up with a reasonable (and often super efficient, because ADHDers hate to waste time as it seems to just slip away) solution, for any problem. In fact, I can come up with endless solutions. I'm the "idea man" (but don't count on me to follow through.) As a result, I can find the positive in nearly all situations.

And the energy. Oh, the energy ADHD gifts you is invaluable. Envious even. How do you think I could swim 6 hours a day and still "go" to school and excel? None. Stop. Energy.

In my experience, I would wish ADHD as a gift for everyone. It's fairly well-known that most of history's greatest inventors and scientists were blessed with this affliction. The first to come to mind is Albert Einstein...

...wait a minute. Here it is. The flaw in my theories above. Einstein. Perhaps the most famous part of Einstein's story, is how much he struggled. How he forgot and lost things. Was distracted in class. Did not actually do all that well academically. His crazy hair, and unique personality. He simply, did not fit in, anywhere.

I think about this, and I think about my own children. I see my Brock, and mostly, my George. Oh how fascinating, funny and unique they are. I embrace all of their tics. Again, all those positive words come to mind. But then I see the struggle. How simple homework takes 2 hours, when it should take 2 minutes. How overwhelmed they get because all of those 30 topics swirling up there in their brain are too hard to harness. They can't seem to pull them down and line them up and see how much they can accomplish. Instead, they see hurdle after hurdle. They hear "be quiet, sit still, stop stretching your shirt, where are your shoes, where is your backpack, why can you not listen!?" I realize, not everyone with ADHD enjoys it. Not everyone gets mostly perks without a lot of consequences.

I smile, when I go to pick up my children from aftercare and see that every single back pack is lined along the wall, except for 2. Hanging from the hand rail, on the curve. George is right, it looks like the perfect hook for a backpack. I'm sure the instructions were to place your bag along the wall, but that curiosity, that eye, that impulsivity, it sets you apart. But it can set you back.

I've been thinking about ADHD a lot lately. When do you get the diagnosis. Do you really want a formal diagnosis. When do you treat? Do you treat? Will the creativity disappear? Will your generous, sweet, wonderful child get negatively labeled? Is it worth it to keep that untouchable uniqueness yet struggle, day in and day out to stay afloat? For some with the condition, like me, the answer is easy. The hurdles just were lower, fewer and further between. For others, those hurdles are there before you even get to the bottom of the stairs in the morning.

For some reason, my personality matched with ADHD was a great fit. Though, in hindsight, I remember my swim coaches saying "you could see it, the instant you walked on the deck, which Erin showed up. The one that could not and would not lose, or the one that would give up." In med school,  once material got so intense and massive, I struggled at times. I was at the will of my hyper-focus times and if those didn't fall in good timing with exams...well, my performance yo-yo'd all over the place. Unlike Michael Phelps, I was never really able to figure out what made me tick. I still struggle, to this day. My mom was probably right, I should have done yoga or meditated - but to my over-active mind, that sounds like torture.

I am not sure it's within my capabilities to be on time. Whether it's due to distraction, always searching for my phone, purse, keys, avoidance of being early and bored or straight up procrastination...I am always late. Despite all this, I feel I've nothing but flourished.
Such a fascinating, and necessary condition, ADHD. Our world would never advance without these out of the box thinkers. Without the rule benders. The boundary testers. The intense, hyper-focus that allows you to create a light bulb after thousands of failures. How boring would entertainment be without the new dance moves you create, the news sounds you connect, the jokes you make...the child's emporium of imagination! Disney!! Yes, he had ADHD too.

I guess, like pretty much everything for me, I'll continue to think about ADHD. A lot.





Tuesday, May 8, 2018

Natural Beauty

I don't know the exact age one suddenly becomes aware of their external appearance, but I feel like for me it landed somewhere in that super awkward 5th grade, age 11-12. I remember really wanting a pair of Gap overalls. Not just any overalls. Gap.

I think my best friend at the time kept pushing me to shave my legs and get a "training bra". Something I would have never wanted to do on my own. When I came to my mother about these things, she all but scoffed.

"Why would you want to shave your legs!? Then you have to just keep shaving them. It's such a pain. Put it off as long as you can."

"A bra!? Sweetie, you don't need that yet."

Don't even get me started on her opinion of make up before the age of 30!!

Even through my high school and college years, with my "athletic build" (aka lucky to even call them A cups, AKA pecs) my mother continued to be surprised that I would opt to wear a bra. As if it were an option!!?? We call this a societal norm, mother. *eye roll*

In hindsight, I realize that hair growing, Birkenstock wearing, bra-avoiding woman is and always was a hippie. Nevertheless, her "natural beauty" tendencies rubbed off on me. I couldn't help but agree, shaving is a pain (maybe that's why I swam, so I had an excuse not to), bras uncomfortable and make-up cumbersome. Add to this my impatience, inability to sit still and the tooth sensitivity of a 97 year old, we have the perfect storm of NO DESIRE to maintain hair nor face. Especially, in the spa type setting.

Part of my wants to believe my mother. That natural beauty is best. That I got her wonderful Lebanese skin, not my father's Irish genes. That I don't need to have a morning and night routine for my face. That it's ok to go 6-10 months between hairs cuts and 4-8 months between coloring. That maybe it's ok to just go grey. That even though I simply shower and put lotion on my face every 1-4 days, I will avoid that bastart named time. Sucking the life away from my once beautiful, youthful, strong, tight skin and body.

Yet, the logical side of my knows this isn't possible. I am not special. Then there's the perfectionist side of me (which I attempt to suppress on an hourly basis) can't just "let myself go".

I am finally getting to that point in life, where I look at pictures of myself and think, "Oh god. Delete that!!! I can't possibly, actually, in real life, look like that...f%#*" Delete. Delete. Delete. Please god, that was bad lighting or a f%#*ed up lens. Right!?

Based on the increasing frequency of this occurrence as well as the ever-evolving improvement of the phone camera...I think I might actually look like that.

I am 35, and, with this recent Achilles tendon rupture during a fun game of pickleball, feeling every bit of that age.

My hair is greying. My wrinkles becoming more evident. (Do I continue to lose weight and allow the wrinkles to multiply, or just keep the pounds which support my baby face?! Descisions, decisions.) My rosie red cheeks (also known as the skin condition Rosacea) is no longer "cute". Nor are the freckles (AKA sun spots, AKA pre-cancer) that fill my face, shoulders, arms and quite possibly back (I mean, I can't see back there.)

Basically, what I am trying to say, is that I have moments where I've decided, I'm too far gone. Time has done it again. Never will my skin, hair, body, ever look youthful again without some MAJOR help. The effort of which I don't think I'll ever be ready to give.

Then, I have a busy Saturday of running around, taking my children to sporting events, prepping for a birthday party scheduled for the next day. I'm Gimping about in my boot, feeling old and decrepit and questioning why I committed to going to a wedding tonight as well. Before I know it, the sitter will be arriving in 25 minutes, and I haven't even showered! Nor has Matt.

I sprint {hobble} to the shower, I dry my hair, I lather on some tinted face moisturizer and a bit of bronzer, eye shadow/liner/mascara and blush (because the Rosacea isn't red enough) as the straightener warms up...run it through my hair a few times, and we're off to the show.

I insist on a few selfies, because, well, we are somewhat put together for the first time in a few months...and low and behold!!!!!???
I can see a glimpse of the once youthful, Erin. She's there. All is not lost, nor too far gone. Well, I'll be damned. Maybe my lens really IS broken this time?? Though, my roots are SUPER evident, so, no denying that whole thing...
...but without a single filter, I choose to see the natural beauty. (And Matt looks nice too.)