Welcome, Togo

Welcome to our West African nation visitor from Togo. My ignorance has completely unveiled itself, as I did not even know this was a country. You have to be one of the most unique recipients of my postings. Thank you.

To the rest of you...I know where you live, when you visited, and for how long too. Even if you didn't leave a comment. Site meter is a cool thing (and a bit of an ego stroke if you want to see how many people are stopping by).

I used our food warants to buy provisions for the remainder of Team Church who will join me tomorrow. The man tried to thwart my efforts to buy baby carrots and cinnamon Life cereal. Okay, he successfully prevented me from the cereal (I actually bought Kix), but I got the carrots. Take that. Juneau is otherwise still cold and beautiful. I seem to work all day, so will try to get some pictures tomorrow or on the weekend.

Welcome to Juneau

One night sleep doesn't quite do it, but maybe I'll be more refreshed tomorrow. I am in Juneau with the rest of the fam still in Anchorage. Jana had a much livelier night with a power outage, waking children and scared dogs crapping on the floor. Did I mention that I didn't hear my phone ring at 1:30 a.m. because I was alseep. Worst father ever.

On a more entertaining note, I will try to get some Juneau pix up. It is phenomenally beautiful here, and unseasonably cold. Actually, it almost never gets this cold here. It has ranged from about -6F to 10F above over the past two days. The steep, narrow, labrynthine streets of Juneau are so frozen that I had to give up on my quest of driving to my apartment 6 blocks early and walk. A friend and I spent nearly an hour trying out the many ways one can slide down a hill in a minivan. The view is worth it, however, and I bought chains today so the rest of Team Church will be able to drive to the front door. Still exciting when you start sliding out with chains on.

Juneau is an interesting place. The legislature is in session right now, and there is a remarkably well educated liberal populace in this town living in $300,000 shanties so that they can walk to work. (I'm not talking about you house, Clint, I swear. I know how much you paid for it.) There is also a fantastic bagel shop, something that Anchorage desperately lacks. I'll try to throw some history at you tomorrow, as I don't much kid stuff to add when they are a few hundred miles away. Peas.

Fun with styrofoam

The brave new world of YouTube embedded into my blog. How exciting is that?

Quiet

It's kind of quiet around here right now. I am not sure I know what to do with that. Jana went shopping and I am at home with all three of them (kind of like "he who shall remain nameless"). I hope I don't jinx myself by appreciating this too much. Ella is sleeping my lap, sucking her thumb. Something Jackson never did, likely because of the stroke. We used to think we were lucky that he never developed the habit.



Okay, she just shot vomit out her nose. That's just plain disgusting. The joys of parenthood.



With all children and pregnancies, first or fifth, most parents are appropriately cautious and appropriately anxious. Although we (I use "we" in the royal sense) had a nearly picture perfect prenatal course with Jackson, the subsequent events and findings provided a little more than the usual concern when we first found out we were pregnant. Imagine, if you will, that concern doubling (or truthfully, expanding exponentially) when we found out that we were having twins. Despite all of our stress, however, things have been without complication (minus the extended morning sickness and discomfort that accompanies twinning). Jana made to more than 37 weeks, the planned c-section went off without a hitch, and the twins have been breastfeeding like champs (the skills my wife has...).

Okay, now Jonathon just pee'd on the wall (and himself a little). Again, gross.

I'd better go. We are going to Juneau this week (the whole Team and Grandma) so that I can work at a clinic there over the next month. It should be fun. More posts and pictures to follow.

A little all over the place

“You’re my friend, Daddy.” Yeah, that’s what I am living for right now. How long does unconditional love last? I thought it was good with dogs. Babies are still only lasting two hours between feeds. Consuming during the day, flat out exhausting at night. Everyone else is still hangin’ tough.

Overwhelming medical bills apparently have their benefits, at least for the insured. We just got a bill for our hospital stay (not including the doctor’s fees) totaling nearly twelve thousand dollars. This was in addition to a ballpark estimate of ten thousand for all the prenatal care. Thankfully we had already met our yearly deductible and the stay was covered. What happens to all the good folks who don’t have this insurance? We just watched the movie Sicko, which admittedly is biased and a soapbox for Michael Moore, but provides a startling image of our health care in comparison to several other industrialized nations and some not-so-industrialized.

This leads me back to government cheese. I have been trying to write the past couple of days and wax poetic about using food vouchers (calling them food stamps seem so pedestrian and even more pitiful). The process is simple, in a government kind of way. We qualify for six things:
1)milk
2) cereal
3) eggs
4) beans/peanut butter/non-milk protein
5) juice and
6) government cheese
(Jana actually qualifies for a couple more through breast feeding, oddly enough, tuna and carrots.)

We have specific brands and even more specific sizes of product for which we qualify. We are encouraged to use coupons and look for sale items whenever possible. This seems fair enough, although is quite labor intensive, and unlikely that many people other than those of us a little embarrassed by our dependence will go the extra distance. We can’t combine our purchase with non approved items, and ID is required in conjunction with the voucher at each transaction.

As I approach the register, I find myself casing the store. Looking for friends, patients, coworkers, and other casual acquaintances that may catch me in my unseemingly deed. I shouldn’t be embarrassed. I work for a living. I pay my taxes. And most importantly this is only a bridge. In six months, I will have a real job. Despite my occasional quiet financial desperation, I know deep down that in six months I will be remarkably marketable, and am well trained to make money. Why is this uncomfortable? Is it just me? I hand over my voucher and my number of items is gratefully few. I sign, bag and go. I don’t purchase additional items as this might draw attention to me. This is only temporary. I am thankful for the support we have.

Doom and gloom

I swear, it is not all doom and gloom like I am making it sound. Most of the last post is a culmination of the past two years of learning to live with a child who has a "disability" (in quotes because I don't think Jackson realizes that he is at all hampered-although I do have one sad story that I may share at some point) and the financial bearing it has had on us. Truthfully, I am a physician, and upon further discussion with my cohorts in training, we have decided that we are "well trained to make money" regardless of whether we find the perfect job. So...all of our financial woes are self limited due to the occupation I have chosen. We, again are very fortunate in our lives, our careers, and our children. Thank you, however, to those who have sent your heartfelt notes.

I will write more on our experience with the government aid programs tomorrow. Today I want to say that we had a really nice weekend. Probably one of the most enjoyable weekends (sleeplessness aside) that we have had in some time. Most of the was in my interactions with Jackson. The babies are still "lumps" and have something left to be desired in the way of personality (can you tell I like two year olds better? There seem to be baby people and toddler people in this world. I am a toddler person.) We spent Friday at the H2Oasis, America's third largest indoor water park. Kind of pitiful actually, but for a couple bucks, I can take Jackson to play on the pirate ship, swim in the wave pool, and climb and crawl over all sorts of water recreational equipment (in the company of dozens of other diapered kids, ugh, I hope they use lots of chlorine). Jackson loves this place, and he will gladly tall you all sorts of stories about going through the waterfall and down the tunnel slide ("It was scary"). Saturday was spent sledding and at a three year old's birthday party. Cake, games, dinosaur shaped peanut butter sandwiches, and his first time down the sled hill by himself. Perfect. Seeing that his father will be unemployed in a few months, Jackson also let his dad do a little networking with a Doc whose practice he might be interested in joining. Never thought I'd be conducting business at a kid's party. There was something so very 'Vince Vaughn in Old School' about it.

I should put a paragraph here. The weekend was topped off by a trip to Grammy and Papa's cabin, a snow cave, and a snowmachine ride around the neighborhood. Nothing makes a boy happier than a snowmachine (or a four wheeler in summer). It has been a long time since we recreated. I am enjoying some time well spent with the fam. There, I suppose that's a little more uplifting. Back to the horrors of parenting tomorrow, what do ya think? PS-I'm not very adept at arranging the pictures on the page, but here are a few.

Government Cheese. Part One

Please note: I wrote this about a month ago, and am finally comfortable sharing it. As beautiful as our children are, parenthood has been more difficult, more complicated than I ever expected.

I am most humbled this week as I apply for government assistance for the first time in my life. I pay my taxes. I work. I've paid my dues and what do I have to show for my efforts? Government cheese. This is a long story and may take me several days to explain, so please bear with me...

Once upon a time a nice young professional couple decided to have a child. They were blessed with one of the smarted, most angelic, and most humorous child a couple could ask for, but it came at a price...

For those of you who don't know, Jackson, my son, was born with evidence of a cerebral vascular incident. A stroke likely occurred during the third trimester of our pregnancy and completely occluded the posterior branch of his right middle cerebral artery. Please note the distribution on the following image. This amounted to nearly 10-15% of Jackson's brain. Not a small chunk.

We did not know this for some time. Jackson made it to nearly a year before we started wondering why he was left hand dominant already. This is developmentally unusual, but not totally obvious. In the retro spectrometer, I feel like we should have known. I am observant. I am a physician. I am a father. I missed it completely, but looking at old pictures he had the left hand contracture, torticollis, and possible facial droop that should have tipped me off.

Truth be told, even our own pediatrician didn't really catch on, as Jackson is a wonderfully interactive and bright child (he takes after his father) and compensates incredibly well. The past year or so has been filled with doctor’s appointments, cardiologists, ophthalmologists, pediatric intensivists, a neurologist, physical therapy and occupational therapy. We (I use the royal sense, but truthfully it has been Jana more than I) have taken Jackson to therapy up to five times a week over the past year, and have been fortunate to have been reasonably well insured, to a point.

Not to draw pity or attention to our financial status, but I feel it is pertinent in telling the story. Just to break down our financial situation...I am a medical resident. If I were paid hourly, I'd be better off picking apples. This is part of my training and I am not upset with what I earn. Many people earn far less than I. Jana is a pharmacist, but due to our impending delivery (twins, yes, twins) her abdominal girth has made it difficult for her to continue working the part time job she held at the hospital. We have been fortunate that throughout all of our adult/married lives, one of us has had a job while the other was in school/training. This has allowed us to be less than frugal at times, particularly prior to the birth of our son Jackson. We have always paid our bills, I paid off my initial (undergrad) set of student loans, and Jana has paid off her undergrad and graduate student loans as well.

The complicating factor has been Jackson. We are happy that I have a job which provides insurance, but amazingly, despite the fact that I work for a hospital (and a Catholic mission hospital at that), we have fairly mediocre insurance. Again, not to complain, we are thankful for what we have. Jackson's medical condition, however, has required significant resources and his physical and occupation therapy was covered for much of the past year until we met the end of our benefit. What did that mean to us? We have had to assume full responsibility of his therapy bills. Now, we have cut down on the frequency, but to give you an idea, if we continued at the initial number of sessions per week (usually about 4) our monthly PT/OT bills alone would be in excess of $3200. More than my salary, more than our mortgage, more than our allegedly financially secure positions in life (I'm a physician for Pete's sake) could handle.


We are truly blessed with family who has helped us, and with some creative financing, deferments, belt tightening, etc, we are doing okay. The twins have pushed us into an entirely different realm, however, and now we qualify for Denali Kid Care (the state Medicaid program which covers pregnant women and children) as well as WIC, the program for Women Infants and Children, which insures that this demographic has adequate nutrition.

Thus bringing us to government cheese…

I am a survivor.

It has come to this. I have had to covertly work my way through the minefield of children's toys and canines to descend into the basement (skipping the step with the squeak) to have a few minutes to myself to write. Getting things done has been the most complicated of tasks since the babies came along. I thought it was bad with one child, but apparently I was wrong.

Jana left me alone with the children last night.

I was going to leave that statement without saying more, because it is terrifying in it's own right. She didn't leave me for 10 minutes to check on the neighbors. Not half an hour to go to the store. Jana actually had the audacity to need some adult quiet time and went to dinner with the girls from work. To a nice dinner. Without me. Leaving me alone with the children. I know it is hard to understand the gravity of this situation if you are without the bevy of younglings that we seem to have. (I was trying to think of a nice analogy, but can't. Please just sympathize if you don't understand.)

The evening was started with tears as Jana headed out to the car. Jackson was crying too. We quickly moved to diversion techniques and spent the evening watching Wonder Pets. Episode after episode of Wonder Pets. It never gets old, and the boy was appeased. The rest of the night I went from baby to baby as one was hungry, then the other was hungry. One would cry, then the other would cry. Their base level of functioning made their actions pretty simple and similar, and by the end of the evening some of my base neurological response had been worn down and I was able to sit peacefully as everyone cried around me.

I have to say that all things considered, it went pretty well. I try not to tell Jana that. I try to put on a weak, beat down smile, hang my head and say "it went okay." Fun is not a word I would use to describe it, and if there are people out there who can regularly do this on their own, my hat is off to them. I love my children, but I am much happier if I am not alone with them.

They won't stop crying...

The babies won't stop crying. Jackson won't stop crying. To say that I am a little overwhelmed this evening would be akin to saying that hemorrhoidectomy smarted a little bit. There is an innate sense of panic when that crying pitch is hit. It is much like the instinctive reaction to a rattlesnake's rattle or any other situation that drums up the fight or flight instinct. Additionally, I feel helpless for a number of reasons. 1) Babies don't listen to me. 2) 2 1/2 year old's don't listen to me. 3) I have nothing to barter to stop the crying. 4)My milk hasn't come in yet.

This was one of those nights where you start to realize that the loss of control that results in child abuse is not so far from home. That said, I am fortunately cognizant enough to know when to walk away, and have endless resources to give me the break I need, to prevent the unthinkable. But I have to say that I understand a little.

What happens when you place a young "adult," barely outside of childhood themselves, in this position? What tools have they learned over the years that would prepare them to manage this situation appropriately? Throw in lack of education. Throw in poor parental modelling. Throw in substance abuse. This is why child abuse happens. To note, not all abusers are young, poorly educated drug addicts (smokin' the reefer). There are some older ones too, but I sense a lot more malice in their position. Can the damage that leads an individual to child abuse be repaired. I have seen this many times. First in my former life as a Forensic Scientist (not to be confused with Scientologist), and now as a Family Physician. I have seen many devastated lives, children and adults.

Birth control in the water. Parenting licenses. Abstinence "agreements". Forced sterilization. Anyone know the data regarding countries with the least amount vs. countries with the greats amount of abuse? There aren't a lot of regulatory means, and we don't seem to be set up real well in this country to educate our way out.

Sorry, kind of a depressing way to start this series on kids (please note that this is part of an agreement I made as part of some family leave from work). The babies have stopped crying, and Jackson is asleep. We were fighting off whale sharks (he knows that they are actually krill feeders and nearly harmless) to our last waking moment tonight. Everyone is much more peaceful when they are sleeping. I hope to get to that point some day. Pictures tomorrow.

"Here we go again"...or...."How a medical Resident and Father of three sporadically tries to ease his writing jones"

The icy cold North Pacific wind is blowing as I sit on the couch of my rented apartment, waiting for the next page or call from the hospital. I am warm and it is quiet. The quiet is a little unsettling. It is something that I am not used to hearing these days. There are now three children at home with their mother, and I am in Kodiak. Alone.

I am here by choice, I guess. I was fortunate enough to work here last year as a resident, and they were desperate for someone to cover their hospital call for the weekend. We need the money. For the first time in my life, I feel an over whelming responsibility to provide for my family. The extension of Team Church to five human members (plus two dogs) has been an interesting change.

Don’t get me wrong. They are paying me well, and this is a pretty good place to be. I even get more sleep here (but don’t tell Jana). I would probably even be here if we didn’t need the money, just for the experience. Our story is a little complicated these days and over the next few weeks, I will write more to explain. Please bear with the garrulous nature of my writing, as I promise the entries will get long. As an exchange, I promise to provide more pictures.