On the mend!

Thanks be to God, Rebecca seems as though she is on the mend. She slept much better last night and did not seem to be feverish this morning (I didn't irritate her by checking it). Although she still didn't eat breakfast, she laughed at the Mickey Mouse Clubhouse opening song and she sang along with the Little Einsteins. I took this as an excellent sign! Although she was still pretty lethargic today, she took an interest in her lunch, and she ate a lot of wagon wheel pasta with homemade alfredo sauce that I made for her in an attempt to tempt her to eat. Then this afternoon, she was sweaty and her skin was a little clammy, but I think it was just that her fever broke finally.

Dr. Wong called me this afternoon with the tests. Nothing grew out in the urine sample overnight. That's a good sign, although they continue culturing it for a couple more days. No results back from the blood cultures (they should take 3 days). The CBC showed a white cell count of 19, while the reference range for her is below 11. So that indicates some kind of infection somewhere, but it could also indicate an infection that is going away (like ears and tonsils) in a very stressed child (like one who'd just been subjected to being catheterized and held down for a blood draw). If there was something really dangerous, the white cell count would likely be higher. All her other counts look like a baby who is sick but whose immune system is responding appropriately. Dr. Wong's one concern was the possibility of pneumonia, so we're watching her for any kind of cough or heavy breathing, but there's nothing like that. So in all likelihood, she had some kind of viral infection on top of the ears and tonsils.

Tonight, she's been much more active than in recent days, has laughed a lot and is playing. Probably responsible for her feeling much better is a special delivery package from her Grammy, which included a smushy stuffed dog named Huggley Dougley. Rebecca has indeed hugged it and smiles at it and carries it around. So hopefully she is well on the way to recovery. Sorry no pics the last few days. I'll try to remedy that soon!

More pitiful!

Not satisfied with the fact that at Urgent Care, the doctor just gave her more of the same antibiotics she'd just been on (which obviously didn't prevent whatever new sickness she got), I called her pediatrician's office first thing yesterday morning. The nurse agreed with me and so Ramy picked Rebecca up, then picked me up at Casa Colina, and we headed east for a 2:15 appointment. After scaring the crap out of me when the doctor was asking questions about symptoms of meningitis, Dr. Wong seemed pretty convinced that it was likely a urinary tract infection. So they did the bag on her to get a urine sample, and we waited and waited and tried to get her to drink more, to no avail. So they had to catheterize her to get the urine sample. They did the dipstick in the office, and sent the rest of it to be cultured. The dipstick came back clean, so that indicates away from a UTI. Just to be sure there wasn't something more sinister, she ordered a blood culture in addition to a CBC. So it looks like it is probably viral. Dr. Wong just wanted to rule out any kind of serious bacterial thing. She was still running a 102.4° fever in the doctor's office yesterday.

Over night, her fever seems to have stayed down and she slept well last night. Dr. Wong is going to call me this morning to let me know what the CBC showed. It will be a couple of days before the blood and urine cultures come back.

Pitiful

After four days on antibiotics, we thought Rebecca was well on the way to recovery. Then today, she was just pretty lethargic and wanted me to hold her all day. In fact, I never put her down from 11:00 a.m. to 4:30 p.m., and she just wanted to lay on my shoulder. At first, I thought she was just her normal sweaty self from being up against me so long, but then I realized she was burning up. I took her temp and it was 101.4°F, so I got an urgent care appointment. Off we went to endure another ordeal of having her ears and throat examined, which resulted in her puking up snot on my leg. The worst was that her temperature there was 103.9°F. Although her ears are improving, her throat and tonsils are infected. So five more days of antibiotics. We're alternating acetaminophen and ibuprofen for her fever and trying to convince her to drink. Hopefully she will be feeling better in the morning. I'm debating whether I should go to work or stay at home with her. She's so comfortable with Nanny Rebecca and both Ramy and I will just be a few miles away in Pomona, so I am inclined to go in and see how things go. But then I feel guilty for leaving her if she is sick. I may call in the morning and see if I have a full slate of clients scheduled. Things have been slow, so maybe I don't have anyone until the afternoon. If so, then I'll stay home in the morning and maybe Ramy can come home early. Please pray Rebecca will be her happy self very, very soon!

Of course, this occurred in the midst of my organizational abyss of internship applications. Fortunately, I've got the ones that need to be mailed out this week ready to go. Actually, all of the ones due before November 15 are good to go, so I have time to finish the others.

Always trust a mother's instinct

So I mentioned in my (eternally long) post last night that I was concerned about Rebecca, because she just hadn't been herself. This morning, I just felt more uneasy about her, because she was really cranky and clingy. I asked Nanny Rebecca to keep a close eye on her and report in. She let me know that she was lethargic, wouldn't eat, and then immediately called to tell me that twice Rebecca cried out in her sleep during her nap and then immediately went back to sleep. Still no fever, no pulling on her ears, no cough or anything specific, but I got an appointment for her. So Ramy came home early, got her, and brought her to Loma Linda, and I met them at the doctor's office. Sure enough, ear infection. So we got 6 days of penicillin, and hopefully she'll be her normal affable self very soon.

Musings

The end of at least the application process is in sight. I am basically just making all my copies of everything now and am in the process of organizing all the papers into the appropriate site folder. Of course, after making all the copies of my AAPI Part 1 last night, today I got the confirmation of my match number. Although I know that it is perfectly fine to wait and give that info to the sites later (most people have to do that, in fact), it will bug me if I don't go ahead and put it on there now. So I'm just going to reprint that first page with the match number added. I still haven't finished all my cover letters. I'm working my way through them in order of the application due dates. Although my goal is to get them all out by Monday, I'm making sure that at least those November 1st ones are done. I am picking up the remainder of my letters of recommendation tomorrow from plus my AAPI Part 2s. It's so annoying that there are so many little extra things for each one. A couple of my sites want copies of my evaluations from former training sites. A couple have their own supplemental applications. One wants you to completely recategorize all the hours and clients you've seen in a totally different way than you have to do on the standard AAPI (and there's a program I've been paying for for the last 4 years that does that for me). But, I will say that this part of the process is much more enjoyable than writing the comp paper and working on my proposal, so I'll stop complaining!

Thankfully, it hasn't been quite as hectic at Casa Colina this week. I only had one full evaluation yesterday, and it was a pretty standard one. I got the report done this morning. I just did feedbacks this morning, then had my brain injury education group and supervision. Because we have such a need, I'm developing a new group for young women with acquired brain injuries (but not frontal lobe damage). Basically women under the age of 40 who've had strokes, AVM ruptures, encephalopathy, aneurysms, etc. Amazing there are enough that I actually have a group. I think it will be an interesting and rewarding group to lead, because I have tested all of the clients that will be in it, and they're all fascinating cases and very interesting women.

I am continually amazed by the human spirit. It's an interesting thing to see people when they are at the most trying point of their life. Although there's no right way to grieve a loss (and anyone who goes through a devastating medical crisis experiences great loss), it is interesting to see how people respond. Generally, people respond the same way they respond to "normal life" but in a more magnified way. The people who were apparently a$$wipes before their brains got messed up are even moreso afterwards. Those who faced everyday complaints with grace seem to have the same approach to recovery. One of the young women in my group is truly alive only because of a miracle (to put it unscientifically, her brain basically exploded). Despite the huge mountain of obstacles she faces and the fact that she is one of the most severely impaired in our area, she is always cheerful and pleasant. She inquires about how the other patients are doing, and she actually is interested. She is even kind to the most frustrating of patients. Every day she plugs away at her 7 hours of therapies and asks for more homework, striving for the smallest of improvements. She is quick to talk about her faith and to list the blessings she has received. It is amazing to see how people can summon up courage and march on through the worst life can deal you.

I'm interested too in the role that other people play in recovery. This borders a bit into my research interests, but it is abundantly clear that those who are surrounded by love and support do indeed get better faster and more completely. This was certainly true for me in my own ordeal, and I think it was the same with my dad's recovery to live to see Rebecca. I watched this same patient and her mother (who was just there for support) today in my group. She stroked her daughter's hand absentmindedly, just out of some kind of habit of reassurance. She noticed her daughter's prism glasses were crooked and straightened them for her, then smoothed her hair. It reminded me of my own mother giving me pedicures and rubbing cuticle oil around my nails in the SICU and all the "magic mama kisses" I received to heal up everything that needed healing. I see it every time Rebecca gets a boo-boo of any sort, and she runs to me or Ramy or Grammy for us to kiss it so it is "No More!" and then she's convinced the hurt has been eradicated. I guess the message in that is that we should always be trying to show love to the people we love, because the power that has goes much further than we give it credit.

Whoa! I'm completely unsure of where all that came from, because I had no real intention to bore you all with the things that float through my stream of consciousness at the end of the day when I'm holding Rebecca and trying to get her to fall asleep and typing one-handed.

There was a funny event of the day, kind of. I did feedback with this one guy who was run over (as a pedestrian) by a car and had a traumatic brain injury as a result and most affected was his frontal lobe. Frontal lobe damage is often associated with a lack of awareness of your impairments. I generally start feedback with clients by talking to them about why we do the testing, what it can tell us, and then I ask them about how they felt about the testing, what they found difficult, what they found to be most easy, etc. In most cases, it opens the door to talk about the results, and their impairments are usually in line with what they already mentioned as being difficult. So that's how I began. However, this guy started telling me how he thought it was really easy and he was surprised at how well he did. Errr, no. In fact, he did not do well at all. The best part was that this guy makes up non-words (e.g., framulas, pragits, mixicals - all words he used today) to cover up the fact that he can't bring to mind the words he actually wants to say. So after I explained the results of his tests to him and talked about how frontal lobe damage can cause lack of awareness of these problems, social inappropriateness, etc., he said, "Well, [expletive], that's the best [expletive] way to live I ever heard of! All my life I quixivaled (???) and now I got this [expletive] brain damage and I can act like a meffelump (???) and it's a great excuse!" Not exactly the outcome I like to achieve with my clients, but I guess it is a good example of benefit finding!

I'm a little worried about my Rebecca. Her allergies got stirred up when we were in Tennessee, but I thought they'd calmed down. However, both Nanny Rebecca and I have noticed a couple of times when we're holding her (as she falls asleep) that she feels unusually hot. Then when she wakes up and is active, she feels normal temperature. I took her temp while she was falling asleep just now, and no fever, but she was radiating heat like a furnace. She was really cranky this morning and just crabby all day today for Nanny Rebecca. However, she is less congested (possibly because she also reached that red-letter favorite milestone of my mother's - she can now blow her nose!). I'm going to see how she does tonight and tomorrow, and if she isn't 100% by tomorrow afternoon, we'll go see Dr. Jeng.

And because it is election season, here's a little bit of my political humor for you.

Back in Cali

This was us with Molly and family at the Pumpkin Patch.

And here's the Girl Posse (minus Lisa, who was off being operatic), from our cookout Saturday night.


So we are home again, in Southern California. We had an uneventful flight. Rebecca slept most of the flight, and she didn't have any ear trouble (I was worried, because she is having an allergy attack and has been stuffy and snotty). Ramy's sister Myrna picked us up at LAX (we flew out of Ontario, but back into LAX). I was able to get all three suitcases unpacked yesterday afternoon while Ramy took Rebecca to see his mom. Went to the grocery store and we were all pretty tired and went to bed early. Rebecca was asleep by 7:30 (which was 9:30 Central time). Today, I woke up early and got some work done on my internship applications while Rebecca slept. Then she woke up in a really good mood and was content to watch Mickey Mouse Clubhouse and Little Einsteins while I did even more work! Hallelujah! (Or, as Rebecca says, "Hi-dee-doo-dah!" We went to Trader Joes and cleaned up in the kitchen. Then I made some really delicious pumpkin bread and pumpkin muffins. I guess it is kind of like doing a rain dance in hopes of rain - if I cook and bake fall things, then hopefully it will cool off and actually be like fall! As it is, temps are in the high 80s still and we're wearing shorts. Bleh.

Here's the recipe I use for the pumpkin bread/pumpkin muffins. This recipe will make two loaves of pumpkin bread or a loaf of bread and 12 muffins, or 24 muffins.

3 cups sugar
1/2 cup applesauce
1/2 cup vegetable (I use canola) oil
4 eggs
2 cups pumpkin puree
2/3 cup water
3 1/3 cups all-purpose flour
2 tsp. baking soda
1 1/2 tsp. salt
1 1/2 tsp. cinnamon
3/4 tsp. freshly grated nutmeg (or 1 tsp. of the jarred stuff)
1 cup chopped pecans or walnuts
1/4 cup brown sugar

Preheat oven to 350 degrees. Grease and flour two loaf pans. Mix sugar, applesauce, and oil with mixer. Add eggs and blend. Add pumpkin and blend. Add water and blend. Combine flour, baking soda, salt, cinnamon, and nutmeg and add slowly, mixing just until fully incorporated and not lumpy. Stir in chopped nuts. Fill pans equally. Sprinkle with brown sugar. Bake loaves for 1 hour or until golden brown. (If making muffins, cook time will be approximately 30-35 minutes).

Update from Tennessee

We are still here in Tennessee, and we've been having a really great time. I've been shopping a lot with my mom (and Rebecca). Ramy has enjoyed the opportunity to just hang at home, nap, and relax. We've taken Rebecca to the park a couple of times and enjoyed the nice weather.




On Monday morning, I took my mom to the chiropractor after her fall, and then we shopped at Bridge Street Town Center while Ramy and Rebecca chilled in Fayetteville. Monday night, we met my friend Melissa and her family in Franklin for dinner. Stupidly, I didn't take any pictures, but we had a great time. It is always fun to see Mel and remember our high school days in CHP. Tuesday, we took Rebecca to Nashville to get her flu shot and did a little shopping at the Little Cottage in Franklin. We had barbecue for dinner with my mom's good friend Marilyn. Wednesday, we met Brian for lunch at O'Houlihans and then went shopping in Franklin with my aunt. For dinner, we met up with the girl posse and Molly, Jay, and Jack for dinner at Las Trojas. Jack and Rebecca were having a lot of fun together, and Molly and I love to get them together.



Today, Rebecca and I had lunch with my childhood best friend Shannon. When we were in the throws of teen angst, we had a falling out over a stupid guy who ended up meaning nothing in either of our lives. Recently, we got back in touch over Facebook and met up for lunch. Her little girl Brooke is just a couple of weeks younger than Rebecca. It was so great to see Shannon after so many years. Rebecca and Brooke were super cute together, and although I snapped a bunch of the two cute little toddlers, I didn't get any of me and Shannon. We're planning to get together again at Christmas though. Here are some pics.

Rebecca and Jack at the Pumpkin Patch

Yesterday, we met up with Molly, Jay, Jack, and Jay's mom and sister at the Tate Farms Pumpkin Patch. It was a really warm but gorgeous day, and we had a great time. Of course, Rebecca and Jack were the cutest children there. They had slides, swings, a petting zoo, a hay may, some kind of allergy-laden opportunity to jump around in a trailer full of cotton, a hay ride to pick your own pumpkins, and all kinds of other fun stuff. I think both the kids had a good time.

Rebecca really enjoyed petting the goats!


Jack and Rebecca sliding


I think they're discussing where to drive this tractor.


Punkin' pickin'

The deed is done!

I successfully defended my dissertation proposal this afternoon! What a relief! It's funny, but I finally feel like the end of this long academic journey is actually in sight. Now I can concentrate on my internship applications. But in the more immediate future, I can focus on a nice fall getaway with my husband and daughter and enjoy some time with my family and friends.

Unfortunately, as much as I would like to just take a load off tonight, it's 8:00 p.m. and we'll be leaving for the airport at 4:00 a.m. As of yet, I've yet to pack a thing and we haven't eaten dinner.

No time to write but some pics

I'm proposing my dissertation tomorrow at noon my time. It should be about 2 hours long. Please pray for good news!!!

Above are a series of pics my mom took of Rebecca at Gymboree when she was here. (A hint: if you want to see a larger oic, you can click on the pics to see a bigger version).

Fall weekend

It has been a cool fall weekend here, for the most part. I have soooo enjoyed the cooler weather, and I can admit that it is mostly because I've been so anxious to put Rebecca in her cute fall clothes that have been sitting in her closet waiting for the temps to drop below 95. This weekend was my chance! As you can see from the pics above, she was attired in fall themed clothing today at church. Apparently I went to church and looked like death warmed over, or at least that is what the pictures that Ramy took of me with Rebecca looked like. And that's why you won't see them on here - that's the beauty of it being my blog, you see.

On Friday, Rebecca and I got up early. I finished up the last touches of my proposal document and emailed it to my committee members. Then we drove over to Casa Colina so I could drop something off and went to our new Gymboree class time of 9:45. I like that time so much better than her old time of 11:45. Rebecca was loving Gymboree! She played with her friend Megan, and a little boy named Aidan followed her around and wanted to play with her (Rebecca was less than interested in him). Next we drove out to Loma Linda so that I could drop off the hard copies of my dissertation proposal to my committee members and pick up all the forms I need to get done. We already had plans to meet my friend Julie and her baby girl Adelaide afterward, but as it turned out, Julie had to go to LLU for the same reason as me. So we traipsed around the campus getting forms A, C, Q, XX, ABC123...whatever and had a nice chat with Dr. Vermeersch about internship application questions. When we were finished, we drove to Victoria Gardens, where we had lunch and participated in a little retail therapy to ease our dissertation proposal/internship application stress. It worked! After redeeming my Gymbucks, I felt much more relaxed (and Rebecca has even more cute clothes, which always makes me happy). We got home around 4:30, and Rebecca sacked out. Friday night, we drove to Monrovia to have dinner with our friends Maddie and Paul and their little girls Rachel and Ashley. It is always nice to meet up with them.

Yesterday morning, we awoke to gray skies and rain! WOO HOO! The first rain of the season is always exciting. It was sweats and hoodies weather! We cleaned up around the house and played with Rebecca. Then I needed to exchange some things at Gymboree (different sizes than I could get at Victoria Gardens), so we walked around at the Shoppes at Chino Hills. Ramy also got new windshield wipers for me and installed them on my car. We got takeout Italian for dinner, because I was craving fettucini alfredo, and we just watched tv at home and played with Crazy Rebecca. Crazy Rebecca, by the way, has a funny but almost maniacal laugh. We were driving around yesterday, with both Ramy and me in the front seat and Rebecca was in the back and she kept laughing this deep laugh. Then we'd laugh at her, and she'd laugh because we were laughing at her. It's a shame she has nothing to be happy about in life. ;-) I spent most of the evening doing laundry, since I hadn't done any in two weeks. Ramy folded I don't know how many piles of laundry. A man that volunteers to fold laundry - can anyone possibly have a more amazing husband than me?

This morning we went to church, and now Rebecca is taking a nap, while Ramy went in to the office for a couple of hours. I just finished writing up a neuropsych report and need to put away laundry. Ramy's murder trial will likely be in the jury's hands by Tuesday afternoon, so then it is just a wait and see game. I think he'll be relieved when the trial itself is over. Thursday is my dissertation proposal defense. I'm not really nervous at all, surprisingly. We'll both be soooo glad to have these things off our backs and minds so that we can enjoy our autumn vacation in Tennessee next week. I suppose at some point, I will need to pack. Ramy has gotten a stash of clothes that he leaves at my mom's house, so he will probably have nothing to pack. Rebecca, of course, will bring 3/4 of her closet. You just never know what a toddler will need to wear. As for me, I end up throwing things randomly into a suitcase and then wondering what I've brought with me and what I've forgotten.

Dancing Rebecca

Here's a picture of Rebecca dancing to one of the bands last weekend at our church's Harvest Festival. (I hear gasps of horror from my Baptist and CoC friends at the idea of church-sanctioned dancing. I won't tell them that we also had a beer and wine tent).

Crazy Rebecca availed herself of a blue Sharpie marker this morning while I was getting ready to leave. I thought she was coloring with her crayons on some paper I had put down for her. Instead, she found a blue sharpie and colored all over her legs with it. When I gasped and said, "Rebecca, what have you been doing!?" she grinned, pointed to her body art, and chuckled "heh heh heh." Thank goodness it is turning cooler and she can wear long pants so her temporary tattos won't be visible until it wears off!

I have a date!

Well, glory hallelujah! Thanks to some strong-arming from my chair, my dissertation proposal defense has been scheduled for next Thursday (October 9) at noon.

It was another interesting day at work. I had a Hollywood VIP who had been coked out on a private island and ended up with a traumatic brain injury. He had absolutely no insight as to his deficits and his opinion of himself and his importance was quite grandiose. In fact, he insisted that Hollywood would come to a screeching halt if he were not allowed to get back to his work this very day (never mind that his accident occurred at the end of July and as far as I know, Hollywood has carried on just find without him). Not only was he insistent that he was perfectly fine and had no problems other than than that he falls sometimes and runs into things a good bit, he was sure that if we'd let him back in his work environment, he could teach us things about neuropsychology the likes of which we had never seen. He perseverated on the fact that the tests we wanted to do had nothing to do with his life, that he had no interest in them, and that they were "kindergarten stuff" compared with the things his brain worked with every day (if that were the case, then wouldn't you think it would be better to just demonstrate your superiority and be allowed to go home?). Our tests couldn't possibly capture his intelligence. Also, he's completely indifferent to the fact that his wife has left him (hard to imagine why, isn't it?) After some discussion with him by myself, my supervisor, and the (male) neuropsychology fellow, we thought he was agreeable to doing the tests (since it could indeed be his ticket out). But then when I started testing, we had to continually go back through the litany of why our tests were pure crap and were meaningless to him, because his brain worked different than ours, yadda yadda yadda. Ultimately, things escalated to the point that he had to be put in restraints, get some Haldol, and go to the hospital for a 72 hour hold (actually, it will probably be a 14 day hold, because they're probably going to have to get a conservatorship for him).

I'm telling you folks, you can't make stuff up that's this good! But the moral of the story is, don't let anything happen to your frontal lobes. It probably won't make you a pleasant person. Also, just like that old commercial from the 80s with the eggs frying taught us, your brain on drugs is not a good thing. And combining being high with getting a TBI is an even worse idea.

This afternoon, I got to see one of my favorite patients take her first steps on her own. I tested her about a month ago, and she's made great progress since then. I'll admit that it pisses me off a bit that there are people like her who are trying so desperately to get better and whose life was so cruelly blunted by a freak malformation in her brain, when there are jerks like the one I just talked about who not only put themselves in harm's way to get the brain injury to begin with but who are such assholes and take up our time to rehabilitate them. It's a sweet thing to see this lady with her husband though. He's so supportive of her, and although I think he isn't giving her the room to grieve the losses she's experienced, it's also completely obvious that

Ramy's murder trial is underway. He isn't feeling too confident about it, but he's holding his own with his cross-examinations, and hopefully he will feel better about it when he gets to launch his defense. Of course, the sad part of being a public defender is that you often don't get very much with which to work.

Rebecca is as delightful as ever. "Oh no" and "yippee" are her words of the day. And she's added more animals sounds to her repertoire. She now imitates the sounds made by a lion, tiger, monkey, dog, cat, duck, cow, bee, and frog. Nanny Rebecca and she enjoyed going out to get a banana smoothie yesterday, since it was so hot. (We're having a fall heatwave). Rebecca thoroughly enjoyed it. She's a happy girl, although I think she was a bit confused about Grammy's disappearance. She got up this morning and went expectantly into the guest room. I asked if she was looking for Grammy and she replied quizzically, "Geh-geh???"