Ear infection

S:Pt. presents with her mother and brother today.  Mother reports day 4 of "cold-like symptoms, cough, runny nose."  Denies any fever until this morning.  C/O ear pain starting this am, which mother reports giving Motrin 3/4 tsp at 8:00am with a tympanic temp of 101.1 at that time as well.  Pt. sitting in mother's lap, fussing.  Points to right ear when asked which ear hurts.

O: Temp 101.1 now.  Other VS stable.  Eyes with yellow drainage, sclera with pink tinge.  Nose with yellow/greenish drainage.  Non-productive cough, lungs CTA, negative for wheeze.

A: AOM to R ear with bulging TM, sinusitis, conjunctivitis.

P: Cefdinir PO daily.  RTC in 3 days if symptoms worsen.







She'd had a runny nose for 3 days or so.  Typical around here.  Always hard to tell if it is allergies or a cold.  So we let it run the course, and wait and see.  Last night, her typical 13 hours straight sleep was interrupted with several "I am painful cries."  That paired with a fever of 101.1 degrees, I knew something was up.  Because I had to spend $648 dollars on an otoscope set for grad school, I figured I might as well use it and get use to it before I start my pediatric clinicals this Monday.  So I whipped it out, and my fussy 2.5 year old little lady let me take a peek inside each ear.  I didn't even have to look very long in her right ear to "diagnose" (in quotes because I am obviously not qualified to diagnose yet) her with acute otitis media (ear infection).  In fact, the normal pearly, opaque ear drum was red, and bulging.  Poor gal.

So I scheduled her an appointment to see a pediatrician at the office we go to, which around here, is a several hour event unfortuantely.  Not sure why it takes so long to see a provider here...but it does.

Anyway, the pediatrician diagnosed her with AOM, and a bulging right ear drum.  She asked me if K needed to be seen also.  I said not yet.  His ears look just fine to me today, he is afebrile, and only has had cold symptoms for about 2 days... but that I will keep an eye on him and return with him if anything changes.  She went on to educated me about how the common cold spreads, but ear infections don't, so he could end up with just a cold and not an ear infection.  I sat there, and just let her tell me all this stuff about colds/ear infections (that I already knew).  

She prescribed Cefdinir, which I questioned our of curiosity since amox is the first abx of choice for AOM in pediatrics.  She looked at me with a smile, and said - you must be going to school or something.  I said I was going to school to be an NP, and then her smile faded.

Not sure why there is such hostility between MD and NP, but goodness it is...silliness.

It isn't like it is rocket science to diagnose ear infections...

Anyway, my gals ears will start feeling better, but my opinion of the pediatric office I currently take my children to might not.  Unfortunately we live in a more rural area, and since I don't want to drive 45 minutes to the closest pediatrician office when my kids are sick, I suppose I can suck up my pride and continue taking my kids to be seen at the pediatrician office that hates NPs...that is until I become one and can diagnose and prescribe for them myself :).

Take that OCP!

Love tank = overflowing

6:30am - sleepy head waker. lunch maker. love note creator. school bus taker. goodbye kisser.

7:30am - noon - lego toilet builder. "letter writing" teacher. kitchen dance-party master. book reader.

1:00-4:00pm - pharmacology studier. classroom sitter.

 5:00pm - 45 minute commuter.
6:00pm - kiddo snuggler. dinner preparer. bathtime helper. piggy back giver. bed-time kisser.
7:00pm - homework overachiever.

8:00pm - country road runner. sunset chaser.  sweat dripper.

 9:00pm - laundry folder. dishwasher loader.

10:00pm - love my Mr. :).
*****
We were asked in class today what role defines us.  And as I ran though the above scenario of my day, and the roles I take on throughout my life, I quickly realized my answer.  While I am every.single.one. of these roles listed above (plus RN, didn't talk about that one), the major role that defines me will always be wife.

WIFE to my Mr..

Always.

Because I was a wife first.  My sacred relationship with my Mr. has gifted me the opportunity to take on role of Mama.  And with his amazing, unwavering support I have also be able to take on the role of RN, and in a year, hopefully APRN.

I can honestly say I am better, because he is part of my life.

Today was a great reminder, and I feel so very thankful.

K turns 4

Celebrating him as he turns 4 today.

This little boy, the middle-little, the 2nd born (just like his mama), he will always have a special place in my heart.  

 Us 2nd borns, we just get each other.

My Kiplin Miles and his Kip-isms at 4 years old...

He is independent.  Almost too much so.  And amazingly handsome.

While he is smothered in hugs and kisses just like his siblings, he is more reserved in his affection.  So when he shows it, with that unsolicited hug, oh goodness it is something to cherish.

He prefers to go somewhere everyday.  I love to make this happen.  We both get a little stir crazy and love a good outing.

He loves being wild - jumping, running, wrestling.

 The couch pillows entertain him for hours.  Seriously.  He loves to use them to build forts with.  He also loves to stack them in tall towers and jump from the couch into them.

He looks forward to a piggy back ride up the stairs before bedtime, and when we tuck him in at night, he always ends with "I go night-night, I go to the swings at the park."  My little adventure seeker, always hopeful that tomorrow will bring a park-filled day adventure.

He insists on wearing socks to bed, always.  Even in summer.  Silly boy.

And sleeps with his door open, purposly placing a gazillion little toys in front of his door frame so that we can't close it when he falls asleep.

He loves his big brother, they are trusty side kicks

A favorite is hide-n'-seek, though he hasn't mastered the understanding of the game just yet.  "you hide here mom, I go count and come here, and you go RAWR at me, OKAY?" 

He still adores his brown blankies I picked out special for him when he was growing in my belly.

 And in his 4 years of life, a few favorites remain - the trusty brown blanket.
He insists on sleeping with both of them - one on each side of his pillow each night.  

He still loves "Georgie"

 

and has a heart melting smile

Some new things he is learning -

He has taken a strong liking to swimming lessons, and looks forward to Wednesday night lessons "Mom is it a swimming night yet?"

Perhaps because of his love for swimming, he now prefers baths, and wants to stay in "forever and ever." 

He has also mastered the art of pedal pushing, which was tough at first because he wanted to push both feet at the same time.  

He like legos, star wars ones, and tells me about all these $100 sets he imagines getting each day.  Such a dreamer, that kiddo.

My sweet, boy.  Happy, happy birthday.  I am excited to see what we learn together in your 4th year!

8

We conquered our 7th year of marriage.

My wedding ring slides up and down on my finger, much less snug than it was on our August wedding day in Oregon.  It is less shiny now, in need of a good cleaning, but that gets thrown by the wayside in an attempt to keep up with life.  Despite the lotion caked crevases, and white gold that could use a dip to make it look more like white gold again, this ring still remains the prettiest, most prized piece of jewelry I own.  This circular piece of jewelry, the most amazing symbol of a forever lasting commitment, one that has no end.  Marriage, to him, has been the most sacred promise I have ever made.  I am so very lucky we were able to begin our marriage journey when we did.

We have grown up together.  From high school sweethearts...

 Into a young Mr. and Mrs August 20, 2005.

To now - August 2013

8 years later, we are still young (getting married young does that for you!), but now our relationship has grown to include full time careers, college degrees/debt, graduate school, a car, a minivan, a mortgage, 3 little loves...and it is all so full, and rich, and...us.  Marriage is beautiful.  It is fun, messy, deep, and tender, and I am just so very lucky I get to experience it, everyday, with him.  Because even on our worst day, and we've had them, I'd choose him a million times over.  Because he is great.

The 7th year wasn't full of only roses and rainbows, it was so much more.  It was overcoming difficulty, and discovering that with trials and ugliness, ultimately we have LOVE.  And love, LOVE, well, it is more than enough.  Always.  Of this, I'm sure.

and I know that love is what we've got.

Cheers to enjoying year number 8 together, may it bring continued growth together as a couple, more kisses, a masters degree and a FNP job, a vacation, and lots of happiness.

  

Mama and her boys

Date day with my boys.  Despicable Me 2.

Obligatory picture in the van before we went in.  You can tell R was just so thrilled.  "Hurry up mom, we're going to miss the beginning."

So I said "We can go in as soon as we pretend to look happy first, for a picture."  They chirped up really quick, and so we went in.

Noteworthy, it was K's very first movie at the theaters.  He only asked to get up and play on the stairs 5 times, which for a 90 minute movie was good for an almost 4 year old.  Thankfully the movie had been out in the theater for a while now, and so aside from the 3 gray-haired couples watching the movie, and that other family with two boys similarly aged as mine it was fine that K ran up and down the stairs a bit.

They have already made plans for a movie date.  Next hit - Planes.  The verdict is still out whether or not P or I will be the one to take them.

While I was out on date day with the boys, P was out with our favorite little gal.  P reported sweet J went on a trip to DQ, followed by running in the trails, then jumping on the trampoline, and finally a long bubble bath.

<3 family.="" my="" p="">

Saturday night with R

I was budgeted from work tonight.  I used flextime and essentially got paid to spend a night, one-on-one with my sweet R.

Paul had to be at some freshman orientation thing for work late, so I tucked K and J into bed.  As I went to tuck R into bed, I decided that spending time late into the evening with just him would be worth the cranky 6 year old the next day.  When I proposed this idea, he was just so over the moon excited.

I let him decide what to do.

His choice of fun for the evening, a s'more fest.

Mr. Bones ate 2, which was probably good for him.  Little man just doesn't eat very much, and his recent growth spurt has him looking like...well Mr. Bones.

He wanted to know what I did when I was 6 years old.  I told him how I use to dance, and he belly giggled so hard in disbelief.  It was a moment that made the distance between my parents house and mine so very far away...a moment when I would have loved to be able to get a picture or a video of me dancing when I was 6 to show R I wasn't kidding around.  

 I asked him what he thought of our s'more fest.  He gave me a thumbs up, and said "this is the best night ever.  EVER!  I so lucky you are my mom."

 Little man knows what to say to melt his mama into letting him stay up way, way, way past his bedtime.  So we watched the sunset together.

 and then jumped on the trampoline in the dark.


And after a quick shower to wash away the smell of fire pit, he spied on his little brother and took a picture of him with my phone.  Which was one of the most adorable things I have seen.  I only wish I could have taken a picture of R while he was taking a pic of sleeping K.

 After the sneek-attack picture, we made it into his room finally, over two hours past his normal bedtime.  We snuggled up in bed, read a quick book, and while I was getting ready to leave Mr. chatterbox just couldn't stop.  So I soaked him up, learning what goes on in his growing 6 year old mind.  We talked about pirates, his special girlfriend H, how he is on the verge of needing a haircut, that the sunsets out of R's window and rises from K's, how it is really only 6 in Oregon when it is 9 here and he wondered what all his family in Oregon were doing while he was getting tucked in.

Then he had to take a picture of himself being a pirate...

 and of his Skylander tag from his new shirt.

He told me "your the greatest mom ever."

His love language is quality time.  I am sure of this.  

                                                                                                                                                     

An early birthday celebration for K

Instead of hosting a huge party this year, we chose to spend our money getting a huge trampoline - it was K's only request when asked what he wanted for his birthday.  Because the trampoline came early, and R requested to celebrate a bit early (since K's birthday is on a school day and R didn't want to miss out) we had his "party" (which consisted of just us) early.

 Funfetti cupcake tradition - I will be bummed if they ever stop requesting this as their cake of choice for special occasions.

 Kip read the ingredients first - "first you need a cup a yoi-ul, some water, and three eggs"

 I told him to give me his best smile...

 and then to make a silly face.

Happy "Birthday" to my favorite (almost) 4 year old.