Halloweeners

We had a moderate amount of fun over Halloween. Candy acquisition consisted of just going to the ward's Trunk or Treat. No kids came to our apartment though, so we consumed that bag of Twix or whatever it was that Ellen bought (obviously I really didn't participate in that - I wasn't fast enough).

Originally Natalia was going to be the black cat that Sonja was last year and Sonja was going to be a princess. Natalia wanted to wear both Sonja's princess dress and her black cat costume, as seen below. But Ellen found this pink-trimmed witch costume at Rite-Aid or something, so she became that. We told her she was a "witch princess" so she ran with that.

Making some Ikea Shelves...

Lots more pictures on the Flickr link to the right... -->

Blogs are so 2009...

Wow, just wow. Easily our longest gap ever. Family and friends have long since stopped bugging us for updates, and probably have just resigned themselves to the belief that we've given up on blogging. I think it's just funny that our last post was titled Fall Picture Catch Up, as if that was a long gap or something. At least we have been updating pictures on Flickr, so those are at least as recent as June.

Seriously, it's almost been a year though, so quite a bit has happened. I went from being an inexperienced first year resident to an inexperienced second year radiology resident. Starting in July, I now take call, which means that I have to stay at the hospital after work until 8:00 AM the next day (= a full 24 hours), and read all the studies that come in overnight to the ER. Obviously, my vigilance has increased dramatically; I no longer have someone I can just turn to and ask,"What do you think? Nasty fracture or totally normal?" Technically, I can call the attending radiologists, it's just something you don't want to do unless you really need to. Especially at 4am. I haven't had to yet, but I imagine that's coming up in the near future. It's been a little easier to deal with because I've started a strange new sleeping schedule largely composed of short naps throughout the day rather than a long sleeping period at night. I've been doing this since March of this year and so far it's been mostly good. I can't get into it now, but maybe I'll have a post later about it.

Hopefully Ellen will tell you a bit more about her, but she's been good, on the whole. She's been getting a lot of freelance work lately from her old job. We had a lot of insurance headaches for Sonja's therapy, but it seemed to work out for the best for 2010. For 2009, they basically told us "sorry, we know you did everything you needed to do, but we don't care, and we're not paying for that year." For 2010, there does appear to be some money coming in.

I think the most major news about Sonja (at least as far as day to day life is concerned) is that she is potty-trained! Yes! That happened a while ago, starting at the beginning of June, and she did pretty well about going by herself when she needed to. Since she tries to avoid verbal communication when she doesn't have to, she pretty quickly adapted to just running to the bathroom and going when it was time. We tried to teach her to say "I want potty" but that's sort of less effective with her (even though we're still trying obviously). She's gradually moved passed wetting the bed and needing the potty chair; these last 2 changes are much more recent.

With Natalia, there's something new just about every week, so I won't waste my time trying to go into everything. She really won't stop talking all the time. She loves when I come home; halfway across the apartment when I open the door, there is a distinctly audible "I HEAR DADDY!!" And she has been saying "hi" to everything probably for a year now - that hasn't slowed at all, although she has been limiting it lately to living things rather than inanimate objects and abstract concepts ("hi happy" being an example of one of her phrases from just a couple months ago when she saw one of us smiling). She's also a slave to routine, like most normal toddlers, I imagine. She has a strict bedtime routine, which wasn't changed much by getting her a twin bed to sleep in a couple months ago. Bedtime consists of reading a book, then a "book for bed" where she gets to choose a book to take to bed with her, then finding her beloved pink blanket, then getting in bed, then prayers, then singing "itsy bitsy spider" and "twinkle twinkle little star" in that order.

Here are some videos for your amusement.

This is Natalia saying hi to her cousin Scarlett (Marissa's daughter)

And... Natalia giving us her repertoire of songs (these are just her favorite)

Those are the major things. I plan on uploading a lot of videos to YouTube in the near future, so hopefully that will be fun for everyone. And by everyone, I mean grandparents. I will let you know.

Fall Picture Catchup

We've been MIA, but we're trying to shape up. We also moved. We posted lots of new pics here.

Natalia is obsessed with her hat. She had to wear it to sleep in last night. That must have been comfortable. She also insists on wearing it to church today.



Halloween was double cute, with Sonja in her same cat costume as last year (hey, why not?) and Natalia as a ladybug. We carved our first pumpkin too, but nothing fancy. I definitely learned about what to do different next year. The best part was Scott dried and made some delicious flavored pumpkin seeds.

Looks better than it tastes:


At the ward Halloween party (unfortunately, I cannot get Sonja to look at the camera ever):


Mommy and chocolate is all a girl needs:


I think we all look weird here except Natalia, but it's the only one with all of us:


Sharing candy:



That's quite enough sharing for now:



Mouths full:

A word of advice...

Don't ever let me borrow your laptop.

Videoz of teh childrenz

I just found out that Google Video is no more. Well, it still exists, but no more uploading I guess. So my videos will have to go somewhere else. Somewhere where you can become famous just by dancing and lip syncing a song in the comfort of your own room, or by taking a picture of yourself every day for 6 years. That's right, YouTube. I was going to do Flickr video, but they only allow 90 second clips.

Anyway, the videos on my channel are a little less viral. Right now, it's just a couple videos of the girls (mainly Natalia for now). Here's a sample, where Ellen reads the book Moo Baa La La La to her. If you press that HQ button in the lower right, you can see it in its (near) original quality.

Other videos can be seen on my YouTube channel here. More to come, although it will be sort of in reverse chronology, since the ones here now are the latest that we've taken.

My punishment for finishing all my cases and getting out of work early: a flat tire on my bike. Nice.

What I Do

Some of you may be curious about this. For those that aren't? Sweet.

I'm a radiology resident. That means i'm learning how to be a radiologist. I have 13 different 4-week rotations per year - the rotations are through different anatomy and methods of imaging. For instance, Chest, Neuro, Abdominal CT, Abdominal Ultrasound, Pediatrics, Nuclear Medicine, Musculoskeletal, Breast, Interventional, Gastrointestinal Fluoroscopy. Well, actually that's all of them.

Right now, I'm on nuclear medicine. It is a unique specialty in that it is all about imaging the patient from the inside instead of the outside. Basically we inject a radioactive particle that is usually connected to a biological molecule, and then measure the radioactive signal that the stuck particle gives off from inside the body.

Got it? Riiiight...

So for example, attach radioactive fluorine to some sugar, and inject it. Anywhere that sugar goes, you'll be able to detect the signal given off by the fluorine. Cancers are really active and consume a lot of sugar. So they give off a high signal, and you can find little cancers that have spread places in the body you normally couldn't see with a CAT scan or MRI even.

Here is a case I just looked at:

On the left is a front (anterior) view, on the right is a back (posterior) view of the same person. Click to enlarge.

This is called a bone scan. We used a radioactive material called Technetium-99m (Tc-99m) and attached it to a molecule called MDP (which contains phosphate), and it attaches to calcium. So anywhere you have a lot of calcium activity (i.e. bones) you are going to get a radioactive signal from Tc-99m.

The above was from a 9-year old boy. He had some back pain or something, anyway, that part was negative for any findings. The cool part is the growth plates. Can you see the really bright lines on the knees and shoulders and ankles (and a couple other places)? That means there is a lot of activity there. Pretty cool, right? When you get to be 16-18 or so, those lines fade away as the growth plates close up and stop their activity.

Anyway, so what do I do? I think that was the original question. I sit at a desk with a computer with 3-6 monitors. I have a list of all the patients that need nuclear medicine studies to be read. Then, I load them up and dictate (voice recognition software) what I think into the microphone. Then the attending radiologist (my boss) comes by and tells me what I thought that was wrong. Then I fix what I did wrong and submit it. Yay! It's actually pretty enjoyable for me. Oh, there's also conferences and stuff. And I have to study a lot at night.

But overall, this has been a pretty cool rotation. The volume is low, so there is a lot of time during the workday to learn and discuss cases. Or blog about your job. Shhhhhhh...

Post with a text

I can post to this blog with a text message? Awesome. Watch out, Twitter nerds.

It Is Finished.

I just checked, and my last blog post was here, on September 24 of last year. That's some serious neglect, easily my longest ever. I can explain, really. Well maybe not explain, but throw down some excuses that you may or may not choose to accept. Anyway.

The big excuse for me not blogging is really this: I recently was involved in an atrocity called an intern year. There's a lot of mixed feelings still going on in my head about this. On one hand, I got to work with a bunch of cool people (interns, residents, attendings) and even learned some medicine in the process while meeting a few cool patients. On the other hand, basically everything else sucked.

I suppose it's relative. The most difficult aspect of any situation differs from person to person. Given two men who've lost their job, for example, one might feel an extreme loss of self assurance and self image derived from his lack of ability to care for his family. The other may find the sudden change in schedule and new job-finding duties incredibly jarring. For me, if there's any sense of waste or lack of purpose in a situation, I really can't deal with it for very long.

Well, was there a sense of waste in my intern year? Umm... well, actually I can't think of a better definition for an intern. Someone who perpetually cleans up messes others shouldn't have made.

There's a reason there really isn't an "intern" job description. You just do what everyone demands you do. A form "needs" to be signed at 3am? Well, I'll be right there. The patient's family wants to complain about the food? Well, I can do a whole lot about that, thanks for giving me a call.

I'm normally a pretty cheerful guy, but it really got to be too much. I started experiencing something that I've never experienced in my life: constant seething rage.

Sure I've been mad before. I just never have been this kind of mad. It's different.

First, I'm going to come right out and admit my lack of blogging (and lack of writing of any kind, really, including emails and such) was not a result of lack of time. I've used the excuse, of course, and the "spend the night at the hospital every 4th night working 30 hours straight" and the "one day off a week maximum" really didn't afford me a whole lot of leisure time, but I did have it.

No, time wasn't the main problem. You've noticed, of course, that when you're mad about something, it's hard to care about anything else. It's also essentially impossible to change the situtation when you don't even know that you're mad.

In other words, motivation to do most productive and/or useful tasks pretty much dropped out the window. For example, I just basically stopped planning out my week on Sunday, something I normally find extremely low-investment and high-yield; it used to be enjoyable most of the time and, failing that, at least I forced myself to do it. Nope. Completely stopped. Either I didn't see the point because I was working every day that week or I was so wasted I fell asleep looking at my Outlook calendar. There were definitely things I could have planned. Even working 80 hours and sleeping 56 (some of which were ostensibly supposed to overlap since I spent the night at the hospital 1-2 nights a week), that's 168 - 80 - 56 = 32 other hours I could have used for emails and blogging and all that stuff.

But lo, let us rejoice, for this is not a sad story, but a happy one. I am able to write this to you now because when the burden finally lifted on March 24th, and I returned home, after having spent the night at the hospital with minimal head-nodding-in-my-chair naps, I was able to fall upon my bed and begin the cleansing process.

There were two weeks between ending internship and starting radiology, and that was great, but it was less about the time off and more about the perspective change. I had a couple weeks off in December as well, but in the back of my mind during that vacation, I was just dreading the return, and all I could see ahead was more of the same. This time, after internship was all done, I would often sit in a chair and smile as I envisioned waking up and going to do something I really liked... I could feel the anger just diffuse out of me.

Although the anger went away, the bad habits are still dying down. The shortness and impatience with other people, something I developed subconsciously as a coping mechanism during internship, certainly didn't disappear overnight, and I think I'm still working on that. But, it's happening.

I'm doing radiology now, and it's tiring and there's a lot more reading/studying than there was during internship. But, I like it. Strange feeling, that. Right now I'm on a nuclear medicine rotation, which is pretty low-volume and high-teaching, and full of advanced physics and other nerdery that I eat up.

So I have both the motivation and time to tell you about it. No excuse, anymore. Which means: I'm back. At least for today.

What an Inspiration

I've really been moved by the horrible story of Byrd and Melanie Billings who were killed last week. They were well off and, instead of spending money on themselves, used their resources to adopt children - mostly those with special needs. They left 17 children behind. Our family had "special needs" thrust upon us. The Billings family volunteered to have their lives changed forever, to spend the rest of their days making a difference rather than enjoy the good life. Knowing what it really is like, I really can't fathom that decision, which makes me realize how far I still am from being Christlike.

May their family find healing and comfort.

Brother, Can You Spare A Hundred Million Dimes?

Wow, it's been a long time since our last post. Frankly, I've been kind of discouraged about posting, given the constant subject of thought and discussion in our household. But a lot has happened. I'll try to post about other things too.

We made a decision that we felt really good about and has been really good for Sonja. A couple weeks ago, we started her on very expensive 20-hour-a-week applied behavioral analysis (ABA) therapy. Some insurances cover it; ours does not, automatically, at least. We are in the process of applying and waiting and possibly appealing. But if it doesn't, we are getting some miraculous help from some amazingly generous people in our lives. Believe me, if we owned a house or car, we would sell it in a heartbeat. The best part, though, is that we are at peace. We know it's what she needs.

Basically, this therapy is very evidence-based and data-driven. Sonja has two therapists who work with her during the week and a PhD who assesses her once a week at our team meeting to set the curriculum for the following week. It's hard core, which is what she needs. They teach skills over and over until she gets it. Her physical imitation skills were basically nonexistent. The very first day she learned clapping by imitating. Two weeks later, she has generalized it by following the actions during song time in nursery (generalizing meaning she has been taught clapping and patting her head, but in nursery she was stomping her feet and doing other actions not explicitly taught her). She is imitating me more as well. I can't emphasize enough what a huge step this is - imitation is how children start to learn. She has also learned a lot of words, also through repetition (eg, several objects on the table and she has to "give me the spoon" or whatever they ask). She doesn't pass a skill until she gets it 100% two days in a row. Her verbal imitation is really good already, so it's just a matter of working on her language processing and teaching her to listen to each part of a sentence. She's learning English as a foreign language right now, basically. I wish we had done this sooner. But she's making really good progress. She loves it too, because she gets to watch Curious George and eat M&Ms as a motivator between tasks.

I've also added something from my old life back in - I'm going to a book group once a month and reading the books! Actually, I've never belonged to a book group, so I get a little too excited about it. I haven't read a book in like a year that didn't have the word "autism" in the title and suddenly I've read a book and two novellas. So exciting!

Natalia is imitating sounds and she understands and is trying to say "thank you," "again," and "all done." She points to Mom and Dad and says "Dada" for both of us. She will also twist her fat body back and forth when you tell her to dance and she will stop immediately when you tell her to stop. It's hilarious. It's also odd because, at almost 3, Sonja is also learning these skills, including pointing (it's taking awhile - her motor skills are behind) and following verbal instructions. I'm just glad both of my girls are progressing, albeit at different rates.

Very cute picture alert! (in no particular order)

Natalia's rule number 1: Mommy's pants are not a prize to be given up lightly.



Rule number 2: Mommy's finger is not a prize to be given up lightly. Actually anything to do with Mommy's personage is not to be let go of under any circumstances, especially hair or pinched bits of skin:



Sonja playing with playdoh again:



Natalia learning to walk after bath time:



Three cuties at the Lincoln Park Zoo:



Natalia the clown. She actually kept it on for about 3 second before taking it off:



This picture is blurry because I had to snap it quickly. When we offer her a spoonful of green beans or peas, she snaps into this tragic pose until she thinks the coast is clear. But it never is. We make her eat them anyway:



A meeting of the minds - sharing blades of grass. Check out that muffin top (on Natalia of course). We can't get any shirts to cover her belly, poor thing:



Sonja in Natalia's chair. After Natalia gets out, she gets in and requests the "seatbelt" to be put on. She is definitely jealous of the attention paid to Natalia at mealtime:



Natalia asleep. Her mean parents kept her up after 6:30:



Natalia loving attention from Grandma:



Chocolate face:



Sonja's first pigtails. This took me awhile, but she was pretty patient with me:



As mentioned before, Sonja likes to sit wherever Natalia sits:



Baby with Milk Jug: A Study

My Little Sonja

I love my little Sonja. She is getting more fun to hang around - much better eye contact, developing opinions on things (mostly nonverbal), responding more to simple questions such as "what do you want" and "what's that?" She's starting to answer things like "what are they doing?" if she sees a picture of animals sleeping, for example. Still a long way to go, as was emphasized to me when she got evaluated for placement in a special education program at the school - response to verbal direction being the biggest problem for a school setting. Don't worry, Sonja, we'll get there. She said her first four word sentence two weeks ago - "I want blue marker." That's the structure of all her sentences, "I want..." but it is effective.

She got surgery to put in ear tubes a couple weeks ago (her ears have been blocked up for months with fluid). A minor procedure. It was heartbreaking to see all the amazingly brave little kids in the waiting room waiting for much worse stuff - children with deformities, cancer, mental disabilities and in wheelchairs. If you know a family with a handicapped child, please help them! I can't imagine the burdens they must feel.

I'm posting these pictures because Sonja looked freaking cute drugged up in her hospital gown.

Not happy with her banana-like appearance:


The socks seem to make the outfit work:


See how serene I look once my child has been drugged? This gives me all kinds of ideas...


So pretty, yet so wasted:


Sonja's favorite part of the Lincoln Park Zoo:


Looking for the seal (psst, it's right behind you):


Sonja's admiration for Cardinal Richelieu cannot be denied:


Thanks, Grandma H for the play-doh. It's my favorite:




She likes playing with her trains until Natalia tries to get in on the action (which is most of the time):


Fell asleep waiting for Mommy. Sorry, babe!

Catch up - Natalia

I've been waiting for Scott to post like he promised, but a man's promises are like dust in the wind. Or something...
We have been really sick. Scott got a week and a half off after his/our indescribably hard year, and he used it to take care of us. Poor Scott. At least no one ended up in the hospital from it, unlike a couple of Sonja's friends.
On a lighter note, I have some freaking cute pictures to post, so here I go. Here's Natalia's, and I'll try to post one for Sonja soon. Natalia is 9 months old and very mobile.

She continues her need to wear sweats to encase her chunk.



First swing - a pensive and joyful experience for all





Daddy's toys are her favorite.



She happily plays with others until she sees or hears Mommy. Then she realizes she was miserable the whole time. You really have to click on the pictures to get the full effect of her expression. She has a temper...

Revving up:



Realizing I'm not going to get her:



She loves to pull herself on everything and share her ball or block with me or Sonja. Sonja tries to push her away and WWIII ensues.