Why I don’t have Monday’s Blog Post Written

Here is why I don’t have a blog post written for this dreary Monday morning:

I spent my entire day with Gannon at the University of Iowa Hospitals – here is more on that story here: Gannon’s Big Day!

Saturday morning we were up bright and early by 5:30 am. Little did we know we were in for an adventure!

On our way to my sister’s baby shower we stopped at a rescue habitat Fontana Park near Hazleton. Carver was so lucky he got to go to the zoo! It was SO COLD but they had fox, eagle, skunk, raccoon, coyote, and usually they have a black bear!

Then it was on to the farmer’s market to find some fresh produce for mom to eat while she’s on her iodine free diet. Read more on that here:

Check out this delicious pumpkin casserole! I LOVED IT and mom and I can’t wait to try it this weekend. Will update you guys with the recipe!

Then we kind of sort of ended up stopping at a random library and it happened to be a Halloween themed story hour so we sat and listened to a few books!

Then it was a quick run to Walmart to buy mom new shoes because hers busted out:

Then it was on to the BABY SHOWER for my sweet baby nephew coming in January!

Then we flew back home for my friend Mariah’s wedding:

This is my best friend Regan:

We had such a blast catching up at the wedding while our boys talked farming.

Then this morning I woke up early because I know this next week is CRAZY BUSY and needs lots of prep work.

While I stayed busy there was plenty of snuggling:

Craig’s lunch got packed for the week

The toy room got tidied and organized

My new pillows came in the mail so I got those all set out

Craig our together my new computer desk

I penciled out the schedule for the week

I laid out the boy’s clothes for the week

I made a pan of brownies for Craig’s lunch

I ate most of the pan of brownies I made for Craig’s lunch.

Mountains of laundry got tackled

I did about 3 dishwasher load a of dishes

I did even more laundry

Clothes were sorted folded and put away

I made the worlds fastest meal prep meal: Tator tot casserole

I laid out my clothes for the week

I repacked the diaper bags

Made prime rib for supper

Made Mac and cheese with hotdogs for Carver when the sitter comes tomorrow night

I did even more laundry

Sorted through clinical paperwork

The boys both got baths

Took an inventory of things I need to pick up after work tomorrow night

Listened to just about every Dave Ramsey and Rachel Cruze podcast that exists

Realized it was 10 pm and that I needed to go to bed to be at work tomorrow

Went to bed and realized I never wrote a blog post

And those are all of the reasons why I don’t have a well thought out blog post for you all this morning!

Please forgive me, I hope this will do 😉

Check back at 5:00 PM

Good morning friends!

I feel like I’m failing at blog life this week! Check back for a post at 5:00 PM tonight! I’ll have an update on our little Gannon for you all! We didn’t get home from Iowa City until LATE last night.

In the meantime, if you’re new to the site you can check out these posts to get all caught up on Gannon’s (my son’s) medical drama so you’re ready for tonight’s blog post!

Why I don’t have a blog post on Monday morning…

Here is why I don’t have a blog post written for this dreary Monday morning:

I spent my entire day with Gannon at the University of Iowa Hospitals – here is more on that story here: http://www.thepinkshoelaces.com/2019/10/12/gannons-big-day/

Saturday morning we were up bright and early by 5:30 am. Craig and I had breakfast together before the boys got up. Craig was off to work, I took the boys and we were off! Little did we know we were in for an adventure!

On our way to my sister’s baby shower we stopped at a rescue habitat Fontana Park near Hazleton. Carver was so lucky he got to go to the zoo! It was SO COLD but they had fox, eagle, skunk, raccoon, coyote, and usually they have a black bear!

Mom has posted on the blog about this awesome habitat before! Here’s a link: https://www.joscountryjunction.com/grandma-day/

Carver is checking out the ducks. I’ve never actually seen a fox this close before! It’s such a neat little park.

Then it was on to the farmer’s market to find some fresh produce for mom to eat while she’s on her iodine free diet. Read more on that here: https://www.joscountryjunction.com/the-diet/

Check out this delicious pumpkin casserole! I LOVED IT and mom and I can’t wait to try it this weekend. Will update you guys with the recipe!

Then we kind of sort of ended up stopping at a random library and it happened to be a Halloween themed story hour so we sat and listened to a few books!

How cool was this little hideout in the library? They had such an awesome kid’s room and the staff was so so friendly!

Then it was a quick run to Walmart to buy mom new shoes because hers totally busted out at the library:

Then it was on to the BABY SHOWER for my sweet baby nephew coming in January!

Baby food game! I totally failed – Kayla and Kelli were much better at shower games – I always lose.

Then we flew back home for my friend Mariah’s wedding:

This is my best friend Regan:

Isn’t she lovely? Isn’t she wonderful?

We had such a blast catching up at the wedding while our boys talked farming.

Then this morning I woke up early because I know this next week is CRAZY BUSY and needs lots of prep work.

While I stayed busy there was plenty of snuggling:

Craig’s lunch got packed for the week

The toy room got tidied and organized

My new pillows came in the mail so I got those all set out

Craig our together my new computer desk

I penciled out the schedule for the week

I laid out the boy’s clothes for the week

I made a pan of brownies for Craig’s lunch

I ate most of the pan of brownies I made for Craig’s lunch.

Mountains of laundry got tackled

I did about 3 dishwasher loads of dishes

I did even more laundry

Clothes were sorted folded and put away

I made the worlds fastest meal prep meal: Tator tot casserole

I laid out my clothes for the week

I repacked the diaper bags

Made prime rib for supper

Made Mac and cheese with hotdogs for Carver when the sitter comes tomorrow night

I did even more laundry

Sorted through clinical paperwork

The boys both got baths

Took an inventory of things I need to pick up after work tomorrow night

Listened to just about every Dave Ramsey and Rachel Cruze podcast that exists

Realized it was 10 pm and that I needed to go to bed to be at work tomorrow

Went to bed and realized I never wrote a blog post

And those are all of the reasons why I don’t have a well thought out blog post for you all this morning!

Please forgive me, I hope this will do!

😉

Gannon’s Big Day!

So if you read my last post about Gannon, you know we went down the the University of Iowa yesterday. This post won’t make much sense unless you read that one so check it out here:

Gannon Joseph Friedman

We left about 6:40 am for a 9:00 appointment. First was our appointment with the urologist.

I brought up all of my concerns, why I thought he might have prune belly, we talked for a long time. He had a resident with him and she was very attentive as well.

The main lobby of the children’s hospital – pictures don’t do it justice!

There are several yellow flags that aren’t enough of a problem to hand out a diagnosis of prune belly. The number one reason his because his kidneys appear normal on imaging. Yes his bladder is consistently large. He does seem to have some sort of abnormal ab muscles and his testicles have not descended. But none of these symptoms are enough to cause a diagnosis. He went through each set of imaging with me and explained why he thought this was gastrointestinal tract related. This was helpful. He said maybe it could be a “variant” of prune belly but to use that as a last resort diagnosis AFTER he sees GI. We will set up a surgery with them in the next few months.

On to GI. Our main concern with GI is that Gannon cries when he poops and why does his belly look like that?

The Pediatric Specialties Clinic – this whole hospital is so well decorated and shiny and new 😍😍

GI thinks it still could be prune belly because if it is a variant their kidneys can appear normal but the distended bladder would be enough for a diagnosis.

GI ordered a “lower GI series” which consisted of Gannon being strapped down, a catheter inserted into his rectum and fed through the large bowel while administering contrast. Lots of contrast.

They had to strap Gannon down with his arms above his head to get the imaging they needed. He didn’t like that much but it had to be done. Motherhood is not for the faint of heart!

The staff were amazing. They did such a good job of explaining and taking care of Gannon. It was hard to watch but they made it okay.

We went to lunch after that while we were waiting for the images to result. Isn’t this a beautiful hospital?

In the meantime Gannon was…expelling the contrast in large quantity. I went to change his diaper, he started crying/pushing and PROJECTILE poopy contrast all over me and the bathroom, my pants, shirt, shoes, the floor, the changing table – everywhere.

The poop-explosion that I wore for the rest of the day! Not to mention my pants or shoes!

I stood there in shock for a good 3 minutes trying to figure out what to do. I wiped off as best as I could – I used all my wipes and I asked the receptionist to put the bathroom out of order until housekeeping could come 🤦‍♀️🤦‍♀️

Anyway, here’s what the lower GI study showed:

Gannon’s anatomy of his large bowel is abnormal. There’s lots of extra bowel, they call that “redundant.” Instead of the colon going to the left it goes to the right. He had monstrous amounts of stool his his colon despite being regular. His anus also appears abnormal. Possible prune belly. Possible Herschsprungs. Possible Chronic pseudo obstruction. Possible anus imperfecta. At this point anything is possible.

The contrast lights up the path of his large images tone

They consulted surgery who wants us to come back on Tuesday after the surgeon review his case. Likely whatever Gannon has needs to be fixed or diagnosed with surgery. So that will be 3:20 pm on Tuesday next week.

They listened to me. They believed me. The validated my concerns. They took action. They got other departments involved. This is not sad news – this is wonderful. To hope they would tell us “he’s just fine” is not what we want right now. We know there is something wrong and we want answers which I think we will get much closer on Tuesday.

Thanks to all who have reached out. I’ll let you know what I know when I know it.

Gannon Joseph Friedman

By the time you’re reading this post, my 7 month old son Gannon and I are likely well on our way to Iowa City to the Stead Family Children’s Hospital. We’ve been awaiting this appointment for over a month now.

If you follow my mom’s blog or my personal Facebook page, you probably are aware of Gannon’s health issues. I say health issues because, well, we don’t have a diagnosis yet.

First of all, this is a little odd sharing with the world but it is just a body part: Gannon’s testicles never descended to where they need to be. I’m telling you this because it is an important part of the story. One is still hanging out up by his bladder and he will need surgery in the next few months to fix this. Anyway, onto the rest of the story…

March/April 2019

Last March, Gannon was barely 6 weeks old. I brought him to the doctor after he had projectile vomited a few times and had like a 99 degree temperature. While assessing him we noticed Gannon’s belly was way over distended.

An abdominal xray showed LOTS of gas in his bowels and “the rectal vault was empty” therefore suggesting some sort of illeus or blockage somewhere in his digestive tract. The next day he wasn’t any better and he started having these “screaming spells” where he would pull his legs up to his chest and just scream every 5-10 minutes or so.

We brought him to the ER where I work this time instead of the clinic. They did an ultrasound – they found something called “intermittent intussusception” – his bowel was telescoping into itself.

We were sent to St. Mary’s Hospital in Rochester (the hospital associated with Mayo Clinic) and in the ER they repeated the ultrasound, did a rectal exam, started an IV, catheterized him for a urine sample and decided to admit him for further testing.

The ultrasound showed that the intermittent intasussception had relieved itself but while they were checking out the other organs, they couldn’t see what they needed to because his bladder was so distended/large and they saw “debris” in his bladder. That was about all that was said about it. This is a significant part of the story but not until just recently.

They also found during his rectal exam that he had a very narrow anus, rectum, and even colon. They were suspicious of Herschprung’s disease which required a rectal biopsy which eventually (4 days after he was admitted) came back negative.

Gannon’s CT scan – all of the black is gas – this angle would be like if you were standing in front of Gannon and we looked at his belly

I’ll be honest, our experience with Mayo wasn’t great. Testing took FOREVER. There was plenty of sitting and waiting. I had to beg them to give him Tylenol for when he was screaming. We were admitted on a Friday – he got a CT scan, a rectal biopsy was done at bedside, and that was it. We didn’t get any results until TUESDAY when they promptly rushed us out the door when all results came back negative. They told me to stop breast feeding because maybe he was allergic to milk. We bought really expensive formula to try at home. They told us to use glycerin suppositories to relieve his belly distention which was still very much a problem.

The CT scan at mayo ALSO confirmed he had a large distended bladder – but again – no one said anything.

I asked for a referral the the University of Iowa – about 2.5 hours SOUTH of our house. The referral was sent on Friday morning. I had a call by 12 pm telling me to come down to see a gastrointestinal specialist at 4 pm THAT DAY! Talk about service! We spend an overnight at the University – a brand new children’s hospital and had an xray, blood work, an ultrasound all by about 7 p.m. that night.

The Stead Family Children’s Hospital is just beautiful

They rounded on him the next morning. They dismissed everything that Mayo said – he could breastfeed and he didn’t have to do any “anal dilation” and while they didn’t know why his belly was so big, he was released that day. A 16 hour hospital stay told us more than a 5 day hospital stay at Mayo.

While I wasn’t convinced that Gannon was “normal” I felt at peace with the U of I’s conclusion.

Flash forward to August 2019:

Gannon was 6 months old and he is NOT sitting up by himself – not even trying. Which isn’t a huge deal but something we have been monitoring. He’s almost 8 months now and while he’s “better” at sitting up he still topples over and can only sit up if he is using his hands to support him.

Gannon’s belly is still so big. He has soft spots in his belly. If he drinks a bottle I can feel the fluid slosh up against his stomach if I hold my hand over his belly.

Gannon cries every time he has a bowel movement – just screams – but his feces are soft and not what you would expect for constipation.

Gannon breaks out into this rash after he eats baby food. We still aren’t sure what is causing that.

Gannon chokes very often. Crackers are hard for him, even baby food will send him into a choking fit.

Gannon doesn’t babble or practice talking like other babies his age do and sometimes he isn’t very good at engaging or maintaining eye contact.

I think I have Gannon diagnosed. We won’t know if I’m right until tomorrow after we see the genito-urinary specialist:

I think Gannon has something called Prune Belly Syndrome (PBS) or Eagle-Barret syndrome. However this is usually diagnosed during an ultrasound during the pregnancy. If Gannon has this it would be a variant of the disease.

The three symptoms of PBS is undescended bilateral testicles, weak or missing abdominal muscles, and distended/large/not functioning urinary tract organs.

Gannon and his favorite cousin twin Georgia 🙂

Gannon has all three without any further testing. Remember they couldn’t see his GI tract because his bladder was so big and descended? Remember it showed he had “debris” in his bladder? Remember his testicles haven’t descended? The big huge belly could be explained by weak or missing abdominal muscles. That’s probably why he isn’t able to sit up yet.

So as symptoms have progressed this past August/September we are again referred to the GI specialty and now GU. Both of those appointments are early tomorrow morning. Here’s what I hope to gain:

  • a surgery date for his testicular procedure
  • further imaging of his GI tract – preferably a VCUG (voiding cystourethrogram)
  • GI to advise on why he cries every time he poops (probably a rectal exam to determine if he needs more imaging)
  • I’d like to know how many abdominal muscles are actually present
  • How do we build up the ab muscles he has?
  • How do we monitor him long term?

So that is that. I feel crazy sometimes. Obviously something is not right but obviously he’s growing just fine. I do know what a sweet personality he has. We love him so so much. His diagnosis won’t change the way we feel about him whatsoever.

I’ll update when I can.

10 Reasons I LOVE Being an ER Nurse!

In honor of Emergency Nurses week which lands October 6th-12th, here are 10 reasons why I love being an ER nurse!

1. Shifts go by FAST

(For the most part). When we are super busy it feels like time flies! I work 12 hour shifts and I love it – I either work 7 am to 7 pm or 7pm to 7am! I love both shifts equally and I flip flop shifts a lot – often in the same week! People call me crazy but we do self scheduling in our emergency department and I sign up for the rotating shifts! I have to work 3 – 12 hour shifts a week – I wouldn’t want it any other way!

2. Emergency nursing is all about TEAMWORK!

Each day I work, my team consists of a doctor, another nurse, and an assortment of EMTs and paramedics. We coordinate with ancillary departments such as lab, radiology, social services, and EMS. Every team member plays a vital role in the care of our patient and it is well known that we can’t do our job without the other team member(s). We all hold a mutual respect for each other’s role.

My coworkers/team members are amazing. They make my job so much fun. They also understand what it is like to work in an emergency setting: the frequent flyers, the rude patients, the safety concerns, the disrespect, the heartbreak, the trauma, the things you can’t unsee, THEY GET IT. I can lean on them for support in a way I can’t lean on my husband or my friends.

We all know each other’s weaknesses and strengths. We are all invested in the care of the patient and want the best outcome. Being a member of the emergency healthcare team is such a privilege and I do not take it for granted.

3. You never know what is coming through the door!

When I ask nurses why they wouldn’t want to work in the emergency department, this is the #1 answer: I don’t know what will come through the door next.

THAT’S WHAT I LOVE! I LOVE knowing that things can change any second. I love the challenge of managing several critical patients showing up at the same time. I love the rush. I love the unknown. More than that, as I’ve become a stronger nurse, I love knowing that I can HANDLE anything that comes through the door.

This may sound arrogant but…..

  1. You have to be confident in your skills – what if I said “I don’t think I can handle anything that comes in.” That isn’t reassuring.
  2. I am NEVER alone – refer back to reason I love ER nursing #2 – I have an amazing team.

4. You get to work with every population!

I work in a general critical access hospital – this means that it is a small hospital. We have 25 beds between med-surg floor and OB. The ER has 10 beds. We average seeing about 25 patients a day. I work with every type of patient of every age of every background. We have quite the diversity of patients – more than you’d expect in the rural midwest. Each population brings its’ own unique problems and considerations so my day NEVER looks the same!

5. I LOVE starting IVs.

Seriously though, I LOVE starting IVs. If I ever work in a bigger hospital, I think I would apply to be on the IV team! I start an average of 0-10 IV’s a day. The ER nurses and paramedics serve as a resource to the rest of the hospital for difficult IV starts. There is nothing more rewarding than being able gain IV access on the first stick of a difficult patient – all the way from newborn babies to the elderly.

6. You get to work with EVERY body system and learn how one affects the other!

From the relationship between magnesium and potassium, to the interactions of ace inhibitors and why it can have a cough as a side effect, I’m such a NERD when it comes to how medications effect the body and how each body system effects the other. If we aren’t sure how compazine works, why does it cure a migraine? Does this medication act as an anticoagulant or a anti platelet? Why is toradol more effective than narcotics when treating kidney stones? Why is a beta blocker given for a STEMI instead of a calcium channel blocker? Just when you think you have a handle on it, a new medication or disease process comes along!

7. You get to know frequent flyers!

Frequent flyers is sometimes used as a derogatory term in emergency departments. For me – I love my “repeat customers.” I get to know them, their health history, their chronic problems, their families and I feel like I can take the best care of them! I “sign up” to take them right away – they are relieved when they see me and I take pride in knowing that I am the best nurse to care for them!

8. You get to see some cool stuff.

This one is obvious. Every time I tell someone I’m an ER nurse their first response is usually “I bet you see some cool stuff.” Yes, I do. Sometimes I’m laughing all the way home, sometimes crying. Some days I spend all day learning and some days the cases are pretty predictable. I have to be really careful how I word this answer. Obviously I don’t WANT people to get hurt and have really cool injuries but it happens and sometimes I come across a really interesting case – traumas, medical mysteries, deep deep lacerations, incision and drainage of cysts, gun shot wounds, etc.

9. I get to develop my multitasking skills everyday!

I LOVE this part. My mind automatically multitasks and develops to do lists and can go a mile a minute – I didn’t start off like this but my management and multitasking skills get stronger every time we have a crazy busy day with truly critical patients and only 10 beds and an ambulance coming in and going out and an IV start in CT and a GI bleed who needs blood hung and a helicopter landing and a suicidal patient requiring one on one care and that little tot just threw up in the lobby and med surg is ready for report and I haven’t peed in 8 hours and forget a lunch break – I LOVE days like that.

10. I’m a resource to other departments.

I love starting pediatric IVs. I did not used to. I used to beg the paramedics to step in for me or send someone else with more experience down to start baby or kiddie IVs until one day a good friend of mine said “you won’t learn if you don’t try.” I spent the next year taking EVERY possible IV start and pediatric IV start available. I studied it, I watched other experienced medics, I would assist whenever I could, and now I’m a resource. I’m a relief to others who are scared like I used to be. Am I perfect? NO. I don’t get nearly enough exposure but by taking every opportunity to learn I have built my confidence and I’m now a resource to my coworkers and other departments. This is an example of how I reach to be the best nurse I can be for my patients. I also try to offer as much experience as I can to other departments. If we have a critical patient, I’ll ask med – surg to send down a “newbie nurse” and I’ll walk through treating the patient step by step so they are more prepared and understand how to handle critical situations such as hanging drips, giving RSI medications, or working through a code. Be the mentor you wish you had.

That’s all folks! Thank an ER nurse this week! I’ve also seen that it is PEDIATRIC NURSES WEEK! ❤️❤️ so show them all the love you can too!