Friday, December 23, 2011
Thursday, December 22, 2011
On October 16th, Zephra's youngest daughter, Zayna, turned two. She's such a sweetheart. She looks just like Zephra did at that age. She has Zephra's auburn hair, green eyes, and freckles. She's already putting sentences together and saying words that most of her two year old peers wouldn't normally say. Even Zelda wasn't putting together sentences until she was around three. She says, "I want some food," or she will say, "I want," followed by the specific name of the object, action, or food. She also says, "I love Nana," and "I love Papaw". Her latest saying is, "Mommy is a big meanie." Alexander taught her that one. Zephra threatened to teach Zayna how to say, "Daddy's so lazy." I really hope she doesn't.
- Wallace Memorial Hospital won some awards and were presented with them in January. Ryker and I were privileged to be able to attend the awards ceremonies.
- On Valentine's Day, Ryker surprised me by taking me to Los Angeles! He knew I had always wanted to go to LA. It meant so much to me that he went all out! He doesn't travel well, so he usually spends the first day of any trip resting up in the hotel room. This time, he accompanied me to the spa as soon as we arrived to the hotel. We spent the week in Los Angeles and had an amazing time!
- We went to a Seder Dinner at Ryker's parents house in March. (Ryker's father by adoption is Jewish. Ryker's mother is half Cambodian. Ryker has such an amazing cultured background, and the children and I have learned so much from both of his parents.)
- For our thirteenth anniversary in May, Ryker and I went to Rio, where we spent our honeymoon! We rekindled so many wonderful memories, we bought souvenirs for our children, and we've decided to take them to Rio next summer so they can see where our marriage began.
- We took the children to Disney World in June. Ryker's parents and Daisy and Steve's daughter, Ashtyn, joined us. Ryker's birthday took place during our trip, so his parents and I took the children so he could have the afternoon to himself, then we had him meet us for dinner, where we totally surprised him.
- My parents celebrated their 40th wedding anniversary in August. My siblings and I threw them an intimate anniversary party. Aidan and Achilles took footage from our home movies and made an amazing video for them. Veronica and Victoria were in charge of decorating, and I coordinated getting the five of us together for photos so Mom and Dad could have pictures of us. After the anniversary party, we all got together for a photo of our entire families; Mom and Dad; Aidan, his wife, Bridget, and their six children, plus one on the way; Achilles, his wife, Briannon, and their six children; Ryker and I, and our four children; and Veronica and Victoria, my youngest siblings. They graduated high school last year, and are now part of the way through their first year of college. That's so hard to believe! My parents were beyond thrilled that we put so much time and effort into the Ruby Wedding Anniversary. Now the question is, can we top this on their 50th anniversary?
- September 10th, I turned another year older. I had the day off, so I slept until ten, when Ryker and the children brought me breakfast in bed. Ryker ran me a hot bubble bath. I spent an hour relaxing in the tub. My besties, Daisy, Tallullah, and Gabrielle, took me to lunch at this little coffee house that offered cheese and chocolate fondue. We had fun skewering things to dip into the cheese or chocolate. Then, the four of us went to a spa together. I came home to find a romantic, candlelit dinner waiting on the balcony overlooking our private beach in the backyard. My parents had taken the kids to Chuck E. Cheese, and then to spend the night with them, so Ryker and I had the evening to ourselves. After we ate, we sat on the beach and watched the waves. It was a very good birthday.
- For Halloween, Hannah dressed up as a "spelling bee" by donning a bee costume and carrying around her spelling book. It was cute and funny. Katie was a Siamese cat. (She said she hoped that Daddy wasn't allergic to her costume.) Maddy and Gregory dressed as news anchors and had a comedy routine they performed for anyone who would listen/watch them. (It's funny how opposite my indentical twins, Hannah and Katie, are, but Maddy and Gregory are so much alike! Twins are truly a mystery.)
- November came, bringing germs that ran rampant through our house. We passed them around for a bit. Thankfully, we were all better by Thanksgiving and able to join my parents for dinner at their house. Ryker's parents had us over for dinner the following week.
- We have two Christmas trees. One in the living room, and one downstairs in the sitting area (the two trees pictured above). Hannah, Kate, Maddy, and Gregory informed me that they wanted their own tree. That's what we did today...
Friday, December 16, 2011
(Decorations outside of our house.)
December, 2023Merry Christmas!Not a whole lot has changed since last year, and to me, that's a good thing. Things have been good, for the most part.Steve is well. He's still the chief of medicine at Wallace Memorial Hospital, still a workaholic, and still a devoted husband and father. I love him more everyday.
Our son, Declan, is doing extremely well in school. It's still so hard to believe he graduated high school at the age of fifteen! He's in his second year of college at the age of seventeen now, and well on his way to med school, although he can't decide what he's going to specialize in. He may pursue two specialties, like his father. During the summer, he works as a deejay and he's in demand.
Speaking of Declan, he came home this morning. Steve and I were having coffee before he left for work, and Declan walked into the living room. It was such a nice surprise. He said he wasn't coming home until tomorrow. He spent the morning helping me around the house. We laid around and watched television. We decided to surprise Steve, so we went to Wallace Memorial to have lunch with him. Ashtyn will be over the moon when she comes home and sees her big brother. It's always good to have him home.Our daughter, Ashtyn, is also striving high academically. Her teacher and principal had discussed allowing her to move ahead a grade last year. We decided to allow her to do so with concerns, but she amazed us all. She is the youngest student in the eighth grade, and her classmates look up to her! Ashtyn announced that she has decided to be a doctor. Looks like both of my children are following in their father's footsteps!Ashtyn is actively involved in helping those in need. Her class at school is having a food drive, and next Sunday, the class is going to the mall to purchase things from the angel tree. Ashtyn's Sunday school class is taking toy donations to send to children overseas. She has really jumped in and helped them. I remember two years ago, when she approached me with so many questions about how to help them. I answered her questions and she just burst into tears. She really has a heart of gold. She said the best thing I did for her was when I took her to volunteer at a homeless shelter. We're doing that again this year. As usual, she's been using all of her Christmas money to buy gifts for those in need. She's such a good kid. I am truly blessed to have such good children. I couldn't be prouder of both of them.I still work in publishing. I finished my book, but I'm not giving out the title just yet. I'm meeting with my boss after the New Year so he can look it over and tell me if I need to make any adjustments or corrections. I've decided to use my name, rather than a pen name. I also need to mention that I have been declared cancer free!
So that brings us to Events and Happenings!
- In January, the hospital won several awards for best overall care, best oncology department, and #1 in cardiac care and rehab services. Later on, Wallace Memorial won another award for neurology. We attended all of the awards ceremonies and celebrations.
- In February, Ashtyn had to undergo a tonsilectomy. She recovered quickly and was back to her old self in a few days. Steve was too busy to do much for Valentine's Day, so I surprised him at work. We spent a couple of hours hanging out in his office. He ordered take out and I brought some pink iced heart shaped sugar cookies that Ashtyn and I made earlier. He went a step further with roses and jewelry.
- I celebrated my birthday on February 25th. Declan came home to spend my birthday weekend with me. He and his girlfriend, Anya, took me to lunch at my favorite restaurant in Manhattan. When Steve and Ashtyn got home, the five of us went to dinner. Gabrielle, Leah, Tallullah, and I went for the annual birthday tea at the tea room on Saturday. It's a birthday tradition to get together for tea and petit fours for our birthdays.
- In March, Ashtyn celebrated her birthday. I hosted a slumber party for her, which went very well. Her birthday was also the second anniversary of the day I was declared cancer free last year!
- In April, Declan and Ashtyn had spring break at the same time for once, so we took a trip to France to visit Steve's parents. We had an amazing time.
- In May, Ashtyn completed the seventh grade and Declan completed his first year of college.
- In June, Steve and I celebrated our thirteenth year of marriage. We spent eight days in Cozumel, Mexico, just the two of us, while Ashtyn went to Disney World with our best friends, Leah and Ryker, and their children, Hannah, Kate, Maddy, and Gregory. Declan went to Colorado with my cousin Tallullah, her husband, Paul, and their children, Zephra, Zane, and Zayden.
- July, we spent two weeks in Japan. Steve's parents, as well as mine, met us there. Trevor, his wife, Amber, and Benjiro, and his wife Elizabeth, joined us the following week. Declan got to bring Anya to Japan for the first time. She had such a great time. It was essentially Ashtyn's first time to Japan, that she remembers. She was a baby the first time we took her. Declan and Anya were kind enough to dote on her. They took her on a day trip to Tokyo. Steve, Trevor, and Benjiro visited former colleagues at the newly built hospital. My father and Steve's father went to see a sumo wrestling match. Amber, Elizabeth, my mother, and Steve's mother, Katerina, went shopping in the village. Anya and Ashtyn came with us a few times.
- In August, we took a trip to Rio, and spent a week enjoying the sand and sun. We took the cable car to Sugar Loaf Mountain, hiked up to the Christ statue on Corcovado Hill, and took many other tours that consisted of boat rides, swimming, walking tours, etc. We had so much fun.
- Steve's birthday was a few days after Ashtyn returned to school, on August 29th.
- In September, Declan returned to college. I was sad to see him go. The good news was that Steve and I had some downtime to get back into the swing of things at school/work. This was my third year going back to work full time. Ashtyn is in the National Honor Society again this year. Her teacher told us that she's already doing English and Math at high school level.
- My mother had a cancer scare, but it turned out to be nothing. (THANK GOD!)
- In October, I was so sick, I battled one illness after another. On Halloween, I was too sick to take Ashtyn trick-or-treating, and Steve had to work late the last week of October. Leah and Ryker were kind enough to take Ashtyn, along with their four children. Ashtyn had a great time with Hannah, Katie, Maddy, and Gregory.
- Steve's mother had a breast cancer scare, but thankfully her biopsy proved benign.
- In November, Declan celebrated his seventeenth birthday. Unfortunately, he got the sick the day after he came home for Thanksgiving Break. He spent the entire time he was home, sick in bed. Thankfully, he managed to join us for Thanksgiving dinner.
- Our friends, Peter and Gabrielle are having a rough time of it. Peter and his fifteen year old son, Logan, were seriously injured the day after Thanksgiving, when Peter's car exploded. Logan sustained the worst of the injuries and had to have a lengthy surgery. They held an emergency blood drive for him, which saved his life. Peter spent two days in the hospital, and Logan may get out on Christmas Day, we hope. He's doing some better. Peter had to undergo rhinoplasty, and he's feeling miserable.
- My Grandma Rio and Grandpa Tory also passed away the week of Thanksgiving, when their pilot lost control of their private jet.
- Thanksgiving Day was bittersweet with Declan being sick and the death of both of my grandparents. The good news was that all of my family, including my Uncle Griffin, Aunt Brooklyn, and their children, who are usually away for the holidays, spent Thanksgiving at our house. We caught up on how everyone's lives were going, reminisced about Grandma and Grandpa, and ate WAY TOO MUCH! Declan's girlfriend, Anya Rossi, and her mother, Gia, came over for Thanksgiving Dinner. That has become a tradition the last two years.
- My grandparents visitation took place on Sunday night and the funeral/graveside service on Monday afternoon. The services were beautiful.
- Steve decided that we needed a short vacation, so we went to the mountains to regroup. Declan and Steve went snowboarding while Ashtyn and I shopped and took some skiing lessons. I am embarrassed to report that my thirteen year old is a much better skier than I am!
That brings us to December, and we are all getting ready for the holidays. Ashtyn, Declan, and I baked and decorated cookies earlier today. Anya and her mother, Gia, came and brought Italian Wedding Cookies, then the five of us hit the mall so Ashtyn could see Santa. It was so funny to watch as Ashtyn explained to Santa that she wants to be a doctor for Christmas. The look on his face was priceless!Merry Christmas, Everyone!Daisy Jade, Steven, Declan, and Ashtyn Fiona Michelle!
Friday, December 2, 2011
Sunday, November 27, 2011
Definition of NIGHTMARE
Thursday, November 24, 2011
Tuesday, November 15, 2011
Bruce Wayne as seen in 1989-1990.
Patient BW, DOB 2/16/1971
by RUSSELL SAUNDERS on NOVEMBER 14, 2011
Patient: Wayne, Bruce
Emergency Contact: Dick Grayson, XXX-269-9637
Interval History: Patient was seen for his last annual physical approximately one year ago. Since that time he has had numerous visits for acute illnesses or injuries, generally accompanied either by his companion Mr. Grayson or Alfred, a senior member of his household staff. These recent maladies appear to be in keeping with the pattern that has emerged over the past several years, in which significant medical problems are associated with odd or incongruous explanations. Most recently, patient was seen for numerous areas of lower extremity cutaneous blistering, erythema and thickening, consistent with moderate to severe frostbite. Patient had reportedly gotten lost while camping in the mountains, but could not account for how he had sustained these injuries in mid-August.
Past Medical History: As stated, patient has a somewhat lengthy and complicated medical history, best summarized by system –
Orthopedic: By far the greatest contributor to patient’s ongoing morbidity are his multiple and seemingly ceaseless musculoskeletal injuries. The most significant of these was sustained several years ago, when he was rushed to GCGH with several fractures of his lumbar vertebrae, reportedly after falling while rappelling. Skeletal series obtained at that time revealed numerous (>20) areas of orthopedic injury in various states of healing, which could not be fully explained by recent fall, including areas of all extremities and many ribs; confirmatory bone scan similarly showed many areas of increased uptake. Patient’s robust stature is not consistent with osteogenesis imperfecta, and skin biopsy was negative for abnormal collagen and P3H1 or CRTAP genetic defects. Malignancy was suspected, but eventually ruled out following oncology consultation. Patient explained most of these (and most subsequent) injuries as being the result of membership in a private and apparently quite intense mixed martial arts club. Patient has denied being the victim of domestic abuse by Mr. Grayson following indirect and direct questioning on numerous occasions.
Neurologic: Patient has been evaluated numerous times over the past several years with complaints of headache, blurry vision, memory deficits, nausea and emotional lability. As with above injuries, most of these symptoms occur following some blow to the head during MMA sparring or competition, and were diagnosed as consistent with concussion. (Patient reports that the club frowns upon protective headgear, a stand with which he seemingly complies despite numerous exhortations to do otherwise.) Following the third such episode, patient was referred to neurology due to significant concern about second-impact syndrome. While no gray matter changes in the cingulate gyrus or white matter hyperintensities were noted on magnetic resonance imaging, given history and known risk factors neurology has recommended MRI to be repeated every two years, and they are arranging for diffusion tensor imaging in the near future.
Allergic: Earlier this year, patient was again rushed to GCGH for what appeared to be severe anaphylaxis, with marked angioedema of the face and hands, and widespread urticaria. After administration of high-dose IV Solu-Medrol, patient’s angioedema resolved sufficiently for him to report “tripping into a bunch of weeds” while hiking, and he eventually left the emergency department against medical advice. On outpatient follow-up, patient was referred for urgent allergy testing given the severity of his reaction. Skin-prick testing was negative for all food allergies, but was markedly and instantly positive in reaction to all plant allergens, such that a dose of IM Decadron was administered by allergist in the office. Despite was appears to be an extraordinary hypersensitivity to phytochemicals, patient has had no further symptoms following the one episode.
Psychiatric: During most visits, patient displays a somewhat somber and flat affect. Numerous inquiries into his mood yield answers that it is “just fine,” followed by requests to change the topic of questioning. While dysthymia or frank depression is suspected (particularly considering patient’s voluntary participation in flagrantly harmful recreational activities), patient seems to have avoided any major depressive episodes. More worrisome was an episode about a year and a half ago, during which patient appeared to have a psychotic break. On arrival at GCGH, patient was found to be suffering from vivid, terrifying hallucinations, rendering him essentially incoherent and requiring high doses of both benzodiazepines and haloperidol to abate. After regaining consciousness several hours later, patient stated that the “stress of [his] job” had gotten to him. He vehemently refused evaluation by Arkham consulting psychiatrist, and eventually left the ED AMA.
Social History: Patient denies smoking, drinking or taking any illegal controlled substances. He resides with Mr. Grayson, reportedly without romantic involvement. Diet consists largely of meals prepared by private household cooking staff. He reports serially monogamous sexual relationships with female partners. When asked, he states that he “usually has proper equipment,” which is interpreted to mean that condoms are used for contraception and STI prevention.
Family History: Both parents deceased (homicide). Generally assumed to be non-contributory
Temp 98.7, HR 60, RR 12, BP 113/68
General – well-nourished, well-appearing adult male in NAD; alert, oriented, cooperative
Skin – confluent, symmetrical, faintly erythematous rash extending from anterior hairline onto malar region (“from the hazmat mask they make me wear when I visit the lab”); four linear, well-healed lacerations on left pectoral (“fencing accident”). Numerous ecchymotic areas in various stages of healing
HEENT – small area of firm edema on the left occiput, c/w contusion. PERRLA, EOMI. TMs grossly intact bilat. Nares patent. Oropharynx normal. Good dentition, with evidence of repaired trauma
Chest – CTAB
CV – RRR without murmur. Radial, femoral pulses +2/4
Abd – soft, NTND, no HSM, + BS x 4.
Ext – well-defined (borderline hypertrophic) musculature. Limited active ROM in shoulders, elbows, wrists, knees, ankles, consistent with healing contusion/sprain or overuse injuries in numerous joints. Normal tone, strength UE/LE bilat.
Neuro – CN 2-12 grossly intact. ? faint resting tremor. FTN intact, no dysdiadokinesia. DTR +2/4 at patella, Achilles. Gait normal. Refuses MMS exam (“I have an aversion to riddles.”)
Psych – well-groomed, pleasant and conversational. A & O x3. Affect somewhat flat (baseline, as stated above)
Assessment/Plan — 40-year-old male with complicated past medical history as noted. Generally normal exam, excepting the following:
Rash — Patient advised that mask seems to be causing an irritant rash, and advised him to have lab personnel fit him with another, less occlusive size.
Resting tremor — Given risk factors stated above, there is some concern about early Parkinsonism. Will contact patient’s neurologist to have next follow-up appointment moved up.
Joint stiffness — As with previous visits, patient was advised to consider recreational activities that carry less risk of ongoing physical injury, or at very least allow himself to heal fully from previous trauma before returning to participation. Given the apparently quite aggressive tendencies of patient’s MMA club, advised him that almost any other activity he might choose is likely to confer less risk of ongoing morbidity (or even mortality). Patient responded to this advice with his usual polite indifference.
Looking more globally, there is some concern that there is an underlying illness that accounts for some of patient’s extensive symptomatology. Discussed with patient that there may be some obscure syndrome that includes brittle bones, but also propensity for severe hypersensitivity, psychiatric symptoms and skin damage. Advised him that many journals publish reports of puzzling cases, which may allow other physicians to comment helpfully about treatments or diagnoses that might be pertinent. Patient politely but emphatically refuses consent for such publication at this time.
Advised patient to limit stress, continue with (hopefully more benign form of) physical activity, continue with healthy diet. Flu shot administered. Planned follow-up in one year, sooner as needed.
(Note to clerical staff — please exclude the following note if there are future record requests. An alternate explanation, more plausible than the histories associated with many of patient’s injuries, is a series of industrial mishaps. As head of Wayne Enterprises, patient presumably takes a very active role in the company’s various subsidiary R&D departments. These subsidiaries include biotech, chemical and numerous other firms that traffic in hazardous materials. One might infer that some of patient’s more extreme medical problems stem from exposure to these hazards while taking a hands-on approach to running his company. There are a few understandable reasons that patient might wish to keep the true nature of his injuries private, despite assurances of medical confidentiality given that leaks of this information might undermine confidence in his company’s governance or alternatively might jeopardize secret government contracts. While it is somewhat regrettable that patient does not feel comfortable revealing the true nature of these injuries and exposures, it is nevertheless understandable.)