Woohoo!

So first the big news - I passed the Advanced Metabolic Module test! Yay! People kept telling me that I was stressing too much and over-studying and I'd be fine. Well, anyone who knows me won't find it alarming that I was over-stressed and over-studying for any sort of test. I know the material but the part that always stresses me the most about tests is trying to figure out how much detail I need to be able to go into. I talked to nurses who had already tested out of the Metabolic Module and they all said to just go off the study guide we were given. However, that still gives you a lot of leeway when you get things on the study guide that say, "Explain the pathophysiology of DIC (disseminated intravascular coagulation)." Soooooo does that mean you want the 2 minute explanation of DIC, or do you want me to give you the 15 minute explanation and go into this sort of detail:

And then there were questions like, "What's the standard treatment for liver transplant rejection?" The answer is steroids. Then you think, "Wait... that can't possibly be it. That's a one-word answer. There must be more to it than that!" But there isn't. You keep second-guessing yourself - but it really is just a one-word answer.

Anyway, I passed, I'm officially an Advanced Metabolic Nurse, I can stop studying and get back to doing stuff I want to do (like read non-medical books and crochet) and I'll get a nice little pay raise for proving that I'm now slightly smarter. I would have done it even without the pay incentive though - I love to learn new things and be challenged - but I won't turn down an extra 2.5%. :)

Well, on to the fun stuff (Mira, of course). A few days ago she actually took a few steps on her own! And it wasn't to come to Mom or Dad or anything like that... Nope, she was chasing after the cat. Go figure. So Mark and I were really excited, but ever since then we cannot convince this child to try to walk anymore. I think she realized that as cool as walking probably is, it won't get her where she wants to go as fast as if she were crawling. So why bother with walking? So she doesn't. But give her that little pink car and she's like a race car driver - a drunk one at that.

She's also still really into dancing. This theme might be getting tedious to some of you but Mark and I think it's the cutest thing to watch Mira when some music goes on. She's starting to do this crumping sort of move where she puts her hands in the air and bounces up and down. We're trying to teach her to do a "Touchdown!" move with her arms. We're also trying to teach her the difference between "mama" and "dada." Not that she needs to know the difference yet but she might actually be getting the hang of it. For days both Mark and I were Dada. Mark of course was thrilled with this. I started patting myself on the chest and saying "Mama" over and over while I was holding her, then patting Mark and saying "Dada." The next day both Mark and I were Mama. Then the day after we were both Dada again. So cute! But today she started crying when I walked out of the room and I heard her saying "Maaamaaa! Maamaa!" She's never done that before so maybe she is figuring it out.

This picture makes me smile. Most babies fall asleep cuddling a special blanket, or a stuffed animal or some other soft "comfort" object. Mira falls asleep cuddling her bottle. No, seriously. I'll cuddle her and give her her bedtime bottle, and then after she's done with the bottle she still wants to hold onto the bottle until she falls asleep. Weird. But cute, of course. :)

My next goal for a video I need to capture is Mira playing on the iPad. I got an iPad 2 for Christmas (LOVE LOVE LOVE this toy, btw) and Mira being the technology lover that she is really enjoys it too. (Mark was very annoyed with the iPad for a long time - he kept saying it was a waste of money and I don't need it and the whole concept was stupid, but now he gets excited when I don't take the iPad to work with me so he can play games on it.) I have some fun apps for Mira on there that she likes to play. It's so cute to watch her use her right index finger to touch the screen, since that's what she sees me doing. What she doesn't see me do but she does anyway is resort to smacking the screen with her whole hand. Yes, I did invest in a screen protector. :) So I'm going to attempt to get a good video of my techie geek daughter playing with an iPad.

Holy Cuteness!

Mira turned 11 months old today! That is insane - that means that in a month she'll be a whole year old! It can't possibly have been that long already!

Mira is starting to look less like a baby and more like a little girl. Some of her little mannerisms that she's learning - like pointing at things and waving bye-bye and doing her own little sign for "more" (she opens and closes her right hand when she wants more of something... totally not what the ASL says "more" looks like but whatever, we know what she means) - it all really looks like things a toddler would do. She's so mobile now it's easy to forget she's a baby still. She could totally walk off if she wanted to, but she doesn't (thankfully). She can stand by herself for as long as she wants, and she can "dance" without holding onto anything. She plays with toys standing unassisted and drinks a sippy cup standing by herself and she cruises all over the place as fast as anything with her hand barely holding onto the furniture, but the second she realizes she's standing by herself she quickly grabs onto something for support or squats down and crawls off. Well, like I said, I'm not going to push her to walk faster. She's on track and when she's ready to walk she'll just figure it out and when that happens it will all hit the fan!

She still loves that pink and purple car she got for Christmas. Although for some reason now she'll only push it when it's sideways. Even though it's definitely much harder that way, that's the way she wants to do it. Watch her and you'll see she's definitely ready to be walking. (Sorry it's so short.)

 She's doing well with sippy cups, although there's still nothing like a bottle at bedtime!

She's watching the cat

And since we're on the topic of bedtime... It's a constant evolution, I guess. She mostly sleeps through the night still but now that she's teething again she's started waking up in the middle of the night again. Luckily it's just once when it does happen and she's back to sleep fairly quickly, but that would probably explain why I feel so exhausted and sleep-deprived these days. I wish those teeth would just break through already! Her top left is finally through and the top right has been trying to come through for weeks but it's just having a lot of trouble. Her poor gums are all bruised and swollen and it looks so sad. I've never seen that happen before but after asking around it sounds like that's fairly normal and I should stop my PICU RN mommy freakout. Sometimes I REALLY don't like my job. Not because of the job itself but because of the things I see there. It doesn't bother me as much to take care of kids that were born with some congenital defect... There's nothing to do about that. What scares the shit out of me are the kids that are totally normal and healthy and suddenly drop dead with a dilated cardiomyopathy of unknown etiology or the kid who was run over by the parents pulling out of the driveway. You know, ignorance really is bliss.

Anyway, moving on... Mira is turning into a little dancing queen! I think that should be her theme song. Every time she hears any sort of music - a commercial on TV, one of her toys, walking through the grocery store - she starts boogieing! She's so energetic about it that she's almost jumping off the ground (and if she's in her crib holding onto the rail she has figured out how to jump). It is SO cute! And she never seems to get tired of it either! The other day I started playing some music on my phone and gave it to her. She bounced and danced and wiggled for 15 minutes - pretty impressive for a baby her age!

I'm really trying to get into reading her lots of books, since her attention span is finally long enough to last through a few pages of a book. Being the master of mimicry that she is, now she tries to read the books herself. She'll pick up a book, study it with a serious little pondering frown on her face, open the book (which is upside down most of the time but who cares), point at the pictures, and start babbling. "Ba ba ba ba... doo... dissshhh... ya ya ya ya ya.... SHRIEK!!!!!!" I've tried so many times to get a video of this but as soon as I get the camera out she crawls over to me to grab the camera.

I thought we would have to wait about 15 more years for this!

She loves playing with some wooden blocks she got for Christmas. Mostly she likes for someone to build a tower so she can knock it down. Recently she's gotten really interested in pulling toys out of the box or bucket or whatever they live in - and then she carefully puts the toys back in, and pulls them out again, one by one. I'm really afraid to make this observation because everyone thinks their own kid is the super gifted genius, but this seems a little advanced for 10-11 months. Or maybe I'm wrong, but either way she's getting a lot better about playing with toys by herself and not needing me to be in the room 5 feet away from her at all times.

The 1 year mark means it's time for more professional photographs! It's early, yes, but we have a lot of crap happening in the next couple of months. We tried out a new photographer this time, since the lady I usually use only does natural lighting, and I don't think Mira's old enough to do well with an outdoor photo shoot in the winter. We could have done a shoot in the indoor studio but it's small and Mira's getting big and harder to keep in one spot. So we tried out this studio in Draper, which is a long drive but it was so worth it! Especially since we got 70 photos (they told us Mira was the easiest baby they've ever photographed and that's one reason they were able to get so many good shots) that they gave to us the same day so we didn't have to wait for the CD to be mailed to us. Oh my cuteness!! If you'd like to see the whole album let me know, but here are a few of my favorites.

Our little princess

I love this one

This might be our favorite

A bowl full of ruffles!

Watch out, she's in-bound!

Ooh... This looks good...

Hmm... I should taste some more to make sure it all tastes good

The smash cake was so funny. At first she poked her fingers into the cupcake and looked at us like she wasn't sure what we wanted her to do with it, so I took some frosting on my finger and put it in her mouth. Then she got into it! She didn't go completely crazy with it but she definitely enjoyed it and boy was it messy! It was so funny though, she had everyone in the studio laughing. I think some of these pictures will have to be printed off and framed very prominently in our house. :)

Dedicated to a Fallen Officer

Well the year has been off to a bit of a rough start. Not anything really horrible but just a lot of things all at once. The first thing isn't really a bad thing. Last week everyone came down with a respiratory virus and because of all the meds I had to take to function, Mira is now weaned. So it's not a horrible thing like I said, because she was losing interest for the last month anyway and she doesn't seem to miss it at all, plus because I dried up I didn't have any engorgement pain (which I wouldn't wish on my worst enemy). So really it was the best way it could have happened. I had been starting to worry about how I was going to wean her since we're coming up on a year (ack!) but this took care of it for me. There is a part of me that's the tiniest bit sad, because this is another reminder that she's getting close to no longer being a baby anymore. But there's a lot of me that's happy. I've talked to women who gush about how much they love nursing and they may as well have been saying that they love to gouge their eyes out with a rusty nail - that's how much sense it makes to me. I did like the cuddle time, but other than that I hated every second of nursing. I only stuck with it for so long because I know it's what is best. Looking back I'm surprised I stuck with it for almost 11 months - I had lots of problems and I didn't like it and when she was little it would take Mira an hour to feed, and when she needed to eat every 2 hours, that was all I did, plus I had no support from Mark at all through the whole thing. I won't air my dirty laundry here (as tempting as it would be to get some sympathy), but at least it's not an issue we need to worry about anymore. So that's done, and now I can wear dresses and turtlenecks and whatever I want to wear again (now that the last of the padding has fallen off I'm less than my prepregnancy weight) and I can ingest whatever I want without worrying about how it will affect another little person - basically, for the first time in almost 2 years, I have my body back. And that is certainly something to celebrate! :)

My free time (what little I have) has been spent studying for my Advanced Metabolic Module test next week. My unit has some advanced educational opportunities for the nurses so we can train in different pt populations. We can have specialized training in Advanced Respiratory, Neurotrauma, Cardiac, and Metabolic pts, plus there's ECMO (extracorporeal membranous oxygenation, which is basically heart-lung bypass, which I will never touch). It involves class time, research, presentations, plus of course hands-on training with that pt population. Besides ECMO, the metabolic pts are the sickest and busiest and have a million things wrong with them - which means there's a million things I need to know for my oral testing next week. I'm sure I'll test out and wonder what I was so worried about, but right now it's stressful to try to learn everything and try to remember what an elevated GGT indicates and what electrolyte imbalances occur with a metabolic acidosis. Since Mira is mobile, the only times I have to study are after she goes to bed (which is when I'm ready for bed), or at work (which doesn't guarantee I'll have time to study). So this is a cause of more stress - I think I'll have to find a babysitter for her for a couple days in the next week so I can leave the house and cram.

The sad stuff involves funerals - not anyone very close to us but you'll see why these are sad. This weekend I went to the funeral of a child I took care of a LOT last summer. I calculated that I spent well over 200 hours taking care of him and he was hands down the sickest pt I've ever had. From a completely detached point of view, this poor boy needed to die. He was so sick for so long - I can't go into details because of HIPAA but he really is in a better place now. But it's beyond devastating for parents to lose their child, especially after going through so much. The parents both hugged me and told me "Thank you for all your help." That was so validating for me - the end result was the same, but at least I helped get him better so he could be at home with his family when he died. Maybe I did make a difference.

This next funeral made national news so everyone is probably already aware of it but I'll review the basics anyway. On January 4th, 12 officers from various Utah agencies went to serve a drug-related search warrant and the suspect shot 6 of them, killing one, Officer Jared Francom of the Ogden Police Department. Ogden is about 20 minutes north of us. The suspect, in a perfect just world, would have had his brains blown out at the scene. The department would have had a lawsuit from the family and they would settle out of court because it's easier and cheaper than going to court, but at least a jackass who had the audacity to purposefully shoot 6 police officers, who were doing their job to protect and serve, would be gone and taken care of. At least the prosecutor will be going for the death penalty, which he should. Obviously this is a subject that is very emotionally charged for me, as you might imagine. We don't personally know any of the officers involved but law enforcement is a very tight-knot brotherhood and you don't have to have personally known an officer killed in the line of duty to lose a brother. Mark goes on calls like this all the time. It could have been any officer. Every day an officer goes to work, they don't know if they'll come home safe. Most of the time they do. But there's always the chance that they won't, and they know that. Maybe that's one reason these police funerals are so hard - but they are absolutely incredible at the same time. It's worth seeing, if it didn't mean an officer had to die to see the amazing show of support from the law enforcement community. Apparently there were officers from Chicago and Philadelphia at this funeral. When an officer from Mark's dept was killed on duty a few years ago there were officers from as far away as Florida. Law enforcement is the perfect definition of a brotherhood. We weren't able to go to the funeral, even though we wanted to - Mark had to work his regular shift and that was when I was really feeling under the weather and I could barely get off the couch. But we watched the procession on TV and there were some amazing and beautiful pictures and videos posted. Here are some pictures.

Notice the firefighters saluting on the ladders

Just to explain this next video so it makes sense to everyone: at a police funeral they do something called a final 10-42. You'll hear a long beep, which alerts everyone on the radio to stand by for emergency radio traffic. Weber Dispatch calls on the radio for Officer Francom, whose number is Whiskey 12. Whenever an officer signs off duty at the end of his/her shift, they tell dispatch they are "10-42." Dispatch calls for the fallen officer 3 times, and when they don't get a response, they announce that officer is 10-42 and the end of watch. I can hold it together during a police funeral until the final 10-42 and then I lose it and bawl uncontrollably because it's so sad. Click on the link to see the video.

Officer Francom's Final 10-42

Here's another really touching video. Just to make it even sadder, someone put Josh Groban as the background music.

Officer Francom's Funeral

I will put up another post with more updates on Mira in a few days. I'll have more pictures and videos organized by then and I don't feel like adding them on here. I don't know why this has been so emotional for me, except that it's a harsh reminder to me, again, that who's to say something like this won't happen to Mark someday? Don't worry, I'm fine, I just need some more time to reflect and I'll be ready to have some cheerful posts again soon. And believe me when I say there will be some AWESOME cute pics! But just not here.

I'll end this with a poem - I think it sums everything up well. I'm sure most people who read this blog have some respect for police anyway, but maybe you can take an extra moment to truly appreciate what law enforcement does for the community.

"The Final Inspection"

The policeman stood and faced his God,
Which must always come to pass.
He hoped his shoes were shining.
Just as brightly as his brass.

"Step forward now, policeman.
How shall I deal with you?
Have you always turned the other cheek?
To My church have you been true?"

The policeman squared his shoulders and said,
"No, Lord, I guess I ain't,
Because those of us who carry badges
can't always be a saint.

I've had to work most Sundays,
and at times my talk was rough,
and sometimes I've been violent,
Because the streets are awfully tough.

But I never took a penny,
That wasn't mine to keep....
Though I worked a lot of overtime
When the bills got just too steep.

And I never passed a cry for help,
Though at times I shook with fear.
And sometimes, God forgive me,
I've wept unmanly tears.

I know I don't deserve a place
Among the people here.
They never wanted me around
Except to calm their fear.

If you've a place for me here,
Lord, It needn't be so grand.
I never expected or had too much,
But if you don't.....I'll understand.

There was silence all around the throne
Where the saints had often trod.
As the policeman waited quietly,
For the judgment of his God.

"Step forward now, policeman,
You've borne your burdens well.
Come walk a beat on Heaven's streets,
You've done your time in hell."

Author Unknown