Wednesday, September 9, 2015

My Grandma

Working as a family doc I come across hospice, dying, death… quite often. Sad to say, signing death certificates is as routine as signing an authorization for a medication refill. But every now and then… I allow my emotions to overcome me and I am right there crying at the bedside with the loved one’s family members. 

This past weekend, I managed to squeeze a trip in to visit my almost 99 year old grandmother, leaving my four kids in the very capable and willing hands of their daddy. This grandmother, my “ah ma”, helped raise me so she has a special place in my heart. So in just one year time, I found my ah-ma to be a little more frail, a little more fragile, and unable to speak anymore. However, she is in better shape than I was expecting given some of the frantic phone calls I received late Spring. Her eyes are very alert and she seems to recognize me. She would nod her head a couple of times and before I left, she was squeezing my arm. I even got her utter a few numbers in Japanese with me while I counted. Every time I visit her, I wonder if this is the last time we’ll get to interact… 

My ah-ma was a formidable woman… raised 6 kids almost literally by herself since grandpa (ah-gong) was off working in the city. Not only did she deal with the day to day stuff that moms deal with when they have a handful of kids to manage, but she ran a ping-pong table business to support the family while grandpa was away. This is how my dad and many of his siblings became so good at playing ping-pong. If customers were few, they would step in to play. If they lost, the game is free, if they won, the customers would pay. 

Although circumstance did not allow grandma to get much formal education, I remember her as a very sharp woman. She was also a fantastic cook. 

It is hard for me to see her this way… so different… 

This weekend had me thinking a lot about life… the purpose of life… how our bodies are made to fail us eventually… and then what? As Christians, we believe there is more to this life than just what is here… we have hope and faith in God’s promises. That there is more to come and what is to come is going to be more marvelous and glorious than anything we can ever imagine. 

This Sunday, I was googling churches to attend and was hoping to go to one that had expository preaching. Initially, I was disappointed when I looked at the sermon notes and realized that the preacher was going to do a topical approach. However, I soon realized that God brought me there to specifically answer some of the questions that I was pondering all weekend. The entire sermon was about heaven! The preacher quoted from the Bible, passage after passage… these are some of the verses… 
 “Do not let your hearts be troubled. You believe in God; believe also in me. My Father’s house has many rooms; if that were not so, would I have told you that I am going there to prepare a place for you? And if I go and prepare a place for you, I will come back and take you to be with me that you also may be where I am. (John 14:1-3) 

Brothers and sisters, we do not want you to be uninformed about those who sleep in death, so that you do not grieve like the rest of mankind, who have no hope. For we believe that Jesus died and rose again, and so we believe that God will bring with Jesus those who have fallen asleep in him. According to the Lord’s word, we tell you that we who are still alive, who are left until the coming of the Lord, will certainly not precede those who have fallen asleep. For the Lord himself will come down from heaven, with a loud command, with the voice of the archangel and with the trumpet call of God, and the dead in Christ will rise first. After that, we who are still alive and are left will be caught up together with them in the clouds to meet the Lord in the air. And so we will be with the Lord forever. (1 Thessalonians 4:13-17)

But our citizenship is in heaven. And we eagerly await a Savior from there, the Lord Jesus Christ, who, by the power that enables him to bring everything under his control, will transform our lowly bodies so that they will be like his glorious body. (Philippians 3:20-21)

Then I saw “a new heaven and a new earth,” for the first heaven and the first earth had passed away, and there was no longer any sea. I saw the Holy City, the new Jerusalem, coming down out of heaven from God, prepared as a bride beautifully dressed for her husband. And I heard a loud voice from the throne saying, “Look! God’s dwelling place is now among the people, and he will dwell with them. They will be his people, and God himself will be with them and be their God. ‘He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away.” He who was seated on the throne said, “I am making everything new!” Then he said, “Write this down, for these words are trustworthy and true.” (Revelations 21:1-5)

Therefore, “they are before the throne of God and serve him day and night in his temple; and he who sits on the throne will shelter them with his presence. ‘Never again will they hunger; never again will they thirst. The sun will not beat down on them,’ nor any scorching heat. For the Lamb at the center of the throne will be their shepherd; ‘he will lead them to springs of living water.’ ‘And God will wipe away every tear from their eyes.’” (Revelations 7:15-17)

Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus. Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—think about such things. Whatever you have learned or received or heard from me, or seen in me—put it into practice. And the God of peace will be with you. (Philippians 4:6-9)
There are probably so many more. 

Leaving my ah-ma was especially hard this weekend. Again, I am not sure whether I would be able to visit her again and if I do…. how much would she change? As I held her hand sobbing, she looked at me and seemed to be saying to me “aiya, don’t cry” Although nonverbal with words, she has been very communicative with some squeezing of her hand and with the movement of her eyes and head.

I love you, ah-ma. I don’t know at the end of the day whether you chose to believe in God and heaven… but I pray that God in His mercy can still speak to your heart… despite the outside shell of a weakened and frail body and a forgetful mind… that inside maybe you still hear and understand everything we are saying… that He would speak to your soul and you’d respond… and that I would see you in glorious form one day.

Sunday, September 6, 2015

Yosemite National Park and The Plague

Hello world!  It has been way too long…
So many things to catch up on… where to start…
As I knew it would, the summer just flew by. This has been the third year in a row that we packed a tremendous amount of luggage and flew six hours cross country to California. Herding our little ones through airport security and all that that entails is like… well… I can’t think of a good analogy. But the one huge difference this summer is that this is the first summer in EIGHT years that I am not either pregnant or nursing! Whoo-hoo! The physical freedom… I cannot even put into words…
Why all this trouble, you may wonder...  I am a very sentimental person and I value certain intangibles. Seeing my cousins and extended family and watching my kids form relationships with their extended cousins makes it all more than worth it.
Now we can’t fly six hours and put our kids through a three hour time zone change just to fly back after a long weekend, so we decided to make a vacation out of it and headed to Yosemite National Park.
Yes, this is the same Yosemite that CNN was reporting cases of plague.  And yes… we arrived there right when the first case was reported and left there right when they reported a second case.
So I had to do some research on bubonic plague since this is not something we see often these days and I definitely did not come across any cases as a medical student or resident.  Here is the basic 101:
It is a severe potentially deadly bacterial infection
It is caused by a bacteria called Yersinia pestis.  Usually transmitted by a bite from fleas or wild rodents such as rats, squirrels, chipmunks, and prairie dogs.  If the bacteria reaches the lungs, then it can be transmitted from human to human by respiratory droplets from coughing.
So this bacteria is the cause of the famous Black Death which killed 70 million to 200 million people in Europe during the Middle Ages.  However, it is still around today.  In the US, it is mostly found in the west (California, Colorado, Arizona, New Mexico) in more remote areas.  Since April 2015 there has been 11 human cases.
Bubonic plague...
  • fever and chills
  • malaise
  • headaches
  • muscle pains
  • seizures
  • painful lymph node gland swellings (groin, armpit, or neck)
If Pneumonic plague...
  • fever
  • cough
  • difficulty breathing
  • bloody sputum
  • chest pain
If Septicemic plague...
  • fever
  • abdominal pain
  • diarrhea
  • nausea
  • vomiting
  • bleeding 
Requires antibiotics within first 24 hours or can result in death.  Need to be hospitilized for oxygen, respiratory support, fluids, and monitoring.
  • Do not handle sick or dead animal bodies
  • Avoid rodents (mice, rats) and rodent droppings
  • Avoid insect bites by using an insect repellent containing DEET
  • Eliminate fleas from your home
Here's more info from CDC website:
Well, we are all fine. 
Yosemite is beautiful by the way… unfortunately, it was dry due to California’s drought… but beautiful just the same.

Wednesday, May 27, 2015

18 Month Stage

This is my favorite stage!  L is 18 months right now and such a riot to be around. He is fun to interact with and his personality is definitely becoming more apparent.  So far this kid has not thrown any of those "slam the body on the ground, writhe, go limp and scream" tantrums yet... couple of my other kids hit it by this age.  So we'll see... maybe we'll skip it with this one...

L loves to imitate!  He especially loves to copy his 3 year old brother.  It is quite comical actually to hear him sometimes echoing everything that his brother utters.  E is having a blast with this as well and will often come up with pretty silly things to say just so he can hear L say it.

So other than language explosion, this is also a time of tremendous growth in many areas.  Some fun things things we're seeing:

self feeding - usually quite messy but he is so proud of himself when he successfully gets food from spoon to mouth.  We usually help feed him in between his attempts for efficiency sake and to decrease clean up but I suppose we really should just let him do this more...

dancing - we'll often see him wiggling, jiggling... bending and clapping to his sister's piano playing or when we have music in the background...

climbing - climbs on everything!  watch out!

hugging -  love that he can hug me back now and pat the back of my neck with his little hands

imitating - as mentioned before, L loves to imitate.  He not only repeats words and syllables but loves to mirror our actions as well.  Often we see him walking around with a pretend cell phone held up to his ear and he is jabbering away... then   "okay, bye!"

stripping - yup, I've walked in on him with his bottom bare... somehow managed to take off his clothes and diapers...

throwing - well, this started close to when he turned a year and has not really stopped.  What is so amusing about throwing stuff on the floor during meals?  All my kids did this...

jumping - kind of.. they are more like exaggerated knee bends right now... but getting there...

singing - not as clear and verbose as his sisters were at this age... but I can make out the tune and catch a few words... he's trying...

competing for attention - o he is definitely trying to get his voice heard above all the bustle and chatter from his older siblings. Not easy being the youngest of four but this kiddo sure knows how to make his presence known.

Cliche I know... but he is growing way too fast! I can not believe we are out of the baby stage for good.  Well, here we go... gearing up to hit the "terrible twos"!

Tuesday, May 19, 2015

Happy Mother's Day 2015

Happy totally belated Mother’s Day to all the mothers out there! It takes a couple’s retreat with our church small group for me to find time and energy to think and blog. 

We are going through a book and video series by Frances Chan called Forgotten God: Reversing Our Tragic Neglect of the Holy Spirit. In one of the sessions, we watched Chapter 5 where Chan was talking about relationships. He used the analogy of his relationship with his kids to demonstrate Gods relationship with us. Chan shows love differently to each of his kids but at the end of the day it is so important to him that each child knows to the very core that he loves them with all his heart… and that is what God desires for us. So this also led me to think about my role as mom and the nuances that make my relationship with each of my children special. I am reminded of Gary Chapman's book The 5 Love Languages of Children and how I use different languages of love to express my affection to each of my children. The 5 primary love languages that Chapman talks about are: physical touch, words of affirmation, quality time, acts of service, and gifts.

My seven year old is in public school. I spend a lot of time with her especially before bedtime, talking about her day, her friendships, her ups and her downs. She is my super sensitive child and thrives on encouragement and praise. She needs more of my emotional support right now and highly values words of affirmation.

My second daughter loves to hug and kiss. Whenever she senses that I’m upset with her she often wants me to give her a hug right away. This is often hard for me because I need time to cool off… but I realize that physical touch is a very important demonstration of love to her.

My three year old boy is active and loud and likes to play with his imaginary “shoot gun” making shooting noises everywhere and crashing his toy cars and trucks everywhere. At the same time he has such a sweet spirit and will randomly say “I love you” to me, one of his sisters, or a caregiver who is around. He seems to especially love the times right before nap or bedtime when we sit and read together. Since I am running around so much working part time and driving the older kids to activities, the quality time that I can spend with him is truly treasured.

My youngest requires the most amount of my physical attention. He is wholly dependent on others to meet his physical needs. He is uttering many words now and competes for attention by calling out “mommeee”! He has also learned to hug back and pat the back of my neck with his little hands. At this stage I find that I’m showing love to him mostly by my acts of service, though I’m sure I will be using other languages of love as he grows and his needs change. 

 I have made many mistakes as mom and will make many more... but at the end of the day, like Chan, I desire my kids to know that they are genuinely, utterly, and fiercely loved.


Wednesday, April 29, 2015

Spring Break Trip

I've been meaning to post this for a while...

So!  After hearing good things about Busch Gardens and Colonial Williamsburg we decided to take the kids to Williamsburg, VA for Spring Break.  

Getting there...
Some families can drive at night to save time while the kids sleep in the car. Our kids don't sleep well in the car so we decided to just leave first thing in the morning. It means we spend a day just driving but we didn't want to start off the week with grumpy sleep deprived kids.  Google maps estimated about 5 hrs but it took us closer to 7 with all the pit stops and traffic that we hit. The three older kids did fine in the car... the girls sat in the back and chit-chatted almost the whole drive. Paper and markers are all they need to be occupied.  E just entertained himself with a few car toys that we packed. I was actually surprised at how low key and easy he was. 

But now L who is 16 months... was super bored and I had to entertain him with songs and whatever toys or objects around the car I could find. Entertainment went something like this.  I'd hand him a toy.  He would examine it for a few seconds... if we're lucky a few minutes.. then tosses it to the side.  And of course it is the opposite side where I can't reach and would have to unbuckle... stretch over his carseat... then blindly search with my hand to retrieve the toy.  This happened often because of course right after he throws the toy, he wants it back!  

So during his "nap time" was when we pulled out the electronics for the older 3 to watch with headphones. Though L normally takes a 2-3 hr nap in the afternoons, he only napped 30 min in the car. See... my kids just don't sleep in cars...

With 4 kids ages 7 and under, we really did not feel like all squishing into a small hotel room.  Plus, we've reached the limit they would allow for folks in 1 room and would have to get 2 rooms now!  5 is the limit unless you get a suite...

So we got this deal through a travel club to stay at King's Creek Plantation for a little over $400 for the whole week. We had 2 bedrooms, 2 full baths, a full kitchen, a living room, and most important of all... a laundry machine. I think we ran the laundry at least once a day because of soiled clothing from either food spills or just diaper overflow. Added plus was an indoor swimming pool and 2 hot tubs (which I used one night after the kids were sleeping). There were other activities and such that they offered but we didn't have time for. There was even a playground and miniature golf that was all part of the complex and included in our stay... but again, we just didn't have time for it... plus it was super cold the first few days.

The theme park...
Well, this was our first time at Busch Gardens. We got this Spring Bounce discount online which was a great deal. Kids 5 and under are free so we only paid for 2 adults and 1 child. Plus, it gave us unlimited access for 7 consecutive days to both Colonial Williamsburg and Busch Gardens with free parking.

Busch Gardens is definitely a beautiful park and it was neat to walk through the different European "country" themes.  They had enough kiddie rides to entertain the little ones and some pretty impressive coasters as well.  Perhaps compares to other parks that we've been to so far with our kids... this one stands out because of some of the thrilling rides.

The rides...
So we spent a lot of time in Land of the Dragons and Sesame Street Forest of Fun.  Even our youngest who is not yet 17 months could go on most of these rides without an accompanying adult.

Some rides L went on included:

E my 3 year old's favorite rides were:

  • Der Autoban Jr - They have an older kid version I but love that they have a kiddie version where a 3 year old is able to drive a car all by himself.  Took E a few tries to figure out how to move around without keep getting stuck... I think the attendant could probably be more involved in getting the little kids unstuck.
  • Der Roto Baron - This was just a cool airplane ride
My more daring 5 year old enjoyed Grover's Alpine Express even though her 7 year old sister didn't want to try it.

Surprisingly, both girls loved Curse of DarKastle! They probably went on this ride at least 6 times.  I must say it was a pretty cool ride because you wear these 3D glasses and it literally feels like things are being thrown at you. The simulation was impressive and I felt like I was inside a cartoon. Sitting in the front totally made it seem more real.

Other rides the kids particularly enjoyed included:
Now it's been a looong time since I've been on any thrilling coaster rides. This trip I had time for two of them.  
  • Verbolten - Now this ride has moved to my list of "most cool rides ever"!  There is a section where we enter the "black forest" where it was super dark and filled with lots of surprises.  Very impressive I must say... in fact, I was so thrilled I told my husband he had to go ride it while I took my turn watching the 4 kids.  The downside for not going with any other adults was that we couldn't go on these coaster rides together!
  • Apollos Chariot - I went on this ride first and during the initial ascent I remember thinking to myself... now why am I doing this again? I kept thinking about the woman who fell off the Texas coaster in 2013.  I must really be getting old.  I never used to think these kind of thoughts when I was riding coasters left and right as a teen and young adult.
We will definitely have to go back to Williamburg, VA.  I want to check out some of these other coaster:

The Food...
I was actually pretty impressed.  Trapper's Smokehouse has delicious smoked spare ribs!  I'm getting hungry just thinking about it.  We liked eating at Das Festhaus because they have indoor seating and live entertainment with singing and dancing while we eat our meal.

Their food deal that you can get online wasn't really that much of a deal but I suppose you save a little if you know you will buy lunch at the park.

As for snacks... they had your usual park foods.  My favorite are funnel cakes.  The kids liked the churros.  And of course... who doesn't like ice cream!

All in all... it was a nice family park and we'll likely go back when the kids are older to try some of the bigger rides.  This time it was super nice to only have to pay admission for 1 child!

Colonial Williamsburg
Now Colonial Williamsburg was a different kind of treat.  I can only say it was super cool and we will definitely be back when the kids are older to appreciate the history and education of it more.  This time only my second grader really got it, though both girls loved the wig shop and the clothing shops. Kudos to those folks there who stay in character the whole time!

Tuesday, March 31, 2015

Peanut Allergies

Ah... gotta get my blog for March in...

So some of you may have read all the recent news articles encouraging parents to now introduce peanut products early to babies.  A recent New England Journal of Medicine article prompted all this discussion.  They basically took 640 babies who has severe eczema, asthma, allergies to either consume or avoid peanuts until 5 years old.  The conclusion from the study is that early introduction of peanuts significantly decreases the frequency of peanut allergy development among children who are high risk for this allergy.

This is a big deal because in the past, the recommendation had been the opposite.  Although back in 2008, AAP did say that there was no shown benefit in delaying giving solids beyond 4 to 6 months, many continued this practice of avoiding allergenic foods.  Now it is thought that this old recommendation to delay introducing peanuts to babies has caused the rise in peanut allergies we see in the US!

Well... I'm afraid our youngest has a peanut allergy.  None of our other three children had any significant food allergies, so my guard was down with this one.  While the older brother and sisters were eating peanut butter and jelly sandwiches one morning, I decided to also give L some pieces of bread with a good amount of peanut butter on it.  "Mmmm..." he says and seemed to like it.  So I gave him more.

Now, don't do what I did!   I continued to give L peanut butter topped bread pieces right before our 45 minute car ride to a Please Touch Museum.  Plus, I did not think to pack Benadryl in the car.  So as we were driving, I noticed L starting to rub his eyes and getting really fussy.  I was sitting in the back with him and right before me, hives started popping up on his face.  Wow, this kid is allergic to peanuts!  I went into panicky mommy mode.  We did finally stop at a pharmacy and get some Benadryl for him.  L is fine.  But now we'll have to formally allergy test him!  No more peanuts for now... and sadly maybe forever.

So here's the brief 101 on peanut allergies:

What is it?
Immune system over reacts when peanut is ingested causing symptoms

What are some common symptoms?
  • hives
  • itching or tingling around mouth or throat
  • digestive problems like nausea, vomiting, diarrhea, cramps
  • tightening of throat
  • shortness of breath
  • wheezing
  • runny nose
What is anaphylaxis?
Life-threatening reaction that is induced by food ingestion (most commonly peanuts)

Symptoms of anaphylaxis
  • airway constriction
  • throat swelling
  • blood pressure drop
  • rapid pulse
  • dizziness, lightheadness, or loss of consciousnes
How to treat it?
This would be a medical emergency requiring treatment with an epipen.  In fact, anyone with any food allergy should have an epipen for emergencies.

So peanut allergies can be pretty serious.  If allergic to peanuts, must avoid peanuts or any products that contain peanuts!  Also need to know how to treat mild symptoms and how to spot and respond to more serious reactions.  Talk to your doctor.

Now depending on the severity, there is a possibility to outgrow the allergy.  Testing and retesting can help determine this... but never try to orally challenge your child at home!

Sunday, February 15, 2015

The Flu

Husband is down with the flu.  He says he has never felt so sick before.  For two days he was basically in bed.  Yesterday, he was moving around the house some... but tonight he was back in bed by 7pm.  

It is pretty miserable to experience the flu.  Symptoms come on rapidly and most commonly consists of fever, chills, malaise, and body aches.  I wrote a previous post comparing and contrasting the common cold to allergies.  Web MD has a nice chart comparing the common cold to the flu.  I've included it here:

FeverRareCharacteristic, high
(100-102 degrees F); lasts three to four days
General Aches, PainsSlightUsual; often severe
Fatigue, WeaknessQuite mildCan last up to two to three weeks
Extreme ExhaustionNeverEarly and prominent
Stuffy NoseCommonSometimes
Sore ThroatCommonSometimes
Chest Discomfort,
Mild to moderate;
hacking cough
Common; can become severe
Sinus congestion
or earache
Bronchitis, pneumonia;
can be life-threatening
Good hygieneAnnual flu shot or FluMist
relief of symptoms
Antiviral drugs (Tamiflu or
or Relenza) within 24-48 hours
of onset

Since the flu is contagious about 1 day before and 5-7 days after symptoms start, we are watching our kids carefully.  It may be tricky to determine whether or not a child has body aches.  Plus with kids, they can also have nausea, vomiting, and diarrhea.

Now colds usually lasts 2-3 days... maybe 1 week at most.  The flu can last 1-2 weeks... sometimes longer.  Boy, I sure hope husband feels better soon.  The house is just not the same without a functioning daddy!

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