Dancing

Tonight we put on Bethany's exam practice music (grade 2 Jazz) and had a bit of a dance at the end of our Family Home Evening.  We did the Macarena together (Damien excused himself but he was smiling as he watched us).  We girls thought it was great.  Beth then showed us her other exercises and stretches.  Wow.
Little Hannah didn't want to stop.  "Macareeeeeeeeeeena" she called as she tried to entice us all back into the lounge room.  Then she gave up on us and did a solo performance on the kitchen table.  Damien walked into the kitchen in the middle of her performance: you will hear his OH&S concerns in the background.

Toddler Telephone

Another cute moment from this week:
While Damien was at work on Tuesday we spoke briefly on the phone. Hannah badgered me for a turn, and Damien was very gracious, despite being insanely busy.
I love the look on her little face. 

That baby fringe of whispy bits is causing trouble, but I'm determined to not trim it.


I'm typing now with one hand because Bethany woke Hannah up (grrrr) and I'm giving the little lady a cuddle before I toss her back into bed.

Hannah and Leila like to read

Leila is doing really well with her reading. I caught this cute book-sharing snuggle going on in the Loungeroom, and couldn't help but take out the camera phone.  Leila was reading to Hannah and playing "finding" games with the pictures (it's an eye-spy book).

My Birthday

So, apparently I am 37.
Good opportunity for some self assessment.  I sure don't want to be this heavy at 38 for example.  Possibly the cake won't have helped with that though. (If you think this one looks good, you should have tasted Liz's sticky date cake with caramel sauce).

My birthday celebrations started with being allowed to stay in my dressing gown while Damien took the girls to Dancing.  Nice for me to have a more relaxed morning (plus, there was no way anyone else would have been ready in time without lots of help, and I couldn't get myself ready at the same time as them...).

My actual "party" started at about 5: 20 when Granny arrived with Libby and her 3 girls.  They suprised me, because Libby doesn't currently have a working, registered car.  Mum actually drove all the way down to Dover to pick them up.  Then she went back to get Dad, because her car only seats 5.

Later on Matt and Liz arrived with their kids (minus Lewis).  We ate, and talked and the kids played all over the house, then we headed downstairs to show each other our favorite youtube clips.  We still don't have a couch downstairs, so we roughed it on an inflatable mattress, cushious, various small chairs etc.
Here are some links: boomwhackers more boomwhackers, evolution of dance, musical prank, and Badgers.  Badgers was from Damien, in case you haven't guessed.  I should have added in potato salad too.
It was nice to get my set of Boomwhackers out and watch the cousins play with them.  Jordan was particularly impressed.

Next time Granny goes to extraordinary lengths to bring Libby to something, I think we will be helping out too.  Somebody else should have dropped Granny home so that Grandpa didn't have to the trip and then come back to Lauderdale to collect the Burton Family for the return run to Dover.  Poor Rhiannon got way too tired while waiting and things got nasty.  Sorry Libby, we should have thought that one through.

Just as we were waving Matt's family goodbye I got another call-in.  Third call in for the same guy in a week.  I got a sympathy cuddle with Damien on the couch for 5 minutes because I was depressed at the whole idea of having to go to work again (and on my Birthday too).  I already had a 5 hour paper work backlog.

Because this is MY blog, and it is about MY birthday, I'm going to gratuitously add the following rundown of my case that night in the CCU ward, and hope I'm putting it in English:

MY VERY INTERESTING DEFIBRILLATOR CASE

I am called in because the emergency staff witness an arrhythmia that is too slow for Mr R's implanted defibrillator to detect.  They think that the nurses cured the arrhythmia with an injection.  Would I please alter the lower detection rate?  It is already on the lowest setting I could get it to do earlier in the afternoon.

I arrive, and do a quick internet search on this particular devices rate limitations.  I will have to change multiple parameters to get it to let me anti-tachy-pace at 145 beats per minute.  I ring the device specialists to discuss what I have concluded.

A little after midnight I use a computer to talk to the patient's implanted defibrillator.  It tells me it has saved Mr R's life twice since I saw him in Emergency earlier in the day (he got a shock from the device this morning).

The above graph plots the interval between heart contractions, big light blue dots for the atrium and tiny dots for the ventricle.  Lower dots = faster heart rate.  At the start of this graph, the ventricle is going twice as fast as the atrium, and the rate pattern zig-zags.  I have only ever seen this pattern on this patient (this week).  Horizontal lines show the intervention zones.    You have to get a high proportion of dots within the zone before therapy will be initiated,

So, (from left to right) slow ventricular tachycardia (patient felt awful, but was not treated by device, because the rhythm did not consistently fall beyond that first detection line).  Very unusually, the atrial rate is half the ventricular rate, and seems to be in sync.  There is then a sudden increase in ventricular rate, falling within the second therapy zone (he's gone from slow tachycardia to a faster more dangerous rhythm - too fast for a detectable pulse).  Device detects arrhythmia, and saves his life by delivering a VERY fast run of paced beats, painlessly tricking the heart out of the arrhythmia and back to normal.  If that hadn't worked, or if the rate was faster than the lowest line, it would have smacked him with a painful electric shock to save his life.  I conclude that the emergency staff didn't save him, the device did.

The next picture shows what the device was doing at the time of the slow ventricular tachycardia:  It was pacing over the top!!!  "Hey, the heart's going inappropriately too fast, lets try and trigger heart beats along with it".  It seems that the atrial pacing is triggered by the ventricular rate (firing off after every second contraction).  Very strange indeed.

I realise that for every second ventricular contraction on the previous interval plot the device is counting the pacing spike, not the sensed beat underneath it, and that this is why the interval plot zig-zags.  This is interfering with accurate rate detection.  I tried to send this picture to the device specialist (who needs to get a new mobile phone that will show pictures!).  He can't explain my observation.  We decide that I'll fax him the rhythm strip on Monday.

My job was to reconfigure the therapy zones so that the slow arrhythmia would be treated (before things got really nasty).  Turns out that there is an extra algorhythm turned on to help stabilise the ventricular rate (it helps in the presence of atrial arrhythmias).  It is called V rate stabilisation, and delivers a paced beat (both chambers) following an early native ventricular contraction (or ventricular ectopic beat).    I turn off the algorhythm, because it is blocking me from resetting the lower detection rate.  I also adjust how fast the device will crank up too in response to physical exercise, because it was too close to the arrhythmia zone. I print out, disconnect and say goodbye to the patient.

While I am writing in the notes, he does it again.  At 133 beats a minute, still below my new detection rate.  Patient feels like rubbish.  I plug my machine in to manually deliver some anti-tachy pacing therapy, but while it is loading up, he deteriorates, the rate gets higher, and the device saves him automatically.
That wasn't particularly cool, because he suffered for a bit too long before the therapy was delivered.  What was cool (well, hey, I was excited) the device didn't try to pace over the top of his arrhythmia this time, and displays the slow VT as a regular row of lines, not a zig-zag.  It was that darn V rate stabilisation algorhythm.  I have heard of V rate stabilisation before, but didn't know that it would be active even if there wasn't an atrial arrhythmia.   My zig-zag graph makes sense now, and I LOVE THAT.  I must point out to the company that it can prevent arrhythmia detection (they probably already know, but slow VT like this isn't very common).  I wonder if my cardiologists have even heard of V rate stabilisation.  I love my job.

I ring the Doctor, and tell him I'm resetting the detection zone to 130 beats per minute.  This is the lowest I've ever set a tachy therapy zone in my career.  They take Mr R off amiodarone on the basis of nasty things happening to his resting 12 lead ECG, and I write in his notes all over again.  I decide that it is too late at night to bother with the rest of my paperwork, and I get home at about 1: 45 am.

The End.

What happened next?  Well I dropped in on him again on Sunday afternoon (after being called in for another case) and he hadn't had a problem since last night.  I'm sure he's going to be the subject of much discussion on Monday.  I nearly fell asleep trying to drive home, but got to have a nap when I arrived.

I am not really looking forward to work tomorrow (I have to do an extra day to make up for sessions canceled due to my Melbourne trip).  If you could drown in paper work I'd be dead.  I love my job, but I hate not being able to keep up with everything I need to do.  Craig comes back in August, so I'll save my nervous breakdown until them.

Queen’s Birthday Tea Party

On Wednesday I had a bunch of little visitors:
Our Relief Society has a little “mother’s group club” in it, and we do various activities around about the place. Twas my turn to organise it this week, so we had a little tea party, being the week of the Queen’s birthday celebration here in Australia.
The mums were all impressed at the nice tea cups I have (didn’t have enough though). My gorgeous tea cup was a gift from my friend Eve, and because my girls all kept wanting to use it I organised pretty tea cups for them one Christmas. One day I want to have about 12 or so… (cups that is, not girls, although girls are wonderful too!)
Anyhow, the tea party sure helped me to get a move on the CLUTTER around my house. Damien saw me trying to neaten up and shampooed the carpet! Yay! Boy was that overdue…
I didn’t’ win all my clutter battles, but I sure did improve things a lot. I was away in Melbourne last Thursday and Friday, had patients to see Saturday afternoon, was called in again on Sunday, and started the week feeling very behind. Inviting people over promotes housekeeping quite a bit. I should do it more often!
Anyhow, back to the tea party: we made cardboard crowns, ate cookies and shared our favourite kids books. Thanks Bron and Kristy for coming along.

Bad Saffy Cat

Mum looked after the girls last Sunday when I was called in to work.
When I came to collect them I discovered that Hannah was wounded.
That’s cats for you!
I’m sure it was the usual formula:

2 year old plus cat = defensive cat action

They all still want a cat though.

Evening music and Stripy Dancing

Following the success of morning music I thought we'd start the new school term with an attempt at evening music.  We are also trialing a revised pocket money system, and a personal mini wheelie bin approach to tidying up, but I won't write about those tonight.

So, the evening music routine has the following rough plan:

10 minute tidy
Next days stuff laid out,
PJs ready (in front of the heater),
Bath time,
Dry & Dress
Teeth
Toilet
Stories & Bed

Tonight we didn't really keep up with the music due to a late supper and  Beth's 5:30 dance lesson (the baths happened before 5).  It was more of an introduction/trial run.

Leila disappeared after I finished helping her clean her teeth. 

I found her in the Lounge room doing a very elaborate creative dance routine to the instrumental nursery rhymes. She was ballet dancing her heart out in gorgeous stripy thermal underwear (the girls often use them as pajamas and then wear them under their school uniforms). It took about 3 attempts to get her out of the lounge room and off to bed.  Man, that girl loves to dance.

Mess

I thought that my house would be tidier on Wednesday because we had less little people around (Libby and her girls were back at Dover).  Not so.  While I was in the shower, there was a bit of an incident at the breakfast table involving milo and play dough.  Cookie cutters took over the kitchen floor (took about 6 attempts and a Dragon Mother to get that sorted - actually I think Damien did a bit of dragoning too).
There was also a cornflake incident that involved the entire loungeroom.  Nice to have a little angel volunteer to help with that one (thanks Hannah!).

More holiday moments

Here are some photos from our busy Wednesday.  We had been fairly housebound during Libby's visit as our car couldn't fit us all in.  I was due to be out-of-the-state on the Thursday and Friday, and felt that we all needed to have a bit of an outing before I disappeared.  It was a miserable day weather-wise, so we went to the Glenorchy YMCA fit'n fun centre (after jobs and errands).

Expensive, but a lot of fun for the kids.  Pity my camera doesn't work all that well in indoor light.

Kitchen chaos

More moments from Libby's visit:

Between beading and biscuits, we sure made a mess.
I made a HUGE batch of gingerbread (7 1/2 cups of flour) in the hope that I would be able to make treats for us, Matt's family and also a welcome to Lauderdale gift for a church family who have just moved in. 2 out of 3 ain't bad.

I ran out of time. We only got half the batch done, and then Matt and Liz arrived. Wednesday was very busy, and then I had to go to Melbourne for 2 days of training (for work).

Granny got to cook up the rest of the mixture. We tried again with cupcakes on Saturday, but when I tried to deliver them the family was out (and I wasn't entirely confident I had the right house). Guess I'll be cooking again today!

Kodak moments

But WHHHHYYYYY can't we buy this packet of jelly snakes?

Licking sauce from her plate.  Ugh.  I am slightly worried that photographing moments like this might re-enforce them rather than discourage them, but took the risk anyway.

Hairdressing and craft

Libby seemed to enjoy (or at least cope with) being surrounded by little girls and having her hair done.

She also had some fun making up a few hair sticks using epoxy glue, wooden "blanks", beads and artificial flowers.

In the evening on the Tuesday we had a visit from Matt and Liz.  Damien was still at work (some serious deadlines he needed to catch up on).
The 4 and up girls enjoyed watching movies on a mattress downstairs while the adults had some fairly serious and much needed conversations upstairs.  I'm very glad we had the opportunity and facilities to talk, and resolve some difficult issues.  I love my family.

Kidnapping Libby

Last Sunday (during the last week of the school holidays) Granny drove down to Dover and kidnapped Libby (along with Rhiannon and Jocelyn) for a visit with me!  She also took Imogen for a few days (Imogen stayed at Kristy's house with Granny and Astra).  Libby was quite surprised (so was Damien) at the proposition, but I think things went pretty well. 
There was heaps of dressing up.  I haven't managed to make Rhiannon a mermaid costume yet, and she really likes to borrow ours.

Leila is being a super something here, standing on top of the couch in her thigh high stockings a purple leotard (it is on backwards by the way - saggy baggy at the front and not covering enough at the back!).

Hannah got to try on our cow costume too (I had the zip repaired only recently).  This was a gift from Liz.  Looks pretty cute, and it is still pretty big.  We should get a fair bit of wear from it (although Hannah does prefer girly dressups).

It was really nice having company with the basic, everyday jobs.  Jocelyn was a good helper, and seemed to enjoy the company and toys at our house.

Hannah is in the in-between stage of giving up her day time sleeps.  She got oversensitive and grotty, but wouldn't go to bed, so I made her a nest with a hot water bottle behind the couch in the Lounge room.  It worked.

The many faces of Leila

What would school holidays be without play dough?

I love how expressive this little lady is.  Lately she has sabotaged a number of nice little photo moments, so I thought I’d share some of the results:

Sneakers and Crocs

Soon after Damien's return from Turkey, I went for a run in ill-fitting sneakers (expensive defense force ones that have never felt quite right).
Needless to say I won't be wearing them again!  It is taking ages for the bruising to disappear.

Hannah decided that she had to have a photo of her feet too.  Crocs are awesome.

Tynwald Park

Just a few photos from our visit to Tynwald park in New Norfolk. Beth chased the other kids around in her vampire teeth, and Leila got to have a lovely play with cousins Sophie and Mariah.

The park has a large circuit of "streets" for kids to ride their bikes and scooters on. It even has working traffic lights!

Hannah still hasn't got the hang of her balance bike, and Leila doesn't like Bethany's old bike yet. She has trouble pedaling. That reminds me, later in the week (with Granny) she tried to ride it along a curved concrete drain in Lauderdale and got stuck when her rear wheel didn't reach the ground (she was pedaling madly in the air held up by her training wheels). Pretty funny.

At Tynwald park we got to watch Lewis flipping his skateboard under his feet. Stephen and he should get together methinks. Sophie rode everybody else's bike and scooter, and Hannah loved being swung (until she sort of got dreamy, let go one hand and ended up covered in dirt and spitting pine bark. She was not happy (but also not hurt). You can blame Me 'cause I was the one pushing at that point. Jordan had a bit of a turn on Leila's scooter too.

Once again Sophie did amazing climbing stunts on all the play equipment. She held her legs out for this photo, they are not resting on anything. Her siblings are pretty good climbers too, and did a great job of helping me get all the bike gear back into the car.