Thursday, February 28, 2019

Update.

Sometime I have a few shifts in a row where I head home just buzzing and happy and excited.  Vickey reminds me that not every shift is like this and I know this, but sometimes you have to slog through the tough ones to get the ones that spin together in a way that is satisfying.  A good shift is when the work is steady, but challenging and you have friends working the rooms ahead of you and behind you to help you out when you need it.  When you have time to go on walks with all your surgical patients.  During the night before one of my shifts, a patient had filed a complaint with the management of the hospital - it was enough to go to the customer relations department which is past the authority of my director.  Anyways, I had grabbed the assignment sheet at 6:30 am and was just reading about my patients for the day and didn't know anything about this high level complaint until 7 am when the morning huddle convened to do the shift change when I realized that they had assigned this particular patient to me.  Nursing-wise, this patient was a piece of cake. I was kind of flattered they trusted me enough to re-right this patient's experience.  And I mostly did, I think.  It's kind of fun for me to do this.  On the same shift, I also had a patient who was admitted into my care who was not stable enough to be on our unit.  So I had to manage a transfer to the ICU, but this is less fun for me.  I like my unit because even though everyone is sick, no one is really, really sick. And because no one is really, really sick, there is nothing in my medication dispenser that can really kill a person, which is what I like when I'm learning to be a nurse.  From Nurse Jackie - The only thing I want to do besides help people is not kill them.   On my unit, a patient's vital signs need to be stable over the course of 4-8 hours.  So if a person needs vitals checked at least hourly, I can't take care of them.  I don't have the medications necessary to stabilize them (because our pyxis doesn't have medications that can kill people, it also - as a corollary, doesn't have medications that can really save you if you are really, really sick), I don't have the expertise, I don't have the monitoring capabilities.  So the transfer to ICU still takes a couple of hours, so I'm running around trying to take vitals every 30 minutes, calling the doctors both on our unit and in ICU to coordinate what care I can do for them.

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I'm starting to tell the doctors what I want for my patients.  They are starting to ask me what the patients need.

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I'm still tired.  I'm looking forward to working less.





Tuesday, February 26, 2019

Light.

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There is light in the morning when I go to work now.  It's a relief to me - to go to work when it is light and I'm looking forward to coming home when it is light as well.  A few weeks ago, I had to stop talking to patients.  I mean, not that I stopped talking to them, but I had to cut all unnecessary chatter from my day.  This distressed me quite a bit, but I'm learning to protect myself which I suppose is what every medical person does.  So fewer hugs, fewer connections, but I'm still hoping for a warm and satisfying interaction.  We'll see how it goes.

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Jeremy and Vince went on a hike this Sunday with the scouts.

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Saturday, February 23, 2019

Self driving cars, pulled pork, greenglass house.

Jeremy's large convening is done.  The report is done.  He didn't even give the talk at the convening - but tbh, that didn't even matter.  It went well,  now he's excited to go onto other things.

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We went to Joan's memorial service today at Blessed Sacrament.  I was a little worried that Edda would start making noise in the middle of it, but she did pretty well.  A little bit of laughing, but nothing more.   We did not make Vince go - he was asleep when we left, but in retrospect we probably should have encouraged him to come and he said at dinner that he would have gone.  Oh well.  We initially thought none of us would be able to make the service - I needed to swap shifts with someone and Jeremy thought he was going be leading a scout excursion, but that got cancelled because of the rain, so I thought three out of the four was a pretty good showing.

I'm feeling weird these days, a combination of anxiety, exhaustion and excitement.  Jeremy made me my requested dinner tonight, pulled pork sandwiches with tater tots.  We were suppose to have a date to watch the indoor US track champs, but then we realized that it cost $75 to get it and then so we didn't.

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I'm trying to use my phone less.  It's hard.  I like to do all the mindless things everyone likes to do on their phone - play candy crush, scroll through instagram, read endless articles about how terrible the world is (though I miss a lot of news).  I think I'm even listening to podcasts too much (at 1.3 speed which does make everyone sound rushed) - it's too much noise in my head.  I've really lost the ability to read a book.  When I think of my childhood, I remember that I'd read ALL the time. 

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Friday, February 22, 2019

Update.

I have officially lost touch.  Who is Jussie Smollett?  I will just have to know there is so much I have no idea about.  But I'm also discovering stuff all the time.  All the time.

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It's a big day for Jeremy. A couple years' worth of work culminates in a big way today.  And he physically feels lousy.  He caught Vince's cold which was Edda's cold.  He would have stayed in bed all day yesterday, but he had a ton of last minute crap to wade through.  Wish him luck!


Wednesday, February 20, 2019

Snow day.

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Snow day!  Which meant that all four of us were home & inside the house all day.  No child care givers, no one else.  This is a rare occurrence.  I shoveled & napped.  Jeremy worked.  Edda smiled and laughed at her videos.  Vince is recovering from a pretty bad cold (he missed school yesterday, so it's just as well today was spent at home).  We filed Vince's first income taxes on the money he made this summer as a camp counselor.  He's getting a refund of about $50.  It feels good.  I'm stressed (so much crying.  god damn it, I wish I would stop crying over tough days at work).  Jeremy is stressed (his back was killing him last night).  We are both tired.  But as I told him this morning when we woke up a bit later than usual to indulge in the sleep day, we are fine.  Everything is fine.

Sunday, February 17, 2019

Wandering Earth.

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Went out to dinner with my parents to a new hibachi place in Rockville Town Square.  Then they were like - we want to see The Wandering Earth.  I was like huh?  What's The Wandering Earth?  It's this big blockbuster sci-fi movie from China that opened there on (Chinese) New Year's Day and was playing in Rockville.  My parents hardly ever propose seeing a movie, so we went.  Well, my parents and I went.  Jeremy and the kids headed home - Vince is actually fighting a pretty bad cold.  The movie was good and I recommend it highly (two thumbs up).  My dad said he preferred Gravity.  More plot, fewer special effects.  Also, my Chinese is terrible.  I could not have made it through without the subtitles.

Saturday, February 16, 2019

Sat. update.

I'm spending the weekend (as Vickey would say) retrenching.  I'm going to do nothing that looks like work and just try to relax.  Take deep breaths and try again next week.  I feel a little ridiculous and overdramatic, but what can I say? I feel what I feel.  I'm spending the day with Edda in our pajamas and I'm doing some quilting squares on the sewing machine I bought months ago and used only once. 

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We went to RM last night to see the student written one act plays.  Vince took this photo of us from the lighting booth.  (Thank you Nat for taking care of Edda).  The plays were good, I was impressed.  When I had kids - even when they were very young, I understood that I would be confused about how they approached love, sex, etc.  Even though I was a prude and very square and studious - falling in love with a boy at 16 when I was in high school was such a pivotal moment in my life, I just can't really imagine not falling in love with someone (I actually don't care which gender) in the second half of high school.  But this is not what is happening in Vince's high school, I think.  Well maybe.  I'm not sure.  There were songs about clearly only being friends between boys and girls - that even though they appeared to have an intimate relationship (hugging and hand holding and hanging out all the time) they insisted (in song) that they were not a romantic pair and in all the plays, heterosexual couplings were the least common.  Then they threw in the "they" pronoun for the singular person which confused me because I'm like - who are the "they" they are talking about?  I'm looking for a plural entity.  And then I realized (late) that that singular person wanted to be addressed as "they".  Anyways, it's all good, the plays were funny and original and it's very interesting to see what kids are thinking about these days.  There was a feminist play called Seneca Falls full of vitriol for capitalists.  I'm glad I grew up when I did and not now, I think I would have spent some time thinking about my gender identity and being confused about it because now it's a thing to think about and be confused about - there was already enough for me to think about in adolescence.  Though when I ask Vince - he says he's sure he's straight, and I'm like - well do you like any girls? and then he says no and then I ask how he knows he's straight then and then he says he'd know and then I launch into the Avenue Q song - if you were gay, that'd be OK! I mean cuz hey, I'd like you anyway!  Then he rolls his eyes at me.  And then I'm like - what!? I love that song.

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Vince told us at intermission that he was going to tell jokes on stage between the third and fourth plays and though I was excited to see him on stage, I was also nervous that he'd tell some inadvertently inappropriate jokes.  But it was all fine.  My favorite was - you are American before you go to the bathroom and American after you go to the bathroom, but what are you while you are in the bathroom?  European. 



Friday, February 15, 2019

Fender bender, crying, cookie.

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Ugh, the terrible week continues.  Jeremy was gone on business on Monday and got home late Tuesday night.  I got into a fender bender (I was at fault) on the way to work at the hospital's employee shuttle lot at 6:25 am on Wed morning (I'm ran into another nurse's brand new 2019 Lexus - she stepped out of the car and recognized me and threw up her hands and said - girl! you knew I had the light! and then we parked our cars, hopped on the shuttle and started exchanging texts about insurance.  I didn't even get to see the damage on our trusty Civic in daylight until today (Friday)).  Thank goodness Wed at work was manageable in terms of the load.  On Thursday, Valentine's Day, I found myself crying at least twice during the day in the employee restroom.  It got so bad that I told my charge nurse that I was going to go cry in the restroom and she looked at me and said - you go ahead and do that for a few minutes.  And then, later in the afternoon, my coworkers were following me around and said - tell me what I can do to help and I'd say, ah nothing, it's nothing and then they said - I won't stop following you around until you tell me how I can help (I found out later that my charge nurse had deployed them to help me out).  It's not that the patients were so bad or so sick or anything, it's just the amount of work that needed to be done on each person.  And then once I start to lose it, it just continues downhill.  My only conclusion from the day is that I'm not doing something efficiently and what I need to cut out is to keep lowering the amount of time that I'm actually nice to a person.  This is not what I want to do.  Of course, there are the more difficult patients and the easier patients but I take pride in getting along with everyone, in making people feel like I'm happy to see them.  And I am happy to see them, unless I'm in the bathroom crying.   I love my patients: the old people without their marbles and want to climb out of bed every 3 seconds, the young people with terrible diagnosis, the trans people, the paralyzed people, the cranky people, the ten thousand people with ten thousand diabetic foot ulcers, the HIV/Hep C/TB positive people, the homeless people with computer science degrees, the family members who sneak in food, the snooty family members from Manhattan, the people with stage four pressure ulcers, the patients who can tell I'm having a bad day and try to lower the amount they are asking from me, haha - I think I'm pretty emotionally sensitive, but some patients are better at it than I am.  I remember one patient I had for two days and the 2nd day it was just slightly busier than the first day and as soon as I walked into her room on the 2nd day - she took one look at me and said - you are stressed today and you weren't yesterday.  I was like - how can you possibly tell?  No one else can tell.  And she said - nah, it's easy to tell and I can tell it from how you walked into the room. 

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I came home late on Valentine's Day and Jeremy gave me a cookie.  Thank goodness.

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Would you rather have HIV or Type 2 diabetes?  I was reading a reddit thing about this and surprisingly most of the doctors on the forum would rather have HIV.  Jeremy said he'd rather have HIV.  It's one pill everyday for HIV for a normal life expectancy with few complications.  For Type 2 diabetes, you have a lifetime of monitoring what you eat, glucose monitoring & insulin injections and all the complications that come from uncontrolled sugars: kidney function, blindness, neuropathy, foot issues.  I'm hoping I never have either.

Monday, February 11, 2019

Crappy, wilderness survival, CardiB again.

Well, that was a crappy weekend shift.  Sundays are always terrible at the hospital for whatever reason.  The regular charge nurses are usually not working, so it's the most senior nurse running the show (which is generally fine, I get along with them well), but Sundays bring out weirdness in everyone.  I think I'm past the grace period given to new nurses by the other nurses on the unit and now it seems like it's OK to yell at me for missing something during my shift or to do the other, maybe more annoying thing, of pretending to be helpful and offer advice and/or correction, but is basically is a snarky way of telling me that they would have been more competent at my job than I was.  Anyways, it's depressing how predictable this well worn path is, I'm perfectly capable of stepping out of it and saying, oh yes, this is the next thing that happens in the first year.  But it doesn't mean my feelings aren't hurt by it all.  When these things happen at the end of the weekend, when I'm fully exhausted and tapped out it's not easy to maintain my emotions.  This is definitely Type II fun.  I'm grateful it's not my main source of income as I can frame this everyday as choosing to go to work as opposed to forced to go to work.  I am learning a lot and mostly like it.  And I'm hyper focused on the end date of my year-long experiment (five months to go!).  I do want to say that generally, I think the unit is very supportive.  I've been in enough work environments with enough bosses and coworkers to understand that this unit is probably as good as it gets.  No one has quit since I've been hired (except for one person who had to move to Florida), that kind of staff stability says something I think.  You can't throw 40 nurses together in a stressful, tiring situation where at least half the people are working at night and not sleeping like a normal person and not have conflict.  Also, I'm pleased to have negotiated a fixed schedule which will hopefully start in four weeks which will bring order back into my life and I'm very much looking forward to it.  Anyways, time just passes and I just show up and see what happens.  Sometimes it's magic (I've realized the best compliment in nursing from a patient is - will you be back tomorrow? and this happens to me often & I feel very lucky to be asked that) and sometimes it's crap.  Like literal crap.  Most days it a good mix of both.  It is entirely too much work for hourly pay that is only a little bit higher than you'd pay for a babysitter on Saturday night, you cannot expect that anyone will stay a long time at bedside.  Which is too bad because it's also clear to me that it takes at least two years to have enough experience to deal with a lot of things.  It's painful for me to think that the whole country is delivering care in hospitals in this manner - with tired and exhausted (and inexperienced) personnel.   Though I intellectually understood this before, it is entirely a different thing to live it.  (The doctors are tired too.  And the pharmacists.  And the PT/OT staff.  And the social workers and case managers. And it goes on and on.  And it is true, they care the most about turning over the beds.  Just like at restaurants and their tables.)

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A run of hard shifts is harder when my support system is also on the go.  Jeremy and Vince were out all weekend doing a wilderness emergency first-aid course required for the scout trip this summer.  And now Jeremy is in Florida on business.  Which means that we are going to talk very little this week. Vickey, my other frequent confidant, is also traveling so it means that I'm without a good venting partner for a stretch of time here.  Then I lean on Vince who tries to be supportive, though understandably not so fond, of his emotionally needy mother.    So that's not great.  Why do I do this to myself?  I could instead go on vacation.  When I have a tiring and emotional shift and want to quit, Jeremy says - ah, you love it, I can tell you love it, you are going to figure it out and do it for years.  You just wait and see.  Vince says - eh, just keep going.  It'll be fine.

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Jeremy and Vince were away all weekend (all weekend meaning 7:30 am to 9:30 pm both Sat and Sun) in Frederick for first aid training for Philmont.  They need two people per group to have this training and Vince and Jeremy are doing it together.  I asked if it needed to be two grown ups and Jeremy said that you just needed to be 16.  From Jeremy's report, Vince has a talent for this stuff.  Last year, when V was a camp counselor, a kid broke his arm while riding a mountain bike and Vince splint his arm and helped him out of the woods.  So this year, at the training, Vince took it quite seriously and performed competently enough at the practicing that when they did the final mass casualty scenario at the very end, they all voted for Vince to be the leader.  Today, at school, Vince was carrying around the emergency first aid booklet at school. There are only a few life threatening things you can do things for out in the wilderness.  Hmm, they are bleeding, sucking chest wound and a flail chest.  All the cardiac stuff is pretty much pointless if you are out there in the woods - the instructors basically said if you can't get the person to the hospital quickly that it's just pointless to start CPR since there is such a low chance of success.  Though they did point out emotionally, if a kid's dad has goes into cardiac arrest and the kid is standing there watching his father die, you do the CPR enthusiastically for thirty minutes.

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I asked him today if he was sure that he didn't want to be a doc (maybe an ER doc?, though I hesitate to ask because I honestly would not wish doctorhood on anyone). He said, nah, he'd be interested in being an EMT.

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More college talk?  OK! Jeremy thought we should take Cal Poly off the list because it's the least diverse of all the public CA colleges.  That there were some racial incidents that happened in the last few years (though these days I'm not sure any college campus has been free from these incidents).  Vince said Vanderbilt just sounds too fancy - though I argued that Nashville sounded like a cool town. Then Vince asked about Caltech and whether it was a public school.  I said it's private, but that I didn't think he should go there.  Jeremy asked why and I said I generally disapproved of a school that didn't have affirmative action and besides, Caltech is just weird.  We looked at Caltech's demographics - it's half Asian and probably there are more half-Asians there than there are African-Americans.  Then Jeremy added - I don't think you can go there because you pretty much have to get an 800 on the math SAT to be admitted.  Vince promptly replied that he was sure he could get an 800 on the SAT math which then reminded me of this recent NYT article on the differences between boys and girls in school.  What about Georgia Tech or RPI, I asked?  Vince didn't like Troy that much and Jeremy thought a technical school might be too limiting - not only in terms of what to study (Jeremy suspects that Vince might end up studying something other than science/engineering), but even if you were an engineer, wouldn't you want to have friends who weren't engineers?  Jeremy asked.  I think engineers make good friends.

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This is amazing Cardi B.  I love you.

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Friday, February 8, 2019

Ning, update.

Ning is back in the mornings from maternity leave!  The 45 min to hour that she works to get Edda dressed and on the bus in the morning helps us enormously.  It means that I can leave for a shift at the hospital when Jeremy travels for work. 

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Nursing update?  It's still hard.  It requires all my focus and energy. I don't cry (I know I've jinxed myself) unless I'm giving the last report to Siji on my second shift in a row, by then I'm exhausted and something about Siji brings it out of me.  She looks at me and says - this is just a job to pay the bills and nothing more.  Your life is outside the hospital.  And I look at her and smile and sniffle a little. 

After about noon until about four pm, the nurses on the unit, instead of saying - hey, how's your day going? as we pass one another in the hallway or med room - a lot of people say, have you eaten yet?  (It's very Asian where the standard greeting is have you eaten yet? no matter what time of day it is.)  On Thursday - I forgot that I hadn't eaten and answered - yes! I've eaten - to all the greetings, but when I came home and emptied my lunchbox, there was my sandwich, completely untouched.  I've hit a slump with putting in IVs.  I've lost my nerve to poke people with needles.  I think I've tried seven in the last couple of weeks and missed them all. 

Wednesday, February 6, 2019

Kitchen, guardianship, college.

Vince is making Valentine's cookies downstairs. The kitchen is a complete disaster.

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I went to the financial planning and guardianship meeting at the school board building tonight.  It's part of my very slow plan to wrench myself out of denial that Edda is growing up and will someday be an adult.  And as an adult, she gets to run her own life unless I take proactive steps in court with a $165 dollar fee and file for guardianship.  I didn't take notes and I only half paid attention because I like to sit in the meeting with the other two hundred parents and think both - "Oh I'm not alone.  This is fantastic."  and simultaneously think "This completely sucks, I wish Edda didn't have Rett Syndrome."  Oh, I guess I always think a third thing when I think the first two things which is - "I could really use a cookie right now." I used to care so much about the details of all financial things - like the limits for contribution and the tax implications and what happens to SSI when you reach a certain number, but now I can't be bothered except to hear the broad strokes of the options.

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Jeremy and I (and others) are slowing putting together a semi-reasonable college list for Vince which he may or may not follow.  He doesn't want to go to a big state school, doesn't want to go to a liberal arts school.  He wants it to be in a mid-sized town.  He wants engineering program.  Here's the list so far.  Granted - this is the parent list, not the Vincent list. Vincent has his own list, I'm sure. Carnegie Mellon as the reach, MD just because.  Then: UCDavis, UC Santa Cruz, Cal Poly, UC Santa Barbara, Case Western, McGill, Villanova, Vanderbilt, Illinois, Wisconsin, Minnesota.  I like Pitt too.  Go Banana slugs!

Monday, February 4, 2019

Vacation, hiking, Usual Suspects, quilt.

I'm on my 4th day of 5 days off in a row and it's been fabulous.  I've been able to relax into it - not really freaked out by going back to the hospital.  I've been trying to pick up my old hobbies again like quilting (I finished one), running (I called Paul and asked him to start coaching me again), seeing my Rett mom friends and talking to Vickey.  This will all get dropped again when I have to start work on Wed when I will work 6 shifts in 9 days.  That seems tough.  But it'll be OK.

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Vince's first term of junior year is over. He did pretty well overall, a couple of Bs but he managed his own time and his own work level without much (well without any) input from me.  As I've said before, it's hard for me to unattach myself from Vince's academic performance, but I mostly have. 

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We went hiking on Sunday afternoon on Sugarloaf mountain - Vince was a little grouchy, but not too bad.

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DC Martin super bowl family dinner.  I ate two Frito pies.

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And then 2nd dinner with the Usual Suspects - Super Bowl Sunday is a fabulous night to go out to eat.  Apparently none of us care about football.

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I finished this quilt!

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Saturday, February 2, 2019

Boar.


Happy Chinese New Year!  Dinner out with the family.  Peking duck all around.

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Friday, February 1, 2019

Logistics, Nat's 30 and burros.

It's been a long, cold week - a logistical nightmare although Jeremy didn't call it a nightmare, he just said we totally managed it fine.  And we did.  I worked at the hospital last weekend and then had Monday and Tuesday off.  Monday, the kids were home all day - non weather related (end of the semester grades were due in for the teachers - or maybe they just needed a break).  Tuesday, the kids went to school on time, but were sent home early at noon for snow.  I was home, so I got Edda from Wootton.  On Wed, I was at the hospital when the two hour delay converted to a closure.  Jeremy had the kids (I'm not sure why I say the kids since Vince is fine on his own so I should just say Jeremy had Edda).  Jeremy had Edda again on Thursday when I was at the hospital for a two hour delay.  Today (Friday), Jeremy went to work and it was me to pick up Edda when school closed again at noon.  Next week, it'll be in the 50s?  60s?  It'll be great.

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On Tuesday, despite the snowstorm, we had a party for Nat's 30th birthday.  No one had to travel very far, Ning & family from the downstairs and Nat & Dara from about a mile away.

The baby is super cute!  Dara was very good at getting him to smile.

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During Nat's party, Jeremy had to deal with entering the lottery for the Boy Scout's Philmont trip he's organizing for this summer.  There are about 25 different itineraries to pick from - the boys had spent a bunch of time picking their top six or eight.  Very happily, they got their #1 choice.  68 miles of hiking with a good mix of daily programming.  The most funny of which is Burro Packing.  I like that the itinerary says - you must take the burro.  There are a lot of videos on YouTube which show stubborn burros refusing to budge on the trail. 

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