Caroline's Breakfast

Just finished feeding Caroline her breakfast. If you ever get to do that... here's how it goes (numbers correspond to objects in the picture; click on the picture to see it bigger):

1. Prevacid (to help with stomach irritating): One 15 mg tablet dissolved in a bit of water [4]; 15 minutes before the rest of her breakfast, you connect her g-tube [2] to the port that was surgically implanted in her stomach wall; then you connect the large syringe [3] to the g-tube and pour the prevacid solution in; you'll need to use a bit more water to get it all in.

4. Water: Caroline gets 9 ounces of free water throughout the day; this is used to flush her tube at the end of each meal; she also gets 8.5 ounces of water mixed with each meal, hence the two water bottles

5. Tegretol (or Carbemazepine; a seizure-control medication): One 100-mg tablet crushed in the mortar and pestle [6].

7. Depakote (another seizure-control medication): three 125-mg capsules filled with tiny granules, called sprinkles; open the capsules and dump the sprinkles into a little cup [8], in which you also put the crushed up tegretol [5]

9. Scale: Turn on the scale and find a measuring cup and spoon [10]; place the cup on the scale and "zero" the scale (press the "on/zero/off" button to make the scale read 0

11. Polycose (carbohydrate additives for Caroline's food): measure in 1 gram of polycose into the measuring cup (using the spoon)

12. KetoCal (Caroline's food; a formula that helps maintain the ketogenic diet, which helps control Caroline's seizures): measure 28 grams of KetoCal into the measuring cup (I usually zero the scale after putting in the polycose)

13. MiraLax (a laxative because ketocal can be a bit constipating): add 1.5 teaspoons of MiraLax to the measuring cup mixture.

Now you're almost ready to feed. Take the water bottle [4] with 8.5 ounces of water and pour it into the measuring cup, mixing it al up until you have a thick milky-looking soup. I usually don't put all 8.5 ounces in--usually more like 7.5 ounces. The remaining water I use to flush the tube after the feeding.

Next, add a bit of the free water to the bottle that used to have 8.5 ounces of water; after adding the water, you should have between three and 5 ounces of water in it (depending on how much you used to mix); these 9 ounces will have to last through four feedings, and you need at least 1.5/2 ounces for flushing each meal; so you have to ration appropriately.

Now you take your measuring cup full of KetoCal mixture, the small cup with the tegretol and the depakote, the water bottle, the g-tube, and the syringe into Caroline's room. You hook the g-tube up to the feeding port in her tummy, connect the syringe, and you're ready to go. First pour in a bit of water and then add the tegretol and depakote; you'll need to add some more water immediately to help the depakote and tegretol not clump up; if they clump (which they are prone to do), they can clog the tube, and that's a pain. Once the medicine is in, you can start pouring in the KetoCal; pour in enough to fill the syringe mostly full, then wait for it to drain most of the way down and add some more. Continue until all the KetoCal is gone; then pour the remaining water into the syringe and let the water run out into her stomach. This will flush the tube and the tube port. When it's all the way in (only a little left in the tube), clamp the tube with the white clamp, remove the tube, and you're done.

Almost. Now you need to wash the measuring cup, tube, syringe, mortar and pestle, and medicine cup. We have a bottle brush and dish soap which work really well to clean the syringe and tube: keep them connected, put some water in the syringe, add some soap, and clean with the bottle brush. This method has allowed our g-tubes to last much longer than they would have otherwise (which is good, cuz they're not terribly cheap).

The Promise of Spring

This afternoon a beautiful woman stopped by my office for a minute. We talked briefly inside and then I walked outside with her. The sun shone brightly with a golden light, creating a warm late-winter day--starting to feel like spring. As we stood and talked beneath a leafless tree, the sun casting a network of shadow branches across her hair and face, I gazed at her smiling eyes and was taken back to similar warm late-winter days 10 years ago when we were dating.

Those were bright, exciting days of anticipation--just days before tulips would emerge, weeks before blossoms would burst open, and a month before we would become engaged (right). After a long winter of cold-weather dating activities (before I knew just how much this California girl dislikes the cold), Christine and I were eager to buy into the promises of spring, and we looked for any opportunity to get out in the sun and enjoy the progressively longer days.

Today we remembered together one such day a decade ago when the sun's angle was not too different from what it was today--the light similarly golden, similarly filtered through the bare branches of trees that had not yet leafed out. Lured by the sunlight and the anticipation of warm days to come, we packed a picnic and headed to a park not far from my office to kickstart spring and inaugurate the outdoor season. There we found an unexpectedly chilly evening and a frigid wind, but we huddled together in blankets and sweatshirts and looked across the valley, enjoying the setting sun and each other's companionship.

From where we stood today, we looked toward that park on the side of the mountain and smiled at our youthful spontaneity. Our fingers intertwined and we talked of love and philosophy and Christine's upcoming 5k race. The conversation was as pleasant as the weather, the smiles were as bright as the sun, and the relationship held all the promise of spring.

Wolf Song

A few minutes ago, Lizzy emerged from the bathroom and announced, "Mom, I just made up a new song. It's called the Song of the Wolf Mother." Then she started to sing, "No dear, it's not time to howl..."

A Step Up the Ladder of Home Improvement Expenses

As fall was coming on, I visited Home Depot one day with a long list of things to buy. On that list was a step ladder. My dad had recently studied my trees with me and given some pruning advice. The trees were now tall enough that I could not prune them standing on a chair. I would need a ladder.

So off I went to Home Depot to get a step ladder. Standing in the ladder aisle, I called my dad for advice. What kind of ladder do I need? Aluminum or fiberglass? How tall do I need it? 6 feet or 8? And should ladders really cost that much? A 6-foot aluminum ladder (which is what my dad recommended) cost $39. That just didn't seem right to me. Realizing I didn't need a ladder just yet--pruning season isn't until late winter/early spring, I decided to postpone the ladder purchase and watch for a sale.

So the months have passed and I've occasionally checked for sales and have looked at other stores. No better deals were forthcoming. So today, now that pruning season is upon us, I decided it was time to bite the bullet and pay $40 for a ladder. So off I went to Home Depot again.

From the garden tools aisle, I called my dad for advice on a long-handled pruner. (I went for the bypass lopper; that's what Dad has.) "Where are you buying a pruner?" my dad asked?

"Home Depot," I replied.

"I'm on my way there right now," he said. "I'll be there in about five minutes."

I mentioned that I was going to get a ladder next and he said he'd meet me in the ladder aisle. We'd have some good male bonding at Home Depot.

Five minutes later, we were standing in front of the ladders studying the aluminum 6-foot ladder I had unfolded in the aisle. It looked decent enough. Had a nice fold-out platform for holding tools or paint buckets. It could support 250 pounds.

"Don't you already have a ladder?" My dad asked. I explained that when I talked to him a few months ago I had decided not to buy the ladder after all, hoping to find a sale on ladders before I needed one. We looked at the price tag: $49. Ouch. My effort to save money had actually cost $10 (decided it wasn't worth waiting longer).

But then came the kicker: "After I talked to you last time," Dad said, "I decided I needed a new stepladder, so I came down and bought one right here... for $39."

Doh.

Lizzy's Sidekick

This afternoon was warm (for February) and the sunny day beckoned Lizzy and her scooter outside. The scooter has been the most popular Christmas present of the year, but due to the weather, it's been an inside present thus far. Lizzy rides it down the hall, through the kitchen, down the ramp into the family room, and back. Back and forth, back and forth. She's had lots of fun scooting around the house, but on a nice day like today, the sidewalk is a more appealing place to ride.

Soon our next door neighbor who is Lizzy's age joined her, and the two scooted up to the garage, where I was working on some things. "Cool blue scooter," I said to Nathan, who quickly clarified that, though it was a cool color, the blue scooter was not his because he couldn't find his scooter. The blue scooter was Nathan's sister's. After a few more comments on the color of his scooter and of Lizzy's pink scooter, Nathan and Lizzy scooted back toward his house. In a minute, Lizzy was rushing in our house to get something and Nathan was going to his house. Unsure what was happening, I went about my business. A while later, Nathan and Lizzy were both coming into our house. Lizzy explained she was getting a notebook and a pencil for Nathan. Having seen the magnifying glass in her pocket, I surmised what was up.

"You going to play spies?" I queried.

"Detectives," Lizzy corrected.

"And this time it's a real case," Nathan informed me.

Lizzy gave the case's official title: "The Case of the Missing Scooter." I wished them luck, and off they went to find Nathan's scooter.

A couple minutes later I went into the garage to get something and overheard Lizzy and Nathan talking on the other side of the van. "...and Eric--" said Lizzy.

"You can cross Jason off the list," said Nathan, referring to his oldest brother, who is a freshman at a nearby university. "Jason hasn't been at our house since I last saw it."

Chuckling, I returned to the kitchen and told Christine they were working on their list of suspects. When I returned to the garage again a few minutes later, I saw the two of them talking to Eric, Nathan's younger brother, who was standing astride his own scooter. On Lizzy's notepad I could see Eric's name crossed out. He must have passed questioning. I asked how the case was going.

"We found some tire tracks going into our garage," said Nathan. Pointing with his foot to the edge of our garage, he continued, "But the tire tracks stopped right here where you go into the garage."

"And we found some dirt tracks, too," chimed in Eric, eager to provide a helpful clue. Lizzy was bent over her notebook, carefully writing something about dirt tracks. Soon they were off to Nathan's garage again, looking for more clues.

Apparently, this effort did not yield the necessary information, for I soon heard our door open again and the three of them came tromping into the kitchen, Eric wheeling his scooter along with him. They needed more detective supplies and headed off into Lizzy's room. As they emerged and headed back out a minute later--armed with Lizzy's walkie talkies and third notebook and pencil (this one for Eric)--Nathan paused to provide color commentary: "Last year Lizzy made posters advertising that she was a detective and I was her sidekick. But we never got any business. If we can solve this case, then maybe we can make new posters and advertise again."

And off they went one more time.

Sadly, this case does not yet have a good ending. I just checked with Lizzy. The Case of the Missing Scooter remains unsolved.