Write a Letter to Santa and Help Wish Kids!

Between November 7 – December 24, visit your local Macy’s store or Macy’s Believe online to submit your child’s letter to Santa and help make dreams come true for Make-A-Wish kids around the country. For every letter received through December 24, Macy’s will donate $1 to Make-A-Wish (up to $1,000,000).

Jack LOVES the idea of Santa. In prior years he has written Santa several letters, made him cards, even even built a shrine in his room. At eight years old, it seems that he might be starting to waiver in his devotion and questioning a bit more, but still – he wrote a letter to Santa this year, asking for a haunted house and asking that Santa respond if he got the message. He included his very own “return receipt,” which was a drawing of some toys and dashed lines to indicate where to cut.

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Santa dutifully responded and Jack was beyond excited. He just knows Santa will come through for him.

David and I set to work looking for a toy haunted house. We didn’t find much, but we didn’t want Jack to feel let down by Santa, especially on the last year he’s likely to believe in him. So we bought a dollhouse and developed a plan to paint it, sand it, and turn it into something haunted. I was also able to find a “monster bucket” on (post-Halloween) sale so that should help us haunt the place up.

This may seem like a lot of effort, but Santa is just one small thing that adds magic to Jack’s life amid all the hardship he endures due to Leukemia. Make-a-Wish helped in this effort this summer, as well, when Jack was granted his wish for a TARDIS bedroom makeover. Jack is still delighted by his room and with the granting of his wish, we saw a happiness in him that we haven’t seen in a long time.

He's in love.

He’s in love.

This holiday season Macy’s is helping to bring magic to more kids with their Believe Campaign by working with the Make-a-Wish Foundation! This year marks the seventh year of Macy’s Believe campaign, which invites believers of all ages to drop off letters to Santa at any Macy’s store by depositing them in special, designated Santa Mail letterboxes. You may also submit your letter online at Macys.com/believe.

For each letter received by December 24th, Macy’s will donate $1 to Make-A-Wish, up to $1 million, to grant the wishes of children (like Jack!) with life-threatening medical conditions. Last year, Make-A-Wish granted the wishes of more than 14,000 children across the United States. A wish is granted every 38 minutes!

Here in the Bay Area, Make-A-Wish is working on granting the wish of 4-year-old Joysse, a girl from San Mateo who was diagnosed with Leukemia. For her one true wish, Joysse asked for a princess party complete with purple and pink decorations, a princess dress with a cape and crown, cake and ice cream and more! She is so excited that she asks her mom, Gabriela, about it every day. Her party is scheduled for January, but as a surprise, Macy’s will be helping her prepare for her wish with a very special celebration at the San Francisco Union Square location.

To help kids like Jack and Joysse this year, make a trip to Macy’s or visit them online to submit your child’s letter to Santa. It’s totally free for you and yet you will get the satisfaction of knowing you’ve helped bring some magic back to the life of a child with a life-threatening illness!

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I was selected for this opportunity as a member of Clever Girls and the content and opinions expressed here are all my own.

Our Little Dez

He already thinks poop is hilarious – he chuckles silently when we are surprised at the contents of his diaper.

He bats at the elephant toy on his bouncer but just glares at the monkey.

He prefers to look to the left.

In his 11 weeks of life, he has gained over 6lbs and is now 12lbs, 15oz.

He has kept up his ability to roll from tummy to back and is trying so hard to creep.

He thinks that baby in the mirror is pretty cute.

He is quite the conversationalist once he gets going.

He gives us lots of smiles while looking up at us under his eyelashes, just like Snow White’s Bashful.

He still has that new baby smell.

I don’t know how we ever lived without him.

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The Looming Return to Work

I go back to work in two weeks. TWO WEEKS. Where did the time go?

I am freaking out, to be honest. It wasn’t like this with Jack. Back then, I couldn’t wait to go back to work. This time is so, so different. I want to stay home with my baby and watch him grow! I want to be able to pick Jack up from school and help him get his homework done!

I don’t want to spend 3 soul-crushing hours a day in a car commuting to a job where I take care of other people while I pay someone to take care of my kids.

This all makes the daycare search harder. I mean, aside from the fact that there are so few places in my area that take infants (which feels like silent judgment that I should be home with my baby), it’s difficult to find a provider I trust. If I’m going to outsource parenting to someone else, I want them to be AWESOME and better than me! I haven’t found that so far, though. I’ve found one place that is acceptable, but she has a tiny house and limited hours and only takes kids until they are 2 years old. And because she’s the only one taking care of the kids and there is a toddler and a 6-month-old, she wouldn’t be able to help Dez get to sleep – he would have to learn (quickly!) to fall asleep in a strange place by himself.

It doesn’t feel right.

I’m still searching. I know it’s down to the wire and so incredibly close to the holidays, but I’m doing my best to shove any rising anxiety to the back of my mind and continue about my business. This is how I’m getting through things (like yesterday’s nightmarish task of taking Jack to get his blood drawn – he is deathly afraid of needles and pain in general).

It’s not strength – it’s denial. LA LA LA EVERYTHING IS FINE. JUST KEEP SWIMMING.

How about a cute baby picture to distract us?

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Calgon, Take Me Away

I finally downloaded WordPress onto my phone. I’m much better at using my phone while nursing than a laptop. I lack coordination. Hopefully this will lead to more blogging.

It’s been a rough couple of weeks. Jack was hospitalized with a blood infection. The baby and I got sick. And then I got a case of mastitis.

Jack is out of the hospital and doing fine, but he’s been on a rigorous antibiotic regimen that involves mixing medication and running an IV several times a day. The worse one is the dose in the middle of the night, but the afternoon dose hasn’t been a picnic, either – usually I’m mixing the IV drugs while using my foot to bounce Dez in the bouncer. I’d run away to join the circus but I’m already there!

This case of mastitis is a bitch. After several days of trying to unclear a plugged duct in my armpit and dealing with horrid shakes and chills and dizzy spells, I called and got some antibiotics. Unfortunately Dez was not tolerating them well at all! So I did what you’re totally not supposed to do – I quit taking them a few days in. Dez is doing much better but I’m not. I now have a mass in my right breast and it hurts like hell! I assume if I keep nursing non-stop on that side it will eventually work itself out (or the breast will fall off?). In the mean time, I want to stay in bed and cry and sleep.

But! Jack has follow-up appointments. And Dez needs shots. And I return to work in a few weeks so I need to find a daycare that takes infants.

Ain’t no rest for the weary…

Kids Notes

I have had so little time to write. It sucks. I need to write. I am much happier when I have been writing.

That’s not to say that I haven’t been happy – I’ve been surprisingly free of baby blues and depression! But how long can I maintain good mental health without participating in something I know keeps me sane?

Anyhoo…here we go with a mad-dash post typed with one hand.

Notes on baby Dez

Dez is a very good baby thus far. Although he absolutely hates getting his diaper changed and wails every time. I think we owe our neighbors some wine for putting up with it. So far I’m not too sleep deprived, but I bet that will change when he wakes up to the world more. And when I go back to work (sob).

David gave Dez his first bottle last week. He took it just fine and then went back to nursing with no problems. Yay for Comotomo bottles!

I got my first smile out of the little guy yesterday when I stuck my tongue out at him. It was awesome! After 5 weeks of nothing but naps and nursing and diapers…finally some interaction!

I’ve been struggling with oversupply again. My body continues to think I should be feeding triplets. This means Dez is gaining weight like crazy and going through zillions of diapers. The cool part of oversupply is that I can pump 3.5 oz. in 5 minutes – on one side. There are lots of cons, though – green poop, gas, choking during letdown, more frequent nursing, so many diapers!!! I am managing better than last time since I know what I’m doing but it’s still frustrating. At least Dez is dealing with it much better than Jack did – maybe because it’s not quite as bad as last time.

At 9 days old, Desmond rolled from his tummy to his back…several times. And he has repeated that performance pretty much daily. He can also go from his back to his side…it’s only a matter of time before he can roll both ways. I fear the toddler years, which will likely come sooner than I would like!

It took a good 3 weeks for his umbilical stump to come off and the area still hasn’t healed so it will need to be treated with silver nitrite. The same thing happened with Jack. I don’t know what’s up with my kids’ belly buttons!

I’m slowly searching for a daycare provider to send Dez to when I return to work in December. It’s a stressful task, to say the least. I’m taking it slow so that I don’t go into a panic and decide to quit my job so that I don’t have to leave my precious baby with a stranger. I thought it’d be easier the second time around but nope! I hope we find a good one right off the bat so that we don’t have to go through everything we went through with finding good care for Jack.

Notes on Jack

Jack is a great big brother. He fetches all kinds of things for me and the baby and always tries to distract the baby during those torturous diaper changes. He’s been good at keeping himself busy when I can’t put the baby down. I’m so thankful we still have our reading and snuggle time together before he goes to sleep so that we can still connect.

He’s generally been in better health and made it to school most days this year. Just a bit over 5 months of treatment left!

We met with his new teacher and found out that he is behind where he should be for a third grader. The things the teacher has noticed are in line with what we’ve seen at home and are common learning problem areas for kids who’ve undergone chemotherapy. We asked his teacher to document anything she sees and we’re going to (again) seek an IEP evaluation – and this time we won’t back down. We’ll be in a better position to argue for the testing now that Jack has been going to school regularly and his teacher is actually noticing his difficulties.

He’s been struggling with his friendships at school. He is so upset when his best friend doesn’t want to play with him and says other kids don’t understand the imagination games he likes to play. I wish I knew how to help him. I had similar issues as a kid but I don’t remember being quite so upset by it. Jack is just so sensitive.

I’ve been very surprised that lately he’s talking more about cancer, too. He found a game in the app store that is all about destroying cancer cells and he loves it! He’s also been drawing blood cells and he found a plush cancer cell on amazon. It’s a little unnerving that he is suddenly so focused on it, but I also think it’s good that he is talking about it. Maybe therapy has helped?

 

Alright, I’d better post this before it self-destructs. More soon, I hope.

Diapering in a Drought

California is in a severe drought. Like many others in the Bay Area (and just about anyone who has grown up in California and lived through many other droughts), our household has long been practicing water-conservation. That means there is not much we can do to cut back further – our lawn is already deader than dead and we dread laundry and dishes so much that every load is completely full anyway.

Having a baby does throw a bit of a wrench in our water conservation efforts, though. There is more laundry to do and being at home during maternity leave means more dishes, as well. When we found out we were expecting, we had thought we would use cloth diapers – one of the few things I saved from Jack’s infancy. But then the drought got worse – it’s now considered to be one of the most severe droughts on record for California. There is talk of fining households that don’t cut their water usage. Even worse, there are worries over drinking water shortages.

Considering this, we started thinking cloth diapering may not be the way to go after all.

There is a lot of debate about the amount of water required to wash cloth diapers versus the resources needed to manufacture disposable diapers and then dispose of them, and which type of diaper has the bigger environmental impact. Most studies seem to come to a similar conclusion – there is no clear answer as to which is better for the environment because availability of resources (water vs. landfill space) differs by geographic area. Landfill space is always an issue, sure, but the scarcity of water can reach emergency levels much more quickly – which is now what we’re looking at in California.

With these things in mind, I started wondering about alternatives to both cloth and disposable diapering. Aside from elimination communication (which I have neither the time nor the stomach to try), other options are gDiapers (with flushable inserts) and cloth diapering services. Unfortunately, gDiapers present many of the same problems as disposables, with the added concern over the possible clogging up of the plumbing in addition to the extra flushing required. Further, in our county they cannot be composted by our waste management company. Diaper services, on the other hand, use only prefold diapers (the kind that require folding and pinning/snappi-ing and a cover) – which I loathe due to the bulk and the lack of moisture-wicking. When I used prefolds with Jack, we easily went through twice as many diapers each day as we would have with other types of cloth and/or disposables. Using twice as much cuts into the benefits of using a service that washes them in bulk, no?

This diapering thing seems so much more complicated that it used to be.

I finally stumbled upon diaper composting services. Some of the same diaper services that offer drop-off/pick-up and washing of prefold cloth diapers also offer a disposable option – you can buy eco-friendly disposable diapers from the company, which will drop them off weekly and pick up the dirty ones to compost at their facility. The service eliminates the extra water usage issue AND saves us from sending more garbage to the landfill (and paying for a bigger garbage can)! Two such services here in the Bay Area are Earth Baby and Tiny Tots.

Right now we’re trying out Earth Baby (they offer a 1-month free trial). So far it’s working out fairly well, although I have to mention that Desmond is a super soaker and has leaked out of the diapers at night lately (in reading reviews, it’s an issue with some babies using the Naty brand of diapers, which are the only brand Earth Baby offers), so we’ve taken to using Huggies for nighttime diapering. The Huggies have to go into our garbage can, of course, but it’s only around 10 diapers a week so…we’ll take it; I can’t be washing sheets every day!

The diaper composting service is not a big money-saver, unfortunately. The diapers and wipes can only be purchased through the service and are more expensive (the service has to make a profit somehow). We are avoiding the cost of additional water usage and a larger garbage can, though. And, well, I am not sad that I’m avoiding the laundry involved with cloth diapers, either…cloth is soft and cute and great for sensitive baby skin, but extra laundry still sucks!

I’m no expert but so far, this seems like one of the most environmentally-friendly diaper options for Californians right now.

What do you think? Does the environmental impact influence your household’s diapering decisions? Do you have drought conditions to take into account in your area?

Desmond’s Birth Story

At 9:30pm on the evening of August 31 (two days after my due date), I started having regular contractions. They weren’t bothering me much but I started timing them just to get an idea of how far apart they were – since this was my second baby, my doctor had advised me to go in if they reached 7 minutes apart so that we could make sure I got two doses of antibiotics for Group B Strep prior to birth. The entire week prior to this, I had several nights where I woke up to contractions that got gradually closer together before petering out at about 8 minutes apart, so I had no real reason to believe these would be different. However, they were different – these contractions steadily got closer together over a couple of hours. I hung out on the exercise ball to help them along and around midnight they were moving right along at 6 minutes apart. I made sure they were consistent for a good hour before I called Labor & Delivery. I wasn’t sure I was in labor – the contractions didn’t seem bad enough to be real labor – but you never know, right?

David and I packed up our stuff and headed to Kaiser so that I could get checked out.

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I was put into an observation room and hooked up to some monitors at about 1:30am (coincidentally, it was Labor Day). After a bit over an hour, a midwife came in to check on my dilation. I was only at 1.5cm (same as I had been on the previous Friday) and she didn’t think my labor had really started, but she felt fairly sure it was close to starting. Not only that, but the baby’s heart rate had decelerated a number of times so she wanted to keep me there for more monitoring. So we sat tight and she came and checked back in around 3am. My contractions were 4-5 minutes apart at that point, so we decided I should go ahead and get admitted.

The baby’s heart rate was fine by 7am and the contractions continued at the same rate. At 12pm, we decided to start on pitocin since I still wasn’t in active labor; we figured that my body just needed a little nudge in the right direction. I had a lot of reservations about pitocin because my labor with Jack had been long and hard, but the midwife assured me that we would go slow with the pitocin and we could turn it down or off if needed.

My contractions certainly intensified on the pitocin. I spent time going between the exercise ball and walking laps with David around the maternity ward.

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By 5pm, I had still only progressed to 3.5cm, although the baby’s head had moved lower into my pelvis. I kept doing my thing and trying to move a lot with contractions. The pitocin was slowly turned up every so often and every 4 hours I also received a dose of Penicillin for the Group B Strep (sidenote: the antibiotics had me in more pain where it was going into the IV than my contractions – OUCH!!!).

Around 7pm I put on my headphones and cranked some music (Lana del Rey!) to help me through the steadily intensifying contractions. I started needing David’s help to get through them but I still felt like the labor was manageable without any medication. David made a comment about how nice all of the nurses and midwives were…

Then there was a shift change at about 9pm…

A midwife named Doris came into the room and outlined her plan for our birth. She immediately started saying that my contractions weren’t productive, that she was concerned about the decels in the baby’s heart rate (which hadn’t occurred for hours by that point), and telling us that I was going to get too tired to birth the baby if things didn’t happen more quickly. There was talk of epidurals (was I SURE I didn’t want one??) and a c-section if I got too tired to push. The more she talked, the more agitated I got, especially after she said something about how if we followed her plan she GUARANTEED the baby would be born by morning.

Doris was a full on medwife. UGH.

After making her initial rounds, she sent our nurse in and instead of increasing the pitocin just a bit as we had been doing, she CRANKED it according to Doris’ instructions. Within 30 minutes I was doubling over with every contraction and sobbing hysterically from the pain. The contractions were maybe coming a minute apart and I had no time to recover between them. I was a shaking, crying mess, and I held onto David for dear life. I felt like I wanted to die.

Doris came back in the room and checked me, said that I still wasn’t at 4cm, asked if I wanted anything for the pain (which I rated at 8-9), and then sent the nurse back in to turn the pitocin up AGAIN. It had been about an hour since it had been cranked up and I was not coping well. Thankfully David stepped in and had the nurse turn the pitocin down a bunch to see if we could slow things down and give me a break. It took a bit of time but the contractions slowed just enough for my sobs to quiet and I was able to get a few breaths in.

Doris came back in at some point and I started crying again and silently wishing harm on her person. As soon as she left, I decided two things – I would go ahead and get an epidural, and I didn’t want Doris anywhere near me for the rest of my labor. David called for the epidural and I begged the nurse to keep Doris away from me and instead send in a doctor.

The epidural was placed right around 12am, in between contractions. It was pretty quick and painless and the numbing started immediately. I still had incredible pain in my tailbone (which I am 99.9% sure I broke when giving birth to Jack), and the anesthesiologist said that the epidural wouldn’t touch that, unfortunately – I just had to get through it. :(

The doctor came in to check my progress then. Right as she was saying, “This is probably going to break your bag of waters,” there was a splash. The staff scrambled to change the padding underneath me and I said that I felt like I was going to poop. The doctor looked down, said it was the baby’s head I was actually feeling, and announced to the team that the baby was coming! The staff kicked it into high gear, but the baby wouldn’t wait – his head slid right out, then his shoulders slowed him just enough for the doctor to get in position before he SHOT OUT like a football. I didn’t even get a single push in!

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Desmond Eric

Desmond Eric was born to a room full of chuckling people at 9/2 at 12:43am. He didn’t cry – instead, he looked around and squeaked a bit every now and then. He was 7 lbs, 1 oz, and measured 19″ with a tuft of blonde hair.

We are totally in love.

He’s Here

On September 2, 2014, at 12:43am, we welcomed our new baby Desmond to the world. He measured 19″ and 7 lbs. 1oz. He was born without a single push on my part!

We are madly in love. Jack met him on his first day of life and said, “This is one of the happiest times of my life!”

Our dog Lambert is channeling Lassie and thinks he should come to Dez’s rescue at the the littlest cry. Lambert even leads David to me when Desmond needs to nurse. We keep trying to tell the dog that we have it covered but he clearly doesn’t think we’re very good at this baby thing.

I’m hoping to get the birth story up soon! Stay tuned!

CA Prop 46 – A Flawed Bill With Negative Impacts On Healthcare

Disclosure: I attended a luncheon hosted by No On 46 in order to learn more about this bill. I was not provided any compensation for this post, and all opinions expressed are my own based on my personal healthcare experiences.

Nearly a month ago, I attended BlogHer ’14 in San Jose. Typically I come home from BlogHer energized and inspired to write, write, write. And I did have some of that, but mostly my mind has been focused on the impending birth of my baby (ANY DAY NOW!).

With that said, I attended a number of healthcare-focused panels during BlogHer. After working* in a hospital in a rural area for several years and then spending an extensive amount of time in hospitals with my son while he’s been fighting Leukemia, I’ve learned a few things about the healthcare system. Still, I didn’t realize how relevant this bill was to me until I learned more about it at BlogHer.

If you’re a California voter, I hope you will take the time to read this post and learn more about this bill (the full text of which can be found here), as it will have impacts on everyone in the state who utilizes the healthcare system. And then, of course, cast your vote in November!

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The three main components of California Proposition 46 are:

  • It raises the cap on the “pain and suffering” portion of medical liability rewards from $250,000 to $1.1 million.
  • It requires both random drug and alcohol testing, as well as routine testing of physicians who are involved in any medical procedure that has an associated “adverse event.”
  • It requires practitioners and prescription drug providers to consult a database prior to prescribing controlled substances to patients.

The rationale behind this bill is that it will deter or prevent prescription medication abuse by patients who “doctor shop” in order to get controlled substances prescribed to them, and hold medical care providers accountable for any fallout events that could result from medication and drug abuse (by both physicians and patients). This is supposed to increase patient and public safety by decreasing the number of adverse events associated with healthcare procedures, and thereby decrease the number of lawsuits. The bill was created in response to an incident in which two children were killed by a driver under the influence of alcohol and prescription painkillers. (Please take the time to read that article – it will provide a lot of context for the motivation behind the bill. After reading it, I would ask that you contemplate whether this bill would actually have prevented the death of those children.)

On the surface, the bill sounds like it addresses a number of issues and would save lives. But, as most of us voters know, there are many bills that make it onto the ballot every year that aim to do something good, but fail to deliver due to flaws in practical application. Prop 46 is one of these flawed bills.

I’ll take this point by point and offer my perspective, as both an individual who has worked in the healthcare system and someone who uses that system extensively, on why this bill is significantly flawed and would actually end up doing more harm than good here in California.

1. It raises the cap on the “pain and suffering” portion of medical malpractice rewards from $250,000 to $1million.

If the cap on what can be awarded to those who file a lawsuit against medical practitioners and hospitals is raised, that additional award money has to come from somewhere. Medical malpractice suits WILL happen, and to accommodate the increased amount of funds that will be awarded, providers and hospitals will need to increase their liability insurance coverage. This will cost them more, and they will pass the cost onto patients by increasing the price tag on procedures or insurance premiums.

What I know from processing contracts and facilitating physician recruitment in a rural California hospital is this: many physicians, particularly specialists, end up closing their private practices due to the high overhead of liability insurance. They move to practicing medicine in HMOs or they leave the state. Hospital systems can negotiate better insurance rates for liability insurance due to the bulk amount they require – independent physicians do not have that bargaining power and end up paying more for liability insurance (even if they don’t end up in lawsuits). This is why seeing independent specialists and doctors in private practice costs patients more.

This hits low-cost clinics – like Planned Parenthood – particularly hard. Many clinics (primarily used by low-income individuals, teens, those without insurance, and minorities) are already struggling to keep their doors open and retain physicians to provide services with little or no pay, and offer quality care to patients.

Note: current law specifies unlimited awards for a patient’s medical costs, punitive damages against the practitioners, and lost wages/earning potential associated with a medical liability case. The current cap of $250,000 only applies to pain and suffering awards.

2. It requires both random and routine drug and alcohol testing of physicians who are involved in any medical procedure that has an associated “adverse event.”

I’m not against drug testing of medical practitioners – patient safety is absolutely paramount and I certainly don’t want someone under the influence in charge of my health! However, more drug testing equals higher costs – the bill as written requires hospitals to bill physicians for these costs. The costs are there whether the practitioners are testing positive or negative for substances, and again increases the cost to physicians of practicing medicine in California.

Aside from the cost factor, the bill would require that practitioners who are involved in a case that resulted in an adverse event (even if that event turned out to be accidental and not related to physician negligence) be suspended from practicing medicine until positive results are investigated [see Section 2350.30(b)].

So, for example: a patient claims to have suffered extra injury from a surgery but it’s not reported until after the procedure (days or weeks or even years after – a statute of limitations on the discovery of adverse events does not appear to be written into the bill). The medical professionals involved in the surgery are sent for drug testing – after the fact (because time travel hasn’t been invented yet). Perhaps they test positive for Vicodin (an opioid) in their system due to a dental procedure they had that day (the day the drug testing is required, which is who knows how long AFTER the surgery on the patient) and said Vicodin wasn’t prescribed by a third party or it was leftover from a prior procedure. (Or maybe the physician smoked marijuana to relax after a particularly intense day of surgeries and they don’t have a prescription!) Their license is suspended until the courts investigate the practitioner and obtain proof that they were not under the influence during the surgery.

How in the world is anyone to know if the physician was under the influence while practicing medicine if the drug testing occurs after the fact? No one can know that, so the (possibly unintended) result of requiring drug testing is that medical practitioners involved in adverse events are presumed to have been under the influence and punished for being under the influence (due to the temporary license suspension) even if it’s impossible to prove that drugs were not involved in the event.

[Note: Prop 46 defines "drugs" as marijuana, cocaine, amphetamines, opiates, and phencyclidine (PCP).]

3. It requires practitioners and prescription drug providers to consult a government-run database prior to prescribing controlled substances to patients.

This portion of the bill is intended to thwart drug-seekers who abuse medications such as prescription painkillers by visiting multiple doctors in order to obtain multiple prescriptions. Any time a medication from a list of controlled substances is prescribed by a physician or the prescription is filled at a pharmacy, the medical professional must first check the CURES database to see if that medication or something similar has been given to that patient before and how often and by whom.

Patient privacy comes into play here because any physician or pharmacist who logs into the database can see your medical history – not just your primary care doctor. Also, law enforcement has access to the database, regardless of the fact that they do not have pharmaceutical training.

In addition, the database is a government-owned and run program. The technology is not up-to-date; it’s slow and unreliable and cannot currently withstand the additional load to servers that would occur if every physician and pharmacist in the state was required to log in every time a prescription was being written or filled. (In September of 2013, Senate Bill 809 was introduced and passed into law, which required upgrades to the CURES database; however, that process was expected to take two years. If Prop 46 passes this fall, it goes into effect immediately – about a year before the upgrades to the database are due to be completed.)

When a physician or pharmacist cannot log into CURES due to a slow server or a crashing system, patients (including those who are NOT drug seekers) will be denied prescription pain relievers. Once again, this issue would hit rural areas the hardest because technology is notoriously behind the times. Even if rural hospitals and clinics have up-to-date physical hardware, internet speeds are rarely optimal.

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One last thing that I feel is important to point out as a strong indicator that Californians should vote no on Prop 46 is the list of supporters (1 senator and 3 organizations) vs. opponents (I’m not actually going to count that gigantic list but it includes officials, doctors and medical groups, medical societies and business groups, labor unions, hospitals and health centers, insurance companies, and other groups such as the ACLU and the Civil Justice Association of California).

* My work in a rural northern California hospital included legal contract tracking and processing and physician recruitment support. I worked with the Business Development, Finance, Risk Management, and Legal departments during my tenure. The hospital’s patient population overwhelmingly consisted of low income people with Medicare coverage and due to the rising costs of healthcare combined with low reimbursement rates from insurance companies, the hospital struggled to stay in operation. Further, it was extremely difficult to recruit quality, experienced physicians to the area due to low compensation compared to the high cost of practicing medicine.

A Wish Come True in Time and Space

After waiting nearly two years, Jack’s wish finally came true.

Initially he’d told Make-a-Wish he wanted to meet Lady Gaga. He made a dance video to the tune of Monster (which was the first time I’d ever seen him dance!) to send to her and he waited patiently for his turn. But he kept slipping further down the list due to kids in more urgent health situations and then Lady Gaga got injured on the road and canceled all her shows in order to get surgery.

In the mean time, Jack’s interests evolved and he became obsessed with Dr. Who. He will debate with you about the scariest aliens in the series and has strong opinions about which doctor is the best (the 11th Doctor, played by Matt Smith, is #1! Christopher Eccleston’s Doctor is #2 and David Tennant comes in at #3). Jack has watched Dr. Who almost every day for the past two years or so. He rarely watches anything else.

JackAge8

Doesn’t he look like a mini Matt Smith??

Last year we decided to give his room a little makeover since we wanted to build him a loft bed anyway. We did our best to turn his room into our (weak) interpretation of the TARDIS. We had limited money, but Jack was happy with the results. He’s got a good imagination, after all, and was able to fill in the blanks.

Not soon after, we talked about his wish and he decided he wanted to change it. He wasn’t very interested in Lady Gaga anymore. Instead, he wanted to meet the aliens from Dr. Who. Unfortunately, Make-a-Wish has a rule that the kids can’t switch from one celebrity wish to another (due to the long wait lists), so Jack settled on a more extensive room makeover that would add a console to his room and really make it into a TARDIS.

He submitted his new wish back in November and then we waited. During the wait, Jack made a lot of comments about how he wished he really had a TARDIS so that he could bypass the waiting altogether. Since the project was so unique, it took some time to find the right designer to work on it. Eventually they found Julie Giampaoli from Showcase Your Place, an interior designer in the area who was up for the challenge despite not knowing about Dr. Who!

She knows now!

Julie and Make-a-Wish pooled together some awesome resources and on July 22nd, the team arrived to get to work. I’ll admit it – I was more than a little nervous when they started drilling into my ceiling. But this was Jack’s wish and I just had to trust the process.

We were not disappointed. This video of the room reveal shows Jack’s stunned reaction pretty well:

 

And here are more extensive pictures of the process:

Jack LOVES his bedroom. He says it’s “too awesome!”

We are all so very thankful to the Make-a-Wish Foundation, their volunteers, and supporters for helping bring Jack’s wish to fruition and put some magic back into his life. We will treasure this experience for the rest of our lives!