Orlando

So, we have been pretty busy recently.  Last weekend, our national anesthesiology meeting was held in Orlando.  I gave a talk at it, and Jason also wanted to go to the conference, so we made it into brief family trip.  The kids missed a few days of school, but since I don't think we will be going back to Orlando anytime soon we decided it would be ok.

We were able to hit up two Disney parks-Epcot and the Magic Kingdom.

We were somewhat unfortunate with the weather--it was unseasonably hot and humid.  Epcot seemed a bit dated to us, but the kids enjoyed it.

Magic Kingdom was great, and not too crowded.   The kids went on all of the rides--no scaredy cats in our family (Though Alaina did not like Splash mountain).   The most poignant moment occurred in the hall of the presidents, where, towards the end of the presentation, Alaina turned to me and said, "Mom, aren't there any girls?"

  

Probably the kids favorite day was one spent at the waterpark Typhoon Lagoon.  The lines were short and the water helped to beat the heat.

My talk went well, and Jason enjoyed the conference as well.  So a good excuse to combine work with pleasure!

Milwaukee Visit

Several weeks ago, I had the opportunity to travel to Milwaukee to the Medical College of Wisconsin.   I gave a val to their pediatric anesthesia department on a Friday, and stayed for the weekend for a simulation day, where fellows practice mock emergencies in anesthesia.   The visit was great, as it is always fun to see another program and learn how they are organized.   My talk went well and the simulation day was fun too.  I managed to hit up Kopp's for custard twice.  Delicious!

As a bonus, I got to see my family!   I was able to have dinner with Judith one night, and on Sunday morning I  went to brunch with my Grandma, Dad, Uncle Jim and Aunt Cathy, cousin Stephanie, and Aunt Judith.   Jeff, Zachary and Gregory even drove up to meet us.   Gregory is getting so big!

I also went to visit the cemetery where my Grandpa Ferschl and Aunt Maggie are buried, as I haven't been in a while.

 So, pretty much the best work trip ever!

The Case of the Missing Front Teeth

For about a month, Alaina has been growing in her top front teeth.   Unfortunately, they grew in behind her baby teeth, resulting in a shark-like double row of teeth.   The further the top ones came in, the more protuberant the baby ones became, until her mouth became really funky looking.  And though both teeth were quite loose, she would NOT let me touch them to pull them out.  One night, I was helping her brush her teeth and one of them turned almost 180 degrees, but still was attached by the front root.  Really downright gross.

That is when the tooth fairy stepped in.   Late one night, one of those teeth disappeared, and a dollar was left snug under her pillow.

Two nights later the other one disappeared.

And now, you can see the beautiful new grown-up teeth that were hiding!

Ethan's Diagnosis

For the past 10 years, I have had the privilege of taking care of children every day as a part of my job.   Some of them are quite healthy--and just need a minor surgical procedure.   Others are critically ill.  For the most part, after my clinical day wraps up, I have had the ability to leave work at work and go home to my healthy kids.

All that changed last week.

Well, really it changed months ago, but we just didn't realize it.    For over six months now, Ethan has been complaining of pain in his hip.   I attributed it to "growing pains".   I brought it up to his pediatrician at his 10 year-old check up.  She examined him and agreed it was not likely something to worry about.  Fast forward to July, and Ethan was still complaining about the pain.   He also was starting to walk more slowly, and his gait had changed.   We contacted our pediatrician again who sent off some blood work (which was normal) and referred us to an orthopedic surgeon.   Since I work with the surgeon, I talked to him at work, and he recommended some x-rays.   The films were normal.   We made an appointment for a few weeks later.

Meanwhile, Ethan started school.   His new school  is about a mile from our house.   When I walked him to school the first day, I was shocked by how severely he was limping.   At a soccer game the following weekend, a friend of mine asked why he was running so strangely.   I talked to the surgeon again.   He recommended an MRI before our appointment.

The MRI showed severe inflammation in Ethan's pelvis and spine.   Instead of seeing the surgeon, we we referred to a pediatric rheumatologist.   Based on his MRI, and some later blood work, Ethan was diagnosed with juvenile ankylosing spondylitis.   This condition is a severe autoimmune disease whereby his immune system basically is attacking his joints in his spine and pelvis.

I cannot explain how horrible I feel about everything.   I have been pushing Ethan to walk and run faster, telling him that he has to play soccer better, stop complaining etc.  Meanwhile his joints were getting eaten apart.  In retrospect, it makes sense--he hasn't been growing as much recently--he always was a taller kid in his class, but in the past year many shorter kids have grown taller than him.  But his body has been too inflamed to grow at the same rate.    Stiffness is a hallmark of this disease.   Even Ethan's basketball coach this summer noticed how stiff he was--and sent him home with special stretches.  But, now we know that none of this was his fault.   It is a lot for me to process.

I feel especially bad since Ethan lives for sports.   He simply loves playing them, and all of his friends are sports kids as well.   But obviously, his condition has affected his skills and ability, and I think that this has effected him socially quite a bit--we are just putting this all together now.

Since the diagnosis, he has started on high-dose naproxen.  That has actually helped.   His gait is not normal, but it looks much better.  He still has pain, but it is less.

The next step will be to start him on a medication called Enbrel.  This medicine is an injection that he will get once a week that targets part of his immune system.   Unfortunately, because it acts to suppress his immune system, there are some very serious risks associated with taking it.   But it is really the only option.   We are waiting to get insurance authorization for it, as it is ridiculously expensive.    

It is really hard, as a mom to have a child with a chronic medical condition.   If nothing else, it has helped me better empathize with the moms of all of the chronically ill kids that I care for, and hopefully it will make me into a better doctor.

I hope he starts to feel better soon.

French Polynesia Part 2

Well, it has been busy and I have a lot to write about, but I think if I don't finish up the vacation post, I never will, so let's start there.

From Moorea we flew to Bora Bora.

Bora Bora has the most beautiful water I have ever seen.   The island (like Moorea) is completely surrounded by a tropical reef--which means the water is completely calm.   The main beach on the island stretches for over 200 feet off shore at a maximum depth of 4 feet. It is a perfect swimming pool!

In Bora Bora, we rented an over water bungalow from Air BnB.   It actually was built by Marlon Brando in the 70s.   Although it hadn't been renovated really since then, it was a fraction of the price of the resorts and suited us well.

Our first full day in Bora Bora we took a tour of the lagoon, with several snorkeling stops.   The coolest was one outside the reef that had about 100 ft deep crystal clear water with multiple reef sharks, and a lemon shark.   The sharks were uninterested in us, but so amazing to see.   The lemon shark really did have yellow eyes.   On another stop, we got to see a manta ray.   Also really neat.

 

The next day, we enjoyed taking a trip out to one of the barrier island and spent the day.   There, we also snorkeled and saw many Eagle rays.   The variety of marine life in French Polynesia was so spectacular.   We also submitted this photo of Ethan for a summer photo contest for Kumon (a extracurricular reading program he does).   We found out at the end of the trip that he won the contest that week--and got $100!   Woo-hoo!

From Bora Bora we went to Tahaa.   We chose to stay in a hotel as a treat for the end of the trip.   The resort we stayed in was really beautiful and had great food (thankfully, as their restaurant was the only one on the island!).   It had an amazing coral reef nearby that had some of the most amazing drift snorkeling I have ever done.   The current was a bit strong for the kids, but Jason and I loved it.

So, overall and awesome 2 weeks.   We got in some good relaxing time, and great family time as well.   I am longing to go back!

First Days of School

I am going to interrupt my vacation post to write a bit about the kids' first day of school last week.

 

Alaina started first grade.   He teacher has been teaching for 36 years, which means she could have been my 1st grade teacher, ha ha!   She seems great.  Alaina's school has been completely remodeled over the past year with a new office, classrooms and common space.    It is really nice.  

Ethan started middle school (gasp!) which is 5th-8th grade in our district.   Though the 5th graders a a bid secluded from the older kids, it was weird to drop him off on Tuesday and see girls with heavy make-up and crop top shirts.   Ugh.

He has a primary language arts teacher and a primary math/science teacher.   Also, all 5th graders are required to learn a musical instrument.   Ethan chose the trombone.   He is supposed to bring it home this week, so we will see how that goes!  He also gets some electives, including woodshop, which he seems to enjoy.   This will be the first year all kids get real grades, so he is a bit nervous about that, but otherwise seems happy.  

As a side note, Jason and I also celebrated our twelfth anniversary last Monday.   Though we counted the trip as our anniversary present, we did enjoy marking the date with a nice family dinner at home!

We are back!

Gosh it has been awhile!

Ethan and Grandpa had a great trip to Santa Barbara.  Highlights included some hikes, the Zoo, and the Botanical Gardens.  I forgot to get some photos from my dad, so I don't have any to share, but it sure sounded like they had a great time!

The following two weeks we had a family summer vacation.   I have always wanted to go to French Polynesia, but the airfare has been prohibitive.   However, about a year ago a discount airline, called French Bee started a San Francisco to Papeete route.   And, with competition comes better fares!   So, we were able to travel there reasonably!

Now, even though the flight prices are down, most of the resorts are still quite expensive--so we opted to mostly stay in air bnb rental properties.   It worked out quite nicely as it gave us extra space and a kitchen for meals.

As it turns out, French Polynesia is not as far as you may think.   It is an 8 hour direct flight from San Francisco--and in the same time zone as Hawaii.   But wow, it had a much different feel than Hawaii. It is much more local and less touristy.   The locals are super friendly.  And they speak French, and eat delicious French food--almost all of the food in the grocery store was imported from France!   And, surprisingly, the grocery store prices were comparable to those in San Francisco.

We started the trip on the Island of Moorea.   This island is composed on absolutely stunning mountains and valleys, surrounded by a crystal clear sea.   We loved our rental house there, which was perched on a hillside with an amazing view.   There were a lot of things to do in Moorea--and we didn't have time to do them all, so I guess we will have to go back 😉

Our first day, we arrived off a red eye flight, so we hung out at the beach, and did some grocery shopping.   Not a bad beach, huh?!?!

After a good night's rest, the next morning we took a hike in the jungle--we saw some beautiful plants.   The kids didn't make it up quite to the viewpoint we aimed for, but Jason did.  

 

 In the afternoon, we went on a whale tour.   This was probably the coolest thing we did on the trip.  August and September are Humpback whale season in French Polynesia, and a marine biologist (and former UC Berkley grad) leads tours each day to see the whales.   We headed out in a boat beyond the reef.   At first it seemed like we might not see anything, but just as we were about to turn around, a mother and baby whale were spotted.   The boat approached them slowly--and then we got to get out and snorkel near them!  This is legal in French Polynesia.   We probably were within 30 feet of the whales.   The mom was just floating there--probably sleeping, the biologist said, and the calf was swimming around her.   Absolutely amazing.  The kids did not get in, since it was open ocean, but they also had a nice view from the surface.

Our second day, we took a lagoon tour.  Unfortunately, it was pouring in the morning, but we had already paid for the tour.  The rain did not last too long, and we did get to snorkel and see sting rays and black-tipped reef sharks.  

We stopped for lunch on a "Motu"-a small island outside of the main island.  By then the weather had turned and it was gorgeous.   During the lunch we learned how to husk and crack a coconut, and make poission cru--a raw fish dish made with coconut milk.   Though I obviously won't be eating any of that, Jason loved it!

  

They also made the kids hats out of palm leaves:

  

Our last day in Moorea, we headed to the Lagoonarium.   This place was like an open water aquarium.   It had several acres of snorkeling and a "fish feeding" session twice a day.   The fish feeding sessions were like being in the tank at the Shedd Aquarium--tons of fish, reef sharks, and sting rays.   The water was absolutely beautiful (though the plastic cover I had to put on my phone dosen't do it any justice!)

We loved Moorea!

I will save the remainder of our trip for a subsequent post, as this is already getting too long!!