He's On a Roll!

Despite all his digestive problems, Cole still seems to be achieving his physical and developmental milestones no problem. Here's a video of his latest accomplishment!

For what it's worth, Sydney rolled over exactly at 4 months too.

Under the Sweat Lodge - I Mean Big Top

Wow - I think we almost melted today. Mom, Syd, Cole, and I went to the circus, and I think it was over 100 degrees under the big top! The acts were good: we saw elephants, tigers, zebras, camels, llamas, trapeze artists, clowns, ATV riders - they had it all. But, the heat was incredibly distracting. In fact, we ended up hightailing it out of there at intermission. Anyway, it was all worth it because Syd got to ride an elephant! This has been a pretty eventful summer with the animal rides for Syd - first the camel and now the elephant. She's fearless!

ABCs!

Fun at Art Square

Yesterday, I took the kids along with Gramma and Terra to Art Square. Art Square is a local art gallery where the Loudoun Academy of the Arts Foundation displays local art work. The August exhibit was the 9th Annual Something Hot Regional Juried Show and Sale. It turns out we know one of the artists whose painting was juried in... our very own Bella Gramma. Although Cole was definitely not in the mood to enjoy the art exhibit, Sydney had a great time looking at the paintings and making comments. She especially liked Gramma's painting of a shop doorway and correctly identified one of the major colors as orange. Our visit was cut short by Cole's crying. Hopefully, they'll let us back in the next time we go!

Look Out Below!

Cole continues his puke-tastic puke-tacular. He pukes after almost every meal, sometimes multiple times. Often, he pukes hours after being fed. For a long time, I've assumed it was something I was eating that caused his problems. However, today's doctor's visit suggested that's not likely the case. After listening to our update on Cole's symptoms, Cole's doctor suggested he might have delayed gastric emptying or DGE (aka: gastroparesis). DGE is a condition in which the stomach takes longer to empty than it should. Some estimates suggest that half of babies with reflux also have some degree of DGE. Symptoms include feeling full quickly while eating, nausea after meals, vomiting and heartburn, and abdominal bloating or pain. The best indication in babies is throwing up undigested or partially digested food several hours after feeding.

Medications are the usual treatment for DGE. In severe cases, surgery may be required.

We'll be heading to a pediatric GI doctor in the next week or so. Hopefully, they'll be able to give us more answers and get us on the road to a less pukey future!

Bergemuda South

Wow. Where to start? We had a blast this past week in the outer banks! The whole gang traveled six hours to Corolla, NC, for a week-long beach vacation. We stayed in a spectacular beach house just steps from the ocean. Here are some highlights:

- We spent almost every morning at the beach. Usually, everyone went except whoever was appointed to keep an eye on Cole (it was clear after day 1 that Cole was not quite ready for the beach).

- We spent almost every afternoon at our private backyard pool. It wasn't fancy, but extremely refreshing.

- We enjoyed an incredible crab leg feast on Wednesday night. We actually ate in a lot, too. We made sandwiches for lunch, had a barbecue in the rain, and enjoyed taco night! All the restaurants that we visited (with the exception of delivered pizza that Jodi and Sarah got) were surprisingly good.

- Tom brought walkie talkies for the drive down and back. We also used them while we were on the beach to keep in contact with Cole and his sitter. At first, I gave Tom a hard time about the walkie talkies (don't cell phones do the same thing?). But - I was wrong. The walkie talkies were great, and I think Big Papa especially enjoyed announcing, "Big Papa copies" and "Big Papa to Beach Blanket."

- We were all surpised to learn that Max can spell. Who knew that we have such an amazingly educated dog in our midst?

- Terra delivered the beat down of all beat downs in Scrabble.

- Sydney managed to lock us out of her room.

- Cole rolled over for the first time - from back to belly.

- Mustache Papa started calling Big Papa Coconut Joe after Big Papa announced that he was coconut brown (I think his skin was closer to a shade of overdone lobster).

- Sarah and Jodi were shopping maniacs. They visited all the shopping plazas within driving distance of the house. Well, maybe not all of them. We were the lucky recipients of their treasures, though! Sarah picked out great OBX magnets for everyone, and Syd and Cole received the cutest souvenir t-shirts!

- Max Gramma managed to fit in several brisk walks and water aerobics almost every day.

- Sydney rolled down a half flight of stairs and took about 10 years of everyone's lives. Thankfully, she's a-okay!

- Bella Gramma perfected the art of floating in the pool. I looked out the window several times and had to do a double take to make sure she was still breathing.

- Everyone was fantastic about helping out with Cole and Sydney. We are so blessed to have such wonderful and supportive family!

- Big Papa got to fly his kites, and helped Syd and Sarah fly a couple he bought them, too.

- Mustache Papa put in plenty of time playing several rounds of babies with Sydney.

- Sydney was especially happy to find a Little Tykes play car at the house. She (and Jodi - we'll keep the pictures for blackmail later) had a blast zooming around Flinstone style!

- Even Max enjoyed his vacation. He met several dogs in the neighborhood, including an enormous Saint Bernard! He made himself comfortable in the house and spent most days sprawled out on the couch.

- Bella Gramma made some excellent food while we were at the beach. My favorite was the Red, Hot, and Blue potato salad and the shrimp salad. Yummy!

- Tom made use of a bike he found at the house. He was spotted riding between the beach and the house with a beer in one hand, handle bar in the other, and whatever item he was helping to bring back or to the beach on his back.

Overall, it was a fantastic, relaxing vacation. There are more pictures on Picasa. I may post more here when I see Big Papa's pictures. Stay tuned!

Pork Chops with Raspberry Sauce

This was incredibly delicious. I think I'll try it with chicken next time around.

1/2 t dried thyme
1/2 t dried sage
1/4 t salt
1/4 t pepper
2 T butter, divided
1 T olive oil
1/4 c raspberry jelly
2 T orange juice
2 T balsamic vinegar

In a small bowl, combine spices. Rub on pork chops. In a skillet, melt 1 T butter and olive oil. Saute pork chops. When cooked, remove the chops from the skillet and keep warm.

In skillet, combine remaining ingredients - except for 1 T butter. Bring to a boil, and then simmer for another 2 to 3 minutes. Just before serving, add 1 T butter.

Serve pork chops with sauce.

My Letter to Fairfax Radiology

Most of you know I was less than pleased with my recent visit to Fairfax Radiology. They were incompetent, unprepared, disorganized, and rude. A copy of the complaint letter I sent them is as follows (I've removed some specific details for privacy). Props to Jodi for her help with it. My brain's been fried lately, and I just couldn't muster the focus required to produce my typical complaint letter on my own. Anyway, I received a voicemail from the COO of Fairfax Radiology this afternoon. Now, we're playing phone tag. It'll be interesting to hear what steps she plans to take so that no other babies who are suffering have an experience like Cole's.

August 1, 2010

Dr. Marshall C Mintz and Mr. William Allison
2722 Merrilee Drive, Suite 230
Fairfax, Virginia 22031

Dear Dr. Mintz and Mr. Allison,

I am writing to inform you of my recent experience at Fairfax Radiology. My son Cole is currently 12 weeks old. For several weeks, he has been suffering from digestive issues including vomiting, abdominal pain, and inconsolable crying. My son’s doctor ordered two examinations for him: a milk scan and an abdominal sonogram. Per the instructions on the exam orders, I called the scheduling phone number to schedule the appointments.

I was pleasantly surprised when the operator informed me that Fairfax Radiology could perform both examinations on the same day. She provided the following instructions:

• Have Cole skip one feeding and one nap (the milk scan required that he not eat, while the sonogram required that he have a full stomach)
• Bring two bottles with nipples
• Arrive at 11:00 am for my 11:30 appointment (so Cole could start drinking his bottles with medicine)
• The milk scan would be performed in two parts – one hour apart, and the sonogram would be performed in between milk scan part one and part two.
• The milk scan part one would take 1 hour; then, there would be a 1-hour break (during which time the sonogram would be performed) before the second part of the scan would be conducted.

The evening before my appointment, I received a call from Fairfax Radiology informing me that they would have to cancel the sonogram appointment because they did not have the appropriate staff available to perform the examination at the Fairfax office. They rescheduled our appointment for a week later at the Herndon office.

On the day of my appointment, I did not feed Cole after 7:00 am (as directed), and I made sure he did not take a nap. As you can imagine, I arrived at the Fairfax office with a very unhappy, uncomfortable baby. He was screaming and could not be consoled. When I checked in with the receptionist on time at 11:00 am, I was informed that the technicians would not be ready for Cole for at least another 25 minutes. I was told I could take my baby "outside for some fresh air." I believe I was given this suggestion so that he would not disturb other patients in the waiting room because he was crying loudly. Given the age and symptoms of my child, why didn’t someone from Fairfax Radiology call me to let me know the office was already behind schedule? While it is somewhat reasonable for adult patients to wait half an hour past their appointment time, it is unreasonable and cruel to expect infants to do the same.

When Cole was finally taken to the examination room, he was inconsolable. It took us nearly a half hour to get him to drink one ounce of breast milk and medicine. Then, the technicians informed us that he could drink the rest of his breast milk to have a full stomach. Cole was so upset, he did not drink the plain breast milk. As the technician put him on the examination table, she told him, "You’re going to regret not eating because after this, you won’t be able to eat for another 3 hours!" When I heard the technician, I immediately asked if we could try feeding him again. She said yes. He did not take the bottle, but after trying, I asked the technician if he could breastfeed. She said yes.

Cole underwent the part one of the milk scan. When part one was finished, we were informed that the wait would be two hours – not one as we were previously told. We came back two hours later, and the technicians finished the exam. I cannot understand why the preparation instructions for the exam were not clearly communicated and why the waiting times in between were not adhered to. I was not offered any explanation by the technicians or office staff.

Next, we had Cole’s abdominal sonogram scheduled. Monday afternoon, I received an automated phone call confirming my appointment and asking that Cole not eat or drink anything after midnight the night before the exam. This was in direct conflict with the previous instructions I had received that asked me to bring him with a full stomach. Because Cole is 12 weeks old, I decided I’d go ahead and feed him until 7:00 am the morning of the appointment (his appointment was scheduled for 10:05 am).

We arrived at the Herndon office at 10:00 am. We were immediately taken to the exam room, where the technician asked me if I brought a bottle with me. I had not been told to bring a bottle with me for this appointment, so I told her I had not. She explained that the sonogram could not be performed unless Cole drank a clear liquid before the exam (either Pedialyte or water). The doctor who was going to perform the exam came in and suggested that she try the exam without the Pedialyte or water in Cole’s stomach. As she was preparing to start the exam, she asked the technician for a specific type of transducer. The technician informed her that the office did not have the type of transducer she needed for the exam. The doctor went ahead and performed the exam with a different type of transducer. After a couple minutes of examination, the doctor informed me that she could not see much and really needed Cole to drink a clear liquid. It was decided that the office staff would obtain a bottle within 30 minutes, and we would retry the examination after Cole drank the clear liquid.

Within 30 minutes, I was provided a bottle with Pedialyte. At this point, it had been 4 hours since Cole had last eaten (he is on a 2.5- to 3-hour schedule). He was, again, inconsolable and was not able to drink the bottle. The doctor suggested that we try the examination again, but she was again unable to get a good picture of Cole’s stomach. The doctor concluded the examination and informed me that she did not "think" he has pyloric stenosis. I believe the doctor was unable to reach a conclusion because the preparation instructions I was given were wrong and because the proper equipment was not available.

As you can imagine, I am incredibly disappointed and frustrated with my experiences at Fairfax Radiology. The service we received was unsatisfactory in the following ways:

• Our sonogram appointment, which had been scheduled a week ahead of time, was cancelled at 4:30 pm the day before the exam because a technician was suddenly not available.
• Initially, I was informed that the abdominal sonogram required a full stomach, when in fact, it did not.
• My 12-week-old baby was made to wait (while overtired, hungry, and screaming) in the waiting room at Fairfax Radiology – even though we arrived exactly at the time we were told to arrive.
• Initially, I was informed that there would be a 1-hour break between milk scan parts one and two, when, in fact, it was a 2-hour break. I was not told that my son would not be able to eat for three hours after part 1 of the exam.
• An automated confirmation call informed me that I could not feed my baby past 12 midnight the day before the sonogram exam; obviously, these were erroneous instructions. A mistake of this magnitude would be traumatic for even a healthy infant; it would have been even worse for an infant dealing with digestive issues.
• I was not told to bring a bottle to the sonogram exam and the office did not have one available – even though it was required equipment.
• I was not told my son would have to drink a clear liquid before the sonogram exam.
• The sonogram technician and doctor did not have the proper equipment available, even though the appointment had been scheduled and confirmed in advance.
• The sonogram exam proved inconclusive with the doctor stating she did not "think" Cole had pyloric stenosis. After putting an infant through this grueling testing, I would expect to have a firm conclusion and believe one could not be reached because of the errors made in preparation and the lack of proper equipment.

While I understand that wait times and delays may not be able to be controlled, my absolute minimum expectations for these tests would be that I receive clear and correct preparation instructions and that the proper equipment would be available to conduct the tests. Even these low expectations were not met in our experience.

My experience exposed Fairfax Radiology as grossly incompetent in every area: from scheduling and preparation to the actual exams themselves. I ask that you immediately review your practices and procedures to better prepare yourselves for future patients. I would ask that the licensing board review this case and your practices to determine if a formal complaint should be filed. In the meantime, I am going to strongly suggest that my doctor consider sending his patients elsewhere and will share my experiences with my new mom groups, family and friends.

Sincerely,

Cole's Mommy

Poor Cole

I guess this was bound to happen - it's the sad story of any little brother who has an older sister. The other day, Sydney and I were playing with Cole - showing him some of his infant toys. Sydney suddenly decided that she wanted to play with his toy, so I suggested that she go find one of her toys that she thought he might like to play with. The picture tells the rest of the story. Sorry - buddy. It's just a matter of time before she starts dressing you up like a baby doll.

It's Been 3 Months...

Well, it's been 3 months (really, 3.5 months) since I became a mother of two. I can easily admit that the last 3 months have been extremely challenging. And - all along - I had incredibly supportive family and friends telling me, "It'll get easier"! It was just hard for to believe that when I was having such a hard time. Anyway, things have been a little easier lately, and I'm starting to have hope that I may be able to swing this without a major breakdown anytime in the near future. Maybe it's that Cole's medicine seems to be working. Maybe it's that I'm trying really hard to relax about having a rigid schedule. Maybe it's that I don't have any surgeries scheduled in the near future. Maybe it's that Sydney actually told me in mid-bite of her chicken nugget today, "Mommy, I need to pee." and then actually peed on the potty. Maybe it's a combination of everything, but things do seem to be getting better. I even took both the kids to Target earlier this week - by myself - and no one cried. Not even mommy!

Happy Birthday Papa!

This weekend we celebrated Papa's birthday! He finally turned 45, so we really pulled out all the stops. We had a great pool party and barbecue followed by banana caramel cupcakes with caramel cream cheese frosting. He received a bunch of nice gifts including plenty of books, a Barnes and Noble gift card, and a snazzy pair of flip flops! He's all set for a beach vacation: books and flip flops... what else do you need? Happy Birthday Papa!

"I Want to Ride the Camel!"

When I became a mom, I never expected to hear my child say, "Mommy, I want to ride the camel." But, that's exactly what Sydney said a couple weeks ago when we visited the Loudoun County Fair!

Loudoun County has a large farming community, and our fair is very agricultural in nature. There are livestock barns with pig, cow, chicken, rabbit, goat, and sheep exhibits. 4H is a big part of the fair, and they even have competitions for the largest fruits and vegetables. Then, there is usually a pet-a-pet show where kids can learn about animals and feed and pet them. We were checking out the pet-a-pet show, when Syd saw the camels. Then, she noticed that other, older children were taking rides on the camels. She immediately said, "Mommy, I want to ride the camel." I asked her if she was sure, and she said yes. So - I went ahead and got in line. I figured we'd get up to the front of the line, and she'd probably chicken out. The sun was really hot, so I parked the stroller under some shade (right next to the camels), and mom took stroller duty with the kids. While I was waiting in line, the trainer and the camel came over to the shade where Mom and Syd were standing. Mom pointed out that the trainer was giving the camel animal crackers as a treat - just like Syd gets animal crackers for her treat. The trainer gave Syd an animal cracker to feed the camel, but Syd just popped it in her mouth and enjoyed! Oh well.

Anyway, I was still waiting in line. There were two little sisters ahead of me that appeared to be the same age as Syd. When it was their turn, they got on the camel, then decided it was a bad idea and got off. Then, it was Syd's turn. I figured, here we go! She got on, and away she went! She rode the camel like a champ! I got plenty of pictures, but as always, Syd takes her fun very seriously, and there aren't any where she's actually smiling. However, I can assure you she had a blast. For a couple weeks now, she's told anyone who would listen that she rode a camel.