Monday, December 21, 2009

happy happy joy joy

Happiness is.... mobile broadband! Ok, so I have to sit on the upstairs front verandah and the planets have to be exactly aligned and sometimes the signal drops out but...

Holiday going well. Except my parents decided to drop in about three days earlier than planned (!parents! gatecrashing our holiday! WTF?!). The cousins are mostly playing well together. Oh, and my s-i-l thinks Patrick is fine: she says it's jjust first child-dom.

Merry Festivities all! From here

PS may not get another chance to get out here again until all the shouting is over.

Oh and thanks for the support :)

Wednesday, December 16, 2009

Pat-RIIIIICK!!!!

Back in 1994 when we were studying child psych at med school, it all seemed so simple.

Children need firm and consistent discipline. That's the secret to happy, well-adjusted kids.

Simple, right? Right??

Firm I can do. Hell, I've done surgical training, I can be as complete an arsehole as you would ever hope to find.

It's the consistent I have a problem with.

When you're young you imagine when you are grown-up, you will have an innate ability to be 'grown up' and responsible, because, well, that's what happens when you grow up. You get to drive a car, spend the money, and be calm and rational at all times.

Yeah. Not so easy.

I didn't ever consider that I would still be grumpy, moody, tired (make that exhausted), hung-over, rushed, time-pressed, angry, sad or any of the other PMS dwarves when I grew up and had children (mind you, I thought I'd be married to my med school crush and have three children and a career before the millennium was out, too).

So sometimes I'm firm and calm. Other times, I cave in and do things I never thought I would (sugar in a bowl? with a spoon? sure. Now just let me finish updating my logbook and this presentation for work). I worry that Patrick is just a wee bit... bratty.

Right now, when I am supposed to be packing (not blogging, note- i haven't had my coffee aaaand Ollie woke up three times for feeds last night so i had plenty of thinking time and I want to get it down before it evaporates like those other brilliant blog posts that I haven't had timetowriteincludingthatbrilliantoneaboutfamiliesandloveand... and... and...) Patrick is wandering up and down the hallway yelling out "Daaaaddeee, D-AAAAd-eeee, I need more bottle! Need more BOT-TLE!! And I'm awfully, awfully tempted to cave in, just so we can do all we need to do (eh-hem) without too much interruption.

My psych said i could reduce the stress in my life by not sweating the small stuff. That's great, but where does not sweating the small stuff (please put your undies back on, no eating on the couch, no computer before breakfast is over, don't snatch (toys from Ollie) become complete slackness- the couch is a mess, what is a few more stains?

This has come to a head because we are spending Christmas with my brother and sister-in-law in coastal Victoria, and her kids just came out of the womb happy, quiet and scream-free. Seriously. I've been there when she tells my neice (who is all of 11 weeks older than Patrick) not to do something... and she does it. No argument! Oh. My. Godness. I fear I will spend the week being embarrassed by the naughtiness of Patrick and her 3 calm, cool and disciplined kids, and end up feeling worse than ever.

How do you all do it? On a scale of 1-10 for consistency, where do you fall? I'd give myself.... well, maybe a 5.9. Which barely seems like a pass. How consistent do you need to be? 8? 9? 10? (fuggit, no-one's that good, are they? are they?)

Thoughts?

Monday, December 14, 2009

wow. serious insight.

I'm listening to a podcast covering (amongst other things) legislation around surrogacy, and I just had a flash of insight.

The reason why medicine and law so often conflict is that medicine deals with generalities, and law deals with specifics.

When making a decision on how best to treat an individual, doctors use the experience of the previous treatments to guage how an individual may respond to a given treatment. In the last 20 years, the concept of "evidence Based Medicine" (or EBM- which always makes me think of "expressed breast milk") has become the guiding light as to how to best manage people- using research- based decisions rather than 'what has akways been done' or even what seems to make intuitive sense. The gold standard in medicine is the Meta-analysis of multiple, large, randomised controlled trials, involving hundreds of thousands of patients. How we treat diseases like breast cancer, heart disease, all the big ones, comes from this evidence. Even in anaesthesia this is true: a Cochrane review of how best to alleviate pain in labour was published not so long ago*.

However, in law, when an individual decision has been made by a judge, this then determines how subsequent matters are decided, rather than the average judgement made on similar matters, which would be the legal equivalent of the randomised controlled trial.

This means that when medical matters come before a group of legal professionals, they care about the specifics of what the treatment means for any one individual. That is, what will work for that individual, rather than for the large number in a cohort study. Which is impossible to predict, of course. We are judged on what we think the specific patient would want to know in terms of risk for any procedure, rather than what works for a large group.

Hmmm. There's a PhD in this, I'm sure. Which I seriously haven't time for. Next year, can you all please remind me that for a time-pressed full time mum, part time doctor, sewing two onesies, a shirt, a pair of board shorts, a pillowslip (trains, of course) and decorating 8 singlets with hand- made applique is a really bad idea? Especially when said person also wants to finish two skirts for herself before, oooh, tomorrow evening when we have to pack it all into the car to drive to Melbourne?

In other non-related and completely random news:

Julia Gillard's hair is looking better. Nicola Roxon, though, OMG. Get some product, woman! Kristina Keneally's hair, however, rocks. And here I am, an avowed feminist, judging female poiticians by their hair.

Ollie sits up, giggles, pulls my hair, loves his brother and is hoovering into the solids. He is, however, getting constipated enough to give his poor little bum a tear. Blood! on the nappy!! sadness all round

Patrick says the most hilarious things. Coming back from here on the bus (if you're ever tempted to go and you are staying on the Gold Coast, seriously, the public bus service is more than easy to negotiate) the driver swevrved to avoid a car and Paddy said "That was close!".

It's hard rubbish in the next suburb and we are going off to grab a new/old clamshell. Whee!!

Oh and we're having the first (Jen) family Christmas in 9 years. Should be, ummm, interesting.

*The plain English conclusion was something helpful like "An epidural is probably of benefit in analgesia to the labouring woman". Like Derrrr.