April 30, 2013

As part of the physical for returning to work for my second job, I had to get immunization titers drawn.  I was born before the days of routine administration of Hepatitis A and B and varicella vaccine.  I did contract the chicken pox at age 13...and no, it was not fun at all--I have a few scars on my face as a result of it.  I fortunately never contracted Hep B, and as far as I know never had Hep A.  

So for nursing school, I got the Hep B vaccine series.   I don't know why I've never have gotten the Hep A vaccine.  I have to have titers drawn for the varicella whenever someone wants proof of immunity...such as now.  My PA threw in the titers for Hep A and B just to be sure.

Otherwise I'm cleared to return to work for the agency job.  I have to decide when I want to start picking up shifts again...I have to wait and see when my primary job wants me there and then work around it. 

In other news, I'm kind of miffed because I finally decided to buy a large bottle of argan oil and it broke after less than a month.  I use it daily...best thing to have ever happened to my rosacea.  Getting the large size was more cost effective:  the initial price was a bit of a sticker shock, but the cost per ounce was lower than the smaller size, plus it would last me for months.

That is, if it didn't fall out of my medicine cabinet when I opened the door, and the glass shatter when it hit the ceramic sink.  


So it's a total loss, as there was no way I could salvage the oil--the glass fragments were too numerous and there was no way to strain it without compromising its purity.  A costly loss, but a loss.  Oh well.

I ordered a different replacement oil:  maracuja (passionfruit).  I didn't feel like experiencing the argan oil sticker shock twice in one month, and the maracuja was on sale.  Plus it has received rave reviews...so I figured a change was as good as a rest.

April 28, 2013

11% there

I lost 7 pounds during the week, and I'm betting most of that is water weight.  Still, a loss is a loss!  I did have to adjust the caloric intake up a bit so breastfeeding isn't adversely affected.

April 25, 2013

Prepping for the return to work

I've completed a whole bunch of review tests with the agency...I surprised myself with how much info I retained about general as well as psych nursing.  I also passed the med/med dose calculation exam.  Sweet.  All that's left to do to be able to return to work there is getting a physical exam.

Meanwhile, back at my main job, I've already been hit with requests to pick up shifts all summer...and that's just my core unit.  I've been warned to expect more requests, as things are not good in per-diem land.  One per-diem is only working 2 days a week (sounds like me) and then not even consistently.  Another per-diem is out for several weeks due to an injury.  And they haven't hired any other per-diems.  So I've been told that they're desperate.

My core unit wanted to be sure to get first dibs on me.  I reminded them that I do belong to them so of course they will get scheduling priority.

Childcare is squared away.  My usual provider agreed to the deal.

I have the electric breastmilk pump ready.  I'm not worried so much about that as I have state law on my side.  I know a few good nooks where I can do it at my main job, and the other job has a specific lactation room.  I do need to figure out how to use the pump, though.  It's supposed to be able to run off of either the battery or AC current.

I also need to figure out how much little one #2 eats over 10 hours so I can prepare accordingly.  The problem is that I have no idea how many ounces he takes in at a feed, as my breasts don't come with gauges that can measure how empty the tanks are.  So for that, I may have to seek some guidance from La Leche as well as from a couple of pumping mothers that I know.

April 21, 2013

Yet another reason I need to start tackling the weight

I've started arranging for childcare for when I return to work.  The problem is that most places won't take on part-time clients:  they want full-time.  This is understandable given the current state of the economy.

I do have a childcare person who I've used in the past and is very professional, very good with little one #1 and from what I've seen, very good with infants...so much so that she'd be worth paying full-time rates for part-time work.   To me, that would be worth it.  So I wrote to see if she'd be willing to accept such an arrangement.  Hopefully she will say Yes, but just in case, I started researching other providers should she decline.  I'm not returning to work until June, but I wanted to start squaring it away now.

I also contacted my agency to let them know when I'll be available and if there's anything I need to do to be ready to resume working for them.  Again, squaring it away now so it's done and ready.

I also decided to break up my remaining RN-BSN classes and registered for the first one (Research) to start at the end of May.  Then it'd be another nursing class (Vulnerable Populations) in August, and then the final one in October.  As it stands, my estimated graduation date is now November 2013.  To be honest, I can't move it up much earlier than that:  based on how the classes are scheduled, even if I were to double up on nursing classes in May, the earliest I could graduate would be September.  Saving two months may not be worth the stress of taking two very tough classes at once.

So about that subject line...

I'm about 32 lb down from my delivery weight.  I'm 11 out from my pregnancy starting weight.  And from my starting weight, I could stand to drop at least 20 or so more.  No more than that because I'm tall.  With my height and build, 160-165 looks healthy on me.

Not too long ago I had blood work done.  I received the results in the mail yesterday.  Everything is normal...except two things.  LDL is 164, and the total cholesterol is 246.   They want me to call for an appointment, which I shall do first thing tomorrow.

Now, I'm not too stressed over this, because it's very common for triglycerides to be elevated in nursing women.  It happened after my first pregnancy.   I was able to bring it back down to normal levels without medication:  it took a few months of dietary changes, exercise and weight loss, but I took it from 212 to 186 and kept it WNL for several years.

I'm confident that I could get it back down with the same game plan.  I kind of have to:  statins are contraindicated in breastfeeding.  And this medical condition is not critical enough for me to stop breastfeeding.

So MyFitnessPal got fired up...again.   I found my Hacker's Diet info and reviewed it.  I started mapping out a walking and Wii fitness plan.  I got out the container of oatmeal.

I'm a sheep on a mission.

April 19, 2013

I'm glad I'm taking four months off

Once I crossed the 8-week postpartum mark this week, I started walking and lifting.  I overdid it the first day as I ended up helping push someone in a wheelchair.  The next day, I worked on the baby's nursery, including some moving of objects.  The next day, I took the baby in the stroller for 1.5 miles.  And during all of this, I've been carrying the baby in his car seat.

Today, I am in abdominal agony.

So now I'm cleared only for gentle walking and non-abdominal exercising.  At 12 weeks, I can start easing (key word:  easing)  into abdominal exercising.

I think my first day back at work is about 16-17 weeks in.   I hope I'll be up to it.  If it wasn't for the fact that the c-section ended in a cute and healthy kid, I'd be mad that I had to have one.


April 15, 2013

Of work and brassieres

I went in for my post-partum checkup/return to work physical.  I'm recovering nicely from the c-section and have the all-clear to exercise once I hit 8 weeks postpartum...basically, by the weekend.  I'm also cleared to return to work.  So I talked with the hospital HR rep, and we've set a return to work date of June 1.  Which is good as I've already been asked if I can start picking up shifts in June.

In other news, I am having a hard time finding brassieres.  As we all know, breastfeeding causes a chest expansion, both in general as well as on an hourly basis.  Now that I'm cleared to resume normal activities, I went to the maternity store to get a measurement to see what size I need.

40F.  Technically, I'm, in the words of the sales assistant who measured me, "38 to 40 and a E to a F."

I read that as a 39 E/F, which does not exist.  I thought that the 38DD was the black hole of brassiere sizes.

When between sizes move up to the next size...hence 40F.

The good news is that in a maternity store, 38DD is a very common bra size.  The bad news is that 40F is not.  For that size you are referred to the "plus-size" section...which not all maternity stores have.


The first maternity store referred me to another in their chain that did have larger bra sizes.  Even there, 40F was the limit.  They had a 42G and a 46G on the rack, but basically, the sizes topped off at 40F.  And there weren't a whole lot of 40Fs either.  I did manage to find four...not my favorite style though, but comfortable enough.

April 8, 2013

7 weeks on: tying up non-clinical ends and working on my health

I found out that the next testing date for the CARN (Certified Addictions Registered Nurse) is in October.  Registration deadline is September.  I need 30 addiction-related CEUs...I already have some thanks to all of the grunt work needed for both the ANCC certification and to keep the CA BON happy.  The problem is that addictions-related CEUs aren't easily found, and if they are found they aren't free.  So I have to stalk them.  Fortunately, my psych journals will give me a few leads, and the Journal of Addictions Nursing is full of them.  But to help mitigate the costs of all of these CEUs, I'm trying to find an inservice or seminar where I can get a batch of them (6-10 units) at one go.

Oh well, it is what it is.

I'm also trying to find out what I need to do to finish this BSN.  I have two more nursing classes to complete before I can take Capstone.  Both of these nursing classes are offered in May, so the options are:

a.  Take both classes at once, then Capstone in July.
b.  Take one class in May, one in July (if they offer it, that is!) and Capstone in September.

I'm trying to see if they offer either of the nursing courses in July...if they do, I may take option B.  If they don't, I think I'll suck it up and take option A.  I really don't want to drag out this BSN any longer...it's been nearly four fecking years.

Fortunately, I am on maternity leave until June 15th, so having to juggle work will not be an issue should I decide on option A.  However, the two classes are both (so the rumor mill says) tough ones, and taking them together may be insane.  Then again, it couldn't be as bad as having to take U.S. History with any class while working full-time.  I'm still recovering from THAT experience.

We'll see.

I followed up with my PCP re my HTN.  Blood pressure is beautiful, at least at the office:  110/76.  I have also been monitoring it at home and those numbers haven't been as beautiful...not scary, but not beautiful.  The weight is down a few pounds since last month, which isn't bad considering it's mostly been diet changes and cutting out the salt.  The PCP and I reviewed all the numbers and decided to stick with the current labetalol dose and follow up in two months.  I'm still to work on the weight loss...this week I go for my 6 week post-partum follow-up and I should be cleared for exercising.

He also ordered an ECG, X-ray and lab work just so we have a baseline.  ECG done (sinus rhythm and normal).  Blood drawn and urine donated (results in a week).   I have to go back later for the X-ray.

In other news, little one #2 is good.  He's much more alert.  He's put on weight like a champ.  He's gotten the breastfeeding bit down perfectly.  He's also lost most of his hair.

I'm incredibly lucky in that he has no problems going to sleep at night:  I put him in his bassinet, tell him it's bedtime, and he entertains himself to sleep.  He wakes 2-4 times a night to nurse, but that's cool:  I just accept that I will not be getting a full night's sleep for the next two years.

We are not as lucky when it comes to daytime napping, however.  But I'm told that takes some time.

In the next week, we're going to try introducing a bottle.  No, I'm not giving up on breastfeeding--I don't plan to do that until he's two.   But if I go back to work my breasts have to go with me while little one #2 can't...so enter the breast pump and bottle.  My sister warned me not to wait too long on introducing the occasional bottle of pumped milk.  She didn't offer it to her younger son until he was 6 months old.  He's now 11 months old and only now is finally willing to take it...sometimes.