Having a break from all of the mummying

Both the kids have been sick over the last few weeks with different things, hand, foot and mouth, tonsillitis, high fevers, all of this has meant more nights with less sleep than usual. I was at breaking point the other day and crying told my husband I just want a break from the kids. That statement is not accurate. Its not so much that I want a break from the kids but a break from myself and my ‘mum brain’.

In order to actually rest I would need to go back in time to a time when –

• I thought that when parents said they hadn’t had a full nights sleep in years that they were exaggerating, hell I’m five years into broken sleep and I still don’t see an end in sight. I could count on my fingers and toes the number of full nights sleep I’ve had since having my kids and most of them meant I was in a different house to my kids!
• I thought that being sick and having to stay home in bed was terrible. Oh what I would give to have a sick day when I could stay at home and look after no-one but myself.
• I thought I was busy!!!! Oh how I laugh when I look back on my pre-child self who thought she was busy. Working full time even as a registrar sitting exams sure I was out of the house a lot but when I got home I got to sleep, or watch TV or do whatever the hell I wanted.
• I thought that going to the toilet was something to be done in privacy not a spectator sport. I and many other parents no longer have shame as we converse with our kids while we wee, or they climb onto our knee for a cuddle whilst releaving yourself. How I long to go back to a time when this was not normal behavior.
• See above but for taking a shower.
• I could drink a cut of tea in peace and quiet. I read this wonderful article about how this mum had transformed her life by getting up a bit earlier to have a cup of tea in peace prior to her children waking. What I hadn’t factored in was that my two year old has the senses of a ninja. I swear she hears my eyes open, my covers rustle and she is there!!!! Sometimes I don’t even hear those squishy little feet pad down the hall after me and she stands and stares at me from the hall way daring me to escape once I realise she is there! I have been known to leave for a run without my runners on just to escape. She’s cute but how the hell is she always there.
• I hadn’t developed mummy ninja senses. I can no longer sleep deeply, I hear a cough, a murmur, an out of place rustle of bed clothes and I am awake, don’t even talk to me about having your new baby sleep in the same room as you, hang on they don’t sleep anyways so not really an issue. I know the different between a tired cry, a my older brother keeps poking me cry, an I’m faking it to get said older brother in trouble cry and an I’m in pain cry and can zip through my house at lightening speed if it is the latter.
• I didn’t know that babies could cry incessantly for days or months. When frazzled mums came to see me with their crying babies and I couldn’t find anything wrong with them I assumed that the Mum wasn’t trying hard enough to settle them, that she needed to get them into a routine, that they were overtired. Ha bloody Ha well wasn’t I proved wrong with my two little hell raisers.
• I thought that parenting wouldn’t be difficult! I can’t believe I actually thought I would be able to do this thing called parenting. I can’t believe I thought if I just followed a routine with them they would sleep, that dummys were not to be used (you stick it in their mouth and the noise stops, hell I’ll take three just in case), that I would automatically be able to breast feed (apparently mine are just for decoration, I wasn’t blessed by the milk fairies) and that being a good person I would produce well behaved kids (well just ha bloody ha all over again).

If I could erase all of this information from my brain for an hour maybe I could rest and not think about the laundry that needs to be done so my kids have clean clothes, the dinners that need to be made, the lunches that need to be packed, the stories that need to be read, the cuddles that need to be given. Every once in a while it just all overwhelms me. I feel like a bad mum for wanting to be away from my children because even when I am away from them I am thinking about them. The problem is if I erased all of my knowledge from above even for an hour for a rest I would lose the knowledge that my kisses make it all better, that my kids love to cuddle me more than anything else in the world and that feeling of complete amazement the first time I held both of them that I could have possibly made something so beautiful and perfect. My beautiful and perfect children may misbehave and drive me crazy but they also opened my heart to true love. I think maybe I just need to learn to chill out!

 

What you don’t know about becoming a GP in Australia until you are one.

I became a doctor because of my desire to help people and my belief in the right for every person to have access to good health care. I worked in the NHS in the UK and left to move to brighter beginnings in Australia where I was not expected to work 100 hours a week as a junior doctor. My career has already encompassed a lot and I found that I enjoyed every specialty I worked in even if I did not enjoy every hospital I worked in. General practice appealed to me as I would get to do a little bit of everything, I would get to have long term relationships with people (this has lots of good points and some bad points, hello patient with a personality disorder that just keeps coming back) and because I could set my own hours.

What I didn’t realise is that General Practice is a business. People do not open up general practices for their love of medicine or to serve the general public, they open them to make money, and this is were I struggle. I limit my books to four patients per hour. This means I do not bill as much money as my colleagues who might see six patients or more per hour. It means that sometimes I might have two quick consults in a row and then I’m sat twiddling my thumbs, I mean studying when I am not too tired (which is never). It does however mean I generally run on time, if someone sits down in my room and tells me they have had thoughts of killing themselves I am not focused on the clock. It also means I have picked up a lot of mental health patients and medically complex patients because they know I will take the time that their care requires.

It means that I have to work through the incredibly complex system that is medicare and know codes for different appointment lengths, for different procedures, that I need to know their complex rules around what can and cannot be billed together, ie if I see a patient and send them for an x-ray and they come back for the results within four hours I cannot bill two separate consults even though they have been seen twice. I need to know that I cannot bill for contraceptive counselling and for inserting an implanon on the same day so the patient has to come back for the procedure on a different day. I need to know that if I do multiple biopsies on the same day for a patient that for each subsequent biopsy the reimbursement decreases and we are therefore encouraged to only do two to three each day and bring the patient back on multiple occasions otherwise we cannot cover our costs.

I also did not realise how much the general public devalues our services. People turn up ten minutes late without phoning to let us know they are running late and still expecting to be seen, yet if we run late they complain. People don’t turn up for appointments they have booked without cancelling them, some of which were booked only two hours before, which means I do not get paid anything for the 15 minutes I have been at work away from my children. They get cross when I say I will no longer see them after they have not turned up twice for appointments saying they have a right to chose who provides their medical care, unfortunately for them I also have the right to chose who I see.

Hospitals send patients home post surgery telling them to follow up with their GP in three days but don’t send us a discharge summery so when the patient turns up for review I have absolutely no idea what is going on, what I am meant to review or what complications the patient may have had.

It is a hard stressful job. It is a job where at times I come home and I wonder why I do it. Then I think of a patient who brought me cakes for going the extra mile for her, of another patient who knitted hats for my children, of another patient who always asks after my children’s health. I do it to help people and I know that I do that but I do have to wonder if it is worth all of the stress. All of the wondering whether patients are going to turn up today, will I get paid enough this fortnight. It is a hard hard job.

When I chose medicine I chose it for the good I could do not for the money I could earn. I want to work in a practice where the quality of medical care is the focus purely and simply but I don’t think they exist within the medicare system because the system is not designed that way.

Letting go one finger at a time.

Its official my Mummy magic days for my oldest child are numbered. I thought I had a bit longer of being able to give him a cuddle and kiss and everything would be better. When I picked him up from school on Friday I was met by a sobbing mess. One of his friends was leaving school to move to South Australia and it was his last day of school. In the eyes of a five year old he may as well have been moving to the moon.

I cuddled my beautiful little boy and reassured him it would be alright. I try to kiss away his tears and he cuddled me back but the tears kept coming. There was no distracting, there was no making this better. It was what it was and it was grief and pain. My child was hurting and I couldn’t make it better, I couldn’t protect him from him.

It was an unwelcome glance into the future for me. To the tears that will come when my children get their hearts broken from their first loves, when someone is mean to them, when they lose at sports. It felt like a test to see if I could handle the things to come. Seeing him hurt so badly made me want to cry too, instead I listened. I listened to his pain and collected his tears. I listened to the unfairness of it all. I listened to his little heart breaking with sadness. After a while the wave of grief rode away and possibly it has left me more scarred than he is.

When you have children your heart fills with more love than you ever thought imaginable, but also with pain because you collect their pain too. It was hard enough living through my own childhood but it is so much harder to live through your childrens. To see them in pain and be powerless to change it, to only be able to cuddle and to listen and to provide chocolate. I know as my children get older I won’t be able to take their pain away but I hope my cuddles will always help them to heal, and I hope they will always know they can talk to me.

My Mum always said you let go of your children one finger at a time, for my oldest that first finger has gone but I’m holding onto the two year olds hand for dear life!

Today I’ll be thankful for dog vomit.

You know it’s not a good sign when your first patient of the day asks if you’re ok and offers to go and buy you a coffee and drop it back to you when you have finished with their consult. I was so tired this morning. I was back at work last night for a meeting with all the other GPs, then up twice overnight with my grumpy two year who is getting back teeth. On a side note if I ever meet anyone who says teething doesn’t hurt I may push needles through their gums and see if it changes their opinion.

When I got out of bed this morning my beautiful little three legged staffy vomited in his bed in the kitchen, as I put this in the washing machine I also realised he had vomited overnight in the laundry room. So after cleaning up two lots of vomit in my sleep deprived state, dropping one child at school and then another at day care I was somewhat over today.

Then I heard that my good friends mum has had a recurrence of her cancer, and that a colleague of my husbands who is only 28 years old with a pregnant wife and three young children has passed away from cancer. That was all it took to snap my first world issues into perspective.

Sometimes when I am tired and my kids are screaming it is so hard to be grateful but I need to try. So I came home from work and walked home in the rain from school with my oldest and then I was grateful as I watched him climbing fences. I was grateful for my two years old health as she watched peppa pig, don’t judge me it stopped the screaming, I was grateful as I made healthy beautiful food for my family. I was grateful when I skyped my tired sister before she went to work. I was grateful as I hugged my grumpy little two year old for the millionth time before she would go to sleep. I was so grateful as I spoke to my husband that he is still here for me and our children.

So today I choose to be grateful and it really is a choice. I choose to be grateful for good friends, grateful for my family, grateful for my house and my job. Grateful for my health, for the fact that every day I take for granted that I get to see my kids grow up. I wanted to put this down on paper so on days when I am not grateful, on days when I am sleep deprived and my kids are screaming and I want to scream too I can read this and remember once again to be grateful. So thank you for showing me the way, the way to be grateful. It is a shame it takes the suffering of others for me to realise how truly blessed I am.

Busting the myths about Hand, Foot and Mouth disease

We have had yet another outbreak of hand, foot and mouth among our local day cares. My little girl had it with temperatures of 40 degrees and a mouth full of blisters. I spend a lot of time educating parents about hand, foot and mouth. Here are the commonest myths I hear and the correct answers.

1. My child has already had hand, foot and mouth, they can’t have it again. The majority of hand, foot and mouth is from Coxsackie virus A 16 or enterovirus 71 there about nine other stains of coxsackie that can also cause it. So as much as it sucks, said the mum whose children have both have it at least three times, they can get it again.
2. It only affects the hands, feet and mouth. Whilst these are the most common places to get blisters they can also appear in the groin, on the buttocks, behind knees and elbows.
3. Once all of the blisters have gone my child is no longer infectious. Nope they actually continue to shed the virus for another six weeks in their stools so you need to be very fastidious about hand washing for another month and a half.
4. Adults can’t get it. Unless you have been exposed to all of the different viruses that cause it in your life, yes you can get it, it is more common to get symptoms from it in children less than five years of age though.
5. It is caught through direct contact with another child with hand, foot and mouth. The virus is excreted in stools, fluid from blisters and also fluid from mucous membranes. Therefore if an infected child sneezes on another child they can become infected. The virus when it lands on an inanimate surface can live for several days and go onto infect another child when they touch the object and then put their fingers in their mouth.
6. They become infectious once the blisters appear. They are actually infectious for 24-36 hours prior to the blisters appearing and may have a high fever and cold like symptoms.
7. It only affects children at day care. Although we see it more commonly in day care children because it is so contagious you child can catch it from sitting in a shopping trolley that an infected child sat in or playing at the park.
8. That they need to see a GP to get treatment to make their child better. Unfortunately there is no treatment for hand, foot and mouth other than simple analgesia and maintaining a good fluid intake.

We had a miserable week here with a very unhappy two year old with a mouth full of blisters refusing to eat and drink but she is all better now. I am scrubbing my hands after every nappy change and crossing my fingers that it is the last time she will get it, only time will tell.

Heres to a life lived well.

Almost every day since I have lived in Australia I have felt incredibly grateful and happy to live in such a wondrous place. We are surrounded by beautiful beaches and we have wonderful friends. On days like today though I feel every single mile that stretches between Australia and England, between me and my family. Today my family gather in Manchester and lay my beautiful Godmother to rest. They will cry together, they will celebrate together, they will remember together and undoubtedly drink together.

My Aunt, who I was also lucky enough to be able to call my Godmother, passed away recently from cancer. I made the decision not too long ago when things took a turn for the worse to travel back on my own to the UK and spend time with her and with my extended family. I don’t regret that decision for a minute as when I was back especially for the first few days she was well enough to joke and laugh with me. It does mean however that I cannot afford either financially or time wise to go back now for the funeral.

I thought I would spend the evening remembering her in my own special way instead. There are so many people who influence you in your life as you grow. My Godmother taught me so many things. She taught me to hug fiercely and love strongly. She always pulled you into a hug as you arrived and before you left, and told me and my cousins that she loved us. I never doubted that she loved me because she told me, I try to remember to tell my friends and family often.

She taught me not to give up. My uncle passed away when my cousins and I were little. She became Mum and Dad to my cousins. Did she get it right every second of every day? I doubt it. Did she ever give up? No. She handled her lot in life with grace. She spoke often of my uncle.

She taught me to speak my mind. Bloody hell, featured a lot in her vocabulary if you upset her. We were never left to doubt what she thought about most things. Being the youngest of the cousins I often got left behind, ‘that’s your lot in life for being the youngest’ she would say as she let me help her in the kitchen instead.

I know she was proud of me for becoming a doctor, and I know she was prouder still when I became a mother. She was so like my Dad with her stubborn streak and I have no doubt that like Dad that was why she lived so long in the face of such a nasty cancer. Like Dad she wanted to see her Grandchildren for as long as possible. Like Dad she died with those she loved the most in the world next to her.

I imagine heaven for my family as a big bar which now has too many seats filled up. Dad, my uncles Ray, Ken, Barry, my Gran and Grandad all there arguing over whose round it is now and welcoming my Aunty Shirley with open arms into strong bear hugs.
Looking down on us kids and smiling as we repeat  mistakes they made in their youth. Laughing as they watch our kids run rings around us as we once did to them. Cheering us on from the sidelines silently and hoping that we feel their prayers for us. I’ll miss the hugs but I am so glad I had the privilege to call her my aunty, my Godmother, to know we stem from the same blood and to remember her with love and affection. So to my family who are there to celebrate her life please do it well and raise at least one glass of wine for me.