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29 October 2012

the Moving Begins - My Story


When I think of my life the memories come with stops and starts while the time frames are determined in my mind by location.  With a dad who is a minister the moving is a given. When younger the moves were a fact of life --- when older the moves were upheavals.  To tell my story and not explain the nature of the moves would be like ignoring the elephant in the room.  So a quick synopsis.

  • Born in Charlotte / lived in Moorseville
  • Wilmington -- I was young when we moved here but I'm unsure of the exact age.  
    • We lived across the road from my aunt and uncle and in the same city as both sets of grandparents, aunt, uncles, and cousins.  I have memories of:
      •  dancing around the living room, jumping on the couches (not our house of course), sleepovers with cousins eating potato chips with ketchup or ranch, playing games on the floor at Grandmama and Grandaddy Cotton's, Reese's Pieces hidden in a coat pocket, dancing to Footloose, gymnastics off the fireplace at Grandmother and Grandaddy Todd's.... and many more...
  • Whiteville ---Kindegarten through half of 4th grade
    • We loved in a house with a giant pine standing at the end and possums that enjoyed looking in our front door at night.  The tree I feared during hurricanes. We lived in a neighborhood and I had friends.  We played in the woods behind our house, built clubhouses, climbed through the sewage drains, roller skated on our steep driveway, and flew down the hill on our bikes.
    • I had friends at church and sleepovers were common.  I had my first "best friends" --- and then we moved.  This one was a challenge but in hindsight it began to build my tolerance.
    • This is where my first memories of my mom's illness surface.  Along with a long held belief that her disease was caused by me. I could point fingers.  I could name names. Words spoken to a child should be carefully selected. But the truth of the matter is I held it near and dear to my little heart and kept quiet. For me to speak of the hurt would cause my mom more pain and confirm the "truth." Years later I spoke the details of this truth to one individual and I watched her tears fall.  Her reassurance and the love in her eyes began to soothe a portion of a very bruised heart....

28 October 2012

Sandy

The lovely beach on a non-hurricane day...


Sitting here reading about Hurricane Sandy on the web.  I am a hurricane girl --  The wait.  The storm.  The aftermath.  It oddly seems like home.  People here in Boston are concerned.  I see the Category 1 rating and it seems almost funny.  Maybe it's the North Carolina in me that has me unconcerned.  I will however add my concern over having a 3rd floor apartment  on a large hill that has no buffers from the wind --- with new partially installed windows.

Anyway --- Memories of hurricanes.  I grew up in North Carolina.  When a hurricane comes calling on the state it doesn't matter where you live.  Most of my young childhood was spent on the NC coast --- and then a little inland.  My thoughts on hurricanes:

  • < Category 3 --- not concerning --- you can sleep through 1-2 :) -- unless you live on an island -- then leave... and leave before it's mandatory or you will never get off the island.
  • The slower it moves --- the more troublesome it is
  • Hurricanes grow in strength over water and weaken over land.  Better to hit land sooner rather than later....
  • Run -- Run --- Buy bread and milk for they will soon be gone
  • If you have a well --- you best be collecting water so you can flush the toilet when the power is out
  • Speaking of power out --- when this occurs --- Eat the icecream FIRST!  It's going to melt and be ruined -- we mustn't let that happen
  • Keep the fridge and freezer closed unless absolutely necessary.  If the freezer is full and the door stays closed the food will last for days --- deep freeze or standard freezer.
  • Be prepared to pick up branches and rake leaves... it's a comin'
  • Good luck finding ice afterwards --- when the power is out there is no ice to be found.
  • Play Games!  Some great family memories were made around the lamp playing games
  • Enjoy it --- you will have to make up the school days missed...
  • Lamps --- old fashioned oil lamps are the most fun --- but a battery powered little lantern is always good to have on hand.
  • Make and keep good friends -- when your power is out for days or weeks you will need friends around the city/town that will get their power back before you.  If you get yours first -- be a good friend.
  • Join a team and go help out those affected --- Baptist Men often take groups to the area and will teach you everything you need to know.  I learned a lot of tools and skills by helping with Hurricane restoration.
It's funny the things you remember.  One of my hurricane memories is when I was in high school.  The hurricane came through and the town had no power for days -- a week or more?  We went to friends houses for showers --- and we had a band competition.  It was a challenge to get everyone together --- but it was a fun relief to the hurricane boredom that comes with a lack of school.

I grew up respecting hurricanes.  When they are large and slow there is a lot of damage to be done.  But I also grew up thinking of hurricanes as mini family vacations with ice cream, snack foods, games, and laughter.  I will take a hurricane any day -- you can keep your earthquakes and tornadoes :)

I will be at the hospital tomorrow --  even though we are in a state of emergency --- If you are one of those lucky enough to have a mini hurricane vacation --- Stay safe and Enjoy.  My prayers go out to you and yours.

Closer to the ocean than I would like to be right now....

The Beginning I Remember - My Story

Me, Mama, and Curious George
I grew up in a great home.  Home meaning the homeyness of the inside of the house.  The house itself changed and changed often.  I think it's why I get restless in one place for too long --- and I  have certain items that go in a particular place in each new home.

My earliest memory is of snow.  I know.. sounds funny.  A Carolina girl talking about snow.  The rarity of it may in fact be part of why the memory is there.  I don't remember how old I was.  We lived in Moorseville and I remember the sliding glass doors at the back of the house.  We were going to play in the snow and my mom tied bread bags over our shoes (why would a NC girl own snow boots?  That's just silly).  I remember being absolutely terrified to step outside into the snow.  My dad was there.  My sister was there.  They were fine but I was certain that as soon as I stepped into the snow I would fall through the Earth and land in China. (Gotta love old-school cartoons) To this day it makes me laugh.  I remember in counseling once years ago I laughed about the memory and the therapist asked if it was because I doubted my parents' ability to keep me safe.  I laughed even harder (not the response he was expecting).  I never doubted that for a minute.  I just didn't want to go to China and be separated from my family.  They were all that I had and I didn't want to lose them.

The memory is fun but the root of the story remains the same.  My family is one of the greatest gifts I have ever been given and one of the things I cherish most.  It played a huge part in who I am today.

I grew up in a great home.  My parents' marriage was an example of the type of marriage I would like one day.  Which is also a big part of why at 32/33 I am still single.  I don't want to settle.  I saw first hand how valuable a good marriage can be --- not only to the two who enter into it but also to the children.  Both the children raised in the household and those who visit.  I didn't really understand that when I was younger.  From a very young age my friends never wanted to go to their house.  They wanted to come to our house.  I found it a bit annoying because I wanted a change of scenery-- but looking back I can understand why.  Many of my friends came from homes with a less than sunny impact on your day.  My house was welcoming.  Even when stress levels were high there was always a sense that everything was going to be okay.  My mom always fixed food enough to feed our family plus a couple of friends because you never knew who would be by for dinner --- and they were always welcome.  I remember many days building forts in the woods until Mama called our name for dinner.  You always knew she would call two times.  If you didn't come the second time she called you were in trouble.  I, of course, never got into trouble :)

Growing up with my extended family was fun -- When I was young we lived in the same town or a neighboring town to most of my family. They are sort of loud and cheerful and always in everyone's business.  Each of my parents is one of four and then you add in all of the people that we consider "Family" and holidays become a big adventure.  It was not uncommon to find people playing games (Yahtzee, Uno, Scrabble, Trouble, Sorry, Jacks, Operation, etc...) Lots of cousins to play with --- and young uncles willing to play tennis in the backyard or crash on the floor and play some embarrassing cheesy girlie game.  Then I think of food --- and the laughter at the children's table.  I still sit at the children's table --- Single ---

I think of my childhood and I'm thankful.  I'm thankful for such a supportive beginning. I'm thankful for my love of games, food, laughter, family, and Southern hospitality.  It's where my story begins and it is the type of beginning I hope "my kids" will one day describe.

27 October 2012

This Year in Review with a Little Contemplation

The view from the edge of  the hill above my house.
 Keep going down this road and you get to Ball Square with super tasty food and art/craftiness from local artists
 (mine is there when I have time to make it)

It's obviously been hit or miss for me to post to the blog.  I had such great intentions but my days are a bit wacky.  So many days that I feel like I have really accomplished something if I have on matching shoes and socks and remember to eat at least once.  

The year so far has been a bit of a whirlwind - but let's be honest.  The last 3 or 4 years have been a whirlwind.  I've had grad school full time, full time clinical, lots of new babies in the family, and now Internship and studying for Boards.  

I'm currently doing my Internship at Boston Children's Hospital on the inpatient neuro team.   My kids have diagnoses including:  post surgical (Arnold Chiari malformations, AVM resections,  Moya Moya, brain tumors, etc....), developmental delays, seizure disorders, MS, Cystic Fibrosis (CF), and Cancer (lots of cancer)... The PT department at BCH is a bit rare in its focus of chest PT (percussion and vibration using postural drainage positions, etc...) and so we get a lot of children (and some adults who have been going to BCH since they were kids) with Cystic Fibrosis for pulmonary cleanouts.  That means chest PT 2-3x/day plus lots of IV antibiotics and some kids also use a airway clearance vest (that vibrates them) to help reduce and clear out "gunk" in their lungs.  My first week or so I thought my arms were going to die.  In fact there were many days that I attempted to add to the blog and typing was not possible secondary to the pain in my forearm muscles.  Even in those days I loved it.  Now I still love it! Who knows... maybe it will make my triceps less "flappy" :).  I do miss the arms I had as a drum major.

When I'm not in class I am typically attempting to study for the Boards.  I have to take the NPTE in January and deep breathing techniques and good music are helping me not panic.  I typically try to put in 1.5-2hrs/day and then 12 hrs during the weekend.  This week has been crazy because of construction in my apt. The guys have been replacing my beautiful old windows with the amazing molding and wavy glass for cheap, plain, and boring (but more efficient) windows this week.  And so each night was spent trying to undo their big mistakes (like putty and paint on my handmade shelves) and rearranging for their work the next day.  Today I'm trying to at least get a good start on the 2 inches of sheet rock dust that covers EVERYTHING.  I can't concentrate with it like this.  I have to at least get my living room better and my kitchen cleaned up.  I have been living on cafeteria food all week.  
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Since I last posted I have gained a new cousin through marriage (Abigail Todd) and TWO new healthy nephews (Gideon David and Elijah Liam).  I was able to spend some time at home before internship.  During that time I was able to spend some time with the lovely young lady who is now my cousin's wife, a friend who will no longer be in NC when I visit, and my pregnant sister and her lovely family.  I have often heard people say how it gets harder to leave each time you visit home.  I used to think it was the opposite.  Don't get me wrong -- there are ALWAYS tears -- be careful if you ever volunteer to drive me to the airport.  But this time with so many changes going on with friends and family I am dreaming of a day when I am not so far from home with no time to go home.
Poor Laurie got to spend her one time with me  one hour after I  arrived in NC after 3 days with absolutely zero sleep.
  I'm amazed I stayed awake.  Poor Girl.  I was so tired she even beat me at Skip-Bo!!

Glad the super red tear filled eyes didn't show up in the pic.
I miss this lady.
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One of my friends from BSU in college is now posting her story on her blog.  I find myself eager to read it each day because the truths she speaks in type are often words echoed in my heart.  I would like to put my story in type.  The goal is just to put it out there.  It's not pretty... It's not easy... Many other people have had much more challenging lives... but it is what has formed me into the person I now am... for better or worse.  Some things I remember with great clarity and some things are shoved so deeply into the back of my mind that they only surface on the late nights in a quiet apartment with Lucy snoring beside me.   Those memories that have sounds and smells to accompany them --- I'd like to share --- and if you happen to read these -- and you remember other things during those times --- chime in....

Our school is big on self reflection.  I think I often reflect too much.  But now as I'm preparing for my future and the end of this journey (school) there is a lot of reflection on who I am, how I got here, who I want to be, where to go, and how to get there...

Feel free to join the journey....

30 June 2012

I bought a new book --- Jesus Calling by Sarah Young.  It was recommended by family and friends but my finances did not allow the purchase until now.  A couple of weeks ago I was ordering a textbook with an Amazon giftcard I received for Christmas.  The amount left over after my textbook purchase was the exact cost of this book.  A sign?  I think so.  Each day has been perfect for what I feel and what's going on that day.
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I finished my clinical rotation at Spaulding (LOVED IT!) and am now back to class.  This is the last semester of classes and that fact makes it especially sweet.  Interviews for our one year internships also occur during this time period.  I have completed all but one of my interviews so far.  The last one will be July 6th.

The stress level of my classmates is increasing in a rapid fashion.  It makes for interesting days.  Add to that the tremendous amount of "group" work required this semester --- and Woohoo!

28 April 2012

Feel Too Much....

I was informed this week that I care too much about my patients. How do you respond to that?  I will admit that I go above and beyond what is required --- but for my own mental well being I will tack an extra 30min to the end of my day to be able to help out the patients and their families. 


Apparently I shouldn't talk to doctors or nurse practioners about my patients status changes.  I shouldn't allow physicians to observe my sessions (even when it is in no way affecting my treatment).  I should take coverage for my kids ---- but not get to choose which child or when.  I should allow a stranger to treat my teen with TBI on the same day that her mom won't be there all day because her brother is having brain surgery at the hospital a couple of blocks away.  I draw the line.  It is hard. It is fast.  I will not cross it.  These kids have enough to bear on a normal day.  Add on additional family trials and what these kids can really use is consistency.  When I can't do it.... that's one thing.  But when you want me to choose to not do it because it would be more convenient.  I think not.  I treat each child the way I would want my child treated.  I treat each family the way I would want my family to be treated.  Because of that ---- I have great relationships to with both patients and their families.  For kids and parents --- that can make all the difference in the world.  


I will never be someone who leaves early on a regular basis.  I will always be the girl who arrives early, helps the nurses, discusses concerns and ideas with other team members, and is willing to help in any way that I can.  It's who I am. It's who I've always been.  I take care of those I love....



21 April 2012

Compromise.... Negotiate?

I get it - Life often requires compromise or negotiation.  If I have a kid who doesn't want to sit on the disk but will sit on a large exercise ball --- do I fight him?  Do I demand he sit on the disk?  Why?  Sitting on the ball will accomplish the same goal.  One kid likes hockey another likes bowling... either works for me as long as we are in high kneeling working on motor control and strength.  Yet to some people this is me being pushed around or having no backbone.  Interesting.


I learned a long time ago that when dealing with children there is one requirement and then you expect the unexpected.  That one requirement? FLEXIBILITY.  It pains me each day to have details of my treatment plan analyzed, terrorized, and criticized.  Kids are not the same as adults and for those of you who think so --- you obviously have not worked with a lot of kids.  Last summer I would plan  each treatment in my head --- it looked something like this:

  1. moist hot pack
  2. stretching
  3. pendulums (10x2)
  4. wall crawls (10x2)
  5. isometrics in doorway 
  6. pully (15x2)
  7. ER/IR with theraband (15x1)
  8. AROM with bar (10x1)
  9. PROM with manual assist
For an adult -- this works ---they will go in each day and do what you ask just how you ask it.  Some get annoyed when things change.  The flexibility required is in progressing the patient --- whether in pushing AROM more, increasing weight, progressing an exercise.  You progress and they do it.

With kids --- It's different.  Each day finds the child wanting to play something different.  Oh there are some things that remain constant -- like my little man's love of hockey or my little girl's love of anything with princesses.  But everything is fluid.  The plans I'm required to give sound something like this:
  1. supine stretching of knee flexors (15sec x3 B) <-- I won't even go there...
  2. sitting on yellow egg for 8min working on sitting balance, equilibrium responses, and sitting posture.
  3. high kneel at high mat working on puzzles for 8min with assist for anterior pelvic tilt to work on posture, endurance, and strength of hip region
  4. Skin Check
  5. Don BAFOs
  6. standing at high mat with Sponge Bob connect four 10min with assist for ant pelvic tilt and knee ext to work on standing posture, endurance, and strength.
  7. Ambulation --- walking with pacer with BAFOs 100'x2.  Will require min-mod A at BLEs and modVCs for flat foot during stance and knee extension.
  8. Either doff BAFOs and skin check or advise parents of AFO schedule and check back later.
Stupid--- you know why?  Because I know why I am doing the things and because today she wants to sit on the giant purple therapy ball and paint by number.  She no longer wants to be a doctor and play operation she wants to play ant in your pants.  Sponge Bob Connect Four is being used by another child and standing today  requires more assist at the knees and no assist at the pelvis.  After 80'x1 pt is complaining that her feet are killing her and AFOs are removed and skin check performed.  We are now going back to paint more while we wait on the redness to subside and calm my crying patient.  This is what I do every day.  SO... In my head it is like this:
  1. Stretch
  2. Sitting Balance - egg'ish
  3. High Kneel with activity
  4. Standing with activity
  5. Walking
So much easier......

This week is an interesting negotiation.  I finally have my darlin' girl out of bed and walking but it's a struggle after being in bed for so long.  It's exhausting, it's painful, and mentally taxing.  And so.... the negotiation comes into play.  She works really hard this week and we really push it to make as many gains as possible and....... She gets to give me a makeover and make up lessons at the end of the week. Part of the negotiation is that I go out for drinks or dinner after work with my make up intact.  This could be interesting.  She tends toward the blue or purple hair, roller derby side of things..... but apparently is a whiz with eye make up.  I don't have much room to complain.  When I do my make up (yes - i do it---- approx 2x/year :) )  It either looks like I have nothing on or I appear to have two black eyes.  So we'll see how this goes.

I love what I do.  I wish I could start studying now for my boards and graduate soon so I can find a inpatient pedi (pediatric) job.  It is exhausting.  It is emotionally taxing on the best days and the worst.  But it's what I know I am meant to do.

This week a doctor said this "You have an amazing way with children.  I came into children through medicine and I love them.  But it is obvious that you came into medicine with an amazing love for children.  I'm look forward to learning a lot from you during your time here."  She now observes some of my sessions and asks me questions on dealing with kids.  I am a true believer that everyone has something to teach.  The student learns from the teacher and the teacher learns from the student.... as long as all involved are willing participants.

16 April 2012

Today one of my kiddos urged me to take my hair down from my ponytail.  The request was then to touch it and she declared  "oh... it's soft."  She was quick to tell me I should keep wearing it down and not put it back up.  There were a lot of reasons I could give for having my hair up... 
  1. One of my other kids is combative and pulls hair if she can get it
  2. It was put up when wet so there will be a funny "ponytail lump" if I keep it down
  3. It needs to be cut and it's rather obnoxious.
  4. The odd weather is making the baby hairs curly and frizzy.
  5. etc....
All of these reasons are true ---How many times have you kept your hair up for one or more of these reasons... but allow me to add in a tiny bit of insight into the situation.  My teenage kiddo with the request has no hair peach fuzz for hair.  She has a giant scar covering her scalp.  Every day is a struggle for her and the little tiny things most people take for granted are the most important.  And so as my girly talked to me about what it will be like with her upcoming brain surgery and their need to shave her head..... I very willingly wore my hair down the rest of the day and allowed her to touch to her liking.

I have been willing to try different hairstyles over the years ---- some very short and some very long.  It was all with the knowledge that it is hair and it will grow back.  As I watch multiple people close to me lose their hair to cancer treatments, brain surgeries, etc.... I am reminded how much hair matters... especially as a female.    You may not be overly concerned about your hair --- but there is something about you --- something that is "you" that you don't want to lose...... Imagine the struggle.... Imagine the heartache..... Now appreciate the fact that you not only have it --- but you don't have to give it up.

I have seen lots of brave kids the last 6 weeks. This kiddo is one of the bravest.  She started out hitting me and now we laugh each day.  I've learned a lot ---- and I've been reminded of values that my family has always held dear.  It's a wonderful time to be alive.
I am almost finished with school... (insert excitations here).  I've made it through the majority of my schooling and have just one semester left of class.  This last semester was a rough one --- We had a full semester of classes but in half of the time.  Add in the 3 days I was out with the NoroVirus and the 1.5-2wks  I was out with Shingles and life became hectic and a bit overwhelming.  However... a surprise ---  This semester resulted in my best grades.  One of my favorite quotes from the semester "Now Christa - I know this semester you got really sick and you ended up with really good grades..... but let's not use this as an educational strategy from now on."  I am in agreement. 


And so to now --- I am currently doing a 10 week full time clinical at Spaulding Rehabilitation Hospital (SRH). It's inpatient acute rehab.   I'm on the pediatric floor and loving it.  My kiddos range from 2mos old up to 21 years.  Some of the diagnoses I've treated include: Central Cord Syndrome (infant), s/p Selective Dorsal Rhizotomy (kids with cerebral palsy (CP)), TBI, failure to thrive, hypernaturemia, DeBarsy Syndrome, s/p tendon lengthening and osteotomies, various neurological changes (without a cause), brain tumors, brain injury from gunshot, brain injury due to falls from windows, neuro injury from surgery mistakes, overall delays, and the list goes on and on....  I love my kids.  They make each day for me a day worth working.  I look forward to working with them each day no matter their mood.  


Below is an example of what each day looks like with my kiddos.  Whether it is something funny said or a child who hasn't spoken in 3 months who places my hands in a prayer position --- babbles a little ---- and then says very clearly "AMEN"...  I love each one and it is hard to see them struggle.

One of my kiddos today asked me an interesting question... "Do you have a mommy on earth or in heaven?" I replied "I have a Mama on Earth in a land far far away called North Carolina." to which the child replied "She must be really pretty... because you are nice.. and my daddy says that nice people are some of the prettiest people..... She's pretty isn't she?" My reply..... "Yes she is --- inside and out.... and one of the nicest people you could ever meet.... She has a special place in her heart for little girls. She would love you." My kiddo's reply... "Your mommy sounds really nice Doctor Christa." and a giant hug with a little head on my shoulder.

Did I mention that I LOVE what I do?