Thursday, January 25, 2007

happens every time

Start at a new school, get sick.

Tuesday night I came down with strep throat for the first time since I was in college. I can't remember the last time I had a fever that wasn't the typical mild post-op elevation of temperature, the kind that doesn't bother anyone.

Tuesday night, I had chills so bad my teeth were chattering, and I was torn between letting them knock (painful) and trying to clench them together so they didn't (also painful, and likely to trigger my TMD again.) In the end I just took both Aleve and then Tylenol a couple of hours later, and went to bed. And woke up with a fever on Wednesday.

I felt terrible all over and didn't notice much of a sore throat, but I decided to look at my throat anyway, hoping it would be strep so I could get treatment -- and relief -- right away. I was shocked by how red my throat was! So I hauled my poor sick self off to the doctors, and they did the rapid strep and it came back positive.

Now I'm on the Z-pack and I do feel a lot better. The fever has dissipated completely but my throat is still very painful. I'm still astounded by how much my throat hurts. I hope it stops soon. (I just realized it's killing me right now because my meds have worn off, but I'll hold off taking more until I'm going to bed.)

So I've been home from work these past two days, but not exactly idle, even though I've been feeling icky. Both days Mom and I did errands to get ready for DS1's birthday party tomorrow; today I brought the kids to the Y and waited during DD's dance class. I drafted two columns while I was waiting -- I was running the nutrition numbers Tuesday night when the strep descended on me -- and then I wrote up both columns after dinner. Now I'm off the hook until April, which is good because I don't want to have to be thinking about a column while we're wrapping up the prep work for the thyroid cancer workshop on March 3... which has also been occupying my time, and my thoughts, as the day creeps ever closer. More on that, later.

Friday, January 19, 2007

teaching is not parenting

(Last day of the four-day week of my first substitute teaching stint)

It rained today, and that made it a very difficult day at school.

The day is structured so that the kids have significant blocks of free time after intense periods of work, so that they can recharge and run around a bit after sitting still and thinking so hard. The key part of that is the running around, which they can't do when it's pouring outside.

Importantly, when the kids have recess, the teachers get a break, also. Today the only break I got was the 15 minutes I grabbed to wolf down my lunch. I spent most of the school day in some combination of thirsty, cold, and having to pee. Today should have been a three cups of tea day, but I only managed one. And when you don't get breaks and the kids are in a perpetual state of fluster, it's hard to find a chance to get to the bathroom. Without that time for me to recharge my own batteries, I wasn't able to keep on top of the class as well as I had earlier in the week. At any given time having six kids asking you for something is the type of thing that can make your head explode -- that didn't happen, but there were a few times when so many were asking for something at once that at one point I said "yes" to too many people, and so we had half the class working out in the hall, when usually only 3 groups of 2 or 3 are allowed to go! Whoops.

By the end of the day, I pretty much gave up trying to keep them quiet. On a normal day, when they've finished all their work they can have recess until their bus leaves or their parents come to pick them up. Consequently they're geared to finishing stuff up at the end of the day, and that's what they did today. But 2:30 and no work pending on a rainy day is a bit of a disaster, with the class breaking down into groups wanting to play different games, and the limited classroom real estate threatening to turn into a battleground. They left the room a mess and I was too exhausted to make them stay and clean it up.

I felt pretty down by the time I left, because it ended on such a chaotic note. But in looking back over the week I think it's stupid to be disappointed. We covered all of the material that the teacher had left for them to do, and then some. It seemed something strange happened every day, but there were no major crises.

I'm still trying to figure out the best way to handle the Class Wit and the Class Lawyer types. You know, the kids who are very smart and very quick with the funny quip, and will argue with everything you say six ways till Sunday. I've been struggling with this all week, and I think I know why. With my own kids, I really appreciate their jokes and I respect their reasoning ability. So I'm conditioned to respond positively to this kind of behavior, as long as it's respectful.

However, making a joke at the family dinner, or arguing with me about something one-on-one, are very different from doing these things in the classroom. In the classroom, they're a disruption, and they steal time away from everyone. Obviously the solutions are 1) to cut off any response to the witty remarks immediately and 2) to not engage in any kind of back-and-forth with the lawyer types. Knowing this and being able to do this consistently are unfortunately not the same! Practice will help.

After school it took a conscious effort for me to get out of teacher mode and not get all grouchy when the kids were making jokes at dinner. It's hard to switch it off once I get into that mindset, and Lord knows I don't want to squash the fun out of my kids.

This is going to be very interesting, I can tell. Even today, which was a hard day, was still satisfying. My disappointment comes from wanting to do a better job, and be more effective at keeping the classroom at an even keel. I have to remember that for the most part we were on task, and we were certainly on task enough to finish them all; that's huge. And it's really cool that I was comfortable with all the class materials -- I didn't just say, "Open to page X and start reading," we had actual lessons. I taught. That's totally cool.

In spite of the bad day and hard moments, I'm officially declaring success.

Thursday, January 18, 2007

the importance of visual aids

What I learned substitute teaching, day 3...

Today was in some ways better -- I know all the kids' names now -- and in some ways more difficult, since the kids know me better, also, and somehow concluded that it was OK to interrupt me every 3.5 seconds.

Eventually I realized that something must be done about that, and I drew an empty box on the board. We had about 5 minutes of material to get through, and every time someone interrupted me or spoke out of turn, I made a tally mark in the box.

These kids are not stupid. I admit I took some pleasure at seeing the discomfort and near fear on some faces: What are those marks for? What are you going to do when the box is full?

I explained I didn't know yet, that the purpose of the box was just to show them how often they interrupted me. By the time we reached the end of the material I wanted to cover, there were 22 tally marks, but the last 10 or so were made by one kid who tried his hardest to get kicked out of class all afternoon. (Dealing with that situation made the day seem very long.)

So now I feel I have a pretty good handle on this group of kids, and of course tomorrow is my last day with them. But that's OK, because all of this experience is invaluable.

By the end of the day my voice was giving out, and my feet were killing me. In spite of that, though, I'm loving this, way more than I expected to. It's pretty awesome to have a job that I really love. I can't say I've ever had one before, at least not one that earned any money.

Wednesday, January 17, 2007

what I've learned about substitute teaching...

Fifth grade edition. Two days down, two days to go.

Fifth graders are interesting. They are, for the most part, autonomous, and can do their work with little or no supervision. The reality is that they will do their work about 60% of the time, and would easily spend the remaining 40% of the time chatting and otherwise goofing around. I don't think this is particular to this class, because I saw exactly the same behavior in the other fifth grade class today when we had a combined class period. I am astounded by how much energy they spend trying to get out of doing their work.

But I digress. Here are the high points:

1. Be decisive. Even if you make the wrong decision, any sign of wishy-washiness will immediately be exploited. If they peg you as a softy, you're toast.

2. Don't smile. This was the advice given to me by one of the other subs at the school, and with this particular age group, it's imperative. Smiles are interpreted as signs of friendliness. I am not there to become a friend. I'm there to make sure they get their work done.

3. If they don't have enough work to do, they'll act up. This afternoon I took away "free" quiet study time because they were neither quiet nor studying, and made them copy out their times tables for 10s, 11s, and 12s. The benefits (to them) of this became obvious when several began asking "What's 12 times 11?" My response: Figure it out. You're supposed to know this stuff already. Plus, the hoped-for result of a quieter classroom was attained, at least for a little while.

4. Impose consequences sooner rather than later. Day 1, I resisted imposing consequences for all the chattiness. Day 2, the class had already lost 5 minutes of recess by 9 o'clock. They were stunned: Did we just lose 5 minutes!? Me: Yes. Them: Can we get it back? Me: No. (Lest you think I am a complete dragon lady, I had already shushed them 3 times, and warned them if I had to shush them again they'd lose that 5 minutes. It's remarkable how quickly a classroom with 27 5th-graders can go from quiet to noisy.)

During reading, the two kids that were fooling around the most got sent out into the hallway to finish reading on their own, some three minutes after I had told them to settle down. (If it had been 10 minutes, I might have gone with another warning; at that point, though, it was obvious the first warning had been meaningless, so why waste another one?)

5. Avoid choosing students via the hand-raising method. Picking a reader or someone to answer a question can be difficult if you don't know the kids' names, so use whatever system the teacher has set up for random selection (we used popsicle sticks with the kids' names on them -- choose a stick, there's the next kid to read), or start at one row or table and proceed from kid to kid.

6. If they think they're finished with an assignment and want to turn it in, they're done, regardless of what's on the paper. I know some of the papers that have been turned in don't represent these kids' best work, but that's their choice, and they'll have to live with the consequences. Contrast this to my philosophy regarding my own children's homework: if it's poorly done, I'll ask them, Is this the best you can do? and give them a chance to notice their mistakes and correct them. But they're my kids, and it's homework.

7. Deny the attention-seekers an audience. In every class, there will be one (or two, or three) kids who dramatize every tiny thing. Usually they're very entertaining. They're also distracting, and often disrespectful, flashing wide innocent eyes as they proclaim I wasn't doing anything!, which is precisely the problem. Nip any such performances in the bud. Sending these kids to work solo out in the hallway is tantamount to banishment to them, hence, it works.

8. Separate the kids who are too chummy. Sometimes, you have to break up the friends or the work isn't going to get done.

9. When covering class material, focus. It's easy to get led far afield from the topic at hand. We were discussing how the Spanish brought slaves from Africa to work their colonies there after many Indian slaves died, and all of a sudden we were talking about the economics of European land ownership. Yes, it was an interesting discussion and the kids probably learned something, but it was tangential to the topic at hand. Unfortunately at this age the kids will fixate on some exotic detail, and pick that out as the most important item of information to remember. Their intellectual sorting and prioritizing abilities are still developing, so if you throw in a lot of extraneous materials, it isn't really doing them any good.

I explained to the class today something I've told my own kids dozens of times: I can't make you do anything -- each of us is responsible for our own behavior -- but I can make your life pretty miserable if you don't do what I ask. There was some resistance to this idea of self-control and personal responsibility, because "It's not my fault" is part of the daily vocabularly of a few of these kids, along with a variety of other excuses. I universally dismiss such excuses, and encourage the kids to move on to the tasks at hand. This is crucial to avoid getting bogged down into a discussion assigning blame, etc. Pass! There's no point. Just get on with the work!

I told some stories at dinner tonight. DS1 told me: Mom, you're great as a mom, but you're scary as a teacher.

That's exactly what I was aiming for.

Monday, January 15, 2007


DS1 had his first sleepover this past Saturday, and had a fantastic time. I was surprised by the amount of anxiety I managed to sustain over the time he was gone.

I have a problem, generally and chronically, with what I call "negative ideation" -- I'm not sure what the technical term would be -- but basically my imagination wanders down every possible horrible path, constantly. I have to, for example, remind myself that of course my daughter isn't going to smash open her head if she slips and falls on the tile, running around in stocking feet. But that's the kind of scenario that flashes through my brain at nearly every possible opportunity -- whether it's the milk cup upending, a glass jar smashing, or a child falling, these scenarios usually involve 1) large messes and 2) great personal injury. I cope by using short phrases to reign in the kids: That's not safe, and also: I worry. If I have to be a little crazy like this, I figure the least I can do is not nag them about it.

Anyway, the boy had a great time and now we're planning a sleepover for his birthday party in a couple of weeks.

In other news, DS2 lost one of his two front teeth, and it's taking all of my willpower not to mock him constantly for his new lisp.

Look everyone! No tooth!

Last but not least, Mom arrived today, and seems much the same as ever, perhaps a little more unsteady on her feet. It feels very comfy having her here. I'm so glad she got away from NE before she had to deal with any snow.

Oh, yeah... I start substitute teaching tomorrow.

Wednesday, January 10, 2007

go with it

I'm having second thoughts about this substitute teaching thing before I've ever set foot in a classroom as a sub. I met this morning with the teacher I'll be subbing for, and she has most excellently arranged for everything during her absence. Earlier, that seemed like a really good thing; my stated substitute teacher philosophy is, "I'm here to maintain the status quo."

I'm not subbing to do my own thing, I'm subbing to see how well I stand up to the classroom environment. So I won't be taking over any classrooms or leading any classes on wild goose chases, although far-ranging discussions are still possible.

But just now it popped into my head how confining it may feel to have to stick to someone else's schedule, all the time. Well, at least unil the end of the school day.

That may be my biggest stumbling block, right there. I really like not being bossed around, and schools are extremely structured environments. It's going to take some getting used to, but I'll go with it.

don't say it, don't even think it: what not to say to your thyca patient

Medblogger Life (and death) posts about a thyroid cancer patient, and begins:
"If I had to pick a cancer to have, I'd pick thyroid cancer."
That's what I tell my patients...

My reply:
Speaking as a thyroid cancer patient, I can tell you that I cringe every time I hear that "If I had to pick a cancer..." line. No one would ever, ever choose cancer, and your saying so is patronizing and annoying. Your patients may not appear to be annoyed when you say this, but that's because they're still in shock from hearing the diagnosis of cancer, and they've still got that word, CANCER, echoing in their brains and they're trying to figure out what's going to happen them, etc. Take my word for it, they'll be irritated later.

Thyroid cancer is not the cancer you'd choose, and it's not a good cancer, either. It is often a manageable, treatable cancer, and the management and treatment options are the good things, not the cancer.

You are correct in that, for the vast majority of patients, thyroid cancer is a die with cancer rather than a die from cancer, but it's still cancer, and it is a cancer that we patients must confront every single day of our lives, post-thyroidectomy. Can you name another cancer that forces its patients to take suppressive chemotherapy every day for the rest of their lives, or they'll die? Our thyroid meds do double duty, providing us the necessary thyroid hormones our absent thyroids would produce, and also keeping our thyroid stimulating hormone very, very low to help prevent the growth of any remaining cancer cells. We have to take this medication every day without fail; we cannot survive without our thyroid hormone supplements. And if our dosage is incorrect or we take it incorrectly, we may face a recurrence that could otherwise have been avoided.

That's not to say that thyroid cancer patients are doomed to a miserable existence. I'm 27 months from diagnosis, and 15 months from my second surgery, which involved four neck dissection procedures. I'd say it took about six to eight months after my diagnosis to get my medication levels correct, and that was rough. Having to go on the low iodine diet prior to follow-up scans is tedious and, because it's easy to make a mistake that can invalidate the scan, nerve-wracking. Day-to-day, I have an active, full life with family and friends and work. But I still have cancer, and my tumor markers are hovering in a gray area that means I have to go for follow-up every few months, so I never get to not-think about it for very long. And even on days when I don't have to think about, I still have to take those meds.

My 8-year-old daughter asked me when I could stop taking my meds. Her experience with medication is limited to analgesics and the occasional antibiotic for strep throat or an ear infection, all of which are limited in time. I told her, "When I'm dead," and she was startled. I had to explain to her that I have to take them every day, for the rest of my life.

I'm OK with it now, but the idea does require some mental adjustment. I urge you not to continue to downplay the significant impact that a thyroid cancer diagnosis will have on your patients' lives.

I also want to apologize if I'm giving the impression that I think you don't care, because it's obvious that you do care, and care a lot. I'm just trying to counsel you against committing the most frequent insult to thyroid cancer patients' intelligence.

Monday, January 08, 2007

Friday Night Lights: more of the same... yay!

I can't keep up with everything that's going on these days, so my informal reviews of Friday Night Lights will be even more haphazard than before, and in fact may disappear altogether if I can't make time to write about it.

That most recent episode, "Nevermind," gives an exceptionally strong episode after a couple of relatively weak ones -- relative being the operative word there, since a "bad" episode of FNL towers above the typical televised dreck out there these days. (Although, to be sure, the quality-to-dreck ratio is increasing every year, miraculously.)

There was a lot of pain and frustration in this episode, and not typical teen angst crap, either: no whining about not getting to use the car or stay out late, but real pain -- a father who can't see how his indifference is destroying his son, and real frustration -- a young man who can't do anything he used to, and has to learn to deal with that.

But balancing all the pain were the brilliant scenes with Landry and Riggins, slogging through Of Mice and Men and forging some kind of bizarre friendship on route to a B- for Riggins' oral report.

The writers are once again trying to snow us with Lyla's purity and overall goodness, in spite of her previous ruthlessness in pursuing Riggins. Has she paid enough for her transgressions? It seems that Jason will forgive her. For what it's worth, I agree with Tami's statement, "There's no shame in forgiveness," up to a point, and that point is where the person you're forgiving continues to play you for a fool. I am starting to believe that Lyla is a headcase and needs serious psychological counseling, above the level that Tami could provide. I wonder when Jason will figure it out.

Matt Saracen just breaks my heart, and I wanted to smack his father upside the head and tell him to stop undercutting his son. Matt had a done a fine job leading the team through the season to date and yet his dad still has to come up with the confidence killing "Don't go folding under the pressure now, son," spew -- which, of course, pretty much crushed Matt.

I don't believe for a minute that Matt's going to Oklahoma, so we'll just have to see how that works out. I mean, what would Landry do without Saracen? Riggins will only tolerate so much of him, after all.

There was no Smash this week, and no Tyra; didn't miss 'em, but I'll be happy to see them when they return. The Taylors continue to be the most realistic married couple on television, and the tussle over bringing out that last trash can was hysterical -- but who ever just throws their trash in loose like that? That'll get you critters for sure. That's the kind of gaffe that's beneath this show, but since it happens very rarely I'm more than willing to give it a pass.

Will Coach Taylor make it to UT as QB coach? I think that depends on whether or not NBC greenlights another season. I was beyond psyched that NBC picked up the full season this year, but whether or not they'll fund another year for an under-performer in the ratings is questionable. I'm not sure how expensive this show is to produce -- no special effects, but a huge cast and lots of locations, so I'm guessing it's pricey, and of course that factors into the decision. If they can maintain this standard and finish out this season, telling one set of complete stories, I think they will have produced some of the best television, ever.

Obviously I hope they do get picked up for another season, or seasons. But I don't want that to happen if it means morphing the show into something it so far hasn't been: a teen high school drama. For now, I'm enjoying what we have.

let us our songs employ...

I noticed this Christmas season at Mass that the powers that be (or at least the powers that type up the song sheets we use each week) have changed the lyrics to "Joy to the World" from the traditional "let men their songs employ" to the active voice, and I'm sure it's just a coincidence, politically correct gender-neutral "let us our songs employ."

I like the idea of participating in the joyous chorus of the heavenly hosts singing the praises of Jesus's birth. But it rankles just a bit that they've tinkered with the lyric.

I won't even get into the discussion I had with DD, in which I had to insist that the use of the term "babe" in "What Child Is This" was not a typo.

Saturday, January 06, 2007

her time

DH is in CT for his grandmother's funeral.

She was a charming, petite woman, and she lived to 99-and-one-half years old. It was her time to go. When I first met DH she had already fallen into that habit that older generations annoy younger ones with, the repeating of the favorite stories. I can't tell you how many times I heard about DH's letters from camp to his Gram, and how he spelled school "s-k-o-o-l."

I didn't see Gram all that often, so it was easy for me to be patient with her. I know for my in-laws, she was often a trial. In these past few years, Gram had obviously given up. She started using a wheelchair four or five years ago, simply because she didn't want to walk anymore. There was no reason for her to use the wheelchair, she just didn't want to try anymore. Her awareness would slip in and out, and I know the last few times we saw her, she recognized that we were somehow related, but she really didn't know who we were. That was in sharp contrast to the early days of my marriage, when we'd visit her with DS1 and she'd take us all around and introduce us to all her friends and the staff, saying how we'd come all the way from AZ to see her (which was, more or less, true). Her decline seemed gradual until it became abrupt, and then suddenly, she was gone. At least that's how it seemed from a distance.

DH took off Thursday morning; the services were Friday. He'll be home Sunday night, and I'm glad he's spending some time with parents and his brothers and their families now. There was no question of all of us going, the expense would've been crushing, and DS2 is just now feeling better after being sick for two weeks.

I know it's the right think for DH to be there, but I wish he were here, too. My mom finally got a diagnosis for her shortness of breath, and it was something completely unexpected: it's her kidneys. Here's one reference to shortness of breath and kidney-related illness which blatantly uses the words kidney failure. This question presciently asks the most important thing:am I going to die? The answer is vaguely hopeful, talking about dialysis and transplants. The thing is, my mother already has a DNR and I'm pretty sure she is not on board with the idea of dialysis. I'm slightly panicked that if Mom gets a serious diagnosis she'll just give up entirely and decide it's her time, too.

Of course I'm operating with only partial information here, and am probably jumping to all sorts of unnecessarily bad conclusions. Mom said her condition is "not life-threatening," but that is so the kind of thing she'd say so I wouldn't worry. This is, after all, the woman who came to my (put together in a week) wedding without mentioning that the very next day she was having a mass of pre-cancerous tissue removed from one of her breasts; she ended up getting a masectomy. She "didn't want to ruin [my] day." I was the only one of my siblings that didn't know; she forbade anyone else telling me. Of course I found out the next morning and stayed with my Dad and sister during Mom's surgery -- but she accomplished her goal, which was for me to enjoy my wedding and not worry about her until afterwards, which was an amazing gift, but also makes me feel like an idiot for scheduling a wedding so close to my Mom's surgery date... which I didn't know about!

Mom's funny, sometimes she's ready to throw in the towel -- she really misses Dad, living alone is difficult, her health is keeping her away from the travels she loves -- but other times, she's psyched about something, like her upcoming 80th birthday party, or traveling to China with one of my sisters-in-law. There's too much variability there for me to predict how this is going to go, and without knowing how serious her medical condition is, there's no point in predicting, anyway.

I'm just not ready for it to be her time. Not yet, not that I believe I ever will be ready. Maybe when she reaches the cusp of 100, it will be OK, the way it was with Gram. I don't know, I don't know. I just know her time should not be soon, and it certainly should not be now.

Spontaneous generation: DS2 told his kindergarden class about Gram's death. His teacher asked him how he felt about it, and he reasoned it out for himself: She didn't live here, recognizing that he didn't really know her, but she loved him. Then: I love her. I'm glad she's in heaven with Jesus.

Wednesday, January 03, 2007

wading into the maelstrom

Before the holidays, there were so many things going on I felt breathless. I thought, Let's just get through this, and then everything will settle down.

I was wrong. It's great to have cleared the decks of all the holiday stuff -- they were delightful, glad they're over -- but looking ahead, there's just as much to do, because somehow or other I've ended up with three jobs.

The oldest "job" is my column, which has been neglected lately. December's deadline for the January issue blew right by me, and I never did write a column last month. There were just too many real-world commitments, complicated by the illnesses of various children, and I wasn't disciplined enough to churn out a column. I have guilt, but not all that much, considering the pittance each column earns me.

The second job is the ThyCa facilitating business. The workshop planning continues apace, with letters and phone calls and all sorts of arrangements to make. These things seem much more like "real" work to me, rather than the goofing around in the kitchen and at the keyboard that the column often is (at least in the creative phase; I can recognize that the finished product is something to be proud of). Because this work feels more "real" it is tremendously satisfying. But before I can get too cocky about my abilities here an email will trickle in from a new patient with questions I have no idea how to answer -- yikes! I'm glad I'm the junior co-facilitator.

The third job will become a reality shortly; I will finally be making a little money when I start substitute teaching over at the kids' school. I didn't expect to be brought on as an employee, but I will be. I like that they'll take care of withholding and Social Security and all that. I'm not terrified -- yet. When my start date (looking like Jan 16 now, but may be sooner) draws closer, I will probably be paralyzed with fear. I've never done anything like this before. What an adventure!

Further adventures await me this week, as DH heads back to CT tomorrow for his grandmother's funeral. He'll be away until Sunday, leaving me to hold down the fort with the kiddos. (sigh) There was no point in all of us going, and it's right for him to be there. It's weird to be so conflicted: I want him to go, but I want him to stay here, too.

For now, the kids are all (finally) healthy, and we're getting back into the school groove. How weird to think that I'll be in the school groove soon, too.