Saving Pennies

Frugal?  Cheap?  Thrifty? I don't think any of those words categorize me, but I am a saver!  For as long as I can remember I have always been a saver.  I was the child who would save her Easter candy for as long as possible (while eating my brother's instead).  It wouldn't be unheard of for me to still have candy left over by the time Halloween came around.  I rarely bought anything with my allowance, but instead watched as my savings continued to grow and grow.  I would "save" my new clothes, not wanting to wear them until I thought it was time. 

I remember having to write my first rent check when I was a Junior in college--I had never written a check for that amount of money and I felt like I was just throwing money down the drain. It took a little while to get used to writing that check every month.  I didn't get my first credit card until a few months before Justin and I got married; and that was only to build up some of my own personal credit before we tied the knot.  The thought of using a card to pay for things frightened me.  I knew too many friends who were thousands and thousands of dollars in debt because of these little plastic things. 

Before children, I wasn't a big spender, but I was definitely not as careful with my money as I am now.  Let's face it, children are expensive and full time childcare for three little ones drains your income pretty quickly.  Before purchasing something I always say to myself  "do I need this?"  Usually the answer is no, at which time I will just walk away.  Although it's much more fun to shop for my little ones now, if I am shopping for myself, I usually go right to the sale rack.  I have an "it's meant to be" attitude and if I don't find something or if they don't have my size, I shrug and move on.  I love finding a bargain though!  Today I was shopping at one of my favorite stores when I decided to browse through the shoe section (after I had already picked clothes out for my oldest and my little buddy-sorry Lauren, you get hand me downs).  I knew I didn't "need" any shoes but you never know what might be on the sale rack.  I had recently bought a pair of gray boots, but thought it might be nice to have a new pair of brown boots (the ones I currently have were purchased eons ago).  Wouldn't you know it I found a pair of brown boots, in my size for $9.40 (original price was over $100!).  Even the check out lady was impressed by my purchase--I'm certain those boots were not marked correctly but lucky me! 

After Justin and I got married we both wanted to be in charge of our finances.  Entering receipts on Quicken, writing bills each month, and monitoring a checking and savings account is fun, right?  I decided to surrender and let him have control, which in hindsight has probably been a great idea. I have no idea what our electricity or water bill is each month.  Although I do cringe during the summer months when Justin waters the lawn every night.  I did know that our cable/Internet bill was well over $100 per month.  Which is why I finally convinced Justin to get rid of cable. When you have twins + one you don't have time to watch TV.  We made good use of our DVR, recording lots and lots of shows but we never had time to watch them.  I think we have both adjusted to being cable-less, although the college football season has been a little challenging. 

Every year my parents are wonderful and give me money for my birthday to spend on something just for me. I set it aside waiting to find something I "want."  Yes, there are tons of things I would love to have, but convincing myself I need them is challenging sometimes.  In fact, my birthday money envelop still has money in it from last year and my birthday is in 3 weeks!  Time to schedule a massage, because that is something I need! 

Groceries are expensive.  The twins are just a little over 13 months old and they eat a lot (and they eat 2 meals a day at day care 5 days a week!).  I can't imagine how much food and milk I will be buying when everyone gets older.  I used to be able to keep my weekly grocery bill to under $50.  With the cost of everything increasing lately, it is really hard to do that any more.  I am not a crazy coupon lady-that in itself is a full time job, but I do check the ads for sales, clip a few coupons from the Sunday paper each week, and try to buy in bulk when possible.  I keep a spreadsheet of the most common items I buy and the best prices for each item.  We rarely eat out for two reasons:  1.  Let's eat at home and save money ;), 2.  With three little ones it is challenging and not enjoyable at all unless we have help.  The twins are literally done eating in 10 minutes and ready to crawl around and cruise the restaurant and Alena is a slow eater like her mommy and daddy. It can take her an hour to finish half a cheeseburger (it doesn't help that she NEVER stops talking).  Needless to say, Justin and I usually get to enjoy about three bites of food before a twin ends up on our lap or we are walking around with one.  So advice to anyone wanting to save money by not eating out: have twins!

So from reading this, you probably think I am a crazy penny pincher (like some people I know), but honestly I think I am just a wise spender.  My little ones have everything they need and then some.  We've made numerous updates on our home, prioritizing what needs to be done first and not choosing cheap materials to make it more affordable.  Yes, our vacations are few and far between but that's not because we don't want to spend the money, but because it's challenging to travel with three kids.  I don't see my ways changing too much in the future as that is what I am planning for. I want to be able to retire at a decent age (so I can enjoy and spend money on my grandchildren), help grow a college fund for each child, and have plenty of money in my savings to do whatever I want when the time comes.  We'll see how this all pans out...

Fall

Fall has always been my favorite season.  How can you not enjoy watching the leaves change colors, sweatshirt weather, and evening strolls while the moon is rising?  There is a reason why I had all three of my kids during this season (OK, so the twins were born before the Fall solstice, but close enough!).

Since having kids, I've grown to love pumpkin patches and Halloween.  You can't beat the festivities at our favorite pumpkin patch, Center Grove Orchard:  Cider donuts, petting zoo, a huge corn pit, a "pillow" to jump on, and the big slide.  We are usually too busy enjoying those things that we never even make it to the hay ride!  Alena is really getting into trick or treating, (read:  gather as much candy as possible).  I love that she's old enough to decide what to dress up as and big enough to walk by herself.  Mom and dad usually end up eating her candy because after a couple of night she forgets about it.  We don't complain. 

When I have time, I like to do most of my baking in the fall because I love pumpkin anything!  This past weekend Alena and I made pumpkin cookies.  Hoping to follow up with pumpkin bars, pumpkin muffins and pumpkin bread in the near future (I have to spread it out before we all get sick of pumpkin stuff!).  Caleb enjoyed the cookies, but the verdict is still out on Lauren.  I also love the smell of hot apple cider-no wonder Yankee makes a candle that scent. 

Who doesn't love jumping in a big pile of leaves?  Alena is so excited to do this this year and keeps waiting for our leaves to fall.  Little ones in a pile of leaves make the perfect picture-hopefully the twins will enjoy it this year.

Fall also means the start of one of my favorite sports-football!  I used to hate football.  I grew up a basketball fan, going to ISU games with my dad.  We never went to football games growing up, and during high school I was too busy chatting with friends and watching the cheerleaders to learn about the game.  Yet, when I went to school at Iowa, I decided to get football tickets because that's what my friends were doing. I soon learned to love the game.  I now enjoy watching college football on Saturdays, (or listening to the games, since we are now cable-less).  Behind gymnastics and track, it's possibly one of my favorite sports to watch.  Tailgating on Saturday mornings became a ritual when we lived in Iowa City and we have quite a few tailgating stories!  

Fall also brings one of my favorite holidays, Thanksgiving.  For as long as I remember, I have always loved turkey day.  This was such an important holiday for my family that we used to have a "practice Thanksgiving" a few weeks before the actual big day to help prepare and make sure the food was "just right."  Let's be honest, as a family, we just love to eat so it was a good excuse to get together and enjoy some yummy food.  We also enjoyed hours and hours of game playing!  I pretty much started playing games as soon as I could hold up cards and remember my Aunt Pat teaching me how to play "Kings on the Corner"  when I was younger.  I love games and miss having the time to play them.  Alena has quite the collection of games and I'm always encouraging her to play them with me.  I'm looking forward to "family game night" when everyone gets older. 

The only thing I don't like about Fall is it seems to be the shortest of the four seasons.  We're only a month in and the weathermen are talking about snow flurries this week!  I just wished I could make this season last a little longer...

When Are You Going To Be A Doctor?

It's hard to believe I have been a nurse practitioner for seven year already. It seems like yesterday I was studying for boards and trying to find a job. Very few weeks go by where I am not explaining to a patient what a nurse practitioner is. This drives me crazy because this is not a new field-nurse practitioners have been around since the 1960's!

Unfortunately, nursing is a complicated career because their are multiple paths to becoming a nurse. You can get your Associates Degree (which is being fazed out because they are really encouraging nurses to get their 4 year degree), or Bachelor's Degree to become an RN. There are still LPNs which can confuse people. Some nurses go on to get their Master's Degree, but that doesn't necessarily mean they are nurse practitioners. Yet all nurse practitioners have a master's degree. See what I mean about confusion? Plus, every state has a different term for nurse practitioners: In Iowa, we are known as Advanced Registered Nurse Practitioners. In other states I may be known as an Advanced Practice Nurse, Advanced Practice Registered Nurse, or simply Nurse Practitioner. To make it even more confusing, a nurse practitioner's scope of practice varies from state to state. Iowa has one of the most "flexible" scopes of practice. There are no restrictions with regards to my prescriptive ability and I can open my own clinic and practice independently. Many other states are more restrictive with regards to what an NP can do.

Probably the two most common questions I get from patients are: When are you going back to school to become a doctor and what is the difference between a nurse practitioner and a physician's assistant. I always laugh at the first one and explain that I don't ever want to become a doctor and that I'm done with school. Being an NP is the best of both worlds-less schooling, thus less school debt, no call/weekends, but still being able to see, diagnose and treat patients. Now if only our salaries were the same...The second question is also easy to answer-we pretty much do the exact same thing.

After 4 years of working in a busy internal medicine office and 3 years working in nephrology, I have gained a ton of experience. There have been moments I will never forget. Like when I have to tell someone they have HIV, hepatitis, an STD, or cancer. There are also patients I will never forget. I will never forget my "dumpster diving" patient who resumed his hobby just 1 week after having open heart surgery and developed a horrible infection in his incision. Nor will I forget his wife of whom I was doing a pap and pelvic on and had an abscess on her abdomen. She proceeded to squeeze the lesion and drainage shot across the room-thank God I had my PPE (personal protective equipment) on. I've been practitioner, nurse, counselor, therapist, and friend for many patients. I've lost many patients. I've shared pictures of my children with patients and met many of my patients own children. I've rejoiced with patients when their CAT scan showed their tumor had shrunk, their diabetes was under better control or their blood pressure was within range. I truly enjoy what I do.

My job as a nephrology nurse practitioner is very unique. On the days I am in town and not seeing patients in the clinic, I round at the six dialysis centers in Des Moines. When seeing patients on dialysis, I evaluate their treatments and make adjustments if needed, monitor labs (specifically their hemoglobin, phosphorus, potassium, and calcium levels, and ensure they are getting good dialysis). I evaluate their blood pressures before, during, and after treatments and make changes in medications if needed. I also adjust their treatment medications pending on what their labs are. Besides addressing dialysis things, many patients believe I am their primary health care provider so I sometimes manage other health conditions too. This means I see the same patients every week on dialysis. I've become close to many of these patients. We talk about our weekends, they ask about my children, and we chit chat about Iowa Football.

During clinic days I see patients who have kidney disease, but are not on dialysis and may never be on dialysis. Some are kidney transplant patients. I do a lot of educating during my clinic, to prepare patients for dialysis if it is in the foreseeable future. I make sure patients are aware of the two different types of dialysis, along with their option for transplant if they are a candidate. I also spend two days a month at the VA hospital seeing Veterans with renal disease. I have a special place in my heart for Veterans. While going to nursing school at the University of Iowa, I worked as a CNA at the VA hospital on the post-surgical floor. I really enjoyed it and the Veterans I met. I especially love the WWII vets! For the most part, they are grateful for their health care and adhere to their treatment regimens.

I also travel out of town 4 days a month (soon to be 3). In two of these towns I only see dialysis patients and the days are usually short. The other two towns I see dialysis patients and do a clinic there. I also have one day a month where I see our home dialysis patients in clinic (home hemodialysis and peritoneal dialysis). I enjoy this day each month because I love that patients have the ability to do dialysis treatments in their own home. Our home dialysis patient census is the largest in the state of Iowa.

You can't beat the flexibility of my current job and I will never find another NP job that is this flexible. On the days I'm not in clinic, I basically make my own schedule. If a child has a doctor's appointment I don't have to have my clinic scheduled cleared to I can take him/her. I often work hard in the beginning of the month, which allows more free time at the end of the month. There is no way I could run a household, take care of three kids, and work full time without this flexibility. In the future as my kids are in sports (hopefully!), it will be easy for me to be done working by 4 to go watch their games. I love not being in the office from 8-5 seeing patients every 15 minutes like my old job. This is the perfect "mom of twins + 1" full time job. 

Alena's 4th Birthday

May 2011

We welcomed your 4th birthday with a three day long celebration!  The day before your birthday, you brought cookies to school and got to wear the special birthday hat.  Most kids wear the hat for a couple hours, but you wore it the entire day, (except during meals and nap time).  School also let you pick out your birthday book and you chose Cinderella. 

That night we traveled to Riverside.  The morning of your birthday, we celebrated by having donuts and then you and dad went to the Iowa Football game!  You had so much fun and especially enjoyed watching the band play and the dance team.  You were also very interested in the score of the game and loved yelling "O" for I-O-W-A after they scored a touchdown.  For dinner that night, you requested pulled BBQ pork sandwiches, Cheetos and fruit.  You also requested a blue cake with pink frosting that you helped Grandma S make.  The cake was decorated with lots and lots and lots of sprinkles :).

Your last birthday celebration was at home, where Aunt Emily, Uncle James, Wyatt, Rylee, Pat and Willard and Grandma and Papa were there to help you celebrate.  You requested a Rapunzel cake for this party and dressed in your Rapunzel dress.  The neighbor's grandchildren, Julia and Madi also helped you celebrate.  Unfortunately it was a chilly, rainy day, but everyone had a great time.  You specifically asked for a guitar and underwear for your birthday :). 

Like I do every year, I watched the videos of when you were first born.  I still remember how surprised I was when I saw you were a little girl. The first six months of your life flew by and before we knew it you were walking at 10 months.  By a year you were saying a number of words.  You have always been very chatty, except when a lot of unfamiliar people are around.  We loved how much you learned from age 1 to 2 and never really experienced the "terrible 2's" with you.  Shortly after turning 2, you were potty trained (because you were SO easy to potty train, I know your brother and sister will be difficult). Every teacher that has had you makes mention of what a great listener you are.  Unfortunately you don't always have your listening ears with you at home, but others are always reminding us of what a great child you are.  Caleb and Lauren are so lucky to have you as their big sister.  You make them laugh more than any one else can and they are always so excited to see you. I can't wait to watch you all grow up together.   

I'm glad that it will be two more years before you go to Kindergarten because I don't think I could handle you going next year.  You are so excited to move into the pre-kindergarten class at school and I know you will really enjoy it.  This curriculum focuses more on different school subjects:  Math, Reading, Writing, Science.

We've loved watching you develop friendships with your classmates, cousins and neighbors.  You like to be a leader, but also don't mind learning from others.  We continue to think you are athletic.  You love running and would love to go for runs with me some day soon.  You can also hit a ball with a baseball bat when it is thrown at you and are  getting good at playing "volleyball".  I'm anxious to get you involved with more activities.  

20 Birthday Questions:

What is your favorite color?  Pink and Purple
What is your favorite toy?  My kitchen
What is your favorite fruit?  Peaches and Mandarin Oranges
What is your favorite movie?  Finding Nemo
What is your favorite TV show?  Martha Speaks
What is your favorite thing to wear?  Dresses
What is your favorite animal?  Giraffe
What is your favorite song?  The Balloon Song ("Alena had a yellow balloon so she blew and blew and blew.  'Til it got so big and fat it grew and grew and grew.  Alena kept it in the air and never let it drop, until one day it hit the ground and suddenly went pop"
What is your favorite book?  Tinkerbell
Who is your favorite friend?  Taylor Peterson
What is your favorite snack?  Cliff Bar
What is your favorite drink?  Lemonade
What is your favorite breakfast food?  Fresh toast, pancakes, waffles
What is your favorite dinner?  Peanut butter and jelly
What is your favorite place to go?  The Park
What is your favorite game?  Tag
What is your favorite thing to do outside?  Play with bouncy balls
What is your favorite holiday?  Easter
What do you sleep with?  Eeyore and Piggy
What do you want to be when you grow up?  A Teacher

Your BFF Taylor (during your first school trip to the pumpkin patch)

Scars

Scars can tell a lot about an individual:  What our childhood was like (clumsy toddlers will have more scars than others), or the hardships we have overcome (injuries/surgeries/battle wounds).  People can have emotional scars too related to personal misfortune or an unpleasant experience.

I can look at a patient and know what surgeries he or she has had:  Knee replacement, kidney transplant, CABG, gunshot wound, cholecystectomy...I'm pretty lucky as I have very few scars, besides the scar on my forehead that happened while vacationing in Minnesota.  I battled a swing my cousin was swinging on and lost.  Surprisingly, I've had three surgeries and not a single scar to show for them!  When I met Justin, he had two prominent scars.  One on his lower back from a cyst that was removed when he was younger, and a second on his leg.  The latter he received from a chair, (you'll have to ask him the story behind that).  Over the years, he has accumulated new scars.  His elbow scar from surgery nearly 4 years ago, his leg scar from the melanoma (which you can hardly see now!), scars from his lympadenectomy and his two laproscopic surgeries (luckily, they used the same incisions). 

Alena has been able to skate by without any major injuries or scars.  Poor Caleb now has three new scars from his recent surgery.  At least they aren't on his face!  He was such a trooper before going back for surgery, even though it was way past his breakfast time.  He didn't make a peep when the nurse took him back to the OR.  The surgery took a little longer than normal and we learned he has the same reaction to anesthesia as his mommy does.  Hopefully his scars will gradually fade as he gets bigger and their won't be any lasting emotional scars from this experience!