April 29, 2008

Even in small town USA

I just have to say that you never know what will happen. Okay, so I live in the middle of a cornfield, in a town of, oh, 2000 maybe. We saw two ambulances, a police car, 2 volunteers and a locksmith pull into the driveway across the street. We just met the guy last weekend. The locksmith went into the house for a minute or two, then left. We have 4 doors to the outside of the house, and I was sitting in the living room. Then I see Jacob run out to the road (a busy road) then ran across the street to see the sirens/lights. They almost had to use one of the ambulances for me. I don't think I've ever moved that quick, but I was out the front door, flipping out that Jacob had quietly gone out the back door, which is by the kitchen and the kids keep their drinks in there. He's old enough I didn't feel I needed to follow him around. How wrong I was I guess. So I run across the street, take him inside and I think he sensed how scared I was because he freaked out, scared to death. I'm still trying to recover from that. That's another one of my mother-of-the-year stories. Man, I tell you what. Anyway, pretty soon, the county sheriff arrived, along with a couple cars with people wearing blue gloves. Then another car pulled in and I recognized the coroner. Yeah. After awhile, they backed a truck up to the front door, and, you guessed it, out comes a body bag. I just can't believe it. I have no idea what went on, but because the locksmith came, I'm guessing it was a suicide. A little bit ago someone knocked on the door to ask where the "Smiths" lived. I didn't recognize the last name, and he then said "They had a tragedy tonight". He looked like a pastor. I feel a little guilty that we watched all of that, like it was a tv show and this family is having some kind of crisis. I'm still stunned. Absolutely stunned. I remember when my life was very boring. Nothing exciting went on, except maybe finding a good deal on groceries, or finding a $1 on the ground. It's been too exciting for my taste this past year.

Deja Vu

Now I'm not passing any judgement, because I really don't have room to talk. My first two children would have been 15 months apart had I carried to my due date with Clara. I had an outpatient come in this weekend that I recognized, what we call a "frequent flyer". I recognized her friend, too. She was 31-32 weeks, and came in with cramping, which turned out to be a nasty UTI. Anyway, she was a very petite 16 year old, G2P1. I figured I must have had her on one of her other visits, so I looked back at the database, which lists all the nurse's assessment for every visit throughout the pregnancy and didn't find my name. Hmm, that's strange because I knew I had taken care of her. So I go through all the questions we have to go through each time and then it dawned on me: I had taken care of her during her 1st pregnancy. She delivered just last fall, and I remember talking to her and her friend because they asked me about my pregnancy. Plus I thought it odd that she came in at 0200 or so with her friend, but she lives with her parents. She always had her friend bring her in after she got off work at a fast food restaurant. After I told her she'd be staying for IV antibiotics until a.m., she called her dad to have him wake up her baby and bring him in. Which her dad did. She should've just let the poor thing sleep at home. Anyway, her babies will only be 10 months apart if she carries to her due date! She actually went for her 6 week postpartum checkup and was pregnant. I can't even imagine, though I know it happens. I've remembered taking care of people before, but never have I mistaken which pregnancy it was!

April 27, 2008


I started having migraines with an aura while I was pregnant with Isaiah. I was about 16 weeks pregnant and one morning, I had a blind spot int he center of my vision that progressed to zigzaging lines the ended up growing larger until it was like a backward C, and in the center of my vision, I had a blind spot. After about 30 minutes, it went away and I had a full blown migraine - nausea, light sensitivity. I had another one a few weeks later, but the headache was mild. Now I never had this before, and rarely even had headaches, but I guess there always has to be a first, right? My OB said that it was probably due to hormonal changes, and that if I wanted, she'd send me to a neurologist after I delivered, because they wouldn't do anything until then. But that it probably was nothing to worry about. Well, I only had a couple more, and didn't have any for serveral weeks at the end. So at my post-partum visit, I decided not to have her refer me. Well, of course after that, I've probably had 1-2 a month since January. Never a bad headache. I can always tell when I about to have an aura, then the aura starts, and I end up with a mild headache that doesn't keep me from doing things. It's just annoying. This past week, I had one thursday and friday. Granted, I was sleep deprived, stressed a bit, the weather was nuts, I do enjoy red wine, and I drink WAY too much caffeine - all triggers for migraines. So I decided I should probably be seen by a doc, but I wasn't too worried. Until I started talking with my co-workers last night and, yes I'm bad, but I looked stuff up on-line. And I know better than to do that. Well, my co-workers all said "Man, you need to get checked out, because so-and-so had a brain aneurysm and blah, blah blah". That thought had never crossed my mind, so thanks for that tidbit of reassurance. Then I found articles about how oral contraceptives increase the risk of stroke in women with migraine auras, an increase risk for stroke and cardiovascular disease, and so the risks of oral contraceptives outweighs the benefits. Well shit. I'm taking POP's (progesterone only) and love them. I have no periods, I do well taking pills at the exact same time everyday. After I'm done breastfeeding, I planned on getting a hormone IUD because I can't get myself to think that a tubal or vasectomy would be a good thing. I guess I'm just scared I might want another child and there are some good birth control methods out there. But if all this is true, that women with migraine auras shouldn't take hormonal birth control, I have few options. One article said that POP's were okay, and there are copper IUD's. I know, I know I shouldn't base my worrying on the internet info and I just need to sit down with my doc and talk about things. But it's hard. My mind wandered this am as I tried to go to sleep about "What if I do have an aneurysm? What if I have a stroke? I don't want to have surgery for that. My kids are so young, what if..." and it goes on. Silly yes, but I come from a long line of worriers. And my symptoms are classic migraine with aura symptoms. So I'm probably freaking out for nothing. Tomorrow a.m., I'm making an appointment, or I might call my OB and see if she'll still make a referral to a neurologist for me (I hate HMO's). And in the meantime, I'm going to try and relax.

April 24, 2008

Going green and lean

So I decided that we needed to be a little "greener" around here. Every week, we would have several bags of garbage, more than any of our neighbors. I thought "well, we do have 3 kids", but then I decided that maybe we should be recycling. The small town we live in doesn't pick up recycling nor does it have a recycle bin to drop things off at, at least that I've found anyway. So this is going to require loading up boxes of containers, cardboard, and newspaper and driving it into the larger town we work in. Which won't be too big of a deal. We also plan on recycling aluminum cans, and we can actually make some money off of that, $.50 per lb. We've been doing this for about 2 weeks, and we really have reduced the amount of garbage we've set out on the curb. If I could only bring myself to use cloth diapers, we'd be golden. But I'm not sure I can bring myself to rinse out poopy diapers. I know my husband won't. We've switched out lightbulbs where we can, and we've insulated the attic. I've also been looking at ways to save us money, especially with gas prices the way they are. I try to make every trip into town count (we live 10 miles away from where we work), and I haven't made many day trips to the grandparents lately. I cancelled my gym membership since all I did there was run on the treadmill, and I can run for free around town. I've been a big coupon clipper since Jacob was a baby, and I buy generic on some things. I also scope out the sale papers on Sunday for deals, especially diapers and wipes, but most of the time I get lazy and don't want to run around town. What I really need to do is sit down and make out a weekly menu and buy according to that. That sounds easy enough, but what will happen is I'll decide I don't want what I've planned for that meal, or I just don't want to cook. I also need to start hitting garage sales. There is a big town garage sale in May, and last year there were quite a few nice things, and lots of good kids clothes. There's also a good kids resale shop that I've consigned with before. I need to take in some clothes and see what they have because all of Jacob's t-shirts from last summer are too short. I've got big plans - we'll see if I can actually do it. Anybody have any good money-saver tips that work for you?

April 23, 2008

Good times

Yesterday was just a great day. Isaiah rolled over last night, from back to front and then back again. And he slept ALL NIGHT LONG!!! I tell you what, while I'm not counting on this being the regular night routine, it is so nice to finally be getting to this point! Last night was probably the best nights sleep I've had in several months!!! He has been sleeping for longer stretches of time. Like Monday night. He fell asleep at 8:30 and slept until 5am, but I was up watching tv until midnight holding him, so that doesn't count. Last night was all night asleep in his crib! Today he has his 4 month check-up. I thought I was going to have to take all three kids with me, something I was not looking forward to since he gets shots today, but my mom offered to come watch the big two. A major life saver. And last night I went running and didn't do too bad. I did walk one block, but that was because our neighbor was out working in her yard when I left and I didn't want to be gasping for breath when I ran by. Yeah, I wanted some dignity! So I'm more optimistic about getting back into shape.

April 22, 2008

Hospital Politics

A few months ago, I talked about how the hospital is going to build a new building and that OB and ICU would be the first dept. in the new building. The current building is just really old, new additions have been added through the years, its confusing how to get from one floor to the next. The old part is just getting to the point where they won't be able to keep it up with codes in a few years. Anyway, we were asked what we would like in a new unit. The OB director, who gets to make the final decision, asked us about LDRP rooms. No one liked the idea. Literally no one. We currently have separate labor and postpartum areas, connected by a hallway. It seems to most of us that it works, as we wouldn't want to be recovering from a c-section and have a woman laboring without an epidural next door, who is next to someone who is holding her stillborn baby. So we all voted no. Well, turns out they really don't care what we want. The plans for the new unit are to be in a triangle, with 2 OR's in the middle and the nursery in the middle, and for all the rooms to be LDRP rooms. The nursery won't be the size we have now, as they really want the babies to stay with the moms. Which is all good with me, but the culture around in this area is to send the baby to the nursery, especially fresh c-sections, for the night and come out for feedings. People will be unhappy with a change like that. We will also handle sicker babies, just not any on vents, or who are really sick. There will be 3 pods, staffed with 1 labor nurse, 1 nursery nurse and 1 postpartum nurse. I'm really unhappy with that. What happens if my labor patient's baby takes a dive? The nursery nurse/postpartum nurse won't be comfortable helping with that, and if another labor nurse comes from her pod, that leaves her patient unattended. What will happen is that everyone will be expected to be able to work all areas, and you can't keep your skills current on 4 areas (ped is also part of our dept., for now). Maybe it won't be that bad, or maybe they'll change the plans, but I doubt that. I just wonder why they even bothered asking us what we wanted when they were going to do what they wanted anyway. I mean, that meeting last year was very long. I could've been doing something else. Yes, I'm being resistant to change, but things work well like they are. If my baby's heading south back in labor, I know that I have competent labor nurses right out at the desk, ready to help. The nurses who do nursery/peds shouldn't have to learn labor, too. It will be a few years before anything happens, so we'll just see how it goes.

April 21, 2008

I feel like a real labor nurse

This weekend I actually felt like the labor nurse I always try to be. I took care of a mom, laboring with her second baby and wanted to go natural. She had a reasonable birthplan that she talked to her doctor about beforehand. With her first, she was induced and ended up with a very dense epidural. She did say that she may change her mind and decide on an epidural, and we talked about when it would be too late. She was my only patient, so I was able to really help her with each contraction. Dad wanted to be involved so I showed him how to do counterpressure and really got him involved in the labor as much as a dad can be. And she was doing quite well. Until she got to 8 cm. That's when people usually start to say "I can't do this". She wanted an epidural, but at that point it was too late. The baby was sitting really low and her cervix was incredibly stretchy. Her doc was already there, and after a couple minutes, her water broke, and the baby was crowning. She pushed twice and had her baby. Then it came time for the stitching of the small tear. Since she was numb last time, she didn't remember the burning from the lidocaine, or feeling the pulling of being stitched up. She nearly came undone, and her doc thought she was actually having a meltdown. Most moms don't pay too much attention to that part when they go no epidural because they just pushed their baby out. She even said afterwards that she wishes she had gotten the epidural and that next time she won't be doing it that way. That was a bit disappointing, because other than the whole stitching, she did really well. After I got her moved out to postpartum, I got another labor patient, a firsttimer who also wanted to deliver without pain meds/epidural. She really wasn't in control and wanted to stay in bed, evn though I encouraged her to reposition, move around, use the ball, etc. She just thought she'd be more uncomfortable if she got up. Pat of me was thinking, "Yeah, you're right, what do I know? I'm only a labor nurse". Finally she decided to try the rocking chair, and she said "You were right, this is so much better than sitting in bed". I don't know if I needed to somehow prove to her I knew what I was doing because after that, she was open to any suggestion I made. Her husband was really supportive, I was able to be there to help her with contractions, and after awhile, her husband was doing all the supporting and she was much more in control with each contraction. She did deliver like she wanted a few hours after I left. All in all, I felt like I was actually able to help encourage my patients to keep going, to believe in themselves, and I even had dads who were really involved. It's nice to see.

April 18, 2008

4 year old insight

Last night, we had an earthquake at about 4:30 a.m. It was several miles away, but the effects were felt for miles. Husband and I woke up to the bed shaking and the windows rattling in this old house. It only lasted about 1 minute, but when you are wondering WTF is going on, it seems like forever. Jacob was the only one of the kids who woke up, and he was screaming. I go in there to comfort him and he says "Someone was shaking my bed". I explain that it was an earthquake. I didn't have a good explanation to what caused the earthquake, but that was okay, because he did. His answer? "One of the spaceships in space didn't watch where they were going and they ran right into Earth. That's why we had an earthquake". And he was quite serious. I just wonder where he comes up with these things!

April 16, 2008

Under quarantine

One thing I worried about after having my first baby was what I would do if I was sick and he was also sick. And as we added number 2 and 3, I thought, man, am I in trouble if all of us are sick at the same time. Well, Monday evening and Tuesday I got to find out what it would be like. Monday afternoon, I woke up and I could tell I had a fever, and my throat was so sore and swollen that I could barely talk. But I had to pick up the kids from daycare, so I took Tylenol and left. I called husband and asked him to make the kids sandwiches for supper because I wasn't going to be feeling up to it (He runs a sandwich shop). So I get the kids loaded up, and as I pull into the parking lot of the restaurant, Jacob vomits all over the back seat of the van. Not what I needed at that point in time. Husband brings out a bucket of water and plenty of wipes, we change Jacob's clothes since we had his school bag, and get the van cleaned up as best we can. I gave Jacob the bucket and told him if he felt sick again, to puke in the bucket. I was praying that it was just a random vomit. Nope. Halfway home, he vomits again. The drive home is basically a straight shot down a highway 12 miles from the restaurant. As I turn to go into town, Jacob spills the bucket of puke. I thought I was going to cry. So, I clean up as best as I can after the getting the kids in the house. At this point, I'm starting to feel worse, and Jacob is laying on the couch. The poor guy ended up vomiting until about 10pm, and started having diarrhea. Clara and Isaiah seemed fine. I did notice the tip of one of Clara's fingers was read and probably infected around the nail cuticle, so I'm going to have to take her to the doc. Isaiah ate at about 8:30 and me, Isaiah and Clara went to bed. Husband stayed up with Jacob until 10, and he carried him up to bed. About this time, I'm freezing cold. I've bundled myself up in 3 huge blankets and I finally realize I'm chilling from fever. I know I shouldn't wrap myself up, but at that point in time I didn't care. I did finally get up for more Tylenol and I decided perhaps I should check my temp, because I felt like death, and it was 102. So I go to bed and manage to sleep a bit, until Clara starts crying. She had vomited in her bed. I get up and have to change her bed, clean her up and find her a puke bucket and while I'm doing this, I'm freezing and sore. I kept thinking that if this was back in the old days, our house would be placed under quarantine! I get back to bed, but never really fall back to sleep for very long. I had forgotten how miserable you get with a fever. Husband had to go to work in the morning, but he came home about 1pm. The one good thing about that night - Isaiah slept through all of it. He slept until 4:30. That part was great! I managed through the morning until nap time. Jacob felt fine when he woke up, but Clara was laid up on the couch vomiting. After Husband got home, he took Isaiah downstairs, and me, Clara and Jacob all took a 4 1/2 hour nap. And we all felt better after waking up, but man did it suck. I'm still crossing my fingers Isaiah doesn't come down with any of what we had. Come on breastmilk, do your thing! We're all fine and healthy now. I don't consider myself to be tough, but after Monday night and Tuesday, I feel a lot tougher and I now know I can handle being sick and taking care of sick kids. I am woman and mother, hear me roar!

April 14, 2008

Routine weekend again

It was another not so bad weekend at work. It would have been better if I wasn't harboring a cold. My throat is on fire, my tonsils are twice as big as usual and my uvula is so swollen it's sitting on the back of my tongue, giving me a constant sensation of almost gagging. It's been great. It really seems like I've had more sickness these past few weeks than ever, just one thing after another. "Sigh". Anyway, had a couple nice deliveries. The first was a second babe for the couple, mom is a nurse, and they came in because she was cramping. She wasn't too active, planned on an epidural eventually. Well, as fate would have it, she started to get active, suddenly dilated very quickly, and she ruptured as she was about to sit up for her epidural. Sitting up for her epidural sealed her fate as the baby started to deliver, before her epidural was in. She had no intentions of doing it without an epidural, but did great. As the baby was crowning, with no doc in sight, she asked who was going to deliver the baby. Um, that would be me. She finally realized this was happening and delivered her baby. She had no faith in herself before, but man she did afterwards. Nothing like a 2 1/2 hour labor! Doc came in right after the baby delivered; the cord hadn't even been cut yet. But, you can't stop real labor. My other delivery was a first baby. I love deliveries in general, but nothing beats a first baby. They were just absolutely thrilled after their baby was born after 20 plus hours of labor.

April 11, 2008

Dumb, duh-dumb dumb DUMB!!

Last night one of the things I have worried about since I started working at the hospital a number of years ago happened. First, I'll backtrack. When I started in critical care, I looked at the schedule and noticed that the grid would be very easy to misread, so I always tried to be careful. Until one day I went into work and found I wasn't scheduled that evening, but I was the next. Embarrassing, yes, but I thought at least it wasn't the other way around. Fast forward to last night. I go into work last night, and another nurse walks in at the same time and asks "Did they just screw up your schedule?" I'm confused and say "No, why?". Apparently I was scheduled to work Wednesday night instead of Thursday. She said the evening charge called and left me a message. I happened to have been up until midnight and never heard the phone ring. I'm still sure they screwed up, so I go in and check the schedule and I wasn't on for last night but was for the night before. Crap, crap and more crap. It ended up that they had flexed the staff too low because they forgot about the nursery, and so I got to stay and work, and the night before they were insanely slow. But I was mortified. I'm not in any trouble because they know I wouldn't just decide "Hey, I don't want to work, so I won't go in". ANd I'm pretty much over it, still a bit embarrassed, but I'll live. I'm surprised they only called once, though. So this a.m when I got home, I checked my calendar and yep, there it was, plain as can be that I was scheduled Wednesday. I'd like to claim insanity due to having 3 kids under the age of 5, but really, I can't. I mean, I am insane, but that doesn't cover this. I just didn't pay close enough attention. Good thing they like me :)

April 10, 2008


I finally had success with one of the infant carriers I have. I was given a front carrier at a baby shower when I was pregnant with Jacob, and I never used it. Jacob hated it so I put it away. I bought a sling right after Isaiah was born, and he hated it, but I was determined. I kept trying the sling and the other carrier. I have given up on the sling but he loved being in the front carrier today. He was happy because he was being held and could see what was going on. I'm happy because I was able to get more housework done. So finally, after 3 1/2 months, we have success!

April 9, 2008

Knowing your labor nurse

After I graduated from college, I only moved about an hour away. And where I live, there is a large company that employs a lot of people I went to school with. So, I end up seeing a lot of people when they come in to have a baby. Most are people that I recognize and then once I see their maiden name, I know who they are, although I might have just remembered them from class and not actually have talked to them in school. My guess is that most don't recognize me, especially since my last name is different. But, it may mean that there are people who recognize me from college that I dont recognize. I wasn't be any means popular, but it was a small private college, I was in a sorority and held office, and was president of a small club on campus. I also see people I did talk to but haven't seen in years. I just wonder how they feel when I come in the room and say "Hi, I'm your nurse tonight". Maybe it's comforting to some to know the nurse because labor is a scary thing. But I tend the think that they think "Great, I went to school with her and now she's going to be looking at my vagina and butt, and oh, what if I crap while pushing, great, just great". Because I would probably be that way. Yeah, when I had my kids I knew the people taking care of me, but I knew that would be the case since I work with them. Most other people don't think about the chance that they might know their labor nurse, because what are the odds? (just for the record, we don't think anything about poop, or seeing your stuff, and I promise we won't be talking about it at the desk) Two of my sorority sisters are expecting this month. With each of them I happened to be working the night they had their first babies, and made sure that I didn't have them as one of my patients because luckily it was an option, but there has been a time or two when I had to take someone I knew as a patient. It does add a bit of stress on my part. I always do my best, but I want to make sure I'm doing my job with people I know because I don't want them to think I suck. And it seems like half the time, I miss the IV, and I'm good at IV's. And it happens to other nurses I work with. Give me a patient who says they're a bad stick, and I see it as a challenge and usually I can get it in when others can't. But give me a person I know who has huge ropes for veins, and the vein blows, or I can't advance it. I do try to avoid taking care of people I know, but I always go in to chat and congratulate them.

Just showing off my munchkins

April 7, 2008

Another weekend

This past weekend at work wasn't too bad. Last night was really slow. Saturday was pretty slow, but kinda sad. We had more babies staying for things like high bilirubins, and a couple grower/feeders. One of the babies was the 31 weeker I took care of a few weeks ago (lates all night, delivered finally after a biophysical profile score of 0/10). The mom was in there and I recognized her, but didn't figure she'd remember me, the nurse who she was upset with for waking her up and messing with her all night. She had said at one time that night something along the lines of "I'm not getting rest and this can't be good for my bloodpressure" She had come in for high blood pressure after taking it at a local store. She asked me Saturday if I worked L&D and if I remembered her. She then said she didn't "get it" that night, but she does now and that she was appreciative of what I did. All I did was my job and what any other nurse would do. But, I tell you, it was nice to hear. Her baby is doing really well. She'll probably get to go home in a couple days. We had another patient who had come in for a tox work-up at 30 weeks who ended up being sent to the high-risk hospital for the same reason as that mom Sunday morning. Her monitor strip actually looked better than the mom I took care of. Her other baby was born at 29 weeks due to high blood pressure and an abruption. So she expected that all would be well with this baby, who scored a 4/10 on its biophysical profile. Unfortunately they don't expect this baby to make it. You never can tell what's going to happen from the monitor. Saturday, my co-worker who found out she was pregnant with twins came in with spotting at 12 weeks, and she lost her babies. They had stopped growing at about 7-8 weeks. Her doc thinks it was twin-twin transfusion, although he said you don't usually see problems with it this early. It's too bad for anyone, but they were so happy because it took them so long to get pregnant with their daughter, and for them to get pregnant so quickly, and with twins. But she said she's glad she at least has a reason to why it happened.

April 4, 2008

"I'm a model, you know what I mean"

"And I do my little turn on the cat walk". Sorry, I got distracted. Nothing too exciting going on here. Just tired of working short-staffed. But, we're in the middle of a nursing shortage so I've come to accept it, not like it, but accept it reluctantly. But it still sucks. This past weekend was bad. I worked 3 12 hour shifts in a row, something I don't like to do, two of those nights I was charge nurse and both of those nights, I ended up taking care of the whole post-partum floor while trying to do charge nurse duties, like finding staff for the next shift. It was a good time. My husband might disagree, but I really don't like being in charge. At least at work anyway. It brings with it a lot of extra stress I don't really need, plus I'd rather take care of labor patients. Plus, it usually ends up that I'm in charge on the nights we're short handed because there isn't a charge nurse and instead of filling my slot as a labor nurse, I get to do double duty. Cuz I'm that good. Ha ha!
I agreed (and my husband agreed) to be in a fashion show for charity this May. The dayshift labor charge nurse asked if I was brave enough to have my whole family involved in this. I talked to husband, and he actually agreed. So in May, all 5 of us will get to strut our stuff down a runway at a country club to raise money for charity. A lot of the docs around town and other nurses are participating. It should be interesting to see if we can get all 3 kids to cooperate! I'm not really very good at posing for pictures, let alone walking a runway. So we'll see how this goes.

April 2, 2008

Milestones and Poop

It's pretty amazing to watch how a baby changes in such a short period of time during the first year. It seems every week, Isaiah is doing something new. He's almost figured out how to flip himself onto his stomach. He gets himself up on a side and gets stuck because he just can't figure out how to get his arm out of the way. He's also able to see a lot farther and will grin at us from across the room. And he's pretty chatty. Hopefully sometime soon he'll hit the sleeping-through-the-night milestone. He has been sleeping better lately. The last 2 nights, he's fallen asleep about 10, wakes up about 2:30am to eat and went back to sleep until about 6:30. So we're getting there.
Lately, Jacob has been acting kinda weird. About 2 weeks ago, he pooped in his pants, something he hasn't done since we took him out of pull-ups. And then I started noticing huge wads of toilet paper in the trash can with poop on it, as well as poop smears on the toilet seat cover. So Friday I washed it. Saturday morning, I noticed his rug in his bedroom. It looked like he pooped on it and smeared it in, and when I woke up that afternoon, there was poop on the toilet seat cover and a bunch of poop-smeared TP. We tried asking him about what he's doing, but he gets embarrassed and won't answer. I can't decide if he's having issues with being able to go, or it he's just having a hard time getting himself clean. Or if maybe its a late set-back because we brought a new baby home. I'm not sure. I'm going to get wipes again to see if that helps and try to push more water. It's just seems weird that all of a sudden he's doing this. And of course, because I'm a nurse, I keep looking for a reason and my mind gets to all the horrible things that I'm sure it's not, but I can't keep from thinking about. Occasionally he'll complain about his belly hurting, but hasn't since all this started. I guess if it continues I'll probably call the peds office to see if any of the nurses there have suggestions.