Dia de San Patricio
Sunday, March 17, 2013
Saturday, March 9, 2013
Two for the Price of One?
The twins have been home a week.
Some people have tried to express the idea that there is a "two for the price of one" deal with twins. And I don't know what they're talking about (and have come to the conclusion that they must not know either).
Surely you can't mean economically: the hospital and our insurance are discussing just how much they're going to pay but the hospital's starting point in the bargaining was $125,000 each! So it can't be in terms of actual monetary price that people are talking about. (Thankfully, our insurance has an out-of-pocket maximum that caps out how much we'll have to pay around the $7,500 range - which we have saved up. Brooke and I both feel that this is one of those little blessings that comes from paying your tithing regularly. And at times like these you discover that the little blessings are actually huge blessings.)
What about in terms of pregnancy difficulty? Well, the first sign that we were having twins was when I joked with Brooke that if her morning sickness was twice as bad, maybe there were twice as many kids. The next week we found out we were having twins and it was funny to see Brooke try to glare at me, smile as wide as she could, and be shell-shocked by the amount our lives had changed in the same instant. Brooke says that the amount of sickness is double, the amount of discomfort is more-than double and the sleep-deprivation during pregnancy is exponential. It's not in terms of stretch-marks either, my "that's no moon" jokes stopped getting courtesy smiles about a month before the twins were born. So it's not in pregnancy effort.
How about delivery? Well, Brooke went into pre-term labor a week before Christmas and stayed in medically-suspended labor until the 19th of January. If Tavian had been head-down, she would have delivered him normally; and if Abbie had then not been head-down, Brooke would then have had to recover from a cesarean section as well. As it is, Brooke does only have one incision scar. (But she made up for that by getting an infection and going back to the hospital for a night.)
Hospital stay? They spent 6-weeks compared to Lizzie's 3 days.
Milk supply? Lactation specialists have Brooke producing nearly a half-gallon per day making for a 9 gallon frozen stockpile.
Diapers? The twins have earned as many Huggies reward points in a week as Lizzie has in the last 2 months.
Laundry? Double the spitting up, blankets, clothes ...
Sleep deprivation? We feed them at the same time and wake the other up if one is hungry to keep them in sync. But Abbie is most alert at 2am-4am and Tav's up at 10am to noon. So if it isn't one it's the other, turning both of us and anyone who has bravely volunteered for a night-shift into a sleep zombie.
My conclusion: anyone who says "Two for the Price of One" is looking for something polite to say but really has no idea what it's like to have twins. I would suggest the Wrigley Doublemint ad "double your pleasure, double your fun."
The doctor who told us we were having twins (and delivered them) immediately followed up the news with "Oh, you guys are going to have so much fun!" His twins now have kids of their own, but he was right. Three of the nurses we saw regularly in the NICU had twins and another was a twin herself; they all agreed that there was a lot of work involved, but there was more than enough fun to make up for it.
There are moments when one is being cute, or the other, and then there are moments when they are being cute together. Normally when one is being a little devil the other is being a perfect angel, and when one is fussy the other will sleep through it. They seem to work together to get you through their own hard times. And all the doctors and nurses agree that the good times only get better once you get past the one-year mark.
We've had a week trying not to die of the cuteness, and we have a lot more to look forward to.
Los gemelos han estado en casa por una semana.
Algunas personas han tratado de expresar la idea de que gemelos vienen "dos por el precio de uno". No sé de qué hablan (y he llegado a la conclusión de que no saben ellos tampoco).
Seguramente no pueden hablar del precio económico: el hospital y nuestro seguro están hablando de cuánto van a pagar, ¡pero el primer precio del hospital fue US$125,000 (MX$1,580,000) cada quien! Por lo tanto, no puede ser el valor monetario de que están hablando. (Afortunadamente, nuestro seguro tiene un máximo de gastos que tapa a las US$ 7.500 - que hemos ya ahorrado. Brooke y yo sentimos que esta es una de esas pequeñas bendiciones que vienen de pagar su diezmo regularmente. Y en momentos como estos descubres que las pequeñas bendiciones son en realidad bendiciones enormes.)
¿Y en cuanto a la dificultad del embarazo? Bueno, la primera señal de que íbamos a tener gemelos era cuando yo bromeaba con Brooke que si su enfermedad de la mañana era el doble de lo malo, a lo mejor había el doble la cantidad de niños. A la semana siguiente nos enteramos de que íbamos a tener gemelos y era divertido ver a Brooke tratar de mirar a mí, hacer la sonrisa tan ancha como pudo, y estar conmocionado por la grandeza del cambiado en nuestras vidas en ese instante. Brooke dice que la enfermedad es doble, el malestar es más del doble - y la falta de sueño durante el embarazo es exponencial. No es en términos de marcas del piel, mi "esa no es una luna" bromeas dejaron de recibir sonrisas de cortesía casi un mes antes de que los gemelos nacieron. Así que no es posible que hablan de la dificultad de embarazo.
¿Qué tal el nacimiento? Bueno, Brooke entró en trabajo de parto prematuro a la semana antes de Navidad y salió del laborío médico-suspendido en el 19 de enero. Si Tavian había estado cabeza hacia abajo, podrían nacer normalmente, y Abbie había estado cabeza arriba, Brooke entonces habría tenido que recuperarse de una cesárea también. Como salieron las cosas, Brooke tiene sólo una cicatriz de la incisión. (Pero ella compensaba por eso por contraer una infección y volver al hospital por una noche.)
Estancia hospitalaria? Pasaron seis semanas en comparación a los 3 días de Lizzie.
Producción de leche? Los especialistas en lactancia han ayudado a Brooke a producir casi un medio galón por día y ahora tenemos un arsenal congelado de 9 galones.
Pañales? Los gemelos han ganado tantos puntos de recompensa Huggies en una semana como Lizzie ha hecho en los últimos 2 meses.
Servicio de lavandería? El doble de escupir para arriba, mantas, ropa ...
La privación del sueño? Les damos de comer al mismo tiempo y despertamos al otro si uno tiene hambre para mantenerlos sincronizados. Pero Abbie está más alerta a las 02 a.m.-04 a.m. y Tav a las 10am hasta el mediodía. Así que si no es uno es el otro, volviendo a nosotros y a cualquiera que se haya ofreció valientemente para un turno de noche a zombis de sueño.
Mi conclusión: el que dice "Dos por el precio de uno" está buscando algo cortés de decir, pero realmente no tiene idea de lo que es tener gemelos. Yo sugeriría que el Wrigley Doublemint anuncio "doble el placer, doble la diversión."
El médico que nos dijo que íbamos a tener gemelos (y los entregó) siguió inmediatamente la noticia con "Ay, ¡ustedes se van a divertir mucho!" Sus gemelos ahora tienen sus propios hijos, pero él tenía razón. Tres de las enfermeras que vimos regularmente en la UCIN tenían gemelos y otra era un gemelo sí misma. Todos están de acuerdo que si hay mucho trabajo, pero hay más que suficiente diversión.
Hay momentos en que uno está siendo lindo, o el otro, y hay momentos en los que son lindos juntos. Normalmente, cuando uno está siendo un pequeño diablo la otra se pone un ángel perfecto. Parece que trabajan juntos para llevarnos a través de sus propios tiempos difíciles. Y todos los médicos y enfermeras están de acuerdo en que los buenos tiempos sólo mejoran cuando pasas la marca de un año.
Hemos tenido una semana tratando de no morir de la monería, y esperamos tener muchas más.
Some people have tried to express the idea that there is a "two for the price of one" deal with twins. And I don't know what they're talking about (and have come to the conclusion that they must not know either).
Surely you can't mean economically: the hospital and our insurance are discussing just how much they're going to pay but the hospital's starting point in the bargaining was $125,000 each! So it can't be in terms of actual monetary price that people are talking about. (Thankfully, our insurance has an out-of-pocket maximum that caps out how much we'll have to pay around the $7,500 range - which we have saved up. Brooke and I both feel that this is one of those little blessings that comes from paying your tithing regularly. And at times like these you discover that the little blessings are actually huge blessings.)
What about in terms of pregnancy difficulty? Well, the first sign that we were having twins was when I joked with Brooke that if her morning sickness was twice as bad, maybe there were twice as many kids. The next week we found out we were having twins and it was funny to see Brooke try to glare at me, smile as wide as she could, and be shell-shocked by the amount our lives had changed in the same instant. Brooke says that the amount of sickness is double, the amount of discomfort is more-than double and the sleep-deprivation during pregnancy is exponential. It's not in terms of stretch-marks either, my "that's no moon" jokes stopped getting courtesy smiles about a month before the twins were born. So it's not in pregnancy effort.
How about delivery? Well, Brooke went into pre-term labor a week before Christmas and stayed in medically-suspended labor until the 19th of January. If Tavian had been head-down, she would have delivered him normally; and if Abbie had then not been head-down, Brooke would then have had to recover from a cesarean section as well. As it is, Brooke does only have one incision scar. (But she made up for that by getting an infection and going back to the hospital for a night.)
Hospital stay? They spent 6-weeks compared to Lizzie's 3 days.
Milk supply? Lactation specialists have Brooke producing nearly a half-gallon per day making for a 9 gallon frozen stockpile.
Diapers? The twins have earned as many Huggies reward points in a week as Lizzie has in the last 2 months.
Laundry? Double the spitting up, blankets, clothes ...
Sleep deprivation? We feed them at the same time and wake the other up if one is hungry to keep them in sync. But Abbie is most alert at 2am-4am and Tav's up at 10am to noon. So if it isn't one it's the other, turning both of us and anyone who has bravely volunteered for a night-shift into a sleep zombie.
My conclusion: anyone who says "Two for the Price of One" is looking for something polite to say but really has no idea what it's like to have twins. I would suggest the Wrigley Doublemint ad "double your pleasure, double your fun."
The doctor who told us we were having twins (and delivered them) immediately followed up the news with "Oh, you guys are going to have so much fun!" His twins now have kids of their own, but he was right. Three of the nurses we saw regularly in the NICU had twins and another was a twin herself; they all agreed that there was a lot of work involved, but there was more than enough fun to make up for it.
There are moments when one is being cute, or the other, and then there are moments when they are being cute together. Normally when one is being a little devil the other is being a perfect angel, and when one is fussy the other will sleep through it. They seem to work together to get you through their own hard times. And all the doctors and nurses agree that the good times only get better once you get past the one-year mark.
We've had a week trying not to die of the cuteness, and we have a lot more to look forward to.
Los gemelos han estado en casa por una semana.
Algunas personas han tratado de expresar la idea de que gemelos vienen "dos por el precio de uno". No sé de qué hablan (y he llegado a la conclusión de que no saben ellos tampoco).
Seguramente no pueden hablar del precio económico: el hospital y nuestro seguro están hablando de cuánto van a pagar, ¡pero el primer precio del hospital fue US$125,000 (MX$1,580,000) cada quien! Por lo tanto, no puede ser el valor monetario de que están hablando. (Afortunadamente, nuestro seguro tiene un máximo de gastos que tapa a las US$ 7.500 - que hemos ya ahorrado. Brooke y yo sentimos que esta es una de esas pequeñas bendiciones que vienen de pagar su diezmo regularmente. Y en momentos como estos descubres que las pequeñas bendiciones son en realidad bendiciones enormes.)
¿Y en cuanto a la dificultad del embarazo? Bueno, la primera señal de que íbamos a tener gemelos era cuando yo bromeaba con Brooke que si su enfermedad de la mañana era el doble de lo malo, a lo mejor había el doble la cantidad de niños. A la semana siguiente nos enteramos de que íbamos a tener gemelos y era divertido ver a Brooke tratar de mirar a mí, hacer la sonrisa tan ancha como pudo, y estar conmocionado por la grandeza del cambiado en nuestras vidas en ese instante. Brooke dice que la enfermedad es doble, el malestar es más del doble - y la falta de sueño durante el embarazo es exponencial. No es en términos de marcas del piel, mi "esa no es una luna" bromeas dejaron de recibir sonrisas de cortesía casi un mes antes de que los gemelos nacieron. Así que no es posible que hablan de la dificultad de embarazo.
¿Qué tal el nacimiento? Bueno, Brooke entró en trabajo de parto prematuro a la semana antes de Navidad y salió del laborío médico-suspendido en el 19 de enero. Si Tavian había estado cabeza hacia abajo, podrían nacer normalmente, y Abbie había estado cabeza arriba, Brooke entonces habría tenido que recuperarse de una cesárea también. Como salieron las cosas, Brooke tiene sólo una cicatriz de la incisión. (Pero ella compensaba por eso por contraer una infección y volver al hospital por una noche.)
Estancia hospitalaria? Pasaron seis semanas en comparación a los 3 días de Lizzie.
Producción de leche? Los especialistas en lactancia han ayudado a Brooke a producir casi un medio galón por día y ahora tenemos un arsenal congelado de 9 galones.
Pañales? Los gemelos han ganado tantos puntos de recompensa Huggies en una semana como Lizzie ha hecho en los últimos 2 meses.
Servicio de lavandería? El doble de escupir para arriba, mantas, ropa ...
La privación del sueño? Les damos de comer al mismo tiempo y despertamos al otro si uno tiene hambre para mantenerlos sincronizados. Pero Abbie está más alerta a las 02 a.m.-04 a.m. y Tav a las 10am hasta el mediodía. Así que si no es uno es el otro, volviendo a nosotros y a cualquiera que se haya ofreció valientemente para un turno de noche a zombis de sueño.
Mi conclusión: el que dice "Dos por el precio de uno" está buscando algo cortés de decir, pero realmente no tiene idea de lo que es tener gemelos. Yo sugeriría que el Wrigley Doublemint anuncio "doble el placer, doble la diversión."
El médico que nos dijo que íbamos a tener gemelos (y los entregó) siguió inmediatamente la noticia con "Ay, ¡ustedes se van a divertir mucho!" Sus gemelos ahora tienen sus propios hijos, pero él tenía razón. Tres de las enfermeras que vimos regularmente en la UCIN tenían gemelos y otra era un gemelo sí misma. Todos están de acuerdo que si hay mucho trabajo, pero hay más que suficiente diversión.
Hay momentos en que uno está siendo lindo, o el otro, y hay momentos en los que son lindos juntos. Normalmente, cuando uno está siendo un pequeño diablo la otra se pone un ángel perfecto. Parece que trabajan juntos para llevarnos a través de sus propios tiempos difíciles. Y todos los médicos y enfermeras están de acuerdo en que los buenos tiempos sólo mejoran cuando pasas la marca de un año.
Hemos tenido una semana tratando de no morir de la monería, y esperamos tener muchas más.
Sunday, March 3, 2013
Twins are Home
The twins have come home from the hospital. We now get to begin feeling like a family.
Thank you again to all of those who prayed for us, who made meals for us, shoveled our sidewalks in a foot of snow, or watched Lizzie for us.
Due to the flu bug they already have, we ask that for this first week or two only family come to visit. But we would be happy to have video chats via gchat or skype with any friends who would like to.
Thank you again to all of those who prayed for us, who made meals for us, shoveled our sidewalks in a foot of snow, or watched Lizzie for us.
Due to the flu bug they already have, we ask that for this first week or two only family come to visit. But we would be happy to have video chats via gchat or skype with any friends who would like to.
Los gemelos
han llegado a casa desde el hospital. Ahora podemos empezar a sentir como una
familia.
Gracias de
nuevo a todos los que oraron por nosotros, que hicieron comidas, que limpiaron
la nieve de alrededor de la casa cuando cayó un pie de nieve, o guardaron a
Lizzie para nosotros.
Debido a la
influenza que ya tienen, les pedimos que para la primera semana o dos sólo vienen familia a visitar. Pero estaríamos
felices de tener chats de vídeo a través de Gchat o skype con amigos a quienes
les gustaría.
Saturday, March 2, 2013
Progress
The twins are progressing. They caught the flu this week, but it isn't RSV and it hasn't slowed them down at all when it comes to eating.
The doctors are feeling pretty good about their progress so much so that they're willing to start guessing when they'll be home. The current guess is Monday.
In preparation for that, today they had their car-seat test. They have to sit in their car-seats for more than 90 minutes and not let their blood-oxygen levels drop. Apparently it takes muscle groups to maintain your airway when slouched like that and some newborns aren't up to the effort. But these two passed with flying colors.
Brooke tells me Abbie was stroking her blanket and looking around at the world from her new point of view. It seems she liked it.
Los gemelos están progresando. Tienen la influenza que tiene la familia, pero no es el tipo bien dañoso y no les ha impedido en el progreso con su comida.
Los doctores están pensando el lunes será el día que saldrán del hospital.
En preparación por ese día, hoy tuvieron su prueba de las sillas. Tienen que sentarse en sus sillas por 90 minutos sin bajar sus niveles de oxygeno en su sangre. Necesitas usar músculos de la garganta para mantener el el aire a sus pulmones cuando estás sentado así. Los gemelos pasaron sus pruebas bien.
Brooke me dice que a Abbie le gusta explorar su mundo de este nuevo punto de vista.
The doctors are feeling pretty good about their progress so much so that they're willing to start guessing when they'll be home. The current guess is Monday.
In preparation for that, today they had their car-seat test. They have to sit in their car-seats for more than 90 minutes and not let their blood-oxygen levels drop. Apparently it takes muscle groups to maintain your airway when slouched like that and some newborns aren't up to the effort. But these two passed with flying colors.
Brooke tells me Abbie was stroking her blanket and looking around at the world from her new point of view. It seems she liked it.
Los gemelos están progresando. Tienen la influenza que tiene la familia, pero no es el tipo bien dañoso y no les ha impedido en el progreso con su comida.
Los doctores están pensando el lunes será el día que saldrán del hospital.
En preparación por ese día, hoy tuvieron su prueba de las sillas. Tienen que sentarse en sus sillas por 90 minutos sin bajar sus niveles de oxygeno en su sangre. Necesitas usar músculos de la garganta para mantener el el aire a sus pulmones cuando estás sentado así. Los gemelos pasaron sus pruebas bien.
Brooke me dice que a Abbie le gusta explorar su mundo de este nuevo punto de vista.
Saturday, February 23, 2013
Twin Update: One Month in Hospital
I spent three hours trying to write a detailed post of how we're all doing. It was pages long and it wasn't very positive. I realized that if I didn't want to read all of that, then why am I writing it? So, here's new and condensed version:
(A friend of mine asked me this week why we don't post new photos. I assure you these are new photos, they're just in the same place. still.)
The first set are with my sister-in-law's camera, so much higher quality if you click on them.
- Lizzie is so sick she can't sing a tune. If she tries to pull her usual 2-year-old 'cry if I don't get my way' stunt, then she quickly finds herself short on both the expected sympathy and drowning in snot. Thank you to my friend Dave for lending us his collection of 70 kids movies.
- I've been sick this week, meaning even less sympathy and even less tolerance for crying.
- Brooke is trying not to get sick, and so far succeeding.
- The twins are still in hospital. I could get into details but really what you want to know is:
- Yes, they're still there.
- No, there's been no real progress for the last two weeks.
- No, the doctors don't have clue when they'll be home. But they have ruled out eating problems, breathing problems and neurological conditions.
(A friend of mine asked me this week why we don't post new photos. I assure you these are new photos, they're just in the same place. still.)
The first set are with my sister-in-law's camera, so much higher quality if you click on them.
This next set shows the awesome stuff the nurses did for their one-month birthday.
And finally, last night when we managed to catch some photos of them awake.
Pasé tres horas intentando escribir un relato detallado de como estamos. Fue muy largo y no muy positivo. Me di cuenta que si ni yo quise leer todo eso, entonces ¿porque lo escribo? Así que, aquí está la versión nueva y compacta:
- Lizzie está tan enferma que no puede cantar. Si ella intenta llorar porque tiene dos años y no le estamos haciendo caso, rápidamente descubre que no hay mucha compasión y está ahogando en flema. Gracias a mi amigo Dave quien nos presto 70 películas para niños.
- También he estado enfermo este semana. He encontrado menos compasión y aun menos tolerancia por llorar.
- Brooke se esfuerza por no enfermarse. Hasta ahora, va bien.
- Los gemelos siguen en hospital. Yo podría dar detalles, pero realmente lo que ustedes quieren saber es:
- Si, siguen en hospital.
- No, no hemos visto ningún progreso por los últimas dos semanas.
- No, los doctores no saben cuando saldrán. Pero ahora saben que no tienen problemas digestivas, respiratorias ni neurológicos.
Entonces, las fotos - la razón real por leer este blog.
(Una amiga me preguntó ¿por qué no ponemos fotos nuevas? Mi respuesta es que si son fotos nuevas, los gemelos simplemente sigan en hospital.
El primer grupo de fotos sacamos con la camera de mi cuñada, así que son de más alta calidad.
El segundo grupo son de las cosas lindas que hicieron las enfermeras por cumplir su primer mes en el hospital.
Y finalmente, anoche cuando logramos sacar algunas con los gemelos despiertos.
Sunday, February 17, 2013
Twin Update: Rinse and Repeat
You would think that since it's been nearly a month with no twin updates, we must have our hands full with the twins and be horribly sleep deprived.
The truth is that no. We're caught in a weird Star Trek TNG plot where time seems to repeat itself daily without noticeable progress. Every morning, Brooke goes to the hospital at 7am and tries to get the twins to eat - and every morning they're too sleepy to make any substantial progress. The doctors scratch their heads, predict that this weekend will be the one where they take off (like the last 3) and assure us that they'll be home in no time. Brooke pumps all day and freezes the excess milk that she doesn't take back to the hospital for the twins' feeding tubes. Then at 7pm, we find babysitters to watch Lizzie while we go try to feed the sleepy twins again.
We've now been in this time loop for a month. We try to keep our spirits up, and the doctors keep assuring us that at least they're stable, they're not going to die - they're just also not going to survive outside that environment yet.
Well today is different, we're going to try letting them get real hungry for a change. Let's see if that puts a little motivation into their sleepy heads.
Thanks again to all the family and friends who make this routine possible, and hopefully we'll break free of the loop soon.
Ok, monologue done. Now cute baby pictures taken from the few times we can get them to wake up:
The truth is that no. We're caught in a weird Star Trek TNG plot where time seems to repeat itself daily without noticeable progress. Every morning, Brooke goes to the hospital at 7am and tries to get the twins to eat - and every morning they're too sleepy to make any substantial progress. The doctors scratch their heads, predict that this weekend will be the one where they take off (like the last 3) and assure us that they'll be home in no time. Brooke pumps all day and freezes the excess milk that she doesn't take back to the hospital for the twins' feeding tubes. Then at 7pm, we find babysitters to watch Lizzie while we go try to feed the sleepy twins again.
We've now been in this time loop for a month. We try to keep our spirits up, and the doctors keep assuring us that at least they're stable, they're not going to die - they're just also not going to survive outside that environment yet.
Well today is different, we're going to try letting them get real hungry for a change. Let's see if that puts a little motivation into their sleepy heads.
Thanks again to all the family and friends who make this routine possible, and hopefully we'll break free of the loop soon.
Ok, monologue done. Now cute baby pictures taken from the few times we can get them to wake up:
Pensarías
que ya cuando ha sido casi un mes sin noticias en nuestro blog, debemos tener
nuestras manos llenas con los gemelos y estar bien cansados.
Pero la
verdad es que no. Estamos atrapados en un episodio de Star Trek donde el tiempo
parece repetirse todos los idas sin progreso notable. Cada mañana, Brooke va al
hospital as las 7 y trata dar a los gemelos ganas de comer - y todas las
mañanas están tan cansados que no comen. Los médicos se rascan la cabeza, predicen
que este fin de semana será aquel en que se mejoran (como los últimos 3) y nos
aseguran que estarán en casa pronto. Toda la leche que no llevamos al hospital
congelamos y regresamos al hospital a las 7 de la tarde para repetir.
Ya hemos
estado en este lazo temporal por un mes. Nos esforzamos por mantener el ánimo y
los medios nos aseguran que por lo menos están estables: no van a morir, pero tampoco
pueden sobrevivir fuera del hospital ahorita.
Pues bien,
hoy es diferente: hoy vamos a dejar de alimentarlos tanto - a ver si el hambre
les da ánimo por aprender. Gracias otra vez a todos los que nos auydan a mantener este situacion dificil.
Bueno,
ahora que he hecho mi monólogo, aquí están algunas fotos de los gemelos en los
mementos cuando están despiertos.
Saturday, February 2, 2013
Back In & Back Out of Hospital
Brooke surprised us both by passing a clot the size of a baseball. When she passed 3 more golf-ball sized ones, we rushed to the ER.
It's a good job we did, about 15 minutes after arriving, her lips turned blue and her blood pressure dropped to 64/45. Suffice to say she was re-admitted to hospital.
After two transfusions, an overnight stay with free meals, and some medication, they sent her home.
Tomorrow the twins are ready to begin nutritive feeding - if they do well, they'll get more meals they have to eat on their own strength. That will keep up until they get to come home.
Thanks again to all our helpers, inside and outside of the hospital.
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