Sunday, March 28, 2010

Latest Crochet

Lately I have made several frogs, a doggie, a pig (not pictured here), another cat, two fish, and a work-in-progress princess. Enjoy my latest creations--when in Victoria Sara and I went to Knotty By Nature, the most fabulous wool shop EVER (check out their blog and website ! I wish we lived closer!). They had this chunky blue verigated artisan wool that I bought to make some aquatic animals and I LOVE IT!!! It is much quicker to make toys with a wool this chunky, and they look all homemade and fuzzy and artisanesque! I've also recently gotten into the whole safety eyes thing...I used to think--yeah RIGHT! How can round glass eyes be safe on a baby toy??? But in fact these are built like a bolt, with a washer on the back that won't come off with any amount of manipulation after it is in place (you have to be darn sure where you want the eye before putting the washer on!). So, I'm finally convinced they are safe and have started using them sometimes. Enjoy! I'm getting better at these! Maybe someday I'll start selling them...















As you can see, the princess really is a work in progress! She is as yet bald. I am currently working on her hair strands, which I plunked on her head for the photo--don't worry, they won't look like that in the end!

Friday, March 26, 2010

The Van

Brent fixed the internet on our photo computer, so you get PHOTOS!!!!!!!!!! Hurrah! Next few posts I will have to pepper you with pictures to make up for the months' long dry text post trend...

First, here is our new van:




So dorky, I know. But I think I'm actually pretty sold on the Grand Caravan--it may be dorky but it sure is practical! The older boys can do up and undo their own seatbelts, no one FIGHTS anymore because they have so much space between them, and the rear seat has a 60/40 split with stow and go seats, so we flip down the 40 and put the dog's bed there, and there is still room behind the 60 for luggage for five people. Seriously! The trunk in the GC is two feet larger than the trunk in a normal van.
David Suzuki says that to make an environmentally friendly vehicle choice, to drive a vehicle that is appropriate for the size of your family. The GC is certainly no Matrix when it comes to fuel efficiency, but it is definitely appropriate for the current size of our family. We rarely drive it empty, and almost never drive it to work unless we're both working and one of us needs to pick up the kids at grandma's. That's rare. Once every three or four months? So, just around town with the kids, and road trips. We have a nice, small, reliable, 1996 standard Toyota Corolla for commuting. It is very fuel efficient.

So, that's the van! I love it and I disdain it at the same time. People can stereotype me now, as a run of the mill middle class mom with kids. BOring. I guess I just have to buy some purple hats or something to shake things up a bit! And who cares what other people think anyways, right?

:)

Anyone want to buy a Matrix? It's for sale!!

Thursday, March 25, 2010

Busy Night Shift [gory work stories]

I seem to have nothing but busy night shifts lately. Since Christmas I have not worked a night shift where I slept a significant amount of time (more than an hour), which was unusual in the past. Last night was not just busy, but BUSY--the type of shift where we have to carve out time between calls (as in, make people WAIT if it's not life threatening) to eat and pee.
We did one call at the mall, where when we arrived I FORGOT to bring inside (a) my stethescope, (b) my form for paperwork, and (c) THE BED in the ambulance. Of COURSE this was a call requiring ALS so I look like a retard and I smell like one too, in front of ALS.

Gurk.

Fortunately my partner laughed, instead of getting mad at me. [sheepish]. The reason I got thrown so far off course was because I was STARVING and right before that call I had spent $6 on a Triple Os veggie burger so as we are arriving, I'm stuffing my face with veggie burger and Triple O Sauce, WHILE DRIVING CODE 3. I'm a safe driver, I swear! :P Shoving the last three bites in at once made me a few steps behind my partner so I got distracted by trying to keep up. Therefore: Gong Show. Here I am, to save your life, with all my equipment in the car. Could you just walk out there for me? I know you're dying and all, but could you help a girl out?


Later there was a huge car crash in the next town over, which required all their ambulances and a helicopter, so we got pulled over there to fill in the gaps and so that was busy, too. One ambulance in a big town=Ass Wuppin.
Later yet we did a pedestrian struck, 16 years old, barely recognizable as human, but still alive. It is remarkable how much blood one body CAN produce, if you add some blunt force trauma, vomit, rain, guts, dirt. And it is remarkable how much suffering we can endure when we are forced to. And thank heaven for sedation. I don't *think* he will survive, but brain injuries are unpredictable, he's young, stranger things have happened, and he was still alive when we took him to the trauma center after stablization at the emergency department closest to where it happened.


I should also mention that I always change identifying information regarding calls I post about, so that peoples' confidentiality is protected. Sometimes I even change around injuries; like broken arm instead of broken leg. I try not to mention the city so that there is less of a chance of 2+2=that lady down the street type of thing happening. You all know I work in Chilliwack, but we often get called to surrounding towns and I've travelled as far as Whistler and have heard of calls to Kamloops, Keremios, Nanaimo, and other far off destinations being performed by Chilliwack crews. So you know.


And dudes, what is WITH elderly people calling an ambulance in the middle of the night for constipation?! CONSTIPATION. Somehow, it always happens to be 4:30 in the morning when things become unbearable. When everyone else is sleeping.


There is this newspaper clipping from The Province Newspaper that I have seen tacked up on nearly every station's bulletin board which shows a small photo of a paramedic in Vancouver sitting on the rear bumper of the ambulance, with his head in his hands. This photo was taken just after an accident in which a two year old girl was hit by a dump truck and killed, and was reportedly very traumatically injured. Any call with children, massive deformity, intent to harm, or abject suffering tend to significantly impact emergency crews, and come back in dreams for years afterwards. Beneath this photo was a letter to the editor which states something to the effect of, "Gordon Campbell, give these paramedics what they are asking for. They see too much. Their work is too valuable. Pay them more."
This is as political as I'm going to get in this space, because obviously I'm not looking for a platform to soapbox about CUPE 873 and everything. But I gotta tell you, when I see 16 year olds with their brains on the pavement in the dark and in the rain, I know I am underpaid for what I do. Not all paramedics in BC are underpaid, but a great number are. I get $10/hour standby when not on a call, and $23/hour when on a call. I have to arrange child care, put on my uniform, drive to work, be away from my family, be unavailable to work any OTHER job, and be ready to deal with anything from emergency childbirth to people burning alive to suicidal individuals to industrial accidents to hiking up mountains with Search and Rescue to rescue injured hikers to sudden deaths to asthma to heart attacks to car accidents to...


I think I've told you about an ALS paramedic I know whose career ended after 20 years because of one call. He was called to the waterfront where a family had parked their car on a pier while they were fishing. Four kids and two adults were in the vehicle eating lunch when the vehicle rolled off the pier into the water and they all drowned. This ALS guy was the ONLY Paramedic with his level of training on scene, which made him intellectually ultimately responsible for every patient there. He had the same nightmare so often he developed insomnia because he was so anxious about experiencing the dream again: He's alone in the back of an ambulance, someone opens the side door and tosses in a drowned child and says, "You have to save him!" and then slams the door shut again. He tries to get up to assess the patient, but an invisible belt keeps him tied to his seat. The door opens again, and another drowned child is thrown in. Again he can't get up. This repeats itself until the ambulance is stacked to the ceiling with dead bodies, and he wakes up sweating and yelling and crying and he never worked another day after that experience.

Another paramedic I know was driving Code 3 through a red light. He saw the intersection was clear, advanced, and a twenty four year old driver turned left in front of him, and the ambulance slammed into the driver's side of his car, killing him instantly. ICBC and the RCMP investigated and found the driver of the car entirely at fault, and the paramedic entirely not at fault, but BC Ambulance still disciplined him for some driving policy misdemeanor. He quit. Between nightmares about the death of that man as he impacted with his ambulance, and unfounded accusations of unsafe driving by management, he couldn't do it anymore.

Another two paramedics I know attended a vehicle fire that had a man inside, still conscious, trapped and burning to death. They still have dreams.

Another paramedic I know has seen six pedestrians struck by trains. One was dismembered and in pieces on the tracks, and the entire inside of his skull was visible when they picked him up to put in the body bag, because it was empty of brain matter. Just a hole, and some shiny bones.

I have dreams, sometimes. Newborns with flesh eating disease and a drowned 16 month old, and I dream about fire.


Can you pay someone $10 an hour to carry all that around?

Tuesday, March 23, 2010

Peevy post

You know what makes me mad? I mean, not really very seriously mad, just peeved and maybe a bit irritated which may SOMETIMES show on my face, a little bit, maybe. I try to be non transparent with my facial expressions, but it doesn't come naturally for me.

So here is a short list;

-Couples who grocery shop together. Like, WTF? WHY does it take two adults to buy food? I'm talking kidless couples. It is handy to have an extra pair of hands around if you are in the store with a gaggle of kids. But it actually re-heeeeee-ally irritates me to watch couples grocery shop together. They always walk SLOW, take up the whole aisle, and are clueless of any attempts to pass. But the thing that peeves me most about these Grocery Couples is that they bicker. Bicker, bicker, bicker. Are you sure we need this? You forgot to get that. And the all time most annoying, 'Do you think we should get [insert random item here]?' Indecisiveness in grocery stores is fatally annoying (in others). So is clulessness.
[pardon my peevishness for anyone who likes to shop with their significant other]

-Clueless shoppers. This was mentioned in my previous bullet, as you may have noticed! :p This includes middle of the aisle buggy pushing space hogs, zig zagging wanderers, people who turn carts without shoulder checking, people who BACK UP without looking behind them, and--my personal favorite--people who randomly STOP in such a way that you can't get past them. Why do they do this? Because they are clueless to the fact that you are behind them, or that they are taking up the whole aisle, and it SLOWS ME DOWN.
[is my hatred of grocery shopping showing? I should really hide that better]

-Interparental phonyness. I know, I know, how much time do we really have to get beyond the small talk with the other parents in our kids' classes? But do we really have to be so FAKE? Blech.

-People who drive their vehicles so they are tailgating the ambulance I am driving while I'm am travelling at a high rate of speed with the lights and sirens ON. SO DANGEROUS. I have called the police on more than one occasion to report these instances. Jerks.

-People driving in the slow lane of the freeway who don't move over while you are merging, even if the right lane is CLEAR.

-The fact that Costco doesn't open until ten. TEN. That is MIDDAY through my day, people! Sheesha.

-When on a rare date alone with my husband, we get seated next to a bunch of tables with little kids. It's not usually all that disruptive, it's just that I want to get away, you know? Those little people are everywhere--it seems we're in danger of them taking over the world!

And that is all. Sorry to be peevy, I feel much better now that I've unloaded that off my chest. I will post more newsy updates soon.

:)

Sunday, March 21, 2010

Another absence

Again, sorry for the infrequent posts. I keep thinking of a gagillion things I want to post about, but early in the week I didn't have the time and later in the week our internet is down. So, unfortunately, NO MEL FOR YOU!!!!
[a Seinfeld reference, for those of you a bit on the young side...]
We had a overnight date this weekend, a full thirty six hours away from my nursling...I think I took it harder than he did, as I cried when he cheerfully left with his grandparents, and I had a nightmare last night that he was abandoned in a train station, while he slept like a log, only waking once for about ten minutes and settling again quickly. He WAS mighty glad to see me, and was pumping both fists as fast as he could with the baby sign for "Milk." Do you want milkies? He nods his head so fast it is in danger of nodding off his neck. Funny boy.

We stayed at a hotel on Granville Street in downtown Vancouver, and had a GC for the hotel restaurant (the hotel stay was a gift from Brent's parents at Christmas). We shopped, saw a show (SO GOOD IT BLEW MY MIND! I'll try to remember to post a review later, with links to the company), ate GOOD FOOD, and spent some quality time together. It rocked.

Dinner's ready so I have to go...
I will post again as soon as I can!
xo

Thursday, March 18, 2010

Wednesday, March 17, 2010

BUSY

Hey, bloggy friends!! I'm sorry I've been negligent of my blog this week--hopefully you haven't given up on me altogether! :) I have a PUH-ILE of homework to get to, but I just wanted to quickly bullet post because I just feel like I miss you all....

-we went to Victoria last week for four days to stay with my cousin Sara and her husband Leigh and their two kids--their youngest is Ryen, the baby you were all praying for last fall with the lump on his neck. In the end, that lump was removed surgically and was determined not to be cancer, but rather the result of an infection. What the infection was, was never discovered despite repeated testing. A medical mystery. I wonder if he'll make it to TLC's Medical Mysteries???
We had a blast. It was a zoo. I saw my sister also. I want to move to VICTORIA! It is the best city EVER!

-We bought a mini van, as indicated in my last post. It is white, boring, conventional, and very practical. It is a Dodge Grand Caravan with stow and go seats and a good 14 inches of trunk space, 60/40 bench seat in the back (we lay down the forty for Simon's bed, left the sixty for Ayden's booster and paraphernalia, and still had enough trunk space for luggage for five people), and the usual air conditioning/keyless entry/power everything. Unfortunately, no privacy glass between the front and rear, with soundproofing. When someone figures THAT one out, mini vans will be a HOT COMMODITY for all who have kids. Trust me.

-my third doula client had her baby this week. Via cesarean. Baby is teensy, and adorable, and eats well with very little fuss. Her mom is recovering with no complications, and is remarkably patient, calm, and persistent in learning the breastfeeding dance and teaching her baby to latch well. I'm quite proud of both of them, and excited for their family!!! Their baby is SO CUTE! I crocheted her a little pig, but forgot to take a picture before I gave it to her. If I remember, I'll bring my camera the next time I visit and I'll record the little piggy to share with you. You know, whenever I get my other computer back and can finally upload photos again.
On the flip side this situation has unrooted some really deep emotions in me. The situation is so similar to Ayden's birth that it is really hard for me to watch without feeling some profoundly negative stuff. Which is interesting, because I don't consider my cesarean to have been traumatic or negative for me. I think it is more that although I don't feel negatively in general, if I were in the same situation in the future I would SOOOO do things differently. And I wish I had had a doula back then to encourage me in a more physiological direction. Well, my mom tried but I was having NONE of her advice--not because I thought it was poor advice, but because I couldn't handle it. Anyways, interesting.

-I walked 6.75 Km today, AND did an hour of boot camp. Why do I still have a jiggly stomach? Seriously, with all this activity I should be friggin skinny.

-I did a clinical observation day at RCH NICU on Monday. I have a bajillion things I want to say about THAT experience, but I'll have to save that for later because I don't have a bajillion minutes right now.

-I made the most fantastic supper tonight. Like, seriously. Oh, I'm so good. And I made it all up out of my head:

Salmon fillets topped with a small amount of butter, soft white goat cheese slices, chopped green onion, lemon slices, white onion rings (chunky) and red peppers (chunky), wrapped in tinfoil and baked at 375 for about 35 minutes. Um, yes, I DID make up this recipe and it WAS the best fish I have ever eaten. In my entire life. Ayden and Riley liked it, too--Ayden had seconds! Matthew likes nothing that is actually FOOD, so no surprises, he didn't like it. But he didn't DETEST it and he ate it with some prodding. That is success in my books. Brent missed out because he went out for St Paddy's Day beers with his watch after work tonight.

To go with the salmon I made the most ama-HAzing salad ever. Diced tomatoes, diced cucumber, snow peas, red onion, diced red pepper, green grapes, onions, and cheddar cheese (diced, again), cooked brown rice, cooled and then tossed with the vegetables in a dressing of olive oil, red wine vinegar, cumin, turmeric, and paprika, and salt and pepper.

NOT ONLY was the fish amazing, and NOT ONLY was the salad amazing, but they were accidentally the most AMAZING pair of recipes together--the curry in the salad was just the perfect compliment to the fish-cheese-onion combination. I almost died of deliciousness. If heaven doesn't have food, I'm going to protest. Bigtime.

And that is all. I love you all. I will write more soon.

xo

Thursday, March 11, 2010

Family Time

The past week and a half or so has been awesome. I've been working more than usual lately in order to pay some bills, and the more I work, the more focused I become on taking advantage of every moment I have with our family. Regular daily cycles are getting easier for me to handle as I get more experienced as a parent, but they still tend to drain me of energy and compete for my focus. Any change in routine is good for reminding me to enjoy my kids as much as possible, and to be patient and calm.

You know, when I'm not stomping and yelling.
:)

So last week we dressed the kids up in their puddle pants and rain jackets and rain boots, and took them for a 4 km hike in the rainforest. They loved it, and it was fantastic. Sunday we designated family day, and went hiking in yet another park (we got a later start and wound up getting chased out of the park in the semi dusk by the park manager, whose job it is to close and lock the gates at 6 pm!!), cooked up a barbeque, and played Harry Potter Clue after supper. It was fabulous. The yellow, blue, and red rain gear the kids have is SO CUTE, I HAVE to remember my camera and somehow get you some pictures. Especially with the dog, mucking around at the edge of a creek somewhere in the woods. Jeepers, so cute. Our Harry Potter Clue game lasted over an hour, and in the end there were two people cards, two location cards, and NO item cards inside the envelope (a fatal error of disorganization, for those who are not Clue players!), so no one won. We had a lot of fun, though, so that was the point anyways!

We have been able to sleep in all week because it is spring break. Well, all except Brent, who has to work. I took the kids to a nearby park on Monday, to exercise the dog and keep the kids busy, and Ayden and Matthew spent the entire time in the ravine, mucking around near the creek. "MOMMY, WE ARE 'SPLORERS!!!" That is, until some guy on a bike brought them back up, saying "I found these guys playing by themselves by the creek down there, are they yours?" This happens a lot more than it should, I think. You give your kids some long reign and other grownups step in. To remind you that you need to supervise better, I guess? I'm trying to do some free range parenting, because I firmly believe it instills confidence, street smarts, appreciation for nature and self limitations, identity, and creativity to spend some time *just* out of earshot or eyesight of one's parents on a regular basis. Apparently all these other grownups didn't get the memo on my parenting style. [the meddling doesn't actually happen a LOT, but it bugs me a lot when it does, so it seems more frequent than it is].
After the park we walked a few extra blocks to McDonald's for lunch, which made the kids over the moon excited. McDonald's is a special treat.

Today I packed all three up and we went to the pool. It was kind of an impromptu trip to the pool, because we originally went to take Riley to his music class. I was 60% sure it would be cancelled for spring break, but wasn't totally sure, so we went just in case. We missed last week so id didn't want to assume and miss another week for nothing. When we saw that it was cancelled, I decided to sign Matthew up for swimming lessons. When the woman at the desk saw Matthew's age versus the last class level he took, she figured he should be assessed by a lifeguard to see what level would be most appropriate for him to go into. I was very happy to get this advice, because Matthew is an incredibly strong swimmer and it would be great to have him in a class that challenges him a bit. But I didn't have his bathing suit so we had to go home first and get that. While I was home I figured public swim might also be on, so I might as well get suits for all of us just in case. It turned out public swim was on right then, so I, brave woman, took three *very* active boys to the pool ALL BY MYSELF! Without even batting an eye. I was exhausted afterwards, but I didn't even think to myself "This is crazy!" more than once or twice. The older boys are fairly good swimmers and very good kids as far as obedience most of the time, so I felt pretty comfortable and relaxed most of the time. Riley got away from me on two occasions--one time he slipped on the pool deck and smacked his cheek pretty hard, and the other time I just lost sight of him (and, I admit, consciousness--you know when you forget to watch for them for a few seconds? And then you realize you're near something dangerous and you don't have an exact location on them and haven't thought about it for at least 15 seconds? yeah, it was like that) for a few seconds, but when I relocated him he was fine, and within about 8 feet of my right elbow.

We have also decided to sell our Matrix and buy a larger vehicle. We really want a Nissan Pathfinder with a third row of seats, but they're way expensive. So we figure we'll wait a few years until Brent makes more, and we are in a better position to own a Pathfinder, and in the meantime we'll get a van. I know, we had a van and got rid of it, but we need more space. The dog and Ayden being unable to buckle his own seatbelt because his booster is too close to the carseat beside it are the two main reasons we no longer fit in the Matrix. So sad. I LOVE that Matrix! Anyways, we found a van in Delta that suits us well, and are going to purchase it tomorrow! I'm SO happy at the prospect of more space that I'm almost totally able to block out how dorky it is to own a minivan again. Not that I claim any participation in any level of coolness or anything. There's just something so 'my parents' generation' about a minivan, you know? My parents are awesome, but I don't want to be them exactly.
:)

Anyways, the van will be awesome. And the family time has been fantastic. Though yesterday in particular I was feeling filled to the top with Matthew's persistence, chatter, and limits testing. He has always been a tester of the outer limits of acceptable behaviour, but lately he has been particularly testy. Over. And. Over. And. Over. In. A. Day.
It takes a village to raise a child, and school is my village. Breaks from school are absolutely necessary and good, but they remind me to appreciate school! Especially with that persistent middle child of mine!

Tuesday, March 9, 2010

VBAC Carnival is up!

When I posted my entry on VBACS for the ICAN carnival and linked it, the carnival wasn't up and running yet. See me, and a good lot of other women, linked and recognized here!

Super duper cool.


I also wanted to link to another VBAC post I did about a year ago, which I think adds another dimension to this discussion! You can read that post here.

Monday, March 8, 2010

“Health is internationally accepted as a fundamental human right. Women and girls’ right to health of the highest attainable standard includes the right to full and reliable medical information; to informed consent, choice and decision-making in health care, reproduction and infant feeding; to privacy and confidentiality; and to safe conditions of work and environment. These rights are reiterated in numerous national and international documents, beginning with the Universal Declaration of Human Rights and the International Convention on the Elimination of all Forms of discrimination Against Women (CEDAW).”


http://infactcanada.ca

Saturday, March 6, 2010

Why is VBAC a vital option?


There is a VBAC blog carnival going on right now. As a woman who believes vehemently in access to VBAC, and who has had both a cesarean and a vaginal birth, I wanted to weigh in on the carnival atmosphere.

Read other blog entries here on the International Cesarean Awareness Network!

Vaginal birth after cesarean. Cesarean births, since their invention as an attempt to rescue infants whose mothers had died or were considered beyond help during childbirth as early as the 1500s, have always been considered a last resort because of the risks involved. Gradually, cesarean surgery became safer and safer, particularly with the introduction of aseptic technique, suturing, low transverse incisions, and antibiotics, and is often now considered quite safe.
Surviving the surgery is now no longer of paramount concern because it is so common. Occasionally, women will experience complications from the surgery which devolve and become fatal, but this is so infrequent that most obstetricians would see this at the very most a handful of times in their entire careers. Many never see it at all.

I had a cesarean delivery with my firstborn son in 2003. I had some complications from the spinal anasthesia, but I had no infection, no bleeding, no dangerous issues with my body afterwards. I was grateful that cesarean surgery is so finely tuned, since I had one.

So why is vaginal birth after cesarean a vital option? Because it is protective. Modern obstetrical subculture tends to oppose VBAC on the basis of the increased risk involved in giving birth vaginally after major uterine surgery. It is true that a woman who has experienced a previous cesarean has a greater risk of having her uterus rupture than a woman who has never had a previous cesarean. But it is not true that cesarean surgery is safer for that woman than vaginal birth. Repeat cesareans are higher risk than initial cesareans, and this is well documented and acknowledged in obstetrics. Many risks associated with cesareans don't develop until subsequent pregnancies: higher rates of placental accretia and placenta previa, higher rates of infertility, higher rates of adhesions, rupture, hemorrhage, ICU admissions post operatively, hystorectomy, and maternal death. Every repeat cesarean a woman has increases all these risks in subsequent pregnancies.
Many women in our culture now desire to have just two children, which makes these risks minimal, but the desire to have two children is not universal. For women who want more than two babies, the prospect of cesarean surgery is more dire.
Encouraging VBAC protects women against these risks.

Encouraging VBAC is also protective of babies. Babies do not develop at a universal rate, and if left alone to birth physiologically, each individual child is born when it is ready. There is no way to measure an individual baby's exact date of 'mature enough,' except to wait until labour begins on its own. Scheduling subsequent cesareans is guesswork which doesn't always guess accurately, which results in babies with higher rates of transient tachypnea, premature birth, or other health problems.

A cesarean surgery bypasses all of the physiological stages of vaginal birth, a complex interplay of chemical and neuromuscular and hormonal factors that we have only begun to understand. We are highly adaptive creatures, but there are forces at work in the birth process which have the potential to affect women, babies, families, and society at large in ways we have yet to discover or understand.

Women who have surgical births are at higher risk of breastfeeding difficulties. Babies are necessarily exposed to drugs during surgical birth, which can suppress a newborn's instinctive breastfeeding behaviours and affect a baby's suck for up to a month afterwards. Women are at increased risk of developing nipple trauma and poor latch from a weak suck or uncoordinated, medicated baby. Inability to initiate breastfeeding puts infants at increased risk of morbid illness as infants and as children, and puts women at increased risk of developing future reproductive and breast cancers, osteoperosis, and other diseases whose frequency is reduced in women who breastfed.
Women who deliver via cesarean have a slightly increased risk of developing postpartum depression, and women who do not breastfeed are well documented to have higher incidences of postpartum depression or mood disorders, which some researchers have speculated to be attributable to the body's perception of an infant death when a woman's body gives birth but does not go on to breastfeed a baby.

VBAC is a vital option for women's health and reproductive rights, because it offers a safe and effective way for her to avoid the above risks involved in cesarean births for her and her baby. Attempted VBAC success rates vary according to geography and birth support and birth attendants and reasons for the original cesarean, but the success rate is recorded as anywhere from 60 to 90 percent. If 60 to 90 percent of women can successfully perform a protective physiological function: normal, vaginal birth--why shouldn't they be encouraged to do so? Why are they being discouraged or even outright banned from doing so en masse? I know ONE woman who was enthusiastically ecouraged by her obstetrician to have a vaginal birth after a cesarean. That was me. I know many women who were discouraged, threatened, bullied, and yes, some even legislated by the courts into having repeat cesareans instead of attempting VBAC.

Another important factor of VBACs is the intellectual impact on women. Women who have cesareans have their babies delivered from them, rather than actively giving birth. These women often overtly or subtly recieve and internalize the message that their bodies are broken, inadequate, weak, or unsuitable for the task of giving birth. Disempowered and delivered OF is not the ideal attitude with which to embark upon the complex and difficult human task of parenting. Many, many women move beyond this state of mind to become empowered and healthy parents, because the human creature is highly adaptable, but it is beneficial for all if the birth process is an empowering one, rather than something women have to move beyond in order to become empowered parents.
In these cases, vaginal birth after cesaran is not simply protective, but redemptive. Women can reclaim a belief in their bodies' ability to give birth in a powerful and self affirming way by giving birth vaginally after a previous cesarean. Birth is beautiful and powerful, and it moves all of us who witness it. It moves the woman who gives birth most of all, and fills her with joy, love, and a sense of strength and trust in herself. This is vital! This is why VBAC is such a vital and powerful option, which should be actively encouraged by all who work with birthing women.


!@#*#!@#$%^!!!!!

Talk about a roller coaster! Update on Rachel's situation and diagnosed IUGR HERE! It's GOOD NEWS!

Love and prayers for Rach

My bloggy friend Rachel is pregnant with her first baby [hello Poppy!]. She is being closely monitored for suspected IUGR, which is quite serious. Please pray for her and her baby!!! Pray that Rachel will be able to eat and keep food down, pray that her baby will grow and grow the way he is supposed to, and pray that she will feel peace, and pray that her baby will be healthy. You can read her story here on her blog.

Please, Jesus, bring on the weight gain. Oust the puking. Plump up the baby. Love on Rachel.

Thanks.

Sleeping

Again several times Ri has requested his toddler bed. Again, several times he has responded well to the return-to-bed routine. But tonight he put up a fight and eventually I left and had Brent try. AND IT WORKED. Hurray!

I was wondering if several of you mommas out there would consider writing posts about how you have experienced/handled getting your kids to sleep? One of my friends was asking about co-sleeping/co-bedding and then transitioning to their own beds, and I thought a mini carnival might help her out. It's good to see a variety of approaches and experiences, I think. Leave me a comment if you think you'd like to participate!

Thursday, March 4, 2010

Healthy, Sick, Dead [work story]

Last night we had a call that I can't get out of my head. I'll tell you the whole story, not just the part where I came in. [Identifying information has been changed].

So a man drives his 48 year old wife to the hospital because she is having chest pain. The hospital takes chest pain quite seriously, and runs tests looking for signs indicating it is all the worst things chest pain could be. It turns out, she is having a heart attack, and a middle of the night run to another hospital for specialized care in a cath lab is necessary. This is where I enter the story, as the driver of the ambulance to take her to the cath lab, code 3, in the middle of the night. See, the cath lab is closed at night and only opens for very dire emergencies. Like this one. So we arrive and the patient is alert, pink, warm, dry [heart attacks often present and pale, cold, and clammy], talking and joking around. Awesome! This bodes well for her probable outcome. Yesterday, this woman felt well and fit and healthy, and today she is sick.

We drive fast to the other hospital, with a nurse on board just in case the patient needs medications to control her pain, and because some of the meds in her IV are above our scope of practice. At three o'clock in the morning, the cath lab is staffed and waiting for us, they do the surgery, and finish and hand her back to us in under an hour. We load her back up. She is pink, warm, dry, talking, happy it's over, and healthy again. I hop in the front seat and take my time on the drive back. Almost an hour later my partner sticks her head through the window between the front and back of the ambulance and says, "Um, can you go a bit faster? Our patient's blood pressure is 80/35 and she looks pretty grey." Woah! What happened there?! So I step it up, and when we arrive at the original hospital and I go to help unload her, she looks like SHIT! In and out of consciousness, pale as a sheet, sick, sick, sick. WAYYYYY worse off than when we picked her up. Holy crap! And her blood pressure just hit a freefall. Normal blood pressure is around 120/80ish--the top number is more significant than the bottom number for paramedics, though it is still significant with regards to health. Above 150 and there is added stress on your heart, lungs, blood vessels, and kidneys in particular. Below 100 and you feel dizzy a lot, have blackout spells, or difficulty moving quickly from a lying or seated position to standing. Below 80 and you lose your radial pulses and have difficulty staying conscious when sitting up or moving a lot. Below 60 and you lose your carotid pulse and seriously compromise oxygenation of your brain.
This woman's blood pressure is now 47/15. The nurse escort is doing not much. I mean, he dumped fluids in her IV and stuff but he didn't seem to be experiencing any of the "Sphynctor factor" my partner and I were experiencing. You know, where you get anxious and your butt sphincter winds up somewhere near your esophagus? We rushed the woman up to ICU and I kid you not, TEN MINUTES later she died. And they pounded and pumped and blew and shocked, and she came back to life again. The last I heard she was still alive but not expected to live beyond another 24 hours. The surgery in the cath lab is performed by sticking a long, flexible, very narrow, hollow tube in her femoral vein and threading it up to her heart to open the blood vessels in her heart and stop the heart attack. When they pulled the catheter (tube) out, it left a hole in that vessel. It would have been closed, but I'm not sure what technique was used, but it was either not closed enough, or the blood thinners she was on to treat the heart attack prevented her body from making a clot to heal that hole, and all five liters of her blood poured out of the vessel, into her abdomen, under the skin so it was impossible to tell from the outside until her pressure dropped and she went pale, cold, clammy, and whoozy. [Yes, whoozy is an official medical term. Or is it vertigo? Ha ha. And yes, I did just make a joke in the middle of recounting tragic mayhem] She was given multiple blood transfusions and many drugs and liters and liters of fluid, and it looked like a war zone in the ICU afterwards. Crazy.

The part I can't get out of my head was the medical intervention part. Without the surgery, she would likely have died. But it was a complication of the surgery that killed her. And so fast. At such a young age. Crazy. Life is just crazy sometimes. You know, it is funny because I had this niggling intuition that we should watch her closely, you know? Like death was hanging around and somehow I smelled him.

Travelling mercies, Mrs. X, whether you survive the ICU or not.

Monday, March 1, 2010

Sleeping Matters

Some new sleeping developments have come about recently, which are always good to share. Getting kids to sleep is a fairly universal issue, so it is interesting to follow each others' journey in this regard!

A couple of developments have been good. Three times now, Riley has specifically requested to go to sleep in his own toddler bed! Not three times in a row, mind you. But three times is nothing to sneeze at. You know how he has been back and forth; our bed, cradle, our bed, crib, our bed, toddler bed, our bed...
For awhile bum patting in the crib was working. Then it stopped working and we moved to sitting beside the crib until he settled down. Then we slowly somehow migrated back to breastfeeding to sleep in our bed again--I think mainly because he started sleeping through the transfer back to his bed again. When we pulled out the toddler bed he liked to play on and around it, but would only sleep in it if he wasn't aware he was sleeping in it. But this past week he has requested to sleep in it. I would say, "Okay Riley, time to lie down and go night-night!" and he usually runs to our bed and climbs in, all excited. But a few times he has run to HIS bed and climbed in, all excited. This is a cool development! He really loves feeling special and like a 'big boy,' sleeping in the same room as his brothers.

At about the same time, he started to change the mechanics of his middle of the night wake up from waking up and WAILING for me to stumble over in the semi darkness and pick him up, to climbing out of bed and coming towards ME! I LOOOOOVE it when they hit this stage! It makes night waking THAT MUCH easier. So far I have been meeting him in the hallway, but soon enough he will be able to make it all the way to my side of the bed and climb in on his own, and it will be *heavenly.* Woot, woot.

Tonight's development was a mixed bag. I've noticed lately that since we (almost entirely--sometimes I come home from a night shift to find it lurking under the covers in my bed...can you really blame daddy for that one? I mean, it's the middle of the night and there's NO BOOB!) turfed the soother, he tosses and turns a bit more before falling asleep. I think maybe it's coincidental, because tonight he was tired but WIRED. He requested his own bed, but was turning like a rotisserie chicken, and on the boob, off the boob, on the boob, off the boob: smack, suck, smack, suck, smack, suck and DRIVING ME NUTS! Eventually I got fed up and passed the torch to Brent. Which is always interesting. If Riley knows I'm in the house and Brent tries to put him to bed, he screams and screams and screams and screams...we've never met the end of his stamina. Tonight was the longest I've ever held out and it was in the realm of about 45 minutes. When I'm not home Brent has to walk him around the house to show him that each room is empty of me, and then he relaxes and falls asleep cuddled up next to Brent. So tonight he got so he was choking on his own spit and throwing himself at the door of the bedroom, and eventually I caved. What good is holding out indefinitely? Seriously. So I tried something new. Instead of going in and lying down and putting up with the smack, suck, smack, suck, smack, suck (which feels almost as bad as nails on a chalkboard after awhile), I sat beside his bed. Every time he got out of bed, I put him back. I didn't make eye contact or talk, I just put him back. I wasn't rough or mad or cold, I just put him back. 6 times, a few wimpers, and he fell asleep. Jeepers. How easy was that?

So my conclusion is this:
He is outgrowing the infant nurse-to-sleep routine. As am I. He is needing some boundaries put in place to help him sort out what to do when put into his wide-open toddler bed. And I remember this trick working just as easily when Ayden was younger. [Matthew is a morning person. Putting him to bed at night has rarely EVER been an issue beyond the first few weeks. His head hits the pillow and he's a goner]. They have to be ready for it--too young and they will put up more of a resistance because their trust isn't consolidated. But once it is, and they are tossing around looking for boundaries, it is a wonderful tool that has worked well for my kids [note: not all tools work for all kids! Sleep is challenging]. Let's hope for continued success with this remarkably focused, persistent little turd of mine...

And a funny one, in the interests of rounding it out...

Worst Frickin' Doula Luck

My third doula client is due the end of March. Do I have the luck and privilege of supporting her in labour? No, I do not. Her baby is breech, her doctors referred to an OB, her OB has recommended against "taking the risk" of a vaginal breech birth (despite the fact that this OBs own surgical SOCIETY has revised the breech position recommendations to include shooting for a vaginal birth BECAUSE IT IS SAFER, and performing surgery if the baby shows signs of distress). Cut, cut, cut, slice, slice, slice, chop, chop, chop--are we making a salad? Oh, no. We are making holes in uteri against the recommendation of our overseeing college because we feel that surgery is safer. Do we think about this woman's future increased risk of placenta previa? Placenta accretia? Uterine rupture? Infertility? Adhesions? Infection? Hemmorhage? Ectopic pregnancy? Future cesareans? Nope. How about the baby's increased risk of transient tachypnea? Premature birth? Laceration with the surgical scalpel? Breastfeeding problems? Hospital-acquired infection? Nope. Well, maybe we do. But we're pretty confident that those things won't happen, because we see them rarely. We're pretty confident that we WILL see complications if we 'let' this woman deliver vaginally though. Because we see them rarely (actually, never, because we surgically deliver all babies who present this way!). Hey wait! That doesn't make sense!


I'm frustrated. No, the whole frickin point isn't just to avoid a cesarean, and don't worry I'm spilling it ALL HERE so that my client has no idea that I'm frustrated. My personal agenda has no business anywhere near her birth. I just get frustrated when I see evidence of very little effort to strive towards natural birth, like it doesn't really matter how a baby enters the world, just so long as it does. Of course it doesn't matter how a baby enters the world if the woman or her baby either would have died or could likely have died or suffered injury from a natural birth. OF COURSE. But when the choice is between a safe vaginal delivery and a safe cesarean, the statistics show a higher risk of complications with the cesarean. The WHO meta reviews have shown that if a region's cesarean rate is higher than 10-15%, women and babies are being harmed more than they are being helped. Why? Because those risks I listed above sometimes come true for some women. This becomes statistically significant at cesarean rates higher than 15%.
So. I want women and their care providers to choose safer options, which strive towards physiological birth. Baby out of vagina. Period. I want this because it is BETTER FOR WOMEN.


Another frustration for me is that my client's OB has not ordered an External Version. Cutting without even *trying* to rotate the baby makes me mad. I've encouraged my client more than once to ask for an EV, so I hope she remembers. And I hope he DOES ONE. And baby FLIPS. Of course I have recommended a host of other baby flippin' tricks as well, which haven't worked thus far. Flip, baby, flip! Because physiological birth is healthiest for woman and baby.

RARGH.