Friday, April 30, 2010

Misbehaving boy? Or a boy with unmet needs?

I am on the email list for the newsletter of an educator named Barry MacDonald, who performs teacher and parenting seminars and wrote a book about educating boys. I really like his style, and have often put into practice what I have learned from him about how boys operate. Here is a link to his latest newsletter, which I found extremely relevant to my family, despite the fact that it is geared towards recess/lunch detentions. Really it is about punitive behavior modification techniques, especially ones which restrict the movement and physical play of boys, which is really great to remember with my uber active houseful of boys [and especially that middle one...if I could only discover the magic key to stimulating his interest in learning responsible and respectful behavior that comes from an internal motivation within him, I'd be GOLDEN!!!]

In particular I appreciated this list of questions to ask ourselves as parents (and educators);

Do we really believe that children misbehave on purpose or that they choose to stay inside at recess [or sit in the time out chair in our bathroom] while others socialize and play?

I would suggest that before we rush to threaten to withhold recess [send to the time out chair] or apply some other sanction, we ought first to ask ourselves broader and deeper questions:

1. Is there a pattern to the misbehavior or underachievement? If so, what might the pattern reveal?

2. What might a particular boy be saying through his behavior that we have not understood?

3. How might we look beyond his recalcitrant behavior to better understand what he needs?

4. If the boy is old enough, who might respectfully seek his input and invite him into authentic partnership? How could we work collaboratively to a positive outcome that he can be a part of?


So great! I really like this guy's approach and I sincerely hope ALL of Matthew's teachers will have gone to one of Barry MacDonald's seminars.....because he's a wiggly one....and a noisy one....and he learns by doing and talking and that macro learning MacDonald describes.....he's a handful! But he has SO MUCH intelligence and potential.

Thursday, April 29, 2010

94%!!!

I just got my grade for my final exam and total theory mark (which is 85% of my total mark). I got 94% for both!!!! Hooray! Hard work, paying off!!! The final 15% of my mark will be a result of my journals, which are reflections on my clinical observation experiences. I have two more observations to do before I can turn my journal in to be marked (we have until the end of May), for that final mark in the breastfeeding course. Hooray! I'm happy with 94 so far :D

Tuesday, April 27, 2010

Why I Chose a Midwife for Round 3

When I got pregnant with Ayden, I was so unprepared to have a baby that I could not emotionally cope with ANYTHING, including entertaining the idea of looking for a midwife. I wish I had, but I was nowhere close to ready to take charge of my health at that point. It took me three months to be emotionally ready to take prenatal vitamins. Yes, I am serious. Dead serious. I remember my mom gently suggesting a midwife a few times until I snapped at her to leave me alone about it. I just couldn't cope. And I knew that in 2003, finding a midwife who was taking patients was a feat that took some doing. There was HUGE demand, and very few midwives. Since then, the supply and demand have come closer together in my geographical area, so it is not a feat any longer. In fact, you can shop around a bit and find a good fit for your personality. Imagine that! In Canadian health care!

And you know the story. Ayden was breech. My doc referred me to an OB, who cut me open, and out came Ayden. On the one hand, I wonder if fate or providence or my subconscious was directing me away from 'birth' as an action that I performed because I was not ready. I mean, I still gave birth! I didn't say the subconscious was logical....

At any rate, I felt cheated. The instant my OB recommended a cesarean, I knew I would try a VBAC. It never occurred to me not to, because I knew it was possible. Is it because my parents and closest aunts and uncles were hippies who embraced all things natural, including birth? Is it because my mom had three vaginal births and spoke very positively of them? Is it because she was a maternity nurse? Was it because of a conversation I remember with her about natural birth, where she said, "Well, yes, [birth] is painful, but giving birth without drugs for pain is better." "Why?" "Because it's better for the baby."? I'm positive the conversation went much deeper than that, but this is what I remember most distinctly. Probably all of the above. Plus I had lived so much of my life anticipating becoming a mother by giving birth naturally. It actually didn't really occur to me that I wouldn't be successful--though my OB assured me at a post natal appointment, "There is no reason why you can't give birth vaginally next time." I remember thinking, "Well, duh. I never considered anything else." But I'm infinitely grateful for her, because she obviously believes in natural birth and the encouragement of an OB in a moment like that could make all the difference for a woman who wasn't quite so certain. And because she did the best she knew how at the time. And because she did a very good job with my surgery.

For my second child, of course I had an adoption agent to facilitate my airport birth. Adoptions are not necessarily a midwife's expertise per se. That birth was fabulous. Painful. Lovely. Unique. Miraculous.

For round 3, I was determined to have my VBAC. I knew from word of mouth and the small amount of research I had done that midwives had better statistics than doctors when it came to cesarean rates. I also knew I was higher risk for a cesarean for round 3 than your average woman, because I had already had a cesarean. So the #1 reason I chose a midwife was to maximize my chances of having a successful VBAC. Period. Doctors in my area have a cesarean rate approaching 30%. Midwives have cesarean rates between 5 and 10%. Done deal, no debate, no question, that was what I was going to choose!

Sometimes I can be a bit single minded, when I have a purpose or a goal in mind. I'm not sure if you noticed.

So, because I was looking for One Thing when I went midwife shopping, I was very pleasantly surprised to encounter a million and one other enjoyable or beneficial things about having a midwife for baby #3: VBAC, take one. I was so determined to go VBAC, I remember being surprised and a bit miffed when my midwife wanted to investigate my medical records to see whether I was a good candidate for VBAC in the early months of my second pregnancy. Like, duh. I TOLD you I was going to have one. What more do you WANT?

Ha, ha.

I was happy to discover that at every appointment, my midwife scheduled me FORTY FIVE MINUTES! And allowed 15 minutes between appointments, and so often spend an HOUR with me. EVERY TIME. Holy crap. I mean, what do you fill forty five minutes with in a healthy pregnancy? Let me tell you, I filled it. Always. There was the regular weight check, pee check, how are you feeling check, fundal height check, and doppler heart rate check. So that took ten minutes. But we always seemed to have lots to discuss, like which hospital to deliver at (based on 'friendliness' towards midwives and VBACs), which tests were available at that point in my pregnancy, and what those might divulge and what the risks and benefits were, diet and exercise, aches and pains, vitamin supplements, my eternal battle with yeast infections (worse when I'm pregnant), how my work is going, how my family feels about my pregnancy, who will be at the birth itself and around afterwards to help me at home, and a million small but significant emotions and thoughts and turmoils and happinesses and fears, which always seemed to leak out in the last ten minutes of our visit. It takes time to build trust, and to reconnect after a few weeks of not seeing each other, so those long appointments are critical to getting to those emotional bits. Midwives do their job so well because they know the women they are serving. You can only expect someone know how best to support someone as they journey through birth if you KNOW that person, at least to some degree, on an emotional and intellectual level.
Sometimes I suspect my doctor doesn't remember anything about me at all, unless she looks at my chart. My midwife remembered, because we had a relationship.

I was also happy to discover that my midwife asked me to weigh MYSELF, and to test my pee MYSELF, which made me more in control of my prenatal care.

I was also happy that she was available to me via pager 24 hours a day throughout my entire pregnancy. I got an ear infection late in my pregnancy and I paged my midwife to check her opinion of my doctor's prescription. I paged her when I thought my water broke the day I went into labour. I paged her the week after Riley was born to ask a question. No way could I EVER page my doctor directly. Let alone 24 hours a day.

My midwife was happy to make a backup plan where in the event that each of the three hospitals she had privileges at was full, we would set up to give birth at home. I preferred this to losing my care provider by going to a different hospital.

I was very happy to discover that when I went into labour, my midwife would COME TO MY HOUSE!!! To be with me in early and active labour, and help me decide when would be best to go to the hospital! And that she would STAY WITH ME from that point on, through active labour, transport to hospital, transition, pushing, delivery, and several hours after the birth. That was incredibly reassuring and felt very nurturing. I didn't have to worry about the logistics of any of that: she would watch over me and I would focus on LABOUR. Awesome.

Then, after the baby was born and I was discharged, she would COME TO MY HOUSE AGAIN!!! And as many times as I needed in the week after that she would also COME TO MY HOUSE!!!

She had training on baby care, breastfeeding, postpartum healing. herbs for my sore perineum, advice, support, and care. I really felt well taken care of. Which was amazing, empowering, and totally positive. I seriously wonder how on earth I found the midwives I did, who seem so well suited to me and my personality. (Thank you, Jesus). I also wonder how women DO IT without that constant, reassuring support of a medical expert on normal birth sitting beside them during the entire process. They held my hand when I asked. They encouraged me when I needed it. They cheered me on. I felt NO FEAR of the birth itself. I feared some other stuff--germs, infection, failure, exhaustion--but I did not fear giving birth. And fortunately none of my fears became problems.
Of course, Riley came out unconscious and needed resuscitation, which I had not anticipated and not thought to fear--and which would feature as a rather large fear for me in future labours--but I didn't know about it so I didn't fear it in advance with #3. And the fact that he needed resuscitation was a fluke of his birth, and did not reflect the skill of my midwife.

I wish deeply that I had been encouraged to or had initiated flipping onto all fours for Riley's actual delivery, or asked for the squat bar when I wanted it late in the pushing stage but was so deep in myself and labour hormones that to speak or ask for something took more effort than I had the energy for. I am sure Riley's birth would have been slightly faster and involved less tearing had I tried these positions instead of being semi reclined, which makes the pelvic joints slightly less mobile and flexible, and shortens the diameter of the pelvic outlet by up to an inch. With a large baby this would have been a beneficial inch to have at my disposal! And perhaps Riley would not have needed my midwife's hand to be slid up beside his head to aid a tight squeeze at the chest/shoulder level, and a third degree tear would not have ensued. And perhaps even his birth would have been faster, which would have meant a shorter time with his cord pinched between his shoulder blade and my pelvic bone, and he would have needed very little, if any, resuscitation. But who knows? And we all make split second decisions when giving medical care to people, and in retrospect other decisions could have ended in better results. I respect my midwife totally, and am grateful to her for her skill and support. My position at the end of pushing is the only thing I would change in retrospect.

I was happy that my midwives followed me an extra two weeks past the normal six weeks that is standard, because I had post partum anxiety. They did not let me go until they knew I had support and treatment started. And then they encouraged me to keep in touch. And if they had not both moved away, I would go back to them in a heartbeat with another pregnancy. The relationship I built with them was something that will stay with me forever. I feel a lot of love and respect for them and gratitude for what they were willing and skilled to give.

So I sought out midwifery care for a statistically better chance at a successful VBAC, and look at all the amazing benefits I was surprised with!

Oh, yes, and statistics won out, and I had my VBAC. I didn't need, want, or wish for drugs, an IV, an epidural, continuous fetal monitoring, or manual help during labour, because I had emotional support and an uncomplicated labour. Oh yeah, and the shower. I would have died without that shower!!! Women praise the heck out of birth tubs but I tell you I absolutely wanted nothing but to STAND in the shower with hot water pouring over me!
Which makes sense. 5'1" me, and 10 lbs of Riley: we needed us some GRAVITY!

I often wonder how much Ayden would have weighed at birth had he been left to cook as long as needed. He was 9 lbs at one week early~would he have been 10 lbs or close to it had he gone to his full term? Most first babies go 'overdue,' so perhaps. Maybe I had GD based on the size of my babies, but maybe I didn't after all. Because when I was pregnant with Ayden I sat on my ass and ate bags and bags of candy and boxes of oranges and bowls and bowls and bowls of white flour macaroni and high fat cheese, and when I was pregnant with Riley I ate carefully measured portions of high protein, low fat, complex carbohydrate ONLY, strict no sugar (except for Sara's baby shower) diet, and exercised daily and intensively, and my babies were relatively the same size.

Strictly conjecture, since I refused the GD test.

Anyways, I came for the statistical probability and went away surprised, challenged, nurtured, and totally changed. Lots of healing went on for me when Riley was born. Lots and lots and lots. Thank you, midwives.

xoxoxo

Monday, April 26, 2010

April 26th

Oh, man, I can't even describe how much I LOVE that picture of Riley and Simon looking out the window. I wanted to add that Matthew was not going to school all by himself--this isn't 1983 anymore! Brent is taking Matthew to school, Riley and Simon are staying home, and I am taking photos. :) Well, we were that day.
TODAY I accomplished some tasks. In the morning I got Ayden to school on time, fully equipped, without yelling. Now, for those of you who have met me first thing in the morning, you know I'm not really a morning person. I would be a really good candidate for a coffee addiction, if I didn't have a sensitive heart [I used to have WPW, a form of SVT, cured by radiofrequency ablation in September 2000 and again in May 2001, which left me with residual sensitivity to anything that stimulates a higher heart rate...and this is your cardiology lesson for today]. In the morning when I get up I am groggy. I prefer to talk to no one until after I have eaten breakfast, which is not generally something I can accomplish with any degree of satisfaction. You know, with all the children running around. Actually, Ayden would be happy if mornings didn't exist, and Riley would be pretty happy with a interaction free pre breakfast period...but Matthew. Ah, Matthew. My little morning man. From the SECOND he wakes up, he's talking. Chatter, chatter, chatter, chatterchatterchatter--and he requires feedback. Ack. So, long story short, sometimes it is a big task for me to get Ayden to school with no yelling. Which isn't actually all Matthew's 'fault,' because ungluing Ayden from his bed and getting his ASS DRESSED AND TEETH BRUSHED AND FOOD IN HIM is a herculean feat. And Riley ALWAYS takes a shit at 8:32. Which is when we need to exit the house. Literally, we're by the front door getting our shoes on, and the stink takes place, at least 80% of the time. Without fail. Guess how happy I am to change that every morning, me who gets anxious about being LATE?!?!!!

SO, all of that to beef up why getting Ayden to school on time, fully equipped, without yelling, a major feat to be proud of.
You know, when I was a kid I used to assume my mom LOVED taking care of me, and that the rightful orbit of the entire universe was directly around me. Funny, now that I'm the mom, I have a lot more insight into how unpleasant some aspects of the job are. And how profoundly the world does NOT revolve around me.
Sigh. It was so nice when it did.

My next accomplished task was boot camp, which I haven't done in over a month, so it was quite a feat...There MAY have been some yelling at Matthew during boot camp, which may or may not have been exacerbated by his tendency to tune me out and my tendency to get cranky when I'm at boot camp working my booty off! But boot camp was my next task.
Then successfully drop Matthew off fed, fully equipped, with a cheerful smile and hug and kiss. Then I tackled my front entryway--we're getting things ready to sell so I have cleaned out the shoe closet and today finished the coats and purses! Hurrah!
Then I picked everyone up from school on time, walking (so simultaneously accomplished walking the dog, another task on my list). I went through my list of 49 emails that were waiting for me [I went away for the weekend with my book club to Widbey Island in Washington, so things piled up a bit]. And THEN I roasted a chicken, made yams from a recipe I made up on the spot, cooked rice, and BAKED BROWNIES FOR DESSERT. From scratch. Baking may be something I'm not so scared of anymore. Wow. If you make really rich brownies and fill them with chocolate chips and walnuts, you can't over eat them, because you would absolutely throw up. I had two, and I never want to see another (totally delicious) brownie again in my life! I'm sure I'll change my tune tomorrow.

There were some bumps in the road along the way, though. Matthew and Riley dumped two suitcases, two footstools, a beach ball, and a handful of large toys down the stairs while I was in the shower. The suitcases chipped the paint on the wall. Not popular. Also, I didn't manage to get that chicken into the oven until 5 pm, and it takes 2 1/2 hours to roast!! I was frantic. I mean FRANTIC! I was freaking out, because the kids will be starving by 7:30, but I can't stomach cooking something else on top of the meal I'm making, and I don't want them FULL when the chicken is ready...and I'm saving as much money as I can because we have three trips planned for this pay period [my trip to Widbey Island with my book club, a trip to the Tulip Festival in Skagit Co, Wash., and a trip to Vernon next weekend to visit my parents], so I can't see ordering in a pizza or something. Ack! In the end, I left the chicken in the oven to fend for itself for twenty minutes, and took the kids to MacDonald's for a snack. I totally could have made a snack that was healthy but the thought was overwhelming, so MacD's came to my rescue. Now, obviously it's not the healthiest so I know everyone will be hungry again in two hours. Perfect! I'll have a nice healthy yummy roast chicken dinner ready for them! :)
Nothing could be better (nor more glaringly hilariously ironic than roasting an organic chicken and feeding your kids MacDonald's beef to tide them over for it!! Lol!).

The brownies were sooooo yummmmmyyyyyy....
And the dog did not eat anything he shouldn't.
And Brent put the kids to bed and fell asleep himself, so I am feeding my TLC addiction: 19 Kids and Counting (yay PVR!). I love watching this huge family navigate daily life. It rocks.

I took a picture of my brownies, but I'll have to post that one later! :) I should have taken a picture of my kids eating them, with chocolate all over their faces and bliss on their faces, and silence in the room! :)

Successful day.

Friday, April 23, 2010

More cute

Yesterday's Earth Day picnic:



Brent caught Riley cuddled up with his baby again last night while I was at work:



The picture face:



Simon and Riley watching Matthew leave for school from our front window:

Happy Earth Day!

I celebrated Earth Day by driving home from work at 6:30 this morning and watching the sun rise. So pretty. And then later, after I slept for a bunch of hours, Matthew and Riley requested a picnic in the backyard, so that was a little bit of Earth Day specialness, too.

:)



Love on the earth today!!!

Wednesday, April 21, 2010

Breastfeeding from the Feminist Breeder's Perspective

I love this blogger. She's awesome. I had to post a link to her recent post regarding breastfeeding, feminism, and guilt--go read it! And fall in love with her, too. She's kick bum awesome (phrase borrowed from Caryn, you're a hoot!). Having just finished my CLASS ON BREASTFEEDING, I would venture a guess that UNETHICAL MARKETING OF INFANT F*ORMULA BY F*ORMULA COMPANIES is what sabotages much of the good intentions and poor follow through in our culture, though Gina doesn't mention f*ormula companies in her post. Evil incarnate, these unethical companies. I will have to blog about that separately one of these days...so much info....so little time...

Best for Babes also addresses this issue quite well, I think--here.

Tuesday, April 20, 2010

Done!

I wrote my final tonight for the breastfeeding course! Whew, that was big. I think I did fairly well. I will truly, truly miss that class from the bottom of my heart; it was the highlight of my week every week since January. Though I am relishing the opportunity to READ FOR PLEASURE~that has to be the hardest part of school for me, is the monopolizing of my reading materials.
I actually learned a ton in this course aside from breastfeeding information--I learned about my academic style, and how inefficient it is when simultaneously raising a family. This is VALUABLE information for me, on the application side of returning to school full time! I learned how to be more efficient, and also how to do a good job without letting a project or exam studying invade my life, psyche, or anxious tendencies beyond what is healthy or balanced. I learned how to do that by failing at that more than once! :) I learned that I'm fairly perfectionistic when it comes to my expectations of myself, and I learned that I need to let that go.
I also learned that I love to learn. I am excited to return to school. It will not simply be a means to an end, but rather a cool experience in situ.
:)
Good to know, because I was worried that I'd be too burned out from my degree and paramedic school to really immerse myself in school again. But I think that I really actually love to go to school.

Anyways, I'm done for now! I have a few clinical observations to finish, and the journaling from those experiences to complete, but so does everyone else, and I have a month to complete that. It won't take me long.
Yippee!

Funding Review Published!

The UBC Midwifery Program has finally received its funding review report. It is being studied and a decision regarding 2010/11 admissions will be made soon (how vague is that???!). Wow! That took forever. We shall see what happens! Good luck, me!

On a related bent, I recently read a large data analysis study published in the Canadian Medical Association journal in August of 2009 regarding Homebirth safety. It is called "Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician." It was conducted in BC. There were over 12,000 cases studied. The outcomes were astounding to me (even me!), given what I believed about birth attendants versus geography. In the US the home birth/midwifery vs. hospital birth/physician attendant is much more divisive than in Canada, and particularly in BC, because here midwives can, and in fact are required to, attend a percentage of their clients' births in hospital. So it has been difficult to accurately study midwifery care results in the US and then apply the results of that study, to our population here in BC. Plus we have universal health care, which also affects outcome percentages and access to midwifery care in the provinces which offer funded midwifery care.

Anyways, I had always figured that it was the attendant more than the geography that affected outcomes. This study shows a low perinatal mortality rate in all three subgroups (midwife attended home birth, midwife attended hospital birth, and physician attended hospital birth of a woman low risk enough to qualify for home birth), but the physician attended hospital mortality rate was TWICE that of the midwife attended home birth group! The rates were:
rate of perinatal death per 1000 births:
planned home births: 0.35
midwife hospital births: 0.57
physician hospital births: 0.64

(all had similar P values, for those research minded folks). Also, the rates of interventions and adverse maternal outcomes were studied and are enormously significant. The entire study can be read here, but I found it fascinating that geography had more of a role in birth outcomes than I had previously considered. The study does not attempt to expound on reasons for increased perinatal mortality in hospital, but results are pretty clear.

This would be interesting to have replicated in future studies. In the meantime, it is excellent food for thought.

Monday, April 19, 2010

93%!!!

My group project/presentation earned us 93%!!! Hooray! :)

CUTE. PERIOD.

Okay, first off, some funny (before the cute. period.)
Here are pix of my boobie cupcakes for my class presentation:




And the other day Riley discovered that we own TRAINS! And that the TRAINS! stick to the other TRIANS! with magnets! And that the TRAINS! travel on tracks which can be built and rebuilt in endless configurations!!! Fortunately, my older two are not above a few hours of TRAINS! themselves, and all three of them happily played for hours, incorporating a room-to-room track system with bridges and stations and ports and all manner of mechanical, machine minded, boy stuff. I got some pix:





As you can see in the above photos, Riley has developed a new 'picture face,' which no doubt looks beautiful and appropriate in HIS mind, but in reality looks kinda weird. The squinty eyed look is never all that attractive. I'm just glad we got his passport pictures done BEFORE the squinty eyed picture face developed. :)

In the category of HIGH CUTENESS, here are some pix of my niece and nephew, who came to visit for two weeks!! Ella (2y9m) and Ruben (9m);







So cute.

And finally, the ultimate cute. period. (and then I should go study for my final exam tomorrow...)
Riley has recently fallen in love with a doll that we bought for Matthew when we adopted him. It is an asian doll (which is REALLY hard to find, btw! So stupid!), a boy (not anatomically correct), and dressed in a sleeper my mom modified to fit the almost-life-sized newborn doll. Not life sized of MY babies, of course, since I give birth to three month old porkers, but life sized of your average five to six pounder. So Riley recently discovered this doll in his toy box and has fallen in love with it. I had to take a picture of him tonight after he fell asleep so you could all see my little baby loving cutesie:

Friday, April 16, 2010

What I saw this morning...(in addition to the abscess)

April 15th, 2010


What I see first thing in the morning is; The top of Riley's head as he snuggles in for some early morning milkies.

The moment that changed me forever was; When I watched the Easter story on stage in my mom's church when I was 16. I'd heard it all before, but that play brought it to life and glued me to Jesus, convincing me that God really WAS full of empathy for the human condition.

The most amazing thing I ever made was; milk.

My favourite book is; The English Patient by Michael Ondaatje (poetry disguised as prose).

I adore being; in a classroom, outdoors, with my family, cuddled.

Give me a broom and I’ll make you some; Dog hair soup? What kind of a question is that?

My perfect date would be; dinner at the boathouse, and a walk along the pier, and at the end of it all Brent gives me my lost wedding rings which he found and decided to surprise me with...

As a blind date, I would be; a moron. I'm sure of it.

When my style is in fashion, it will be; a sad day for my mother!


Yesterday I; worked twelve hours and was really cranky...got chewed out for half an hour by a coworker (a renowned asshole) for something I didn't do. Drove home and put it behind me so I could face three sparkly eyed crazy kids with enthusiasm and patience.
I'm tired of my job. I am done. I don't care anymore, I just want to walk away from being treated like a pile of dog poo.
C'mon, midwifery school....c'mon....

Thursday, April 15, 2010

Yup, abscessy

So I went to my doc, and she said yes, it's an abscess. Which I spelled wrong in my previous post. I was a little distracted.
She said it's better that it opened and drained, because that is what her treatment would have been anyways. Yuck. And she gave me an Rx for antibx cream, and some oral antibx to keep the prescription on hand in case it does get worse rather than better with just the cream. Whew.
Then I asked her about my eye, because I have pink eye (I never had pink eye once in my life until I had kids and now I've had it three or four times in seven years. ROCK ON). So she gave me an Rx for drops for that, in case it doesn't go away in the next few days because it might be viral.
Then I asked her about my blood test results--BONUS to going in today, I get to discuss my results even though nothing came back glaringly off because they didn't call me; they call if results are off but not if they are fine, but this system is dumb because what if the fax got lost? Or no one read it? Or things are only slightly off? Anyways, a few weeks ago I went in and saw my Dr's locum, whom I like better than I like my doctor, btw, because my hair is falling out. I'm going bald. Did I mention that on here? I can't remember. Well, anyways I am. So I went to have my thyroid checked, and asked her to check for anemia and diabetes, also. I fasted, I went and got vampired, and then never heard anything so figured things must be normal. But BONUS, today I went in anyways so I got to talk to her about it.
She said my B12 (or B6? Can't remember) levels are good (they were over the top number of the average levels, I take a B vitamin). My thyroid is mid level, totally average. My RBCs are normal. My ferratin is normal. Good to know. My doc actually printed off my results and gave me a copy! So great! However, my fasting blood sugar was 0.2 above normal~not high enough to diagnose anything, but she said we should 'keep an eye on it,' and retest every year in case I develop Type II diabetes. She asked me about Gestational Diabetes, and I told her that I wasn't at risk in my first pregnancy so I wasn't tested (I was 24 and had no risk factors), and my second pregnancy I refused the test because of chronic yeast infections and not wanting to take the sugar bolus. I said my babies didn't look like GD babies, so if I did have it, it was well controlled. She told me GD is a pretty good predictor of Type II later in life, and dismissed my assessment of my babys' appearance and said, "You can't tell by looking at the baby." I tried to say, "No, you know, the uncontrolled GD babies have big abdomens and flabby fat," but she almost shook her head off its neck, "No, you can't tell that way."
But I know you can! There are distinguishing characteristics! I'm not stupid. But every time I go see her she makes me feel stupid. 99% of the visit is fine and good, but then she always gets her dig in, to ensure that I know she's the expert and I'm the dummy who can't be trusted with the direction of my own health care.
And of course she doesn't counsel me in how to AVOID Type II diabetes, she just tells me to come in and be retested once a year. WTF. Allopathic medicine chaps my ass. NO preventative medicine whatsoever. My doctor drives me crazy. I ALWAYS arrive apprehensive and leave frustrated, because of this tendency to put me down at some point during my visits. She's sorta friendly, and I feel she's compentent as an medical practitioner, and she and I seem to agree when antibiotics are needed and not needed, when bronchodilators are needed and not needed, and she gives pretty standard care compared to other physicians. She confirmed what her locum had said about my hair loss, that sometimes it is related to pregnancy and breastfeeding, and will stop when I finish having and feeding babies. And she said it should grow back. So that's good.
She did ASK how old my baby is, and how long I plan on breastfeeding. She didn't indicate she disapproved, nor approved. But the question itself is a judgement. Or maybe I'm just too sensitive.
So. Pros about my doc?
1. I have one.
2. She's female.
3. She does a standard job.
4. She sees me when it's critical.
5. She has a really nice locum.
6. She generally lets me do what I want with minimal fuss.

Cons about my doc?
1. She's chronically 30 to 60 minutes late.
2. She bills four times as much as your average doc in Langley (you can find their billings online)
3. She makes me feel stupid at least once during the majority of my visits.
4. She laughed at me once for asking if Ayden needed allergy testing when he was too young. You don't LAUGH at a concerned parent. You EDUCATE.
5. She told me "Some women just get them a lot," when I first developed chronic yeast infections and she had done some investigating and got to the end of her known treatments. Wow. That's helpful. Here I am, in pain and infected for the sixth time in four months, allergic to the OTC creams, and she's all [[shrugging shoulders]].
6. She has a tendency to hear of a published study or review and get stuck on those as the gospel truth. Medicine develops. Abnormal presentations happen.
7. She can be dismissive.
8. I don't really connect with her.


Sigh. Hunting for a doc who is taking patients in your own town in Canada is like hunting for a humble man in academia. It takes some doing. The task is so daunting that I put up with the riffraff.

That's my story and I'm sticking to it.

xo

Thanks for loving on me!! And mom, I didn't tell you because I figured you had enough breast lumps in your life in the last year. But if you want me to, I'll share in the future.

:)

There's a hole in my boobie, dear liza, dear liza....

So, if you are squeamish or don't want to hear TMI about my boob, discontinue reading here [hah! Like you don't already know scads about my boobs, but in any case...]

Two weeks ago I lifted up my breast for some reason and noticed this lumpy thing that looked kind of like a big zit on the side of my breast, beneath my line of sight. I thought that it looked weird, but figured it was a zit and would go away. I don't usually get zits there, and this didn't really have a zit head and wasn't painful, but it wasn't hot or sore so I figured it wasn't an infection and I would watch to make sure it went away. I didn't tell anyone except Brent about it, because I didn't want to freak anyone out. Anyone who hears 'lump' on 'breast' thinks cancer, so I figured I'd wait.
In a few days it seemed to shrink, and nothing ever erupted to the surface so I relaxed. Then a few days later it was bigger. And redder. And then it shrunk again. And then it got enormous! And painful! And hot and reddish purplish. And Tuesday I could see a large (nickle sized) mass of what looked like puss under several layers of skin, so I called my doctor. They couldn't get me in before next Tuesday, so I made an appointment for then. But I made plans to go to a walk in clinic in the meantime. Yesterday, however, I was scheduled to work a day shift and as a part time employee I am not eligible for paid sick days, so calling in sick to go see a doctor about my boob thing would mean I would make $0 and have to pick up an extra shift somewhere else--which is VERY tricky given our three kids and Brent's work schedule. So I went. And this morning I figured I would go to a walk in clinic. So I woke up and it still looked big and purple and red and painful, with pus under the skin. Then while breastfeeding Riley brushed it lightly, and the top popped off it and all this bloody pus poured out! SOOOOO DISGUSTING!!!!! I'm not going to a dirty, high traffic area walk in clinic with an open wound to a doctor I don't know, so I phoned my doctor's office and BEGGED them, and they fit me in today at eleven, which is in an hour. I think actually that it is an abcess. GROSS!
I went to have a shower and figured I'd bandage it to keep it dry, and now there is an ACTUAL HOLE in the side of my breast, about 2 mm across, and you can see the inside of my boob through it. Much of the puss has drained out but it is still sore. OMG. WTF. Every time I look at the HOLE IN MY BOOB I have to fight off an anxiety attack. I didn't realize an open wound on my breast would freak me out so much, but it does! I have a lot invested in the health and function of my breasts at this point in my life, I guess! The open wound thing is freaking me out.
Which is hilarious, because I have seen so many disgusting wounds in my 7 1/2 years as a paramedic. I've seen gangrene, black feet, maggots, ulcers down to the bone, weeping holes, flesh eating disease, abcesses, you name it. But when it is on my boob, I'm freaking out.
AUGHHHHHHHHHHH!!!!!!!!!!!!!!!!!!
It's a small hole, really. And not much puss, really. And my breast is still making milk, and I don't have mastitis, or puss in my milk, or milk in my abcess (yet), or CANCER, so I should really be okay.
:)
I guess I'll need some antibiotics, which puts me at risk for another breast yeast infection....yay....
:(
But hooray for the existence of antibiotics when we need them, hey? Too bad i didn't go to the doc yesterday, antibiotics would probably have cleared it up without the hole and subsequent drainage!



(my breast doesn't look this bad)

Tuesday, April 13, 2010

My mom's comment

My mom made a comment on the NICU discussion we're having that I thought would be good to publish where everyone can read it. She's got a good perspective, because she works in the field. Here is what she had to say:

From my experience, the NICU you visited is no exception, though the degree may be worse than others. What you describe is the "standard of care" promoted in north american hospitals. Nils Bergmans research is not well known or well received. Pediatricians are not trained to value "attachment parenting" in the NICU and often sabatage any enlightened nurses. We healthcare providers can model and educate our peers but I feel parents have much more power to elicit change. Spread the word! These babies belong to their parents, not the institutions caring for them. Come prepared with research and evidence. Through out my career I have seen the biggest changes in maternity care come from consumers. My generation got rid of enemas and shave preps (aka brazilians!) and got dads in the delivery rooms. Now you guys are challenged with lowering the C/S rates, taking control of labour and demanding your parental right to advocate for and nurture your your children from birth.
makes me tired just thinking about it!
I'm passing the baton, Melissa!
love mom


I'd also like to add that this morning I spent four hours on the maternity ward shadowing the Lactation Consultant in the VERY SAME HOSPITAL and saw a totally different world. In fact, two of the babies/women we helped had been in the NICU and were sent to the pediatric ward, where every baby had a private or semi private (shared with one other patient) room, and a bed for a parent next to their crib. And parents were rooming in, around the clock. The presence of a bed for a parent, and privacy, and a little (okay, a lot) more square footage is a powerful message that "Parents are welcome here!" And so they are able to follow their natural instinct for proximity to their infant.

What an amazing difference a bed makes, eh?

I also saw a woman today who had her baby yesterday (by VBAC! Yay for VBACs! I told her "Good for you!" at the end of our visit, and she flashed me the proudest smile!) who probably has breast cancer. She has what is aptly called 'orange peel' appearance to her skin, and a breast lump, both of which developed in the last two weeks. Her doctor did not examine her breast when she mentioned it at her prenatal appointment, and it got progressively worse and now her baby is unable to latch on that breast because the tissue is so hard and swollen. Orange peel appearance is indicative of a virulent form of breast cancer. Ooch, poor woman. Poor baby. Poor little family! Here's praying and hoping it is not cancer, but rather some form of dermatitis or something!!! So sad. She breastfed her first baby for 13 months and was hoping to do the same with this one, and the L.C. I was following did not discourage her in any way, because she cannot diagnose cancer, but afterwards we discussed the fact that chemotherapy is contraindicated with breastfeeding. She will have to wean if she does, indeed, have cancer and needs chemotherapy. Radiation treatment is not contraindicated, but this looked pretty bad, likely not a candidate for radiation therapy only. Of course, I'm not an oncologist! So I could be wrong!

Toss a prayer out for her, okay? Some paths are so steep and difficult...

Sunday, April 11, 2010

NICU question

Tonya commented that she hopes this NICU I visited was the exception. I have not visited any other NICUs, but I think it is pretty standard, in both Canada and the U.S. Allopathic medicine has a tendency to fragment patients, separating their physical well being from their emotions and discrediting the impact of social interconnectedness. This tradition is slowly changing, but in order for change to be effective, it has to be a deep cultural change, which acknowledges how important wholeness, and touch, and social, emotional well being are to our health and quality of life. I think often, when NICUs are better than the one I saw, it is a concession rather than a culture change.
The NICU I visited has a reputation for being one of the 'worst' in our area as far as parental involvement (and breastfeeding support), so that is hopeful regarding the other ones. But even in the 'better' ones, babies often 'have to have stable temperature and blood pressure and heart rate BEFORE their mothers can hold them,' which is the opposite of what Nils Bergman has found in his research and practice with premature babies. Kangaroo care, touch, and being held is what helps babies stablize their temperatures, blood pressure, and heart rate (likely because their stress hormone levels drop).
Anyways, I thought I would respond to Tonya's comment with "Some are better, but the vast majority have a really long way to go." With a disclaimer that this is mostly based upon third party reports and friends and family who work in health care or have had babies in the NICU. So things might be better or worse than reported here. :)

In Five years

In five years this is what things will look like in our family:
Ayden will be 12. Yikes! He will be a year away from being a teenager!
Matthew will be 11. Can you imagine Matthew with a deep voice? Omg, that is hilarious!
Riley will be 6 1/2. He'll be halfway through grade one! Ohhhhh, nooooooooo! So sad :((((
The cat will probably be dead.
The dog will be approaching senior citizenship.
I will be 37. ACK! I'll be OLD! (I'm joking. And poking fun of all of you who are 37 or older)
Brent will be 39. HAHAHAHAHAHAHAHAHAHA!!!!!
Brent will have 7 years seniority and experience in his job. Jeepers, I wish I could share with you some of the stories that come out of his job, to augment my paramedic stories. Some are hilarious, some are sad, some are just plain frickin' weird! But I can't. You'll just have to ask me for some stories when you visit me in person! :)
Lotsa love. We have tons of that.


In five years this is what I hope for and would love to see:
Adyen, Matthew, and Riley involved in music (Matthew wants to learn to play guitar, and I'm going to start teaching Ayden violin as soon as we buy him a violin (we are in the research process now). I'd LOVE to be a musical family, singing lots and playing instruments and everyone making fun of me for having the worst voice in our family!
Me, graduating from midwifery school and setting up practice!
All of us moving to a smaller, slower paced community with no freeway and a less materialistic subculture, where we can have a small acreage with a vegetable garden and chickens and a compost, another dog, and a cat who can have a litter or two of kittens. We had kittens and puppies and colts/fillies so many times in my childhood, and I caught birth fever then, I think...

Wowsa. Them's some changes. The thought of Ayden as 12 is really freaking me out! Funny how you just don't actually put the future into a mental picture like that, eh? How old will YOUR kids be in five years? Yeah, how d'you like THEM apples?

Gratitude

I'm grateful for~
...my three boys
...weekends
...the opportunity to learn (school! I'm so thankful for school)
...this husband of mine who works hard, loves deep, and kisses perfectly
...my extended family, who give of themselves ceaselessly
...breastfeeding
...birth
...omega 3 fish oils and thought records, which keep me sane
...sunshine
...cherry blossoms
...you

Wednesday, April 7, 2010

Project Finished!!!!!

I completed my group project for school, and presented it yesterday evening!!!! Hooray, it's done! Our group did FANTASTIC, our poster was fabulous, our presentation funny and engaging, and our written report well done. Phew! That took some TIIIIIME! In the end we did a poster on oversupply--so, not the sexual abuse topic I was considering, nor the other topic I mentioned that I can't remember now....BUT, interesting nonetheless. I can't get blogger to upload my poster, so I'll see if Brent can save it in a format where I can so you can all see. I learned a ton. I cried in frustration at one point. I was overjoyed when we were done. I would be willing to bet we had the best presentation in the class. Shazzam!
[yes, I did just say shazzam]

Hurrah! Now, only one more class and then the final exam, and I'm done! I also have a job offer out of the class--one of my classmates is going to become a Lactation Consultant and open her own private practice. She is worried about meeting the demand in our area and is looking for a partner. At first I thought she meant another LC, but then she said she would be happy to work with a breastfeeding counsellor as well, and then we sorted out that YEAH I'd love to work with her and YEAH she'd love to work with me (I'd take the simpler cases and she'd be available if I needed help, and we would let women know that I'm not an LC), so that has potential to turn into something great! Something I could totally use one of my awesome name suggestions you guys gave me for!!! It's got potential, anyways.


And I need to debrief. I've been avoiding this because it's not so nice, to think about, write about, or respond to, and y'know, it could be considered slanderous if anyone from a certain NICU read it. But I have to debrief, and it's been percolating for awhile.
I went for a clinical observation day to a NICU in our area for the breastfeeding course.


The ward I visited was a 25 bed ward, and there were 25 babies. One incubator was empty because another bed had a set of twins cobedding in it. So the ward was pretty much full, and bustling. I was SO not impressed with the fact that I was supposed to 'float around' instead of being assigned to a nurse, because when I tried to introduce myself and observe, all the nurses said a friendly "Hi!" and then ignored me. Attempts to ask questions were either obviously unwelcome or met with short answers and backs turned. One nurse shooed me away because she was "too busy." I hated it. How am I supposed to learn in that kind of situation? The breastfeeding support I saw was in the realm of sabotage and setting up for failure with poor breastfeeding practice, information, support, and promotion. One woman was trying to breastfeed her jaundiced, full term baby, but the nurse kept giving the baby bottles of formula every time the woman left the ward. Most women with premature or sick (overwhelmingly both) babies were pumping, but a bottle of formula was set at every bedside and I'm positive they were used. One formula feeding shifts the pH of a baby's bowels to a more basic environment, making it a more hospitable environment for pathological bacteria to grow [with constant breastmilk feedings the pH returns to a normal acidic environment in 3 to 4 weeks]. Premature babies are at particular risk for Necrotizing Enterocolitis, where parts of the intestines get infected and die, causing pain, illness, permanent disability, or sometimes death. Formula feeds increase the incidence and severity of NEC for premature babies. I saw quite a few incidences of formula feeding in NG tubes or bottles, and several incidences of breastmilk in NG tubes or bottles. Not one preemie was put to the breast while I was there. Not one baby was put skin to skin. And here is the worst part, which was so traumatic, and which had me crying while I was driving home. Knowing what I have learned the research shows about Kangaroo Care for premature babies, the effects of separation and stress on babies (long term health deficits) which are even more pronounced for premature babies, it was really, really hard to see these babies lying in their incubators with no visitors. While I was there, the jaundiced baby's mom visited twice to breastfeed, and looked prepared to set up camp after she herself was discharged from the maternity ward. A baby who had been in the NICU for three months had a mom visit for an hour, during which time she talked and touched him but was clearly petrified to pick him up or do any baby care (understandably so, since random things caused him to stop breathing for up to a minute at a time--but I'm positive the culture of the ward contributed to her total disempowerment and overwhelming anxiety when it comes to caring for her baby). And the twins had both mom and dad there for two hours. So that is three babies out of 25. Actually, four. That last one was a set of twins, so that's four. Twenty one babies had no visitors. Their medical needs were met, their feeds were done, their health status monitored, but they were not held, talked to, or loved on by family. My textbook says,

"Physical closeness can help reduce emotional stress for both mother and baby."

and
"[Dr. Nils Bergman] describes the baby's (and all other mammals') physical reaction when removed from his natural habitat [which is on the mother's body, on her chest, tummy to tummy], the "proteste-despair response," which is programmed into the baby's hindbrain to ensure survival by decreasing energy consumption and growth via lowering heart rate and body temperature and massively increasing the production of stress hormones. As part of this response, the baby also emits a "separation distress call" to alert the mother that her baby needs her. Once mother and baby are reunited, baby's heart rate and body temperature increase and stress hormones decrease.
Research has found that skin to skin contact of mother and baby reduces the production of stress hormones by 74 percent. High levels of stress hormones inhibit gut function, digestion, and growth. Dr Bergman observes that what is currently considered to be the "normal ranges" of heart rate, temperature, and stress hormones of premies in incubators reflect this "protest-despair response," and that what is truly normal needs to be redefined based on a premie's physiological norms when in skin-to-skin contact with his mother."




When I saw how few parents were physically present that day I was dumbfounded. I know parents. I know TONS of parents. They all love their babies! They all spend tons of time with their babies! They all hate separation from their babies! If their babies are sick they are hovering insomniacs. So, where are all the parents? Some parents were probably sick, caring for other children, sleeping, or any number of legitimate activities, and I was only there for five hours so that leaves a good 19 hours of day (although I doubt many parents visit at night) I wasn't there to observe. I think also that one baby had been born prematurely to a drug addicted woman and apprehended at birth, so it makes sense that she would have been alone if she had not yet been matched with a foster family. But what about the other babies? Alone in their incubators, quietly protest-despairing? As adults we know these babies are well cared for, safe, and the focus of concern for many adults, including family, nurses, doctors, interns, and students. But from a biological point of view, this baby feels that it has reached maximum danger: separation from its mother. It does not know that it is the focus of all this care, but senses danger because of separation from its natural habitat: its mother. And it is left in this state for hours upon hours upon days upon weeks, with minimal interaction with what it knows as safe.
We know from research by Nils Bergman that it is 100% possible to bring together the miracles of modern medicine that is keeping these babies alive, and the miracles of a mother's touch, which sustains and settles a baby so it can focus its energy on the overwhelming business of living and growing.
What I saw seemed overwhelmingly inhumane. It was cruel.
I don't blame the parents, or even the hospital staff, but I would allocate responsibility to the NICU subculture. Not one of the NICU nurses or doctors had any breastfeeding training, and most seemed to equate formula with breastmilk as an infant food. Not one of the incubators had a bed for a parent, and the chairs that were present were not comfortable to sit in for long periods, and definitely not possible to sleep in. The space was limited, and any breastfeeding that was done, the nurses quickly rolled over a screen for privacy, which is considerate if that is what a woman wants, but sends a subtle message that what she is doing doesn't really belong in this space, particularly if it is not something she wants. Which was the case with the woman whose baby was jaundiced: she kept rolling her eyes at me when the screen was wheeled over, and it made things really awkward for her as she obviously did not want the screen.
I have been to a great number of pediatric wards during my career as a paramedic, and ALL of them have a crib or small bed for the patient, and A BED OR PULLOUT CHAIR WHICH BECOMES A BED FOR THE PATIENT'S PARENT. Why are sick babies any less in need of the presence of a parent? Close proximity to its mother is the only safe place an infant knows. Just because their protests are in the protest-despair mode, we don't clue in to the fact that they are in distress. In the absence of the presence of its mother, AN INFANT KNOWS ITS FATHER'S VOICE AND MANNERISMS, and should be place in HIS arms, skin to skin, for safety and comfort as much as possible.
I know that this NICU performs miracles every single day, and saves the lives of these tiny babies. And I should really consider and appreciate this fact more. I should. I know it. But sometimes, saving a life is not enough. You have to do it humanely. REDUCE SUFFERING. Studies show that a breastmilk only diet, early and eventual exclusive breastfeeding, kangaroo care, and the constant presence of the infant's mother results in better outcomes for sick babies. Fewer get sick and die, fewer have setbacks, their setbacks are less severe, they go home earlier, they thrive better, their parents feel more competent to care for them, and they grow up to have healthier lives, higher IQs, and more stable mental health than their non breastmilk-only-kangaroo-cared-mother-present peers.
One plus one equals TWO! We could be so much further ahead if we put NICU interventions together with baby friendly practices. And then I wouldn't feel the NICU was so cruel and inhumane, and I wouldn't feel so sick at the thought of 21 babies in medically functional but socially and emotionally sterile environments. Not to mention all that formula. No donor milk available, just mother's milk and fortified hydrogenated cow's milk proteins.



Anyways. Maybe you all think I'm crazy, or just too sensitive. But I feel that I'm a fairly seasoned paramedic who has seen all kinds of suffering, and my radar was screeching with dissonance and empathy over what I saw in that ward. Nobody was abusing any babies or mistreating them when they moved them around, nobody was neglecting handwashing or heigine, and everybody had an attitude of bustling care for these tiny patients. There was no INTENT of cruelty, but I believe there was systematic cruelty going on regardless of intent. It sucked. And it's hanging around in my brain, and now on my blog. For you all.

Thanks for listening to me rant. It was really hard to see.

Sunday, April 4, 2010

Perspective

Thanks for the suggestions so far, for a company name. Keep them coming if you think of more!!! I'm still percolating, with everyone's ideas (I may have vetoed Fn SMel's for obvious reasons) and am SO grateful, because I really didn't know where to start. So great!

Yesterday I had my first taste of really feeling like a girl lost in a forest of boy. Since my plethora of boys was born I've never been anything but surprised by how FUN it is having boys! Fart jokes and burping and penis fiddling (which starts at like 6 months) and wrestling and climbing and boy NOISE (including the vehicle noises and the animal noises and the 'I'm about to leap on you with only a nanosecond of warning and no concern for your welfare' noises, and the just general loud kid play noises) don't bother me. I often join in! I like having kids I can playfully smack upside the head or shove into a snowbank and get a squeal of laughter out of 99.9% of the time. I can fart better than most men, and think it's hilarious. BUT. I'm still a girl. And yesterday, nobody seemed to understand that I had had enough teasing. My buttons were being pushed and being pushed and when I tried to communicate that I had had enough, that communication was viewed as the revealing of another button to push. You know what I mean? Like in elementary school--or high school, for that matter--when boys kept teasing and teasing relentlessly even when you started crying? Yesterday was like that. And yes, Brent was in on the action. I had some foreshadowing of life with three teenaged boys, egged on by their father. Jeepers. Like sometimes it would just be nice to have someone UNDERSTAND! Someone to go to the spa with. Or shop for shoes with. Or get free hugs from without having to bribe or 'trade' for them (as in, I will use the scissors to cut this scrap of fabric you asked me to cut if you hug me first). Someone who would want to play My Little Ponies instead of Light Sabre Death Destroyers, or maybe brush my hair and tell me I'm pretty.

My niece puts chapstick on her face like it's makeup--on her eyes, lips, cheeks, etc--SO CUTE! One day she had an allergic reaction to the grape sparkle chapstick she had gotten as a gift, and her whole face swelled up. Oh my gosh, how cute is THAT!? But someone like that, who would *get* my girl self without much effort, would be really nice.
Anyways, it was my first real overwhelmed by boy experience. So I thought I would note it here.

Today was easter. In case you hadn't noticed. Easter is a very meaningful time of year for me, because although I grew up in the church I really count my first adult, autonomous, individual choice to follow Jesus at Easter when I was 16.. Which sounds very cliche and funny! But is so true and deep and meaningful for me. It means a lot to me that God understands experientially what it means to be human. And I'm grateful for never having felt abandoned since, despite many peaks and valleys (and valleys, and valleys!). Life shouldn't be easier. But it sure makes a difference to me to know God's love for me deeply and to feel Him walking alongside and behind me, holding me up every step of the way. I often forget important truths about God and about myself, but I don't feel alone. So, I'm happy for easter. It usually makes me cry at easter time to look back on the now many years of love and patience and walking alongside that I have experienced from God.

Today we went to Brent's parents' church so we could be together on easter, since we were all in town. Brent's brother is at RCMP depot and came home for a 36 hour visit, much like the visits I remember so clearly from when Brent was away. It tears your heart out to have to watch his kids and his wife get just a short taste of being together, and have to say goodbye again! I remember so clearly how awful that felt. I'm excited for my brother in law, though. He will make a very good cop. Brent makes a very good cop, too. The patient and compassionate yet firm and confident kind. Not the 'force is good in all situations' kind. Or, like one cop in Chilliwack whom I run into on a regular basis who seems to get a kick out of pushing the buttons of psych patients and getting them MORE riled up rather than calming a situation down. Anyways, today we went to Brent's parents' church and it was interesting because during the service the music pastor described this profound experience where they heard a scuffle in the street behind their house one night and looked out and saw a man assaulted, slump to the ground, and then about a million emergency crews show up and hang around for hours after the ambulance left, interviewing witnesses and stuff. It turns out the man was stabbed and died shortly afterwards. It was an incredible situation to witness and made him think about some existential and philosophical stuff about the state of humanity and things....
But as we were driving home afterwards I said to Brent, "Isn't it interesting how someone can witness something like that and have this profound life changing experience that really makes them ponder the meaning of life, but for people like you and I who do the work we do, a story like that is just another day on the street?" Not that we don't take death seriously, but it ceases to be an existential driving force when you live with an experiential awareness of the fragility of life because of your job. Of course this isn't a criticism of people who don't have that awareness--if you rarely saw death, particularly tragic or violent death, of course it would move you to see someone killed. In fact, that call would certainly move me if I attended it in an ambulance or saw it in my street from my window. But its impact would be different, because my context is filled with stories like that one. And I have to say that the few times I have actually watched someone die have been breathtakingly difficult. But the storytelling itself was interesting, because I was aware of the dichotomy between this being a life changing event to witness for the pastor, yet for me listening I kept waiting for the unusual information to surface, or a black joke to be made, as would happen if the story was relayed to me by another paramedic. The simple story of a man stabbed to death on a dark street sounds within the realm of normal for me, and I know so clearly that this is not the case for the man telling the story, nor for the congregation hearing it.
It's just interesting to note the isolating effect of working in emergency response, and how clearly it comes into focus when I hear stories like this one. Of course it is tragic and profound! I'm not minimizing that. But tragedy is normal for me. In fact as some of you know it can be difficult for me not to EXPECT tragedy as a natural course of life, because it is so normal to me. It takes effort for me to believe my kids will all grow up into adults. Semi normal, healthy adults without drug addictions, major mental illnesses, spinal cord injuries, or early death. It takes enormous effort for me to stay in a mental space where I believe that my kids will grow up, and be healthy and intact. Fortunately, there are fish oils and B complex vitamins and St John's Wort to help me bridge the gap between my skewed perspective and statistical probablility!! :D These are my Prozac.
Such is life!


Saturday, April 3, 2010

Still need name suggestions....

I don't want you all to forget to help me out with suggestions (Caryn's is FUNNY but a bit too long, I think???) for a company name, but I wanted to share some signs from a funny email forward my mom sent me:






My favorite is the cat. There you go: a sample of my sense of humor! This is what I find funny!!!

Needing Input and Ideas!

I need a company name. I'd like it to be kind of open and encompassing, so that I could include all of the following:
Doula care (if I continue), Midwife Homebirth Assistant if I follow this route, future midwife, breastfeeding and post partum support, crocheted toys, AND my serious art/paintings. I need to make business cards, and I would like to develop a website so it should be website-friendly or shortenable. I like names that are meaningful, often in different languages or latin or root words with lots of meanings. Several words would be fine.

I'm having a heck of a time coming up with a name all by myself. Any ideas??? I'm open to all kinds! Even something to start with, where we can play around and come up with something really cool...

Hi!

I miss posting on here. I really do! I think about you guys all the time, and what I'd like to say to you, but am too busy to get to. So tonight I'm going to miss out on some sleep and say hi. Nothing profound or really even all that interesting. But it is good to get back on here again!
I've been busy with school, mostly. This part of my breastfeeding counsellor's course is really intense, with a group project due and a final exam coming up, and clinical observations to do. Ack! I'm drowning in boobs and milk. I love the course but am NOT loving this group project thing. My group is great and our topic is interesting, but we are designing a poster on the computer to be printed at Kinkos and I find this type of thing extremely intimidating and V.E.R.Y. frustrating (ie, the other day I was working on the poster and every time I tried to save a change, the computer would crash. There were some tears. I don't understand computers. Just when you need them the most, they hop on the bus and take off to the next town and get themselves a girlfriend. Who invents a machine like that? With software that doesn't do the job it purports to???! Seriously).
BUT. HOWEVER. I learned a LOT by doing this project and would in future be far better equipped to tackle something like this. So. That's great! Especially considering I'm staring down the telescope at 4 years of school to train in my new career.
You know, I learned yesterday that students at UBC's medical school get 4 hours of training on natural birth? 4 hours! Yikes! I had a doula client whose husband didn't want a midwife because a doctor has gone to school for 'a lot more years than a midwife has.' Um, in one sense, yes. In another: SAY WHAT? Four years of training in natural birth vs. four hours? Total years spent in school can be deceiving. I guess if you think birth is a dangerous event where all can and might go wrong at any moment and leave you childless or wifeless then yes, a doctor might be your best caregiver, since they have a ton of training on pathology and what can go wrong and how to deal with it. But a normal, natural birth has lots of variations, which even four years of training in can leave you with variations you haven't experienced yet, and a midwife trained in normal birth plus how to recognize pathology and refer to a doctor when appropriate, you're in much better hands. In my opinion. And in the opinion of statistics, since doctors have higher intervention rates.
I rant.

In other news, I got up this morning at 10:45 a.m. WOW! I haven't slept that late in YEARS! Holy crap! My older kids got their own breakfast and turned on the TV, and Riley slept alongside me. He has a cold. I guess he was extra tired! That was AWESOME POSSUM!!! Sometime after breakfast Riley got into the wooden trains we have--some Brio and some Thomas the Train stuff. And within a few minutes the older boys caught on and soon all three kids were absorbed in complex wooden train play, with multi system tracks that went from playroom to hallway to bedroom...it was VERY cute, and the first time all three have been so absorbed in playing with one toy all together like that. It was pretty neat!

We spent part of Spring Break at my cousin's place in Victoria and it ROCKED! I wish we had been able to stay longer. She has the best house and yard and dog and kids and self EVER, and we agree on so much and talk so much, it's really fun. Whenever we visit Victoria we wonder, "Why don't we LIVE HERE???!" And make plans to move. It's very high on our list of places to move to in the future.
Ayden wants to become an entomologist and work at the Bug Zoo in Victoria when he grows up. He has convinced Matthew that this is what he should do, also, although Matthew is afraid of bugs and won't touch them. This is hilarious. Ayden is also doing a science project on Bugs and is the most enthusiastic mini scientist in his class because his science project is on his favourite topic in the whole world. I think there may have been some awareness of this on the part of his teachers ;P I took him to the public library and we checked out a book on bugs and he has read the whole thing cover to cover three or four times and keeps dropping all these random facts about bugs. "Did you know that crickets have ears on their legs, mommy? And that aphids are as small as the period at the end of a sentence? And did you know I pet the scorpion at the Bug Zoo in Victoria and I wasn't even scared? It wasn't gross at all! It was just sort of hard and smooth, and it didn't inject me with its venom at all." Yes, I think I would have remembered if it had. I am your mother, after all! Isn't it funny how kids tell you stuff as if you didn't know it, when you were the one who taught them the stuff in the first place, or you were there to witness it?! So funny.

Matthew has been participating in Dr Winters' Log Book/Pee and water drinking schedule for several weeks now. He goes along with the schedule and seems to be improving a tiny bit--when he has accidents now they are less frequent and more like flooding and less like pressure release pees. Which sounds worse but is actually much better. Those pressure release pees really sucked. He floods about once a week. Once at a birthday party. I dropped him off and an hour later the phone rang and it was the dad, "Hi, Mrs. Vose? This is so-and-so's dad. Matthew peed his pants. Can you come and get him?" Nice. Birthday parties are like the Last Frontier of bladder control. There is SO MUCH FUN GOING ON and SO MANY DISTRACTIONS and tons of food that worsens irritable bladders, that it's pretty much hopeless. I should have put him in a pullup for the party, I guess.
But most days, normal days with home and school and family stuff, he is dry. He pees on schedule and in between and listens to his body and doesn't stink or fill up his pants with squirts or frustrate me so bad I want to tie him to a tree and leave him there to be adopted by wolves like Mowgli. So that's an improvement! I think the key components are: increased water intake!!! And peeing on a schedule, and rewarding adherence to the intake and pee schedule, and ignoring the accidents. That way, peeing becomes more habitual. It will be nice when the floods are gone and we can finally conquer the Birthday Party. Easter is hard because he's not supposed to eat chocolate (or citrus, caffeine, or carbonated drinks). Sigh. There may have to be some putting up with floods this weekend. Oh well.

I should go, because it is one o'clock in the morning now! I've a twiddling baby on my boob who wants me to stop clicking behind his head on the keyboard. And p.s. I HATE TWIDDLING!!! Twiddling is where a nursling drinks from one breast and wants to play with the opposite nipple with his hand. They loooooove that other nipple! And it feels like hyperstimulation overload and I hate it! Plus it turns me on to have both nipples played with at the same time, so I'm not interested in having my baby do that for me :P
Is that TMI?
Riley knows I hate twiddling and will try SO hard to resist when he is awake, twisting his wrist around in circles just above my nipple but not actually touching. But when he is tired or half asleep, up the shirt goes his hand, hunting around for a quick twiddle...
When we used a soother he didn't twiddle me, because he twiddled the soother nipple.
Okay, now I really have to go because he just put his hand down my pants! Unless I want my pubic hair ripped out by the roots I really have to go monitor Mr Gropey Hands!!!!
:D