12.30.2008

Welcoming the New Year

My mind is racing. There's so much I want to do. Small adjustments in the daily routine to bring more health and balance to mind and body for myself and my family. Start preparing for the growing and inquiring minds of the kids - trips, projects, looking into spiritual resources that fit our values, thinking about ways to start bringing them into greater interaction with the world around us in a way that fosters a sense of community and mutual responsibility. Roadtrips and camping.

It's all a bit too early for most of that (they're only 3 and 1) but I want to start thinking about it now.

I'm already a little bothered by the consumerfest that was Christmas. I guess to some extent there will always be some gift giving and I do enjoy the excitement and joy the kids get with their new toys, but next year I want to temper it better with other activities that also turn this season into a time of reflection and reaching out. I was so swamped with work in the days leading up to Christmas that I could barely come up to breathe. Now that I have a few days to myself before work kicks back in again, I can't help but take stock and think about how to do things better next year.

I'm looking into vegan cooking. I've just downloaded what looks to be an awesome cookbook from Vegan Dad. And today I'm going to attack clutter and take bags of outgrown toys and clothes to goodwill. And I've approached the firm about taking on a new pro bono client who just inspired the heck out of me with her story. We'll see what happens.

So much life to live and share and love and laugh and so little life to do it in.

Happy New Year, everyone.

11.26.2008

TypeAMama's A Writer

If you go to my profile, it will point you to my new blog, Smitten By the Words. You may have noticed I've opened my profile up so now you can see who I really am. I hope I'm okay with that. This blog has been a personal space for me to sound off about things that I feel pretty strongly about, and I wasn't sure I wanted that connected with my public persona. It's sort of like having an online diary: you know 90% of what you write is going to make you cringe when you look at it again a year later. I suppose if there are any regrets, I can just delete this blog, although the Toddler Tonsillectomy post still gets such an inordinate amount of traffic that I'd like to keep at least that up so that parents dealing with the post-surgical trauma still have the communal wisdom of so many generous readers to lean on.

I'm not sure how much writing I'll continue to do on this blog. I've really let it go the last several months while I wrote my novel and started the hard work of learning about publishing and querying agents. Writing the novel was easy by comparison. This is gut-wrenching. I want to write so badly it hurts. Honestly. But I can't justify spending all my time doing that if I can't contribute to the household with it - not when I've got this law practice that provides reasonably stable cash flow. And writing on the side? With a 1 year old and a 3 year old on top of my regular work? Crazy-making.

So, life takes unexpected twists and turns, and hopefully it all works out. If you've been reading this blog, thank you, and I hope you've found something here that touched you, helped you, gave you a chuckle or made you think about something in a new way. My grandmother told me that the way she knew when she'd learned something new was when she changed her mind about something. She meant it literally, but I'd take it further than that. Learning changes your mind. I love that. This isn't farewell - just a head's up that things are changing. We'll see how it goes. Meantime, if you want to follow the struggle of an unpublished author to break out into a new career, please come visit at the new blog and say hi. It's still a little lonely over there.

Rock on.

10.13.2008

What's wrong with "liberal"?

I've had it up to my mama eyeballs with the use of the "word" liberal in the McCain ads ("Obama and his liberal allies ..." "one of the most liberal voting records in Congres ...") as if accusing someone of being a "liberal" is enough to make people run in terror. It's pissing mama off.

Tell me what a person has done wrong, but don't expect me to get my panties in a wad just because they're a liberal. Time was, being liberal was looked upon as a good thing, a show of a refined, kind and generous character. I recently re-read Jane Austen's Pride and Prejudice (gah! what a great book!) and she frequently uses the word "liberal" as a word of praise to distinguish a particular character as being especially kind and thoughtful. Here's what dictionary.com has to say about liberal. It about sums it up. Liberal is not a bad thing. Trying to make people feel ashamed for reaching out to their neighbors, believing we can work together for a better future, daring to suggest that everyone should have access to a great education and decent, across-the-board healthcare - now that's a bad thing.

lib·er·al /ˈlɪbərəl, ˈlɪbrəl/ Pronunciation Key - Show Spelled Pronunciation[lib-er-uhl, lib-ruhl] Pronunciation Key - Show IPA Pronunciation
–adjective 1. favorable to progress or reform, as in political or religious affairs.
2. (often initial capital letter) noting or pertaining to a political party advocating measures of progressive political reform.
3. of, pertaining to, based on, or advocating liberalism.
4. favorable to or in accord with concepts of maximum individual freedom possible, esp. as guaranteed by law and secured by governmental protection of civil liberties.
5. favoring or permitting freedom of action, esp. with respect to matters of personal belief or expression: a liberal policy toward dissident artists and writers.
6. of or pertaining to representational forms of government rather than aristocracies and monarchies.
7. free from prejudice or bigotry; tolerant: a liberal attitude toward foreigners.
8. open-minded or tolerant, esp. free of or not bound by traditional or conventional ideas, values, etc.
9. characterized by generosity and willingness to give in large amounts: a liberal donor.
10. given freely or abundantly; generous: a liberal donation.
11. not strict or rigorous; free; not literal: a liberal interpretation of a rule.
12. of, pertaining to, or based on the liberal arts.
13. of, pertaining to, or befitting a freeman.
–noun 14. a person of liberal principles or views, esp. in politics or religion.
15. (often initial capital letter) a member of a liberal party in politics, esp. of the Liberal party in Great Britain.


--------------------------------------------------------------------------------

[Origin: 1325–75; ME < L līberālis of freedom, befitting the free, equiv. to līber free + -ālis -al1]

—Related forms
lib·er·al·ly, adverb
lib·er·al·ness, noun


—Synonyms 1. progressive. 7. broad-minded, unprejudiced. 9. beneficent, charitable, openhanded, munificent, unstinting, lavish. See generous. 10. See ample.
—Antonyms 1. reactionary. 8. intolerant. 9, 10. niggardly.

9.05.2008

Not Connecting the Dots on High Gas Prices

I keep reading from my elected candidates' newsletters, as they've gone travelling around Texas, how our number one concern here is the cost of gas.

They had to drive around the state/district to figure that one out?

Anyway. They also all say that to fix it, we have to make ourselves less dependent on foreign oil by 1) drilling drilling drilling here at home to eek out every drop we have, and 2) harnessing more solar, nuclear and wind energy.

Taking the second prong first, the sustainable (at least in the case of solar and wind) resources we have don't fuel our cars. They fuel our utilities, which currently are mostly powered by coal, then by nuclear and water resources. So, by switching to these sustainable resources (which I'm not arguing would be a great idea for climate issues) would make us ... less dependent on our own coal, nuclear and water resources, but would have zero impact on gas prices.

Gas prices are not simply driven by the supply of gas. There are two parts to that equation - supply, and demand. I learned this in high school economics (and a few college and graduate courses after that) (oops there I go - elitist with my elitist education and all, because education is just so shamefully elitist ... but I digress). Plenty of credible research out there (including from the current administration) claims that trying to lower gas prices by increasing our domestic supply will have little to no long-term impact on the price of gas. OPEC still controls the lion's share of the supply out there, and if we step up production, they withhold, and the price stays where it is.

However, we do have some control on our demand. We can push for more fuel-efficient cars. We have the technology, there's no change to our fuel distribution infrastructure needed (like hydrogen cells or all-electric cars require). It's right here, available now. We could increase public mass transportation infrastructure to give people yet another choice besides their gas-dependent cars for getting from point A to point B, making the supply-demand curve even more elastic as consumers have more choice and control over making a market-based decision for how much they're willing to spend on gas for the convenience of riding in their own car.

The little elasticity that we do have in the supply-demand curve now, combined with a slight strengthening of the dollar against foreign currencies (as we do buy most of our oil from abroad) is what has helped prices come down in the last month. Not increased production.

Gas prices are an economic phenomenon, with several realistic options available. Personally, I feel the politicians of either party who neglect to address the entire equation of supply and demand and instead only jump up and down about increasing drilling domestically are a disgrace, serving the profits of american oil companies by continuing to shout out a useless non-solution and distract their constituents from what might actually be effective.

Requiring higher fuel efficiency from cars means I'm immediately spending less on gas because I need less, plus it decreases demand overall and has a macroeconomic effect of a downward shift on the price - two downward pressures on my actual gas expenditures. And if I'm really fed up with the gas price today - I can take the local commuter rail. Take that, Saudi Arabia!

Why oh why aren't those conservative, fiscal economic geniuses in the GOP leaping onto this?

My own Congressional Rep. is John Carter. I subscribe to his newsletter, the Carter Courier, and I'm starting to feel a little sorry for him. He's so out of touch, and, like someone who is out of touch, he's oblivious to how out of touch he is. So it's a little sad to read his newsletter because it's like watching someone running full-on towards a big brick wall and there's nothing you can do to get them to see the wall ahead. If he gets challenged by any sort of qualified Democrat in the next election, this will be his last term, and I almost feel a little badly for the man. I know his heart's in the right place, and I believe he's faithfully served the best as he knew how. I wish him well, but he won't be coming back to office again.

8.06.2008

Vaccinations: Where I've Landed

This debate is really getting hot. The misinformation is flying all around, while critical information is either missing or being withheld. And more vaccinations are on the way, while the AAP is showing signs of taking a more aggressive stance against parents who wish to deviate from the CDC schedule.1 I've tried to distill down what I can from my own research. Yes, it's internet research, and my now ex-pedi would scoff at me for using the internet to research anything medical, but it's all I've got. I don't have a subscription to Lancet or the JAMA and there are plenty of abstracts of studies and government data available online. And with two graduate degrees, one of which included coursework in statistical analysis, experimental design, and regression analysis, I should be able to distinguish the hype from the actual information. I link to sources where possible.

1. If there were an award given out for the greatest invention of the twentieth century, I believe vaccinations would be on the short list for potential recipients.

2. Vaccinations save untold thousands of lives every year and prevent life-long injuries from disease including loss of cognitive function, deafness, blindness, and paralysis.

3. Vaccine manufacturers are not experiencing any sort of threat or burden from litigation or the threat of litigation for liability if their vaccines cause injury because they are IMMUNE from suit for injuries that their vaccines have directly caused. They have been ever since the Vaccine Injury Compensation Fund was created in 1986. The federal law that created the fund, which is paid into by the vaccine manufacturers, also made the vaccine manufacturers and every other party in the chain of supply down to the nurse who actually gives the shot immunity from suit for an injury caused by the vaccine. This immunity does not extend to negligence in the administration of the vaccine, but only covers injuries caused by the vaccines themselves. The immunity also does not extend to fraud or misrepresentation by the manufacturers, as well it shouldn't. I think it's enough that they are excused from liability for the injuries their products cause, don't you?

4. The studies to determine the safety of vaccines prior to their FDA approval generally observe the vaccine recipients only for about 3 - 6 weeks post-injection for any adverse reactions.

5. When adverse reactions do occur, they may or may not be reported to the Vaccine Adverse Event Recording System (although law requires the health care provider to report them, but how can this be enforced?), and there is little to no clinical follow-up of these cases to determine whether the vaccine caused the reaction, what were the short or longer-term outcomes, and whether any information can be obtained by studying these cases more quickly to determine whether there are additional contraindications for the vaccine for particular individuals. This alert from the National Vaccine Information Center regarding Gardasil's HPV vaccination gives a good example of the problem.

6. Scads and scads of studies have been run investigating the safety of vaccines, and time and again they are not able to turn up a statistically significant correlation between administration of the vaccines and adverse health responses. However, these studies (at least every one that I was able to review) were all epidemiological data reviews. Meaning, the study consists of gathering mountains of patient data from a bunch of clinics or hospitals or a specific region and slicing and dicing the data (yes, that's a technical term ;-p ) many ways to see if any relationship can be identified between the receipt of a particular vaccine and whatever health risk is being evaluated. The theory behind the value of epidemiological studies is that, if you have a large enough data sample, the size of the data alone should cancel out any oddities in the individual data so that you can have confidence that if any sort of relationship exists, it will show up in your analysis. Some of the studies rely on data that is from 20 or more years ago, some data pools are smaller than others, some are geographically limited, so these studies are only of limited value, and can't be pointed to, with scientific soundness, as evidence that vaccines are "safe." They can, however, be used to support the statement that so far, we have not been able to find a statistically significant relationship between vaccines and the occurence of asthma, irritable bowel disease, autism, encephalopathy, demyelinizing disorders (including multiple sclerosis), and a host of other diseases.

7. We still don't know what the causes are for a lot of these conditions that are on the rise or understand the processes in the body that are involved.

8. People point to the rise in childhood vaccines and the rise in autism as being parallel and therefore there must be some sort of relationship. Over the last forty years our living environment has changed radically, as have the diagnostic criteria for autism-spectrum disorders. The rise in vaccines alone is not sufficient evidence to link them to the rise in autism. The most recent research has suggested a genetic component to the onset of autism. Again, this does not prove or disprove that the now numerous vaccinations given to young children does not play any role in what must be a very complex etiology.

9. The body's first line of defense in most infectious diseases is the respiratory system. The most important part of our immune defense system, however, is our gut. This much we understand. Vaccines inject the material that triggers the immune response directly to the bloodstream, bypassing the respiratory system and the immune triggers that would have activated there. A few experts are concerned that this method of vaccine delivery could play a role in the increase of auto-immune diseases, particularly IBD. Although their concerns are only based on speculation, the idea that vaccine injections could be a contributing factor is not implausible. Meanwhile, there are very interesting developments in alternative methods of creating immunity other than injecting vaccines directly to the bloodstream, here and here.

10. Reading through some of the stories of cases that have been granted compensation through the Vaccine Injury Compensation Fund will curl your toes and make you go in and hold and kiss your sleeping children. Reading through some of the stories of how children used to suffer with polio and the iron lungs will do the same. This table shows the "adverse events" that are presumed, under the Vaccine Compensation Injury Program, to have been caused by the indicated vaccine. While actual causation is still not proven or, in many cases, attributable to any other cause, the legal presumption allows families to be compensated without having to prove causation.

11. Vaccine manufacturers are major donors to the American Academy of Pediatrics. One of the leading proponents of childhood vaccinations refuses to disclose how much money he has received from vaccine manufacturers. Doctors and non-profit research institutes are not required to disclose how much income they receive from vaccine manufacturers. Or from pharmaceutical companies, for that matter. One doctor from the retinal medicine field has remarked in Senate testimony that doctors ought to be required to don the logo's of their "sponsors" on their labcoats, much like NASCAR drivers, so their patients will be aware if the doctor might have a financial conflict of interest in recommending a particular treatment or procedure or test. Historically and today, the medical profession has held itself above the same conflict of interest ethical rules that apply to every other profession, successfully resisting any attempts to require them to disclose their financial interests in surgery centers, labs, pharceutical companies, or any other supplier of the care or treatment that they prescribe for their patients. Dr. J. Gregory Rosenthal put it very succinctly: "We are literally trading independent medical integrity for corporate profits." Feeding at the trough is fine, but don't be surprised when others notice the stink.

12. The CDC schedule only states the earliest date that vaccines can be "safely" (quote marks only to reflect the limits on available information) administered; it does not include information about the best time to vaccinate the child, or what the risks of contracting any disease might be if any vaccine were delayed by three months, six months, or a year. Infants have natural immunity to many diseases for their first 6 - 12 months that's maternally derived, but this immunity disappears by one year. Hence, the drive to vaccinate as early as possible. But there is not evidence weighing the risks of slightly delaying or spreading out the vaccinations for children living in the US. In fact, one study found that the immune response developed from the monovalent measles vaccine was slightly better than that developed in response to the combined MMR vaccine. As we learn more about the body's natural immune mechanisms and how to best support them, we may discover that there are certain "ideal" times for administering different vaccines, but this information is still a long way off.

13. There are other ingredients in the vaccines besides the vaccine material itself. The list of ingredients for vaccines posted on the CDC website does not match what is listed by the manufacturers on their websites.2 I'm a big fan of informed consent, but when parents and physicians aren't receiving good information about what's included in vaccines, they aren't able to guard against giving a vaccine to someone who may have a known allergic reaction to one of the ingredients.

Reviewing the information, it is obvious why parents are beginning to resist the large number of early childhood vaccinations for their children. The available information is good, but incomplete. There are clear risks and observed adverse reactions, even if the rate of incidence is very low - if you're a parent of a child who experiences one of them, the incidence rate might as well be 100%. There are many disorders on the rise that we don't understand. And our confidence in the impartiality of the medical profession is eroding. If the AAP wants to motivate parents to make what the AAP considers to be the best decision for their child's health - early and complete childhood vaccination - they need to first work to restore trust by requiring complete transparency from their members about their financial interests in the companies who supply the medicines and treatments that they are recommending.

At ten months old, Ada has received all of the CDC-recommended vaccinations to-date. But at her next appointment we will be putting off the MMR. I'm well aware that there is no evidence suggesting that it will be safer if I do it a little older, but there is evidence that her immune response will be slightly better if she receives the first immunization after she is 15 months old. I'm also aware that there isn't information for me to refer to that will help me understand what the chances of her contracting measles, mumps or rubella are in the 6 - 12 months before she gets the first vaccination of the series, but I have found some guidance from the CDC about when they consider giving the first MMR shot at or near the first birthday to be recommended.3 The MMR vaccine seems to be one of the ones that has a higher level of adverse reactions, and twelve months old just seems to be a little immature physically to process it all.

Given all of the data I have at hand, this is the best decision I can come to.

1. Prior to passing the law allowing Texans to file for conscientious objection to vaccinations, there were widespread allegations of doctors and nurses telling parents they were breaking the law by not getting their children vaccinated on the CDC schedule, reporting the parents to CPS for failure to vaccinate, and even forcibly administering a vaccination to a child with a known egg allergy.

2. Re the MMR vaccine:

From the CDC website: "Measles, rubella, and mumps vaccines are available in monovalent measles (Attenuvax , Merck & Co., Inc.), rubella (Meruvax , Merck & Co., Inc.), or mumps (Mumpsvax , Merck & Co., Inc.) form and in combinations: measles-mumps-rubella (MMR) (M-M-R II , Merck & Co., Inc.), measles-rubella (MR) (M-R-Vax , Merck & Co., Inc.), and rubella-mumps (Biavax II , Merck & Co., Inc.) vaccines. Each dose of the combined or monovalent vaccines contains approximately 0.3 milligrams of human albumin, 25 micrograms of neomycin, 14.5 milligrams of sorbitol, and 14.5 milligrams of hydrolyzed gelatin (Merck & Co., Inc., manufacturer's package insert). Live measles vaccine and live mumps vaccine are produced in chick embryo cell culture. Live rubella vaccine is grown in human diploid cell culture."

From the Merck website (had to delve into the "medical providers" area of the website to find this): "Each 0.5 mL dose contains not less than 1,000 TCID50 (tissue culture infectious doses) of measles virus; 12,500 TCID50 of mumps virus; and 1,000 TCID50 of rubella virus. Each dose of the vaccine is calculated to contain sorbitol (14.5 mg), sodium phosphate, sucrose (1.9 mg), sodium chloride [this is regular table salt, NaCl, but still omitted by the CDC], hydrolyzed gelatin (14.5 mg), recombinant human albumin (≤0.3 mg), fetal bovine serum, other buffer and media ingredients and approximately 25 mcg of neomycin. The product contains no preservative." [emphasis added]

3. "Children should receive the first dose of MMR vaccine at age 12-15 months (i.e., on or after the first birthday). In areas where risk for measles is high, initial vaccination with MMR vaccine is recommended for all children as soon as possible upon reaching the first birthday (i.e., at age 12 months). An area where measles risk is high is defined as:
a county with a large inner city population,
a county where a recent measles outbreak has occurred among unvaccinated preschool-aged children, or
a county in which more than five cases of measles have occurred among preschool-aged children during each of the last 5 years.
These recommendations may be implemented for an entire county or only within defined areas of a county. This strategy assumes that the benefit of preventing measles cases among children aged 12-15 months outweighs the slightly reduced efficacy of the vaccine when administered to children aged less than 15 months." Found at the CDC website here.

7.29.2008

News or Just a Crime Report?

I know I'm late to the party in complaining about this, but it's just to the point of being absurd. Our local television news has degenerated to nothing but arrests, suspects sought, and crimes occured, with a little weather and sports on the side.

Every evening I get home with the kids around 4:45. Pooper gets to watch 2 episodes of Thomas (I might ff through the ads and oops maybe a little of the episode too) then we catch the end of the national network nightly news, and then the local news come on at 6. And it's nothing but crime. I get so frustrated I pick up the remote and start going through the channels.

"Police have issued this sketch of the suspect -"

"The body was found on E. Riverside drive by a woman and her father -"

"- Today was indicted on six counts of indecency with a child -"

COME ON, PEOPLE.

The only real local news I have left now is the Statesman daily, the Chronicle weekly, and the Community Impact monthly. This is ridiculous. Such a shame that local television news has gone so far into the trash. I wish I could have the news on with the kids while I finish making dinner and discuss local government, civic events, health news and other items of interest with them rather than opting for HGTV so we don't have to listen to the grisly details of the latest murder-suicide parading as "news."

7.23.2008

CDC Vaccination Schedule

The little one turned 9 months old last month, so at her 9-month wellbaby appointment I asked her pediatrician about perhaps spacing out some of the next vaccinations. She opened her mouth and breathed fire and melted my eyeballs right down my face.

Our pediatrician is one of the leading proponents of timely vaccination of children. She is also as vociferous as she can be about vaccine saftety, especially when it comes to Autism. So, we spent the remainder of the visit with her venting about all of the misinformation and fear and paranoia fed by the media, and I did a lousy job of redirecting the conversation to the many other risks associated with vaccines - encephalopathy, asthma, inflammatory bowel disease - what with the melted eyeballs and all.

And let me not add to false hysteria - I have yet to find a study that has found a positive correlation between vaccines and any of the above conditions. But, and as usual it's a big but, every one of the studies that I found was an epidemiological study. We don't know yet what triggers these conditions to arise in some kids and not in others, although we have a handle on several contributing factors. But why one child's system deteriorates to disease but another's health is resilient, when each is exposed to the same environmental stressors and pathogens, is not yet understood.

Our particular pediatrician, while she was completing her residency, had a 7 year-old girl brought in to the ER by her distraught parents with a sudden 106 fever who had the chicken pox. She had open blisters and a staph infection had invaded through one of them; her entire body was shutting down. She was put on IV antibiotics and taken to ICU, but her heart gave out before the night was over. Can't blame our doctor for being so deeply passionate about vaccinations coming from that sort of personal experience.

So, yes, I want to vaccinate my child. But there's so many of them now, and we still understand so little about the connections between vaccinations and why some children have these extraordinary adverse reactions - even death - and some don't. I feel like I'm playing Russian Roulette every time we go in for more shots. Then I look at the decisions and opinion at the website for the Court of Federal Claims under the Vaccine Injury Compensation Program, and I get a little freaked out.

I've considered changing pediatricians, but that still doesn't solve my dilemma of what to vaccinate for and when. The CDC seems to take the approach of get as many as you can as fast as you can. I know there are alternative schedules out there, but I'd like to see some science backing them up.

I'm in a stew about this one. Ugh.

Doggie Congestive Heart Failure

My dear canine companion of lo these 15 years - predating DH and the kids and even graduation from grad school - is taking four prescription meds now (thankfully much cheaper than people meds) to keep him sufficiently oxygenated in spite of having a bum ticker.

He has a heart with valve problems, which he has tolerated more or less all his life. Now, however, the fluid accumulating in his lungs resulting from the blood not getting pumped through the heart adequately is starting to be a constant bother to him. Besides having him on heavy diuretics to try to keep the fluid out of his lungs, he's on potassium supplement, Vetmedin which is supposed to be helpful for this condition, and a bronchiodilator to help him get more air into his lungs.

He's a very sweet dog, his clouding eyes are still bright and shining, he still has significant spring in his step, and if it wasn't for the coughing and hacking, you'd think he was half his age. And yet, at our last appointment, the vet said that his heart wasn't just bad, it was terrible.

My dog frequently makes me nuts with his whining and begging during dinner time and insistence on being underfoot in the kitchen while I'm rushing around to make dinner, get a baby fed, and monitor Griffin and Ada. But I love him dearly. I am finally having to come to grips with the fact that he is, after all, mortal. I have such conflicted feelings about this. Thankfully the meds seem to have made him more comfortable.

7.14.2008

Voluntarily and Not So Voluntarily Saving Money

My personal assistant quit today. She was lovely and sweet and had to quit for health reasons and I will never find someone else as cheery and efficient and just perky as her. Now I'm worried for her and will have to bug her to make sure she's okay.

I've also decided to have a go at making dinners again. I'm watching cooking shows on the DVR (favoring Ellie Krieger and Jamie Oliver at the moment - mostly I just covet his garden and rustic kitchen and dishes and food prep gadgets). All in all, this should save us a hefty chunk each month. And I may lose my mind, which should help me save on gas.

7.10.2008

The Opposite of Co-Sleeping

If co-sleeping means having everyone together in a big family bed, snuggled warm and close, what's the word for everyone sleeping separately in their own beds, with their own night-time sleep preferences (white noise v. quiet, sheets tucked in v. loose, cat on the bed v. not) intact and not disturbing the other sleepers?

Well-rested?

In our house, we all have our own room and bed for sleeping. We have four bedrooms, and each child is in their own room, Kirby's in the guest room with a loud fan and the cat, and I'm in the master bedroom, quiet and peaceful. Kirby and I each have a monitor so we can hear our assigned sleeping child if they should wake up crying or roll off the bed or whatever. Him, so he can hear it over the fan (and he's a heavy sleeper), and me, because I'm down the hall from Ada's room and might not hear her if she woke up.

I'm getting better nights of sleep now than at any other time previously in our marriage. And you know what? It's good for our family. It's good for me as a parent to be well-rested. It's good for our marriage that Kirby doesn't have the guilt, and me the frustration, of being woken up multiple times in the middle of the night by his kicking his legs during a vivid dream, or coughing from allergies, or turning on the bathroom light for a nighttime call from nature. I'm a very light sleeper, so having kids or animals in the bed is out off the question. I adjusted once during college when I lived in a dorm room that was just off of the main stairwell. I learned to sleep through loud students coming and going at all hours, some coming back from too many drinks and making way too much noise at a really cruel hour. I got used to it and slept. But I guess I'm too old for this now. And sleep is more important than ever, because it's so precious when it's so hard to come by.

I think there are studies out there - outdated studies - that cast sleeping in separate bedrooms as a marital red flag. I don't think that's a judgement that can be made across the board for all situations. Sleeping in the same bed is just a small part of the whole picture of marital intimacy. And if sleeping in separate bedrooms is the only means of getting a good night's sleep without interfering with each other's sleep habits, then it seems there may be more good than bad to it. Including for the health of the marriage.

7.06.2008

Outsourcing It All

I'm sure some media-type will come up with a catchty word for this, because it has to be some sort of trend, even in this dodgy economy. Maybe especially in this dodgy double-income and then some economy. As a lawyer, I bill by the hour. Plus, because my work is more flexible for hours and location, and since Kirby's job and career (and insurance) are the primary financial supports for the household, 98% of the domestic responsibilities - errands, appointments, repairs, service arrangements, shopping, supplying, ordering, cooking, cleaning, dropping off, picking up - fall to me. With a 3 year old and baby, and also trying to work, things get nutty. I get nutty.

About a month ago, it occured to me that, if it wasn't billable and it wasn't spending time with the family, I didn't want to do it anymore. And if freeing me up from some of this stuff helped me to be able to bill just a few more hours a month, then it was worth it and may even pay for itself. So I decided to outsource everything "else" that I do to outside vendors.

Now I have a cleaning service come twice a week for an hour to tidy up, mop floors, and do one major chore. I'm ordering dinners for delivery every Monday. And I just hired a personal assistant who helps with everything else for a few hours a week. There are still some chores for me to do, the largest being the laundry, on top of the daily picking up, washing, loading and unloading the dishwasher. And there's still meal prep to do - I only order one full dinner and then maybe some sides and put something together quickly. But Thursdays we have leftovers, Fridays we order pizza, and Saturdays we eat out or order in, so there's been a significant reduction in the time spent on making dinner. And the assistant can't do everything, but she can do a lot, and it helps. In the two weeks since she's started, all of the burned-out lightbulbs have been replaced, the fridge got cleaned out, she's done my grocery shopping (twice), gotten my broken shoes repaired, and found a handyman to install the baby-gate.

I'll probably start pulling back on some of the services as the kids become more and more self-sufficient. Ada weaning from the bottle this fall will give me back about 3 hrs/day on the weekends, and an hour on weekdays. And oh, not to be washing and mixing bottles every night. And then once she moves down to just one nap, I'll be able to run errands with both kids much more easily, since I'm firm about having her in her crib for each nap. So all of this assistance is just temporary, but it's great while I have it. I wonder what the trend-wathers will call it ... House-sourcing?

6.25.2008

Discrimination Cloaked in Religion

Last night I watched an episode of "30 Days" that followed a Mormon woman from Utah with very fixed beliefs about homosexuality venture to the Northeast to live with a gay couple and their family - four boys that they have adopted in open adoption and from the foster care system. Their home is a farmhouse in the country. It's beautiful and peaceful, and the boys are rambunctious, sweet, and clearly loved, happy and well-cared for. As one of the parents said, how could anyone who was opposed to gay couples adopting children still feel the same way after visiting and staying with them for a month?

If you have an opinion about this one way or the other, I highly recommend that you watch this episode. As it unfolds, what really becomes clear is the complete lack of common ground between people who otherwise would be shoulder to shoulder at their kids' baseball games, the grocery store, and the PTA meeting. On the one hand, it makes me happy to see once again how America is big enough to allow for people with deeply disparate beliefs to live peacefully in society together. On the other hand, it also woke me up to the ways that blending religion and public policy can undermine this broad democracy that I cherish. This was something that I understood in theory, but now I really get it.

Ultimately what it came down to was that people are blinded by their absolute certainty that their own opinions, founded in their religious beliefs, are Right. On its own, this doesn't create any problems and we can all just agree to disagree and get on with our lives. When the problems arise is when one then decides that being Right gives them permission to not only live their own life according to their own beliefs, but to also require that everyone else equally live their lives according to this one "Right" set of beliefs - whether or not they also hold them.

This is what religious extremism is - requiring others, under the force of law, to live according to your own religious beliefs.

This is what the guest from Utah never grasped. No one was telling her that she could not live her life according to her own beliefs. For example, given that she didn't have a houseful of kids and that she was married, I think it's safe to assume that she and her husband practice or use some sort of birth control. There is a non-negligible population within very conservative Christians (and other faiths) that believe that birth control of any variety is immoral. Sex is for procreational purposes only, period. I wonder what her answer would have been if someone had asked her if she would agree that, if she would prohibit a gay couple from getting married or adopting kids, would it be okay for someone else to prohibit her and her husband from practicing or using birth control? The authority of someone to do this comes from the same place that hers does - complete, Bible-based certainty that this is the law of God. So how could she argue against it?

This is the problem of allowing religion to dictate our laws. If our ultimate societal goal is freedom and liberty and the pursuit of happiness, then that means for everyone, including those whose religious beliefs don't conform to your own, and who live their lives accordingly.

There's something else that wasn't raised by this episode that always leads me to the conclusion that really what's going on is discrimination and not religious fervor. There are many, many threats to the sanctity of marriage besides (as asserted by those of the belief-set) gay marriage: no fault divorce, domestic violence, infidelity, to name a few. But I don't see anyone from the Southern Baptist convention putting as much airtime and effort into combatting these ills as they do gay marriage. When I consider this, the inevitable conclusion is that the opposition comes from discriminatory motives and not the religious agenda. If one is going to oppose gay couples adopting children, then I feel that one is obligated to work with equal fervor to address the crisis from the dearth of foster parents available to provide homes for foster children.

The show also presented a woman who was truly injured by her (gay) father's conduct: taking her to sex novelty shops when she was a girl because he wanted her to be "uninhibited" about matters of sexuality, for example - some truly screwed up stuff. His relationships with men lead her to feel inadequate in her gender, and for this reason she opposes gay adoption.

Because heterosexual parents don't also sometimes (tragically) behave inappropriately with their kids when it comes to sexuality? Because heterosexual parents never made one of their kids of the opposite gender feel inadequate or guilty or shameful solely on the basis of their gender?

The succer punch to all of this is the kids who need homes. Gay adoption or not, there are children growing up in conditions and neighborhoods in America that aren't fit for army batallion units. Who will have adult lives coping with the long-term health (physical and mental health) challenges associated with long-term post-traumatic stress disorder. Who are less prepared to live lives that contribute to the social greater good rather than diminish. Who are going to be sharing this world and this town and this neighborhood with my kids and your kids. And who suffered immeasurable loneliness, grief and neglect at the most vulnerable point in their life when they were so young and helpless and should have been hugged and held and sung to and fed well and played with and hugged more every single day.

In a bit of Kismet, the James Dobson camp today pre-released to the Associated Press a scathing piece by Mr. Dobson that will air Tuesday on Focus on the Family about Dobson's take on Barack Obama's discussions of religion and public policy. Sen. Obama gets it - that if we allow the premise that religion should control our public lives, then we have the problem of whose beliefs will be the controlling beliefs. What's ironic is that Sen. Obama's postion actually protects the right of very conservative Christians to live their own lives according to their own values. What they just can't get their heads around is that, because we live in a democratic society, this means that in return they also have to allow others to live according to their beliefs. No, Mr. Dobson would rather call Obama a proponent of a "fruitcake" theology. Name calling - always a good indicator of a well-thought-out opinion.

6.14.2008

Home Decor Overload

What is it about IKEA that makes me want to throw away everything I have and start over? To have time to drive there, walk through the store, stop and look at all the beautiful things that wouldn't fit in my house, I have to block out an afternoon. Kid-free, of course, because otherwise I have to add in time for managing the meltdown just as you exit the toddler toys area for the cafeteria and marketplace.

I would love to have the bright, cheery-yet-organic-and-unfussy-and-organized vibe that is the IKEA brand in place in every room of the house. The kids' toys would all be coordinated in designer colors and yet would feel down-to-earth and simple. The bedding would have playful - but not tasteless - designs in vivid orange and green. All of the CDs, random parts of toys, papers, more random parts of toys, magazines, legal references, office supplies, linens - all of it - would have a stylish and sensible container in clever shelves or cabinets.

But here's the thing - I would have to hire a consultant to do it. Because I don't even have time to shower (unless I squeeze it in in the middle of Ada's first bottle of the morning at 6:20 or so), so when am I going to find time to review my storage and organization and furniture needs, do a gap analysis on what I already have available and could use better, review the IKEA catalog for solutions for what's still needed, and then purchase and install the new stuff? When, I ask you???

If someone wanted to be an IKEA freelance consultant to help me figure this out and take care of it for me, I'd be willing to pay for the help. Maybe I should place an ad on Craigslist.

6.11.2008

Will he EVVVEERRR poop in the potty?

Griffin turned 3 in April, about 2 months ago. Boys potty train between 2.5 and 3.5, so he's not officially late yet. And he didn't walk until he was 15 months, and is still a little speech-delayed, so why should the potty be any different?

But there are a few additional factors at play here:

- his daycare would like to move him along to the next class by the end of the summer (he's about the oldest child in the current group), but he needs to be out of diapers first;

- he's about the size of the average 4 year old, and, therefore, so are his poops; and

- god help us we can't keep cleaning up these diapers much longer.

It occurs to me, when he's older, that Griffin may not take well to discovering that his toddler toilet habits (or lack thereof) were discussed with the global community on the Internet. All I can say is, you brought this on yourself, son. And if this is the worst thing you can come up with to get mad at me about, you had it pretty good.

So here's our plan: We've been talking potty for several months now. He's well-versed in the lexicon of the poop and the pee-pee and the toilet and the paper and the wiping and the flushing. He's not at all interested in the little pretend potties, and given how he has to perch himself on those tiny things, I don't blame him. No, he needs to just get on with it with the actual appliance. He can strip down and put himself on the potty just fine. He's aware when he's pooping because he runs away so we won't make him go upstairs for a change. The kid's ready. We'll buy a few more books, establish more regular times during the day that he routinely goes to sit on the potty, whether or not the visit is productive, and keep building the habits and the practice. If things don't start to catch on by mid-August, we're just going to go cold turkey. He's going to stay home from school on a Thursday and a Friday, and I'm going to clear my calendar. Thursday morning we'll go to the store and make a Big Deal about buying his underwear and tossing the diapers. Then we'll just do it. Going in his pants right now, with the diapers, is very convenient. It will become much less so once there are no diapers to catch it all. I'm hoping by Saturday, when Ada is back home with us (and crawling around on the floor - eeesh) that he will have caught on to go. to. the. potty. By Monday hopefully the accidents will be reduced by half and he can go back to school with maybe just 3 or 4 or 12 changes of clothes. And socks.

5.28.2008

Recovery for Toddler Tonsillectomy

[UPDATE: Note to commenters - because of the heavy traffic this post generates, I moderate comments to weed out the advertisers who try to promote themselves/their products on my blog. Sometimes it takes me a day or more to get to your comment to read and post it, which means there may be a bit of a lag between you posting your comment and me getting it on the blog. I've had some folks post their comment multiple times - rest assured, each one makes it to my inbox. I promise, I'll get to your comment and I'll get it posted as soon as I can. I truly appreciate the global community of support that you parents and caretakers have formed around this one blog post. Keep it up! Much love, TypeAMama.]

We were really taken by surprise by how difficult this has been and how much pain our little guy has been dealing with, so I thought I'd post about our experience in case any information here helps someone else preparing for a tonsillectomy for a 3-yr old. A tonsillectomy is considered major surgery. It may just take 20 or 30 minutes (depending on whether you're also taking the adenoids, adding tubes), but it is major surgery. In an adult, it takes a month for full recovery. In a young child, it's a little over 2 weeks.

I think because most people don't remember how much pain they were in when they were this young (they usually just remember the ice cream) and because the doctors forget that we have no idea what we're really in for, we weren't adequately prepared for this. Because it turns out that what we're in the midst of is ten days of round-the-clock pain management. Actually, I'm hoping it's just ten days. Today is day 7. We'll see.

So, Griffin did great during the procedure itself. In the recovery room, he drank some water and ate a popsicle. He stayed overnight in the hospital, as that's their protocol to make sure the pain can be controlled just by the prescription meds that we'd be using at home. After the surgery, as we sat in the family consultation room to hear from his doctor how the procedure went, his ENT told us that Griffin's were the second-largest tonsils and adenoids he had ever removed. The only ones he'd seen larger had been so big that they crossed over each other.

Upstairs in his hospital room, Griffin ate 4 cups of ice cream in a row. Still doing fine. Then the drugs from the procedure very suddenly wore off before he got his first dose of hydrocodone and it all fell apart. I ran to get a nurse and then tightly held him and rocked him in the bed as he sobbed and choked and watched his heartrate race to 189. We gave him the hydrocodone orally using a syringe, but he spat a lot of it out and cried and yelled more. Turns out the hydrocodone can sting a little. I managed to get the rest into him by feeding it to him bit by bit with spoonfuls of ice cream. It took about 20 minutes for it to start to soothe him, but then an hour later he just went to pieces again. This time the nurse called the doctor and got permission to give him morphine. Finally he relaxed and was woozy but comfortable. Once we were finally "ahead of the pain" again, we were able to maintain with the hydrocodone, and we went home the next day.

It was a good thing that I hadn't pressed to have his IV removed early, as is my usual preference. While he was doing a good job of staying hydrated, the morphine was administered via the IV. So if you're anti-IV like I am, this might be one occasion to leave it in as long as your child is tolerating it well.

This is what we have learned since then:

Toddlers are all-or-nothing when it comes to pain management. While they're on painkillers, your child will act completely comfortable and care free. Don't be fooled. As soon as it's time to give them the next dose, do it, or you'll be dealing with 3o minutes of sobbing and clinging while you wait for the next dose to kick in.

If your prescription says to give the painkillers every 4 hours, but you need to give it to them every 3 hours to adequately control the pain, check with the doctor, but ultimately, do whatever you need to do to keep your child comfortable. I told our ENT yesterday that I was dosing Griffin every 3 to 3 1/2 hours to keep his pain under control and his doctor didn't even blink.

Have a humidifier going full-blast in your child's room whenever they're in there sleeping.

Make your child fill up on fluids before they take a nap and before they go to sleep at night.

Your two big objectives for your child will be pain management and hydration. The less your child drinks, the harder the pain is to manage. Keep them very well hydrated. While they're sleeping, they lose fluids into their bladders and into the copious amounts of sweat that will pour out of them while they're healing, and they aren't drinking any more while they snooze, so their throats dry out. As much as Griffin drinks, he still sometimes wakes up coughing and choking and crying just 2 1/2 hours after his last dose. I've heard the dry throat when waking described by an adult as feeling like you have a bunch of glass in your throat. Ooooowwwww. And then the hydrocodone stings. You'll be doing a lot of rocking and soothing and hugging and holding.

Speaking of stinging hydrocodone, if your child is old enough that you can get them to hold their mouth open so you can spray some chlorasceptic numbing throat spray before they take their hydrocodone, that will help numb the sting a little.

What Griffin could or couldn't eat varied day to day, rather than generally improving over time. Food that he was able to eat one day hurt him the next. I read somewhere that the scabs slough off somewhere between day 5 and day 7, and this is the most painful period post-op. We were at a consistently high level of pain until the 9th day, so I couldn't say for sure if this was the case with us, but I suspect it may be part of the reason for the variability in what he was able to eat.

Your child will have the breath of a dog that's dead in Texas in August, from about day 3 to about ... he still has it at day 9.

Dairy products were on the list of foods to avoid - I have no idea why. Griffin really wants a cold glass of milk in his hands at all times. He doesn't like popsicles, is not interested in jello or pudding. But he drinks milk all day, and it really seems to help him. I keep it in an insulated sippy cup so he can roam around the house with it, and he still comes back for a refresh when the chill has gone away.

Your child may be in constant pain for over a week. We've pulled a matress onto the floor in his room and his dad sleeps in there every night with a watch alarm to wake him up every 3 1/2 hours to give Griffin his painkillers, and then I handle the day shift. Usually Griffin wakes him up in pain before the alarm goes off. Just be prepared for this. It's a bit of a long haul, you're sleep-deprived, your child is miserable. This isn't a good time to be trying to accomplish anything else major in your life.

Getting work done right now is impossible, particularly given how out of sorts he is generally, which is understandable. If you normally work from home, plan to take the next 10 days off.

This isn't the time to be stingy with the DVDs. If your child will sit quietly while they watch tv, this is a good way to distract them from their discomfort and keep them still.

Let your child eat whatever they can. Even if it's just Krispy Kreme donuts for two days. They'll lose a ton of weight while they're recovering, and they can eat broccoli when they're better. Griffin can't even manage cold rice yet, and his ribs are really starting to show now. So, Krispy Kreme it is until he's healed.

They say you can take your child back to daycare 5-7 days post-op. This is nuts. Your child has to receive their pain meds at specific times, and someone needs to keep a close eye on making sure he stays hydrated and doesn't suddenly have the pain meds wear off prior to the time to dose. Also, the daycare can only give the dose according to the times on the prescription, so if your child needs their medicines more frequently, daycare isn't an option. Again - be prepared for this with alternate arrangements if necessary.

Another blogger said that the feeling in their throat while they were recovering from a tonsillectomy like "swallowing a box of tacks." Adults take longer to heal, but I think the pain is about the same for kids and adults, from what I can tell.

Good luck with your own kids' tonsillectomies. Hopefully they won't take as long to heal or be so painful an ordeal as what we're dealing with here, but in case it is, hopefully something I've said here helps.

1.02.2008

Salutations to my 39th new year

It's 2008 and we're all here. Me, the husband I was destined for, and the two kids who've been in my mind and heart for more than 10 years. We're here, I'm done, and now for the living the rest of our lives together. How can it still feel like I'm just getting started when I'm going to be FORTY YEARS OLD this coming September?

I have no new year's resolutions. I could say something noble-sounding, like that I try to live every day with the sort of reflection and mindfulness usually reserved for the first day of the year, blah blah blah. It wouldn't be true, and that sort of self-congratulatory prattle makes me vomit in my mouth a little. Really, I'm just overwhelmed with gratitude just to be here at all, and to be surrounded by these amazing beings that are my family, well, I'm struck dumb with wonder. In my mind, this next year is like starting down the runway for takeoff, watching the kids start to get a toehold on life, their personalities, likes and dislikes, gifts and misgivings. And watching DH and I start to get a toehold on our life as parents, heads of a ship, nurturing our marriage along with our kids, struggling with how much we want to be there every moment that our kids are breathing (I'm definitely pulled more in this direction) and how much we also want to succeed in our professional lives (DH is currently pulled more in this direction; I am too only insofar as I want to help stockpile funds for the family's use for travel, school, etc.).

Runways can be bumpy, too. That's okay. It just means we're picking up speed and liftoff is imminent. And second thought, I do have one resolution - find some way to be more charitable. Either through giving or volunteering. Reach out more. Forgive more.

Happy new year.