Modern Inconveniences.

My last post was triumphant.  I think all that effort to have things hang together facilitated the quick undoing that followed in the past couple of weeks.

Josh brought home a nasty stomach bug which quickly jumped to me.  Poor Elena would shuffle silently to my side as I vomited, and then flush the toilet for me when I had finished.  "Mommy sick," was something she told me for a few days after my recovery.  Thankfully she was spared--I don't think I could have handled cleaning up after myself and her at the same time.

Then our credit card got jacked.  I'm grateful but kind of amazed at how credit card companies take you at your word when reporting fraudulent charges.  "Not us," I say.  Gone!  Of course, I haven't the guts to apply that to our legit charges, but still--how often to people take advantage of that?  We're still waiting on our new cards, which stinks because now I just feel like each purchase I make is a waste of potential rewards.

And then Elena got her thumb caught in the door at school.  I think her teacher used the word "courtesy call" three times that day to describe the notification she gave me of the incident which included, "she can move it" as a sign that all was good.  Not really what I would consider a courtesy call, but it was nice to know, or at least think, that the thumb was okay.  In reality, it is--despite the fracture that goes through her growth plate.  We paid our $35 copay at the ortho hand appointment today to hear in 5 minutes that she's got a great prognosis since the area around the growth plate heals well.  Good thing, since she ripped off the splint in the car on the way home from the ER last Saturday after singing Where is Thumbkin? and waving her blue coband thumb about.

And then our swamp cooler busted.  Steph and Steve's a/c unit had broken the weekend before, so they had holed up at The Vortex (the affectionate and appropriate name for Josh's parents' house).  Thankfully we only spent a night in our hot house (in the morning Elena woke up and promptly asked, "Where pjs go?" when she discovered she was wearing only a diaper) before the Kolnackis were able to head back home and we could take their place.  So tomorrow they come to fix things.... hopefully.  The swamp usually works well until about now when the humidity rises with monsoon season--it's about now each year that Josh and I consider investing the ~$6,000 in having a/c put in as well.  And then those two months pass and we forget about how uncomfortable July and August are in our house until the following year.

So that has been our series of obnoxious events over the past two weeks.  Needless to say, I'm pooped.  Judging by Elena's bedtime of 7:20 tonight, I'd say she is too.

I started on our Maternal Child Health service on Wednesday.  This change in routine is typically energizing for me, since I get a ton of time to spend with mom/baby pairs educating them and myself about breastfeeding and lactation.  We've had a delivery each yesterday and today--todays was sticky, and I was thankful that our patient had made it to the hospital and that we had obstetric back up to help get baby out.  I am helping a med student devise a reading elective for the month her baby is due--one of her classmates said in recognition, "OH!  The breastfeeding elective?" which I thought was kind of funny since right now it's very free form.  The classmate expressed interest in "doing the elective" as well--encouraging that there is interest, but I am still amused that my relatively new found passion keeps giving me opportunities to spread the breastfeeding love.

Anyway, in my preparations for this student's elective, I read The Surgeon General's Call to Action to Support Breastfeeding, just released this year.  I skimmed the 90 page PDF, searching for a few statistics I had heard at a recent conference.  Read this--it blew my mind:

"A more recent study that used costs adjusted to 2007 dollars and evaluated costs associated with additional illnesses and diseases (sudden infant death syndrome, hospitalization for lower respiratory tract infection in infancy, atopic dermatitis, childhood leukemia, childhood obesity, childhood asthma, and type 1 diabetes mellitus) found that if 90 percent of U.S. families followed guidelines to breastfeed exclusively for six months, the United States would save $13 billion annually from reduced direct medical and indirect costs and the cost of premature death. If 80 percent of U.S. families complied, $10.5 billion per year would be saved."


13 billion!  That's on par with shoring up some of the tax loopholes that the government is batting about.  


Anyway, back to the baby we delivered today.  My guess is that the majority of the bajillion of kids this woman has were born at home in Africa, like many of our African refugees.  They are quick to learn what studies have shown (and probably necessitated lots of money to prove): that increased intrapartum surveillance increases C-section rates.  So they tend to wait until the last minute to come to the hospital (if at all) before baby comes.  I am SO happy this patient came to the hospital--I shudder to think about the outcome if she hadn't.  I think this case is one of many that has led to Healthy People 2020 including the following objectives, specifically the last one:





I'm very happy that people are paying attention to the benefits of breastfeeding on our children, and our nation's future health.  I thought today of writing to Michelle Obama and asking her to extend her campaign against childhood obesity to include publicly supporting the WHO, AAFP, and AAP guidelines for breastfeeding.  If a successful, stylish, respected black woman stands in support for breastfeeding, maybe women (specifically young black women!) would listen.  


It's a good thing our swamp cooler is getting fixed tomorrow--I've got to get writing.

My Big Independent Babe.

I can't believe our family survived last week.  I staffed over 175 clinic visits, supervised two circumcisions, facilitated sending two patients to the ER, did every drop off/pick up, kept the house chica-worthy, and put Elena to bed in her new room every night.  My compatriots were just as formidable this week.  Josh was off to the hospital by 6/6:15 every morning after preparing Elena's lunch, and home after 9:30 pm every night except Friday (what a treat to be able to eat dinner as a family!).  After a teary Monday evening pickup ("I want my Mommy!  I want my Mommy!" was what I heard as I opened her classroom door at 5:40 pm), the rest of the week was smooth despite being at daycare from 7:20ish to 5:45ish every day.  And the dogs didn't destroy anything or poop/pee/vomit anywhere in the house as a protest to getting no activity this week.

I'm so happy to have a potentially quiet week coming up in comparison!

Last weekend we converted our guest room into Elena's room.  Our guest room was used by my family about 3-4 times per year, but mostly by our laundry pile, hence the nickname of my aging full-sized bed "The Bed of Laundry".  The bed of laundry, as anyone who has slept in it can attest, is saggy.  Saggy in the middle, lying on a box spring whose beams are broken.  It was time to move on, which is why the bed is now in our backyard, awaiting final arrangements (Goodwill for the mattress, brush and bulky in September for the box spring?).

Elena's resulting room is a lavender sea of serenity, punctuated by her little pink kitchen, our CD-less de-junked shelving unit, and the top of the line twin bed that my then-single husband bought himself upon moving into the Einstein housing in med school at age 22.  (Maybe age 22 is still too young to be forward-looking, but I like to tease Josh about his mini-bed which is so non-conducive to having a snuggle buddy.)  Elena took to her new room immediately, and has been sleeping there all week.  She still wakes up most nights in the middle of the night, calling out for me (though last night it was, "Daddy?  Daddy?").  Thankfully she either stays in bed while calling out, or takes my hand and turns back to her bed to be soothed back to sleep without protest.  Yesterday morning she woke at her post-vacation 5:15, and I went to see if I could snuggle and nurse her back to sleep in our bed.  As I carried her out of her room she turned her head and held out a longing hand towards her bed with a whiny, "Bed??!"  Once in our bed, she on/off snoozed/nursed until 7 am (thank GOD), but that one little wistful glance back at her bed really solidified the fact that our co-sleeping toddler is gone forever, and gone before the age of 2.

That was quick.  Less than two years of watching our little one fall asleep and wake up by our sides.  If we didn't have another one coming so soon I think I'd be even more broken up about it.  I often felt really guilty about the seldom-used beautiful crib that our parents bought us for Elena, until the night she climbed out of it.  But a thing is just a thing, and I am so grateful for all the hours of snuggling that co-sleeping afforded us.  Perhaps our surprisingly easy transition to getting Elena to her own bed is a reward for nearly two years of interrupted sleep, but I prefer to be a big egocentric and say that our physical closeness during sleep facilitated this easy transition.  Sleeping nestled between two parents must be the ultimate in feeling safe, and within the support of that guaranteed safety, Elena's independence was free to develop.  If you don't buy it, check out some of the stuff from Attachment Parenting.

I went to a breastfeeding mini-conference while still on vacation, which featured a talk from an ob/gyn on prenatal, delivery, and immediate postpartum support of breast feeding, as well as from a pediatrician on postpartum support of breastfeeding.  (Why they just didn't ask a family physician to do the whole thing is beyond me, but hey, what do I know?)  After the pediatrician's talk, one of the attendees asked about advising parents who wish to co-sleep, since there is data to suggest that co-sleeping helps facilitate breastfeeding and maternal/child bonding.  Now, I don't know what this woman does in practice, or what she did in her own home, but I do understand that if you are part of an event that is offering CME (continuing medical education) credit to physicians, you probably have to uphold the policy statements of the organization to which you belong.  So the pediatrician basically said that she advises parents to put their baby to sleep in a crib in the parents' room, and she advises against bedsharing, which is consistent with the AAP's policy statement on reducing risk factors for SIDS.  I was really disappointed by her advice, and chimed in that we can give advice to our patients but that it often falls on deaf ears.  I directed the attendee to the Attachment Parenting's website for information about safe co-sleeping practices because I feel that if a mom is asking the doctor about co-sleeping, chances are they're already doing it anyway--why not direct them to information to keep the baby safe in that practice?

I think I posted the link to this article previously, but just love it so much, so here it is again: Why Babies Should Never Sleep Alone.

Okay, I'll step off my soap box now and enjoy Elena's nap by my side in our bed while Josh snoozes away in her bed...

Like Beyoncé, I'm a Survivor.

I have strategically given myself little "treats" each day this week as a reward for being in the office all day.  I don't think I would be faring this well not having had vacation for the preceding two weeks, with or without treats.

My treats are lame.  I'll admit it.  They are also food-centered, but for anyone who knows me, that's no surprise.

Day 1--Choice Greens Southwest Chicken Salad with no chicken for lunch
Day 2--Same salad, but with an iced latte at lunch time
Day 3--Beyond Bread breakfast (which I like to call Beyond Breakfast because it usually serves as a good mid-morning snack... this time I ate the whole damn thing before 9 am) with a latte and Choice Greens salad for lunch

I think I'm going to have to just be happy with giving myself permission to leave the office at 3 (guilt sets in as I realize this means cutting out on a well respected geriatrician's talk from 3-4) to restock our shelves which are getting REALLY bare.  This week Josh hasn't been home before 9 pm at all, which means no Trader Joes, which stinks because when I have to do all daycare runs, work every day, and prepare dinner and do bedtime, I could really use some half-prepared meals.  Poor Elena went to daycare yesterday with frozen peas, frozen corn, frozen edamame, and some ripped up frozen Nan bread (all unfrozen before going to school of course).  (Those were some fun stools to clean up.)  What a lame lunch--no offense to Josh who put it together.

When Josh is in the UMC ICU, I get a glimpse at what being a single parent must be like.  I think I've said this before--sorry to sound like a broken record.  (And I'm mostly apologizing to single parents because as part of a two-parent household, I *know* I've taken Josh's help for granted!)  I just don't know how people don't completely blow a gasket on a daily basis raising kids alone--and I'm only dealing with one child for 1-2 weeks at a time, and that time involves a dad who occasionally is home long enough to change diaper or make a lunch.

Okay, so maybe my feathers got a bit ruffled in the early afternoon today and negativity started to ooze a bit.  Gotta keep that in check.  (Of course, this post is becoming totally stream of consciousness as well as more of a "note to self".)

I'm totally cheap, and couldn't let today's CSA pickup go.  My summertime partner was supposed to pick up, but is away on vacation, and I realized this last minute and couldn't find someone else to pick it up... until Liz Moran offered.  That girl is saintly.  Liz, who picked up her own share earlier in the afternoon, went back to pick up mine so that instead of driving all over town with a tired, hungry, cranky toddler, I could feed, snuggle, and put that toddler to bed.  And get my produce tomorrow.  Liz is my hero.

Tomorrow is Liz Day.  I'm going to be positive and pleasant and food-treat-free as part of expressing my gratitude to Liz.  And any ideas on how to make carrots more interesting would be appreciated... by both Liz and me!

...And there went May.

Okay, so May was an absent month for blogging.  And I was on vacation for two weeks.  Oops.  Our time away in Key West, however, did include staying in a place that had the suckiest wireless connection ever, if that is any excuse.

Tonight Josh is off seeing a movie (X-Men.  who cares?), which is only fair since he gave me my own mental health break this evening in the form of a yoga class (letting me go to one, not actually leading it... but if you know Josh you knew that already).  I inspired someone at yoga tonight by doing urdhva dhanurasana, or upward facing bow or wheel pose--whichever you prefer.  He told me often complained about doing that pose, but felt like seeing my 7-month gestational belly reaching for the sky made him relinquish the excuses.  It was nice to feel inspirational, even if I did inspire him through shame.... a little. :)

I have to say that tonight's yoga teacher has inspired me in a shameless way to greet the unknown with a warm and open smile.  Or at least try.  I am starting back to work tomorrow after two weeks away--and my week is going to suhh-huck since I am supervising residents EVERY single clinic session this upcoming week.  Yikes.  I feel like I need to strategically plan my treats to myself to get through the week.  Anyway, I'm anticipating lots of "how was vacation?"'s as well as comments around how pregnant I look, and I am going to do my best to be as bright as can be rather than wallow in the fact that I am stuck in clinic ALL DAY, EVERY DAY this week.  (Okay, so maybe I need to wallow a little bit just to get it all out.)

Continuing on in the practicing positivity vein, Josh and I did a pretty amazing job at creating a room for Elena this weekend.  Our guest bedroom had previously been a repository for beds, CDs, old loose photos, and lots of other crap.  It really lacked character, and often contained ALL the laundry in one huge messy pile.  Now it is a lavender haven of fun for Elena, complete with our new hand-me-down pink kitchen, pictured below with not my child:


I love Elena's room so much that I foresee spending lots of time there.  It's junk-free (minus the closet, but being able to close those doors helps ignore that fact) with clean walls, and she keeps running from one thing to the next, mostly bringing me concoctions from her kitchen with a chipper, "Here, Mommy!"  When we returned from Florida she kept rushing from the sink with her mini-pot to Isaac's face, encouraging him to drink what she had "put" in the pot ("Here, Isaac!").  He didn't appreciate it as much as I do--at least I pretend there is something in the pot instead of turning my nose away.  Sheesh.  Dogs--how rude!

Having Elena in her own room is weird.  Suddenly our bed feels huge again.  Of course, this is only night #2 of non-cosleeping.  Last night she would have been with us for the latter half of the night if she had just settled back down and went to sleep, but her constant stirring and whining led to Josh snuggling with her in her bed instead.  It's all a process, right?

Here is a picture of my cute kid at the beach.  This was around the time she started throwing sand: