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Wednesday, May 25, 2011

Vitamin D and why you need it!

I got the results of my blood work back, but first wanted to mention something else: vitamin D. I live in a Great Lakes climate, which means we get few piddling days of sunshine compared to some, and thus, not as much of the "sunshine vitamin," as it's called. My gastroenterologist ordered additional blood work for me and we discovered that, like many people in this area, my Vitamin D levels were in the crapper.

At first I thought, okay, so what does this mean? Then I studied up on the symptoms and was shocked: among them are many symptoms that mimic hypothyroidism and other conditions, namely joint pain, which I already suffer from as a result of having Crohn's. Other symptoms apparently include chronic fatigue, depression, stroke and osteoporosis, diabetes and heart disease. Other sources I checked said brain fog and even mental illness was associated with it. Holy crap!

Other symptoms seemed to affect only women, like more moodiness during menstruation.

My doctor prescribed a honking dose of 50,000U per week for three months, and then I would taper off to a regular vitamin-sized dose of 400U per day after that. Keeping my fingers crossed!

Tuesday, May 24, 2011

I want my life back!

Since I've decided I definitely have some kind of whacked thyroid problem, it's been amazingly liberating to talk about it with others. It's also interesting to hear who else is dealing with it, too. It's like the blinders are off; the curtain of doom has been lifted.

I was talking with my daughter's preschool teacher about it - and while we chatted, at least three other people overheard us and were sharing their stories, too. Jan - who is my age - asked me, "Why do you think my hair is so gray?" I didn't know. "Because of hypothyroidism." She said most people thought she was just going gray prematurely like her mother, but she isn't even 40 yet and is mostly gray now. She told me a heartbreaking story of how her doctor has basically been ignoring her symptoms.

"He told me to stop drinking pop and get off the couch," she said. Jan, who is overweight, is a mom of three and doesn't even drink pop, apparently. She had painful, weird periods, fatigue, lack of motivation and a bunch of other symptoms, including low sex drive.

"My doctor said, 'You're depressed.'" As far as her sex drive, he told her, "Just fake it."

Wow. Now there's solid medical advice for you.

Jan, like me, said she doesn't feel depressed, just unmotivated. In fact, when her doctor gave her a depression test, she apparently passed with flying colors.

He refused to treat her further because she was "within range," even though he was only using the TSH as a guideline. She told me she is in the process of looking for a new doctor. God, I hope so.

I think Jan has been on meds but is still having symptoms. And because her TSH is coming back 'normal,' her jackass doctor doesn't want to deal with her. He chalks it up to the "you're an overweight mother of three" and thinks that's the end of it. She finally demanded a referral to see an endocrinologist.

Another mom told me she was having no symptoms, but bloodwork showed that she needed medication. I'm not sure exactly whether she only had a TSH or other tests done, since most doctors will only order the TSH and consider that a definitive benchmark. With no symptoms, I'm not sure how he even knew what to look for, since as far as I know it's never routinely done unless you have complaints.

I knew in my heart and in my head that something was not right - I'm not the most athletic person, but I couldn't even lift the garage door while holding my son without feeling like it was a monumental effort. Muscle weakness and fatigue are two big red flags. I'm still pissed at my OB for not even sending the results of my bloodwork from last year to my primary physician, and he never went over the results of my test with me, either. My "depression," if you want to call it that, was particularly weird - because I don't feel depressed. And for someone who is supposed to be depressed, I sure sing and laugh a lot. What's with that?

I'm nervous about medication - not in the sense that I don't want to take it, but that it'll be difficult to get levels managed and regulate everything. From what I understand, many people do well with synthetic versions like Synthroid and Levoxyl, and then there are those like Jan, who are still symptomatic while on meds. Therefore their doctors say, "But you're on medication, you should be doing fine," and won't do anything else. They pay more attention to lab results than symptoms.

I explained it to my husband like this: take the color wheel - your desired color is orange. You have two components, red and yellow, that make up that color. Many see the orange and say, "Well, it's still orange," even though there might be a little too much red or yellow in it. Sometimes it's subtle, sometimes not. If the levels of red and yellow are off, the end result might be too orange or not enough. Settling for one shade of orange might work in the short run, until you realize you really want it to be a deeper shade, for example. Then you have to tinker with the amounts of red and yellow until you get the right end result. A major oversimplification, but that's what it feels like to me.

It boggles my mind that something so seemingly common is so ignored, or mistreated. I wonder, how many people suffer through infertility because of this? Go through expensive, extensive treatments when the answer, although not entirely simple, is easier than going through IVF and a whole host of other things? How many are diagnosed with depression and given various meds when really, they're only treating a symptom? (And apparently, antidepressants will also mess with thyroid function, making the problem even worse.) How many are still symptomatic but treated, yet their doctors don't want to do anything more about it? How much of our country's overweight population is either undiagnosed or improperly diagnosed, and hanging on to extra weight, all because their doctor says, "You need to get off the couch and stop drinking soda pop!"

Most frustrating is the endless list of symptoms - some the same, some different - that various sources list. Depending on which list I look at, I have few symptoms; others, I hit almost all of them. Like other autoimmune disorders (such as Crohn's Disease and rheumatoid arthritis), supposedly hypo can produce joint pain and stiffness, although one woman said her doctor "didn't believe" that was a symptom. So, are you just supposed to live with it? Try to move on anyway? I don't think so!

When something affects the immune system, it's probably very difficult to treat - because we're all individuals. It can affect us in so many ways, but because we've lived in different areas, with different food sources, medications, perhaps chemicals we're exposed to, substances like prescription and illicit drug use, whether or not you were breastfed - who knows? When you stop treating the patient as an individual, as many people were probably 100 years ago before fancy blood tests, you start ignoring the root problem and thus, the person as a whole. It almost makes me think that, instead of seeing an endocrinologist to treat it, we should really be seeing an immunologist.

And with millions of people worldwide suffering from it, I find it hard to believe that we all have an immune disorder. One thing I keep hearing about is the fluoride connection. It's hard to find a source that doesn't sound too "woo" because few mainstream outlets, if any, are talking about it. While thyroid disorders have always existed, I'm curious if our mass flouridation in the water supply is causing so many cases. After all, we drink it, brush our teeth with it (and use fluoridated toothpaste), cook in it and bathe in it. While the concentration is considered quite low, using it every day probably produces some nasty cumulative effects.

As a result of all this, I've learned to listen to my body more, because it's trying to tell me something. A basic education in what exactly the thyroid does revealed to me not only the symptoms I wasn't even picking up on, but the fact that it regulates so much of the body's systems as a whole. Learning how it's often treated, or mistreated, helped me plan for a course of action first so I would know what to do (or not do).

The following are typical (and what some sources say are "uncommon") symptoms:
• fatigue • muscle and joint pain, even though you haven't exercised
• lack of motivation • low sex drive • hair loss • shortness of breath • weight gain
• less stamina and energy • constipation • intolerance to cold temperatures
• dry skin • changes in hair texture • brain fog • inability to lose weight, even with diet and exercise
• infertility or miscarriages • painful periods • irritability • fluid retention, especially in ankles or legs

The list can seem endless, unfortunately. And just having a TSH done often will not reveal anything specific. My advice would be to insist on more in-depth tests if you feel you are not being adequately treated. 

Monday, May 16, 2011

A broken bubble

Whenever my children behave like heathens and pick up on new, undesirable behaviors, I often like to say that the bubble I sealed my children in apparently has a leak. Unfortunately the leak is getting bigger ... and bigger ...

Recently as I got my kid off the bus, a car sped by, the driver shouting out the window at the person in front of him. Mary had her turn signal on, I saw it; and Cranky Driver must not have seen it when he shouted, "What the *@&% are you doing?" We all looked up - me shooting a furtive, panicked look at the kids.

"Why was that guy yelling?" my son asked. "What did he say?"

I will admit right off that I have a horrible habit when it comes to bad language. (cough). It probably started when I was a kid, unfortunately, although I guess my parent filter was turned on, because I never used it around my parents. In college, one of my professors would often say she really has to work on her swearing because she now had two little kids running around. My husband likes to say that when he first knew me, my foul language habit was a lot worse, and maybe he's right, maybe not. (cough)

I dread the day when my kids will start using four-letter words, although I know it's obviously inevitable: a 30-minute bus ride can unravel nearly a decade of parenting techniques. My son already knows what the "middle finger!" means and that it's bad. Of course because he says it, my daughter repeats it - it sounds a bit weird and unnerving to see a blonde-haired, bespectacled, otherwise-innocent-looking preschooler talking about flipping people off. And to think, right now I'm more concerned about my oldest going around calling everything "stupid!" and that his younger brother will start saying it before he even knows all his shapes and colors.

I can remember saying the word "fart" a lot when I was like 10 years old, within earshot of my younger brothers. My stepmom finally had to tell me to stop. I totally get it now; I don't even like my kids saying the word butt, I'll admit. Right now my son is fixated on anything to do with butts and saying "stupid" all the time. I realize that's pretty tame compared to some words he could be using, but I don't really want Tater Tot walking around calling people stupid, either.

TV that might contain language is severely limited, if it's on at all, so I absolutely face with dread the prospect that they might hear me saying something. I mean, it's not like I openly swear around my kids at all, but rather when I know they're a safe distance away, and even then I probably sound more like Yosemite Sam than anything else. I must say, even when I accidentally gave myself searing second-degree burns while cooking dinner a few weeks ago, somehow I managed to suffer in silence - when really all I wanted to do was let loose with a resounding, "F*****cccccccckkkkkk!"

It pains me to think that kids are exposed to so much at such a young age. Today I was listening to Pomplamoose - cleanest pop band ever - and my daughter wanted me to turn it off. I thought about how there are parents driving around in the world right now, huge bass speakers in the back seat with rap music blasting, their poor toddlers sandwiched in there somehow. How a kid can even process all of that, I don't know.

Ahh, they grow up so fast. Time to go find some duct tape to fix that bubble.

Friday, May 13, 2011

Et tu, thyroid?

Sometimes I feel like I'm really getting old. Lately I feel like I've been falling apart, and I'm only 36 - not 76. I have dealt with bouts of Crohn's disease and colitis since the birth of my first child, and thought I had finally triumphed when I no longer had to depend on expensive pills every day to manage my symptoms.

For several years, there have been murky goings on that I just couldn't put my finger on, and recently they seem to have intensified. I have felt intensely unmotivated to do things, even the stuff I used to love doing, and looking back it's probably bothered me for at least a year. I thought it was the weather - the Great Lakes area is not known for an abundance of sunshine and warm weather, which probably accounts for why so many people are depressed around here, it seems. I didn't exactly feel depressed in the traditional sense, but I knew something definitely wasn't right. Great, now what?

Then about 18 months ago I developed swollen, painful glands. It was difficult to swallow and even turn my head, and a mono test came up negative. I decided it must have been something my body was trying to fight off, and that was that. It finally went away, but since I have noticed a strange throat pain - not exactly like a sore throat, but a presence - off and on, just not as bad. I had no clue what was going on.

For several years, my sex drive has been in the crapper, and if it weren't for the God-fearing patience of my husband, I'm sure we would be divorced by now. I developed that before we even had kids, and chalked it up to the old phrase, "The best way to ruin a good sex life is by getting married." Whatever. I wasn't sure what it was, but it was troubling. I asked my old OB's nurse practitioner about it, and she had little to say except ask me why I didn't enjoy sex. I thought, if I knew that answer I wouldn't have asked, would I? I felt stupid for asking and decided to leave that one alone: after all, what young married woman doesn't enjoy sex? I was sure I was in the minority on that one.

Last year I had a regular checkup with my OB, and decided to ask him to check my thyroid levels. I had had some minor suspicions, and my mom mentioned having thyroid problems herself. I knew my grandma had been taking Armour Thyroid for centuries, but for some reason it didn't register in my brain that it was a familial problem. The day I visited the doctor's, I remember being tired; it must have been obvious because even the OB commented on it and asked if I was okay. He even asked if I was depressed, and I said no - because I didn't consciously think it was "real" depression. He left it at that and said, "Well, I have to ask questions like that," and shrugged his shoulders. I thought, God forbid I really was seriously depressed, thinking of all those mothers who are totally overwhelmed and need help but are afraid to admit it.

He called me several days later to tell me that my thyroid antibodies were elevated, which meant nothing to me. When I asked him what that meant, he brushed it off and said, "Basically you'll have to go on medication in the future." End of conversation.

After several months and talks with my mom, I decided to do some reading up on it. I realized that as much as I know about pregnancy and childbirth, for example, I know virtually nothing about thyroid problems, what causes them and what to do about it. I looked at list after list of symptoms, some of which weren't the same, and realized that depending on the list you consulted, I had several of them. I felt a glimmer of hope,  like "This could be what's causing all this?!" I was starting to get to the end of my rope.

I have also heard that thyroid problems are common and very under- or misdiagnosed in people. Some go to several doctors before even getting a definitive answer, and not all lab work will reveal problems. My mom enlightened me that those normal TSH (thyroid stimulating hormone) test results I've had in the past are not very indicative, either, and that individual hormone levels need to be tested, too. I've heard from people who have no symptoms yet their levels are whacked off the charts, or have lots of symptoms with near-normal levels. I've also heard that the reaction my OB gave me about it is typical - that many will only begin treatment once those symptoms start, instead of treating it before serious damage is done. I'm afraid that's been happening for a long time already.

I have an appointment scheduled with my family doctor this afternoon; I'm almost nervous and afraid of what he's going to say (or not say). I fear that he, like many other care providers apparently do, will contribute it all to being an overweight, overwhelmed housewife who is struggling with the joys and trials of three children. Here, here's an antidepressant, it'll make you feel better, is what our culture seems to say a lot of the time. It seems that we can draw lines among two groups: those who will willingly take a pill to solve every problem and symptom in the book, and those who are reluctant to rely on medication even though it's clear they need it. My mom herself takes iodine drops instead of medication, and I'm sure part of her advice to "Take Armour! It's natural! Don't take Synthroid!" is her skepticism of all things Big Pharma. I also wonder if the many people I know who suffer from depression are really being treated for a symptom rather than the actual problem? If it's so under-diagnosed, then who knows? How can we really know for sure?

As far as doctors, I've researched just a little online about area endocrinologists who are more understanding when it comes to treatment. This aspect makes me more fearful, especially because one who gets somewhat high reviews has the bedside manner of a goat and an office staff that, unfortunately, is about as notoriously rude as it gets. How they manage to stay in business, I don't know; but I don't want to be dealing with that in addition to everything else. Seven months' wait for an office visit? Are you kidding me? That's like almost another additional year of dealing with crap and I am not in the mood for that. And then to be berated and chastised by an apparently very rude care provider on top of it? No thanks.

I sort of feel like as far as medication, I'm in the middle. I'm not sure what I want to do about it, or what I can do. I am just learning about how this might be a piece of the big puzzle or the key that magically fits in the lock that explains why I've felt this way for so long. It's like a giant piece of black paper is in front of my face and someone is gradually piercing holes through it, letting light through one chunk at a time.

More reading:
Top thyroid doctors directory - The doctor I researched gets pretty good reviews here, but mostly terrible ones from sites like RateMD's and Health Grades. Scary.
Hypothyroidism Signs and Symptoms -
Stop the Thyroid Madness - A conspiracy theory club, of sorts, that just might be on to something

Wednesday, May 11, 2011

The Boob Man

It seems we have a boob man in the house.

Tater Tot turned two at the end of March, and we are still happily nursing. I always thought I would wean at least when they were asking for milk (kinda like how I thought I'd be done having kids at 30 ha ha) but so far, those plans have changed. It's not that I'm unhappy about it, it's just new territory for us. Tater Tot followed me around from the shower the other day, looking longingly at my chest and asking, "Boo boos? Boo boos?" as I tried to get dressed. It was sort of funny and sort of ... weird at the same time.

A few days ago he got up early and I put him down for his nap a little sooner than usual. By mid-late afternoon, I could tell his energy was flagging. He actually walked up to me and said, "Boo boos?" I kind of looked at him like, "What??" He tugged at my fleece that was half unzipped and said, "Stuck." LOL

I knew I wanted to nurse him at least two years; he's breastfed the longest of all three of my kids. I was adamant about trying with my first, and was determined to go at least six months. Then as we approached that mark, it was nine months. Then a year. I eventually weaned him at 18 months, and his sister nursed until she was 21 months.

I've been thinking about this a lot since he hit his second birthday and trying to really examine my feelings about it - namely, why I feel strange for feeling weird about it in the first place. Why do people care so much? If you ask strangers or a friend, everyone has an opinion, and usually they're willing to share it with you whether you ask them to or not. It's like once you become a parent - before the baby is born, actually - they take vicarious ownership over your body and inject their thoughts, feelings and opinions into the situation as far as what's Socially Acceptable and Good According to All Mankind.

My husband and I have talked about this occasionally, and I asked him point blank why he thought I should stop. He really couldn't come up with much of an answer, so we both agreed that whenever we stopped was fine, no pressure. He has always been very supportive of me nursing the kids as long as I, and they, wanted. I remember him asking me about when I would wean when our oldest reached a year, but honestly I think that was because he was reacting more to social norms and customs, and how it influenced his thinking, more than anything else.

It's strange that we have to defend ourselves to anyone who dares to ask if we're "still nursing?!" Last year my brother got married to a lovely girl from California, and her wonderful mother sat across the table from me at the rehearsal dinner and asked if I was still nursing when I refused beer. (I hate beer anyway.) I said yes (Tater Tot would have been about 17 months old then) and knew I loved her immediately when she didn't even bat an eye at my response, as if it was totally normal.

I came across a question posted on some parenting forum a few weeks ago about a mother who was having trouble with her 17-month-old biting during nursing sessions. I couldn't tell if she wanted to just end the bad behavior, or stop nursing altogether. One person who responded said, "17 months is wayyy too old to be on the boob. You need to wean her." I thought, Wow, that's supportive advice; thanks a lot! I put in my two cents and said, "If you're not trying to wean, ignore X's stupid advice."

I think sometimes we want to hurry up our children's babyhood as fast as we can: we say we enjoy watching them grow, and "They grow so fast!" and yet we're in such a hurry to potty train and wean them. As much of a problem accepting breastfeeding as some people have, they seem to have an even harder time accepting the dual purpose of breasts when it comes to toddlers - as if by the time they're able to hold their own bottle or cup they should be in the kitchen pouring it themselves. And if they can ask for it - well, that's even worse! eyeroll

Why can't we enjoy this time, or at least admit that we're not in any hurry? It doesn't mean our nursing toddler is taking advantage of us or having his way, it means he enjoys that time with us, which will not last. Besides, he's two; it's not like he'll be nursing when he goes off to college.

I bet some people think women who nurse their toddlers are somehow holding on to their babyhood and won't "let them" grow up. Maybe, maybe not. I don't know if I'll have any more kids after Tater Tot, but if I do I'm sure I'll nurse them just as long. He's hovering on the edge of boyhood, not quite a baby and not quite a toddler just yet - almost. Independent, and yet...a boob man. Crazy about cuddling up in mama's lap, one leg flung over the side, chubby little hand tucked up underneath there somewhere, eyelids heavy and lazily dozing.

In the words of my friend Taryn:
Think "extended" breastfeeding (past 1 year) is wrong? Well, Michael Jordan was breastfed to age THREE. Same with Albert Einstein. Jesus Christ, even LONGER. The day YOU have six NBA Championship rings, a Nobel Prize in Physics and the ability to walk on water, we'll talk. Till then, put a cork in it.

Monday, May 9, 2011

Happy Mother's Day, Mommy Dearest

Motherhood: It's our passport
towards insanity. A one-way
ticket on a journey so full of bumps.
But even so, this is one wild ride that
I would never want to miss.
I was recently tagged in this photo on FaceBook, and while it made me laugh, sometimes I feel like it's true.

Yesterday I got to sleep in a little (8 a.m. - woot!) and awoke to wonderful hugs from two of my (already-dressed!) children. Then I went to take a shower and noticed, hey - someone didn't flush. Can't win 'em all, I guess.

I have a mixed bag of feelings about Mother's Day. In our house, almost every day is "Mother's Day," and I can't really complain. I have a husband who bathes the kids, puts the older ones to bed, play wrestles on the floor, all that dad stuff - including gives me some "time off" once in awhile to recharge my batteries. While my older ones are in school, Tater Tot often sleeps for a few hours in the morning, so for someone with three kids I get quite a bit of time to myself. It's what I do with that time that's usually questionable...

This is the time of year where people like to reflect on how good a mother you are. I, on the other hand, tend to internalize things and focus on how bad a mother I often am.

While not as bad as Joan Crawford (I hope not, anyway), there are those times. While I often think that boys are initially more trying than girls, right now my daughter is giving us a run for our money to the point of sheer exhaustion and frustration. The spanking ensues, and both of us feel like shit afterwards and wonder, what was the point of that? We're trying a whole host of things, not many of which are working. I wonder, Can this get any worse? Then my brain fast-forwards ten years and thinks, Why yes, yes it can. 

While most people say how well-behaved my children are, I think, What are they talking about? and smile politely. I sometimes say that out loud and then think, Wow, it really sounds like I'm bad-mouthing my children. Then I feel bad, because they are good kids, just not for me. LOL I sometimes feel like none of them listen to me, at all. Tater Tot is a complete hellion for diaper changes, which often means I'm in crazy positions trying to change him just so he'll comply and not get poop all over the place at the same time. For other people, though - including my husband - he's a complete freaking angel. Which I totally do not get. We are teaching him "please" and "thank you," which he knows but refuses to say. I ask him, "How do you ask? Can you say please?" when he wants something, and he'll drop his shoulders, obviously annoyed, and say "No." Although yesterday the nursery worker at church told me, "He said, 'Water, please.'" Well, at least we know he's learning something.

When my mom was growing up, it seemed few parents showed affection or love for their kids. My grandmother was loving, I guess, but my grandfather was a complete ass who had little patience for his kids, apparently. The cheapskate that he was, he refused to buy glasses for my mother until she was in 8th grade, forcing her to wait through several years of bad vision before he finally caved in and bought a pair. When she cried, he'd take pictures of her and show them to people. She told me he was very impatient, which made me think of all the times I've responded, exasperated, to my daughter. I really hate that part of myself, the part that makes me wonder, Am I turning out like him?

The other day my husband told me how the neighbors - whose kids I've written about before - are having behavior issues. I always thought they never spanked, but apparently they have gone down that road with their daughter, who is very headstrong. The oldest has always been very shy, and now I realize how passive-aggressive he is. Their dad told my husband how S is very angry a lot of the time, and making it through a meal is difficult. I was shocked and thought, Their mom never told me about this. It surprised me, because I always thought they took a very even-keel approach, and thus produced... I don't know, even-keel kids, I guess.

While our husbands spilled the dirt, she has never once talked with me about it. Why is it so hard to talk about the trials we go through with our kids? As if we have to keep up some ridiculous facade?

It also made me realize how, despite our different methods of discipline, we each suffer from the same problems. Anger, not getting what we want RIGHT NOW!, backtalk, the works. The exterior is different, but what's inside is the same, no matter what.

A friend of mine and I were chatting awhile back and she admitted she was diagnosed with bipolar disorder a few years ago. In the time before her diagnosis, she was raging, angry and on the brink of losing it with her child. Her husband was a rock of support to her, and once she sought professional help, she was finally able to cope.

Just hearing her talk about it, though, was a breath of fresh air to me. Finally, someone was admitting that they spank, yell, scream, whatever it was - but they were admitting it. Not trying to hide behind some Better Homes and Gardens farce of motherhood that's only depicted in TV commercials.

At church yesterday, two little kids sang a wonderful song about mothers - tucking little ones into bed at night, making boo boos better, all that good stuff - and I had tears in my eyes. Not tears of happiness, but of sadness. Because while I do that typical mom stuff, I'm not sure if I do it with enough love and patience as I should.

We are so afraid as parents, especially as mothers, to admit the less-than-perfect things we do. The totally inappropriate things that we think, like this. While this was a tremendous laugh, it made me sad in a way for  parents who really do say these things to their kids - who might have started out with good intentions, but who have long-ago teetered over the edge of impatience and just fallen straight into the void that defines child abuse and truly bad parenting. It also reminds me just how easy it is to lose it altogether and do something harsh or dumb, something you can't take back or un-say that could potentially mess everything up forever. Really, sometimes I think there is little separating us "good" parents from the "bad" ones who make headlines.

Saturday, May 7, 2011

Avoiding unnecessary inductions and c-sections: "Every week counts"

I was going to title this post "Sick of being pregnant? So what?!" but thought maybe that would come off as a little harsh.

I've written about this several times, as have a lot of others. Unfortunately, I'm not really sure who's listening (one woman decided that since the Huffington Post, whose link I've included below, was not an unbiased source of news, that perhaps the article wasn't true). I've been posting links ad nauseam to the March of Dimes website for months about Why the Last Weeks of Pregnancy Count, in hopes that someone out there is actually reading it. And this month, they and ACOG have teamed up in hopes of decreasing unnecessarily early births because of elective, non-medical inductions and cesareans.

Obviously there are some exceptions, as this article from the Huffington Post noted. While I was glad to see this subject go mainstream, I did have a problem with this paragraph:
“If a baby needs to be born for a medical reason, that baby should be born,” said Dr. George Macones, an OBGYN at Washington University’s School of Medicine in St. Louis. “But when I was practicing in Philadelphia, patients put pressure to deliver early for what I call ‘social purposes.’”
While I'm certainly not denying that mothers do pressure doctors to do inductions, let's not lay the onus of blame completely on the mother. Doctors are often notorious for scheduling for convenience, and so many women can testify to that in their birth stories. It's also not uncommon for a diagnosis of "failure to progress" to come hours before a physician has an important upcoming event to attend. And sadly, we hear of plenty of doctors who pressure moms into cesareans before their shift runs out at 5 p.m.

As far as 'medical reasons,' this is often another gray area. True medical problems are one thing, but we're also finding more and more that doctors are using questionable medical diagnoses - like big baby and low fluid, most frequently - to assess whether or not the baby should be born. In the case of a big baby, there is no definitive answer to that question, except weighing that child right after birth. Some estimates are more accurate than others, and some are way off. In this case, you need to ask yourself, do I want to risk having major surgery - for this baby and potentially all my children - if my child happens to weigh substantially less than estimated?

It probably sounds like I'm anti-physician. Not really. But I wish people who think that doctors are incapable of doing these things would pull their heads out of their butts for a moment and take a look around.

As far as the Every Week Counts campaign, I'm hoping it gains some serious traction. I am not completely sure what the best answer is - but I wish we'd see some disciplinary action on the part of hospitals and medical boards for those who do like to practice "9-5 obstetrics," or have a higher-than-usual rate of cesareans. Many are coming down on the WHO's recommendation that the optimal c-section rate be around 15 percent, because they consider it an outdated (circa 1985) standard and acknowledge that the ideal c-section rate is a figure no one is really sure of. While that may be true, I think we can argue that this is far from optimal.

I've blogged before about the myth of the emergency cesarean, and have come to realize that words like "medically necessary" are relative terms. When you start questioning what is truly necessary, there are those who quickly become defensive, and assume that you're trying to say you know more than their doctor. No one likes the feeling of being pinned into the corner about their choices, or to essentially be told that perhaps they had choices they didn't even know about. I remember one particularly heated exchange on a pregnancy forum of a mother asking for induction techniques because her baby was 35 weeks gestation and she didn't "want a 9-pound baby." Why, dear God, why?! 

When it comes to laying blame, it probably fits squarely in both corners, as the above quote suggests. There are no shortage of women who want it their way, for a number of reasons - that much is true. HufPo user Trillian4210 writes:
My second baby's tentative due date was 10/10/10. My OB/GYN laughingly told me he hoped I didn't go into labor that day because he was BOOKED SOLID with scheduled c-sections of women who had no medical reason for it but that they wanted that birthday for their kid. That's not a birthday, that's a vanity story. 
What I want to know is, what is this physician doing about it? Are you informing your patients the dangers and giving them a realistic outlook of what could happen? They complain so much about mothers demanding it, when really, you're just facilitating and enabling it to happen by not informing or counseling your patients adequately to stop this from happening. This would be a perfect opportunity to go over with your patients why it's unsafe, and stop the practice altogether, not give in to their whimsical demands.

If a mother's excuse of "I want my baby's birthday to be 10/10/10!" sounds frivolous, then a doctor saying, "Your baby might get too big and then die!" should be code speak for "I have vacation to the Bahamas coming up, and there is no way I'm waiting around for this baby to be born!"

And speaking of the etched in stone due date, those people who like to criticize women for wanting to deliver their babies early are also throwing stones at women who decide to go post-dates and let the baby pick its own day. You just can't win.

For generations we have had instilled in us the idea that every "large" baby will be difficult to birth, that every baby born past 40 weeks "will die," or that because the baby has reached that magic benchmark of 37 weeks, that "it's ready!," like some kind of turkey pop-up timer.

So while it sounds great to blame the mother for going Princess Renegade and wanting everything done according to her plans, the medical community has no one to blame but itself.

Tuesday, May 3, 2011

Free-Range Kids

You probably remember in 2008 (has it been that long already?) when columnist Lenore Skenazy let her son ride home by himself on the NYC subway system. Then she wrote about the experience.

News outlets and TV shows picked up the story. Many were outraged; some thought it was totally awesome. I had mixed reactions. While NYC is one of my favorite cities, even I couldn't probably navigate my way to the subway; but then again, I've never lived there and traveled it every day, either.

I guess as a mom I consider myself somewhere in the middle. We live in a semi-rural area, on a school campus, actually - which is a great little community with lots of nice sidewalks to bike on and kids to play with. Our backyard butts up against the quadrangle, and once my son turned five, he was allowed to bike by himself. He knows his boundaries - like he's not to go on the "black parts" (which are parking lots and access roads, simply because there are some assholes living on campus who decide to treat them like a local freeway and drive too fast). Anyway, for a kid, it's probably heaven to trawl around on your bike, feel the wind in your hair... (if that's possible while wearing a bike helmet, at least).

I try not to think about the random groups of people who occasionally rent buildings on campus for such varied things like athletic tournaments and Buddhist retreats. I try not to think about how quick and easy it is to access the freeway from our house, leading to a major US city and eventually, the Canadian border.

I also think of the places I went on my bike - crossing four lanes of traffic in a busy town, for instance - and how if I had been hit by a car, my mother wouldn't have even known where I was. (We were visiting relatives at the time.)

I grew up a child of the late 70s and 80s, with stories about Adam Walsh making the headlines. He would have been about the same age as me, just a few weeks apart. Later it was Polly Klaas (who was abducted from her own home), and Amy Mihaljevic - a Cleveland area pre-teen who was kidnaped from a shopping center after being there, alone. Her body was recovered in the county next to the one I grew up in.

Jaycee Dugard, whose name recently made headlines after emerging from captivity after nearly 20 years, was kidnaped from the school bus stop, within eyesight of her stepfather and her own home.

I thought to myself, Where was Adam Walsh's mother when this happened? According to this Wiki article, she

let him watch a small group of older boys play video games at a Sears store in Hollywood, Florida, while she walked a few aisles away to shop for a lamp. When RevĂ© returned to the video game section about seven minutes later, Adam and the group of boys were gone.
A few aisles away? What the heck?!

This story reminds me of one I read not long ago about a boy who was sexually assaulted in a public library, while the place was open and his mother sat not far away. (Apparently this isn't the first recent case of this, either.)

Skenazy thinks parents are overprotective and paranoid much of the time, and I suppose in some ways, I agree with her. Every day for an entire school year, I'd watch one mom pull up in her minivan and wait in the driveway for her son to get done with class so she could shuttle him someplace. This at a boarding school, where her son is supposed to learn life skills and how to function as a young man in an environment without his mother hovering over him. She was the true definition of a "helicopter mom," one who refused to admit that her son had anything to do with his troubles at school.

Like Skenazy, I want to instill in my children a sense of responsibility and self-reliance. But I think some unsupervised activities - like the subway ride - might be taking it to extremes. And to assume that any parent who doesn't believe in letting their kids go "free range" is one who immediately rushes to kiss all boo boos of any magnitude, no matter how big or small, is pushing it.

In an age where the "attachment parenting" philosophy is embraced - often by people who think cribs are dangerous and letting your child cry for even "one minute!" is torture on their delicate feelings and emotions, I'm not sure where "free range" fits on the spectrum. My children haven't, as far as I can tell, exhibited any signs of emotional detachment because I let them sob in their crib for exactly two minutes 45 seconds, which sounds a lot less dangerous to them than a chance encounter with a stranger who had ill intentions.

I remember a couple summers ago being at the mini golf course with my husband and our kids. Suddenly a strange boy appeared, hanging out with us a little like he wanted to join in. My husband and I looked at each other like, "Where did he come from?" and looked around for a set of parents who appeared like they belonged to him. There was a small group way on the other side of the course, and a couple of others who looked detached and uncaring. Then he disappeared and that was that. I thought to myself, What if we had been crazy people who wanted to kidnap their child? Aside from the fact that we had our own children with us, it's not uncommon for women to accompany men in their quest to pick up kids - as was the case with Jaycee Dugard's disappearance. (In some ways I think it makes a child more willing to come to a stranger, because a woman is perceived as caring and "safe.")

Skenazy says parents need to relax, because hey - crime is actually at an all-time low. It's actually our perception of crime that is greater. That may be true; statistically the numbers might be down, but it might not be what people are actually seeing when they look out their windows at night. I also wonder what percentage of crimes - from petty theft and vehicle break-ins to rape - go unreported. (Some sources estimate that roughly 60 percent of rapes go unreported.) Some people acknowledge that depending on the level of crime, the police may be called but won't even come to the scene if the estimated damages don't reach a certain amount; otherwise it's not even worth their time. That still makes it crime, though, doesn't it?

Lower crime rates are one thing; but crimes against children are sort of in a separate class by themselves. You take your average criminal and ask him how he feels about child rape, and I bet he'd tell you it's pretty bad. Those who commit heinous crimes - like Jeffrey Dahmer, for instance - are often reviled and hated even worse than 'regular' offenders, taken to task accordingly, it seems. (Dahmer's crimes were so bad, I guess, that the prison population decided to save taxpayers money and do away with him themselves.)

I'm sure Skenazy doesn't advocate putting your children in dangerous situations deliberately, but perhaps her ideas of dangerous are different than someone else's. Her "Take Your Children to the Park and Leave Them There Day" is set for May 21 - although some parents I know won't be leaving their kids. One mom told me that some wackjob stranger has been randomly hiding razor blades along the slides and other playground equipment - for a grand total of 30 found - so that children can cut themselves. She also notes that her small US city has had four abductions attempts while children walked to school, two of which resulted in sexual assaults.

I think people automatically think it's only the "country bumpkins afraid of the big city!" who are the paranoid ones. Maybe; maybe it's because crime now spreads to outlying areas that were once deemed "safe." Not far from my house is a beautiful rural park that unfortunately has also been the target of three suicide attempts within about a year's time, and is also rumored to be a favorite spot among those seeking illicit sexual encounters as well as drug trades. All within the confines of our idyllic little "safe" suburb.

Like it or not, things are not the same as they used to be. Yes, crime has always existed, and crimes against children are nothing new. Perhaps the media is responsible for making us more afraid because we now hear about it all the time. I'm not totally sure I believe this, though. I think offenders are getting more brazen; defying sex offender laws and setting up camp close to schools, for instance, flying under the radar. Because I volunteer at my son's school, I am required to take a workshop and regular refresher courses in identifying sexual abuse in children, and was subjected to interviews given by child predators in what they looked for in victims. Unsupervised, or what they probably consider poorly supervised, children are probably at the top of the list.

But perhaps the biggest place for child predators is online - something that didn't even exist 20 or more years ago when "we were kids." Online chat rooms and porn are the new battleground in the fight for your child's safety and give people even more access than ever before.

In some ways, I see it as a gradual decline in morals and a degrading of society that contributes to why our kids can't have their anal parents just get off their backs already and let them be kids. Yes, in typical kid fashion, they'll experiment, do dumb stuff, and occasionally get burned. When I look around, though, part of it is our own faults - because a difference of opinion on how to raise children has produced parents who let their kids listen to music that's totally inappropriate for their age level; where a fascination for Justin Beiber and Hannah Montana is cultivated and thought to be "cute" in kids who aren't even in kindergarten yet; in young girls who are marketing targets for the fashion industry and encouraged to wear heels and dress beyond their years. Where are the parents? Who knows. Maybe a little too free range?

Every generation says, "Wow, I can't believe what kids do/say/think these days." I'm sure if you compared successive generations from 1900 to the present, there would be some major heart attacks going on over behavior that is considered prudish by today's standards. Bring a gun to school in 1950 and you'd get laughed out of school, one old guy told me. Then again, a classmate of my dad's (who graduated in the late 1950s) decided to take that one step further and shoot his parents in cold blood.
Perhaps crime and abuse are really more prevalent today; maybe not. One thing is for sure, though: the challenges and dangers our children face are changing and getting more and more complex. This isn't 1963 anymore, Lenore.

More reading:
Roger Ebert - Raising Free Range Kids
Online Child Predator Statistics

Monday, May 2, 2011

The new mommy wars

Lately I have found myself caught in a strange time warp, of sorts. Often when I read certain blogs or hear about new FaceBook fan pages popping up, it's like my old, worn-out 36-year-old self has been magically transported back to seventh grade and I didn't even know it.

In my cluelessness, it took me awhile to find out about sites like The Feminist Bragger. A completely weird, bizarre parody designed to basically do nothing but make fun of The Feminist Breeder, I read a few posts and then moved on. Whatever. That was interesting, for like two minutes. Next?

Then last night I stumbled in to the virtual cesspool of "Birth Without BS," a fan page dedicated to cutting through what some people consider woo and getting to the heart of the matter, I can only guess. Fine, that sounds like a good place to start. While there's lots of information, blogs and other stuff out there, obviously it's not a one-size-fits-all deal, and much like shopping for a house or car, we can all choose what we want and don't want.

However, there's one problem: those who don't agree or like certain things have decided to start fan pages and blogs to talk about it. That one kind of left me scratching my head, and I considered it a very ballsy move. Is this what we teach our kids about conflict resolution and how to treat people we don't see eye to eye with?

While I might not agree with everything one blogger says, I don't start an entire blog dedicated to bashing that person and all the stuff she says or does. Who the heck has time for that? I think many women are smart enough to realize what they want or don't want, and I get so tired of hearing how so and so is "promoting" something - like unassisted birth, for instance - with the dreaded anticipation that scads of women are going to blindly follow suit. That expectation is about as bad as the "sheeple" mentality some people have, only in the other direction.

I guess I figure if you don't like it, don't read it. Move on. Do something else. But above all, be respectful of another person's decision or choices.

So now anyone who is different is labeled "BS." (I guess one person's woo is another person's BS. So it's all relative, right?)

Blogs like The Feminist Breeder, Rixa Freeze of Stand and Deliver, Birth Without Fear and Gloria LeMay have been nitpicked and criticized. It leaves me wondering, just who's side are you on, anyway? I find it profoundly strange and sad. And it only makes people like Dr. Amy briefly stop and reload while on her mission to bash anything and everything she doesn't agree with. (At least Dr. Amy has the guts enough to use her real name when attacking people.)

I just wish the drama would stop - it only stirs up more crap and leaves behind those women who are on the fence about birth choices and really need help and support. Instead we should be behaving like the powerful, strong women we are - instead of the childish, petty little girls we should have left behind years ago.