Wednesday, October 17, 2012

How to increase breast milk supply, or make the most of what you have


I never had a doctor mention to me that I had any risk of supply issues, and had several doctors and nurses give me some very bad advice on how to deal with them.  They ranged from "your baby's getting what she needs despite the fact that she's crying all the time and can't sleep." to "just wait, your milk will come in," to "well if your milk hasn't come in by now (five days after delivery) it's not going to come in so you might as well just give up and use formula."  I can't believe how un-informed I found everyone from  the hospital maternity ward staff to my own personal OB!  I mean, it is your job to advise and care for women who have just had a baby, and to make sure that both mother and baby are cared for properly.  One would think that you could recognize that I have SEVERAL of the most severe risks for supply issues and at least warn me that I may have some work ahead of me!

Especially since supply issues are not the end of breast feeding, and there's a lot that can be done to head them off at the pass, but because I didn't know I had supply issues until nearly two weeks after my baby was born I am STILL constantly playing catch-up.  It also seemed like so many caregivers in the hospital were actually afraid to offer any advice.  For example, when my baby had jaundice I kept hearing over and over that hydration was the most important thing to focus on, and that I needed to make sure my baby stayed hydrated, but no one would tell me HOW!  I mean, this was a day or two after she was born, so of course I had next to no supply yet (no one does at that stage) and I was nursing her every 2-3 hours for 30 minutes at a time.  That's what they said I should do, and yet she obviously wasn't getting enough (not enough wet diapers) and the jaundice was getting worse!

Even once I did know I had supply issues I got conflicting advice from doctors, nurses, parenting books, and lactation consultants.  For example my lactation consultant said to supplement the baby with 1-2 oz of formula before each feeding and then finish up on the breast so she comes to associate me with satiation, while my baby's pediatrician said to breastfeed first when she's hungry and will go after it more and finish up on the bottle.  With such conflicting advice, and so many sources that completely ignore breast feeding supply issues I want to share what I've managed to glean about ways to improve supply and get the most you can or your baby.  I really feel the need to consolidate everything I learned and to let other women going through this know it's NOT that uncommon!

So first some of the worst advice I got starting from the very beginning:
"Don't worry about her nose, it's pointed down so she can always breath, and if she needs to breath better she'll just adjust."  Um, no.  You can definately smother a baby with a boob.  Yes, she'll notice if she's not getting enough air and adjust, but that adjustment will mean pulling back and letting go of her latch to gasp for air.  Which will mean you have to go through the process of re-latching over and over.  This leads to slower nursing (since she's not staying on) and nipple soreness from the re-latching.  For goodness sake tilt her head back or push your boob down so she can breathe!

"Just wait and your milk will come in."  In actuality the longer you wait to deal with a supply issue the more you'll be playing catch-up.  I'm STILL playing catch-up over two months later and there's a LOT you can do to improve things, the earlier the better.

"You don't need a breast pump."  The truth is, the more you empty your breasts, the more they will realize that they need to be making more.  The best way to empty your breasts is by baby, but babies get tired, their appetites wax and wane, they sleep through feedings, and you want to make sure you're emptying every last drop!  One of the best ways to increase production is to pump and feed frequently.  There are lots of different techniques and schedules that can help, and I'll discuss that more later, but suffice it to say I wish I'd gotten the pump when I first wanted to rather than listening to the hospital staff and putting it off until after they said I needed it.

"Fifteen minutes on each breast is enough." Ha!  The more stimulation your breasts get the better, and if your baby's tired or is a sleepy nurser like mine was then she may not be working at it that full 15 minutes, so your breasts may not be empty after 15 minutes.  Once I found out I had supply issues I'd feed her for over an hour at a time switching back and forth between breasts to help keep her awake and interested.

"You need to feed her 6-8 times a day."  More like 10 or more.

"You shouldn't supplement with formula."  You need to get 8 wet diapers a day, and if you're not getting that then you need to do what it takes to do that.  We were getting 4.  We told the lactation consultant that and she wigged out!

"Drink a beer as soon as you deliver, and every day after and you won't have any problems."  I heard this over and over, and always from women who'd had copious supply and could AFFORD to pump and dump.  Just when am I supposed to be drinking my beer?  All the books say not to drink within 2 hours of breast feeding, so I have the option of drinking a beer bright before I pump or drinking a beer right before I go to bed with my baby.  Neither of which makes sense when I'm trying to give every drop for my child.  Of course there is barley water and we'll talk more about that when we talk about what you can do for your diet to help.

So now you know what not to listen to, how do you get started trying to establish a good supply.  Keep in mind I'm not any sort of medical professional.  All I know is what I learned with my one baby.  So take everything I say with a grain of salt, I may have no idea what I'm talking about.  It starts before your baby is born.  Have your thyroid checked.  Have your complete blood count checked.  Make sure that your hormones are working and that you're not lacking in any nutrients.  Keep taking your prenatal vitamins and supplement to make up for any deficiencies.

Once you have your baby nurse as frequently as you possibly can.  The more nipple stimulation that better.  In fact you might try the pump before your baby's born, just make sure you don't try this until you reach full term since this can trigger labor.  If you have a premi or a baby with health problems this may be harder than it sounds, this is where the pump comes in.  Use breast compression during nursing to help your baby get ALL the milk out, and once you're done with a feeding see if you can express out any milk remaining.  An empty breast is a breast in production mode, so basically you want to empty your breasts as often as possible.

If you need to supplement  do so guilt free!  You don't want to starve your baby, and you want plenty of fluid moving through your baby to clear out waste.  Just be sure you supplement very small amounts at a time.  This is where it gets really frustrating.  Formula seems to only come in 2 oz doses, but you'll probably only want to supplement .5 to 1 oz at a time to start.  I guess the formula companies want you to over-prepare what you need and dump it out when it doesn't get used?  You can however mix up 2 oz and stick it in the fridge, then pour out .5 of an ounce at a time to reheat when you need it, just be sure to use it up within 24 hours of mixing.

Supply can also change throughout the day.  You may have plenty first thing in the morning, but when it comes time for that last feeding at night don't have enough to satisfy for an hour much less a good night's sleep.  So you may find you need to supplement different amounts at different times of day.

I've been given conflicting advice on whether to breastfeed first or supplement first, so I've tried to do a combination.  After all, I have two boobs!  So I generally start with one breast, supplement  then feed from the other breast.  This takes practice to know how much to supplement   If you give to much your baby won't be interested come the second breast, which isn't good for your supply.  If you give to little then you'll end up giving more late because your baby will be hungry, so the whole issue of what your baby comes to associate with satiation comes into play.  And as a baby goes through growth spurts his apatite will change, so it really can keep you on your toes constantly adjusting what you're doing.

Use wide neck bottles!  I'd bought a really nice set of Dr. Brown's bottles before the baby was born, only to be told that these can cause nipple confusion when you try to use them while breast feeding.  The wider nipples are supposed to latch more like your breast, so your baby won't get as confused about what to do when presented with either.  How you offer the bottle makes a difference too.  Don't just pop it in your baby's mouth nipple down.  Gravity will make it flow faster, and if your baby gets used to the faster flow then this can lead to frustration when they go back to the breast.  Hold the bottle horizontally, tilted so there's just enough milk to fill the nipple.  This way your baby has to work for it, and it has the added bonus of helping to prevent the baby from overeating.  After all, it hurts to work so hard to give him what breast milk you can, only to have it spit right back up at you!

There are a variety of herbs that can be used to help increase supply including milk thistle, and fenugreek, and proprietary blends like More Milk and More Milk Plus.  Keep in mind if you have thyroid issues that fenugreek can lower T3 hormone, so go for straight milk thistle or plain More Milk (not More Milk Plus) if you're worried about your thyroid.  These can be harder to find in stores, but you can order them online.  I saw a pretty fair increase in supply when I started on More Milk.

Eat well, and eat foods that can increase production.  This is not the time to go on a diet.  Be sure you're getting plenty of protein (eggs are a complete protein) and fat, and a wide variety of nutrients.  There are some foods that are supposed to help.  Oatmeal's the one I found most commonly recommended, but google lactation foods and you'll find lots of things to try.  A lot of folks recommended I drink a beer a day, but I tried a few alternative routes so that I could avoid having the alcohol in my system that is not good for the baby.  I cooked with beer.  This cooks out most of the alcohol, but leaves the rest behind, besides beer in chili is good!

You can also make your own barley water which has all the good stuff of beer without the alcohol, and it's not as nasty as it sounds.  You basically want to add a cup or two of barley to a LOT of water and then boil the heck out of it.  I found a recipe that called for about a cup of barley to two liters of water (or about two cups of barley if I filled up my largest soup pot with water).  Bring the water to a boil and then reduce the heat to a simmer for several hours until it's reduced by half.  You can then strain out the barley and eat it or throw it out (I added it to soup) and let the water cool for drinking.  I tried several things to make this more palatable.  You can add sugar and lemon to make a kind of thick lemonade, or add a dash of lemon to each glass for lemon water.  I would also sometimes mix it half and half with a strong flavored juice I liked (cranberry grape worked well), but milder juice like apple seemed to be overwhelmed by the barley water.

No matter what you're drinking, you want to make sure you're drinking plenty to stay hydrated.  After all, you're drinking for two now, and much of what you're drinking is being passed on to your baby.  You don't want to get dehydrated.

You'll also want to be sure you have a breast pump.  I read a lot of suggestions that sound like good ideas but don't really work in the real world.  Who has enough hands to hold a wriggling baby to one breast and a pump to the other simultaneously?  Some folks suggested pumping after every feeding to make SURE the breast was empty, but I never seemed to have time for that.  However I do pump when I wake up in the middle of the night, if it looks like she's going to sleep through a feeding, and very frequently during my work day to try to make things as empty as possible.  The type of pump you use does matter.  I've heard some women swear by the medicinal grade pumps that can be rented, and I wish I'd tried one of these before I bought the one I'm using.  Some women have better results with different flanges.  I got a lot of advice that suggested you should try different pumps, but at $300 to buy a decent electrical pump, or $50 a month to rent that could get very expensive very quickly.

Every little bit of breast milk you can give your baby helps.  It cuts down on tummy ailments and helps your baby's immune system.  Even with all that I've tried I still only make about a third of what my baby needs, but it's worth it to know I'm doing what I can to keep her as healthy as possible.

Wednesday, October 3, 2012

Myths about breastfeeding

I've run across SO many websites dedicated to dispelling the "myths" surrounding breastfeeding, but it seems like so many of them are afraid to say anything unpleasant about breastfeeding for fear it will convince you not to try it.  Now I'm all for breastfeeding, heck it's been really difficult for me and I'm still working to make it better, but I think it's worth sharing that it's not all puppies and rainbows.  I would encourage every mother to breast feed as much as she is able.  There are lots of health benefits involved for all parties, and even if you can't stick with it for one reason or another, every bit that you can do helps both you and your baby.  But if you only hear the good things about breastfeeding, never informing yourself about the ups and downs involved then how can you prepare yourself for what you'll need to do to give breast feeding a concerted effort.  So without further ado here are some myths I see all over the internet that I wish someone had dispelled for me.

Myth: Breast feeding doesn't hurt if you do it right.
Ha!  My nipples have ranged from slightly sore to downright painful for the last two and a half months.  From the week my baby was born I would cringe just to have my towel brush against my nipples when I got out of the shower.  Ever tried to dry your face without your towel touching your nipples?  Maybe if you're more flat chested than me, but I can't seem to manage it.  Now things might be better for you if you're used to having someone suck on your nipples five hours a day, yes that's 10 feedings a day at 15 minutes per breast which is the MINIMUM my lactation consultant recommended to get started, so it just stands to reason that women who haven't breast fed before are going to be sore.  It doesn't help that she sometimes kicks one boob while feeding from the other.

Now there are lots of things that can help, starting with getting your baby to latch properly.  The lanolin cream really does help, and they make these really fantastic gel nipple pads that are cooling and soothing and really fantastic!  The pain gets better with time, well, it comes and goes really.  You'll get a schedule going and be fine for a couple weeks (sore but fine) and then your baby will go through a growth spurt and be ravenously hungry and rub your nipples raw again.  Keep in mind, I haven't had anything like bad nursing problems, no cracked and bleeding nipples like I've read about.  But you'll want to have a few thick bras that  are really protective (and hide the lines from the gel pads mentioned above), and don't be afraid to take a little Ibuprofen now and then.

Myth: The pounds just melt off.
I'm sure they do for some folks, but don't count on it.  I lost weight pretty fast for the first few weeks home from the hospital and then stalled out with about ten pounds to go to my pre-pregnancy weight.  I was talking to a retired GYN nurse who works at my daughter's daycare and she says that's about par for the course.  She said it's because breastfeeding tends to cause fluid retention (makes sense, if you're providing fluid to your baby then your body would want to have plenty of fluid on hand) so most women stall out somewhere around 5-10 lbs above their pre-pregnancy weight.  Of course you can then watch what you eat and probably slowly lose more, but you want to be careful about that when your breastfeeding because you don't want your body to think you're starving.  You also don't want to loose weight to fast because that can release toxins into the breast milk.  Either one can hurt breast milk quality or quantity, so don't plan on slimming down quickly.

Myth: Breastfeeding is free.
Nope, there's still no such thing as a free lunch.  Yes, breastfeeding is more cost effective than formula, but it's still far from free.  Here's a breakdown of what you can expect to spend on breastfeeding:
  • Lanolin - I go through a tube every month and a half or so, and the tubes run about $8 at my local Kroger.  It might be more cost effective to buy them online or in larger sizes, but I haven't checked.
  • "Soothies" Gel Nipple covers - You may not need them all the time, but they're great help for the worst soreness, and you can put them in the fridge for even more effective soothing.  They run about $10 a pair and I forget where I got this last set.
  • Sleep Bras and Nursing Bras - No, they're not the same thing.  You'll want extra protection for your boobs, so even if you don't normally need support while you sleep you'll probably want to get a couple of sleep bras (I got Medela sleep bras, $15-20 on Amazon.com, and wore them 24/7 for my maternity leave).  You'll also want some nursing bras, preferably something without under-wire for the first little while.  I got one actual nursing bra, and then found that my really old stretched out Victoria's Secret bras could be pulled down for nursing pretty conveniently.  Unfortunately, they don't make them like they used to, and you couldn't do this with their memory foam bras, and Victoria's Secret now appears to be addicted to memory foam.  You can get nursing bras that unhook from the top to fold down, or with stretchy bra cups that just pull to the side or down.  I found the second to be more convenient, but they're less supportive than the ones that unhook, so you'll have to figure out what works best for you.
  • Vitamin D drops and other baby supplements - Our pediatrician recommended that unless our baby eats 32 oz or more of formula a day we should give her vitamin D drops daily.  My husband's been the one to buy these, so I don't know how much they are, but I'm sure they're not terribly expensive.  I've heard of other folks needing other vitamin and mineral supplements as well, but we've never needed more, possibly because we're feeding both breast milk and formula.
  • Bottles - Unless you're never planning on leaving your baby with anyone else, or for that matter never planning to need to feed her in her car seat on the way somewhere, you'll need to get some bottles.  How many will vary according to how long you'll ever be away or how often you want to wash dishes, but my lactation consultant strongly recommended using the wide nipple bottles because they're more like a breast which can reduce nipple confusion.  However I haven't seen any wide neck bottles in consignment like I have standard size bottles, so you may find these to be more expensive than if you were exclusively bottle feeding.
  • Breast Pump - Wile I've heard some people have great success with hand expression, the few times I've tried it I got much less than pumping and it took a very long time.  Breast pumps can ranbe from about $50 for the cheapest hand pump I've seen, to around $1000 for a hospital grade pump.  That's to buy.  You can also rent for about $50 a month, and there are accessories to buy to go with that.  I got a decent electric pump for $300 and it works pretty well, though some folks swear the hospital grade pump works better.  I kind-of wish I'd tried it to see if it worked any better, but at this point it seems like a waste.
  • Lactation Consultant - I'm sure this is optional for most folks, but I found our lactation consultant extremely helpful and have been very glad to have someone to go to when I have questions.  I'm sure there's a wide range of cost here, but four our board certified (IBCLC) consultant it was a little under $200 for her to come to our house for three hours, and then she was available to help us by phone and email thereafter.
  • Lactation support foods, herbal supplements  and medicines - You may not need these at all, and some of the foods probably shouldn't be counted.  After all, you have to eat breakfast anyway, and it doesn't cost any more to eat oatmeal (which supports lactation) than any other breakfast.  Still, there are a few things I got specifically to help with lactation including: hulled barley (for making barley water, $10 for a pound on Amazon.com but much cheaper if you buy in bulk), More Milk or More Milk plus (an herbal supplement to increase breast milk production, about $20 for a 2-3 week supply, more cost effective if you buy in larger amounts), and I also got a prescription galactogogue that was $100 for a three month supply.
  • Specialized nursing pillows if you want one - I just used bed pillows, but some folks swear by their Boppys.
  • Your time - It takes longer to breast feed than bottle feed, and takes more work from your baby to get the milk out.  The slower flow is actually one of the benefits of breast feeding since it prevents overeating which in turn can reduce spit-up.  It also makes a baby more aware of when she's full.  I mean, it's the difference between scarfing your food and having a leisurely meal, you have more time to detect satiation.  This can lead to better eating habits in your child's life moving forward, but it also takes more time at each feeding.  My baby can take a bottle in 10 minutes or so, but at the breast takes 40 minutes to an hour per feeding.  That's probably on the long end of things, but if you believe your time is worth something then you'll want to tally that cost.  Remember the adage "Time is money."  I also recently read that breast feeding mothers have reduced earnings over the first five years of their child's life than bottle feeding mothers.  It's possible that's because they're more likely to be stay at home moms or work reduced hours, but it's still worth keeping in mind.
Sure, your actual costs may not add up to the projected $600-1800 cost of formula for the first year.  Many of the costs of breastfeeding are optional, and my largest expenditures have been covered by FSA.  Bottle feeding may also have additional costs due to more child illness and doctor visits; here's a study that says that the extra medical costs to never breast fed babies average $331 to 475 (http://www.ncbi.nlm.nih.gov/pubmed/10103324).  But I'm so tired of hearing about this "free" feeding method.  I wanted you to know what to expect.  

I still think breast feeding is totally worth it.  There are lots of good reasons to at least give it a good try.  If nothing else, it can be an amazing mother/baby bonding experience.  But if we can take the rose colored glasses off and prepare ourselves for the reality of breast feeding then we're much more likely to be successful when we hit the bumps in the road.

Wednesday, September 26, 2012

So I guess that makes me a unicorn?


I've worked very hard to take good care of my baby during the first few months of her life, so while I was searching for how much I should be feeding her sometime back I found a respected website that it is a myth that many women can't supply their baby's needs in breastfeeding.  As I read in baby books, online, and even searched for a lactation consultant I found this sentiment repeated over and over with authors either glossing over supply issues with a trite "true breast milk supply issues are very rare" or in one case going so far as to say "well you've already messed up because you supplemented your baby with formula."  This makes me incandescently angry.

As I have struggled to feed my baby I've found that there are several things that can significantly hurt breast milk supply including:
Long Labor - I think my 38 hours in labor would qualify.
Under-active thyroid - If your body doesn't make enough thyroid hormone to support a healthy metabolism then it's probably not going to support breast milk production very well either.
PCOS (Poly-cystic Ovarian Syndrome) - I've read that PCOS is THE most under-diagnosed condition in women in the US and that it can affect anywhere from 1 in 10 to 1 in 4 (depending on the source) women.  That doesn't sound very rare to me at all!  In fact I read that many of the same conditions that can cause a woman to have trouble getting pregnant can also make it hard for her to breast feed, so if you had to have fertility treatments you might as well plan to work at this.

And these are just the issues I've personally had to deal with.  Some other causes of low supply are:
Anemia - My sister ran into this one, and though I never was technically anemic my iron levels have been very low.
Delivery through C-section - will ALWAYS delay your milk coming in, and can also lead to it coming in slower, so you're constantly playing catch-up
Exhaustion - and who isn't exhausted taking care of a new baby?

And supply issues are a myth?  I'm not saying that EVERY woman who suffers from PCOS or thyroid disease will have supply issues, but these are not uncommon conditions!  I have to think that supply issues deserve more than a one line dismissal in any treatise on breast feeding, especially since there are things you can do to help, and the earlier you start the better.  Come-on LaLeche League, instead of declaring me a non-issue, how about putting some information out there to help and some validation that my issues are REAL!

Wednesday, August 15, 2012

Chick-fil-A, don't'cha just love it?

I've been paying attention to all this Chick-fil-A controversy.  I have a long history with Chick-fil-A, so naturally I sit up and listen whenever I hear them mentioned in the news, or in conversation.  I've found that they are neither the paragon of virtue nor the bastion of evil that everyone seems to make them out to be, but like every company out there they have their good points and their bad points.  Which outweigh the others I don't know.

I started working at Chick-fil-A at the front counter when I was 16, and continued working there off and on as school allowed for a little over five years.  When I first started working there the operator of the store I worked at had two stores, but within a year of my starting he left the store I worked at and went on as operator to other stores.  His assistant manager became our new operator.  It's worth mentioning that the corporate office at Chick-fil-A likes to keep tabs on what's going on at their stores.  All stores are owned by Chick-fil-A, not somebody at the store, and Chick-fil-A has pretty stringent rules about who can become an operator (the equivalent of owner/manager at most franchises) of any store.  There may be a very small handful of independently owned stores still out there, but Chick-fil-A stopped granting such franchises years ago, and the few that remain were grandfathered in.

Our new operator held the store together through some really rough years.  Shortly after I started, the main anchor store in the shopping center closed.  And over the next few years anchor stores came and went, but were gone more than they were there.  We also had the unique benefit of being near where several corporate executives lived, so they would often stop by the store to "check up on us" quite frequently.  It was at this point that I came to recognize the misogynistic attitude of the corporate office at Chick-fil-A.  It's worth noting that a new operator was a divorced woman.  When I started working at this Chick-fil-A store it was the closest one to my house, but by the time I left I actually passed three Chick-fil-A's to get to this one.  As more stores opened up in the area they naturally cut into the business of the pre-existing store.


One store was within 3 miles of ours.  It is debatable whether so many stores in the immediate area would have been approved had the operator at our store held any regard or received any respect from the corporate office.  During this time the store was both remodeled and major construction was undertaken to install a new playground.  Instead of corporate recognizing that difficult situation, we were expected to grow revenues as if we were still located in a busy shopping center with little competition in the area.  Despite hard times remain profitable, even though we didn't achieve the revenue growth dictated by corporate.

Instead of recognizing the achievement of holding the store together in adverse circumstances, win a new super Wal-Mart opened in our shopping center the store was taken away from our operator and given to a new operator.  This demonstrates the utter lack of respect that the Chick-fil-A corporate office had for our operator.


Yes Chick-fil-A is closed on Sundays, but it is far from the Christian work environment that you might think.  For one being closed on Sundays does nothing for orthodox Jews or Seventh Day Adventists.  Sure, I worked with plenty of youth pastors who enjoyed the freedom to work two jobs and the assurance that came from knowing that their schedules would never conflict.  But I also worked with those who were mentally unstable, had superiors who cursed like sailors, and others who displayed misogynistic behavior including leaving white flour hand prints in inappropriate places on the navy pants of female employees.  I had my butt pinched once (he got slapped) and was hit on repeatedly.  But with very few exceptions the customers were worse than my co-workers.

However, Chick-fil-A's not a den of iniquity from top to bottom.  It has it's redeeming qualities.  For starters I worked my way from front counter through pretty much every position in the store, and ended up marketing manager.  Chick-fil-A taught me about work ethic and team work, oh, and how to filet chicken.  We weren't located in the highest end neighborhood, so this particular Chick-fil-A gave opportunity to some pretty underprivileged folks, and a pretty diverse demographic.  I particularly admired one family that had escaped from some South American dictatorship, and all the women in the family worked at Chick-fil-A.  It certainly opened my eyes to a variety of circumstances and what can me accomplished with hard work.  Lots of folks have heard of Chick-fil-A's Winshape scholarships, but Chick-fil-A has a college scholarship program available to all employees who work a certain number of hours (I don't remember how many).  No, it didn't pay for an entire semester, but every little bit helps.

And let's not forget the best thing about Chick-fil-A.  I met my husband when we both worked there in high school, and we had our wedding catered by Chick-fil-A years later (by the same operator we both worked for).

Chick-fil-A's probably the only fast food place I could work at and still eat there.  In fact, up until a few years ago I still ate at Chick-fil-A at least once a week.  I eat there less now not because of any aversion, but simply because I eat out less than I used to.

So no matter what Dan Cathy says, his principles are not pervasive throughout Chick-fil-A, and what he does with his money is his own business.  That being said, Chick-fil-A is a privately held company, and I don't know what percentage Dan owns I don't know, but I'm sure its significant.  Some part of every dollar spent there is going to trickle up to him eventually.

Not to long ago I realized that in living in a capitalistic society one of the ways we vote is by what we buy.  It's a big part of why I drive the car I drive, and buy the frozen pizza that I buy, and Dan Cathy has the right to vote the way he wants as well.  It's up to you to decide whether a vote for scholarships and Sundays off outweighs a vote for Dan and misogyny.  Or if you just care about the chicken.

Friday, August 3, 2012

Now I totally understand...

And I love her more than I ever thought possible.

Sunday, June 17, 2012

Why would I ever do this again?

I read an article not to long back about how pregnancy affects a woman's brain function, and I can tell you, it most definitely does!  For one thing, I seem to get songs stuck in my head and can't get them out for DAYS at a time (as opposed to the normal few hours).  But that wasn't the point of the article.  It was talking about memory.  Apparently pregnant women start losing their memories from the earliest days of pregnancy, and this memory lasts as long as a year past giving birth!  Well, I can attest to the first part of this.  For months I've been forgetting things, like words I want to use in conversation, with much more than normal frequency.  The last couple months, however, I've begun to understand that there's a reason WHY we have this forgetfulness.

BECAUSE IF WE REMEMBERED ALL THIS LATER WE'D NEVER DO IT AGAIN!

I'm not just talking about forgetting labor and delivery, though somehow I think I'll appreciate forgetting that. I'm talking about ALL the things in pregnancy that make us miserable.  From the very first symptom (unexplained heartburn for me) to the lower back pain, swelling hands and feet, and just generally miserable uncomfortableness of the third trimester.  I'm ready, OH SO READY to not be pregnant anymore.  Not ready to be a parent of course, I don't think there's any way to ever be really ready for that, but I'd like to be able to bend over and pick stuff up off the floor, to do yard work again, to be able to walk up the driveway! I'm ready to have this done and over with and be headed toward recovery.

Steve and I had childbirth class yesterday.  There was a slide shown that had symptoms that indicate labor is coming within two weeks.  I realized I'd had all the symptoms on the page, except one (rupture of membranes).  Something tells me I'm not going to make it the three weeks to my due date, and that's ok.  I'm ready.

I've started to write a post about late pregnancy several times lately, but with my memory going I don't remember what-all I was planning to write about, so I'll leave you with a little food for thought.

A few years back the small company that my husband and I worked for was evaluating health insurance plans.  We had a meeting with an insurance representative to discuss options and benefits for various health conditions we expected to treat.  Most questions were about minor surgeries, mental health benefits, and prescription plans, but I asked about how pregnancy was treated, and I'll never forget his response.

"Pregnancy is treated just like any other illness."

Pregnancy?  an illness?  Sure it's uncomfortable and there are health risks, but in what world to people consciously go out and spend thousands of dollars on infertility treatments attempting to catch an illness?  I know women who are DESPERATELY trying to get "sick," and devastated each month when they find out that once again they've failed to contract this disease.  I was one of them eight and a half months ago.  It makes me question the sanity of our entire healthcare system to know that the continuation of the human race is considered a malady.  Though sometimes I look at the state of the world and that makes perfect sense after all.

Friday, May 11, 2012

Pregnancy advice, not like most of you care

So I've been thinking lately about pregnancy and how it's affected my life, the ways I was ready for it, and the ways I really REALLY wasn't.  It's taught me a lot, and while this post may have a limited demographic for an audience I figured I'd share anyway.

Things to do to prepare for pregnancy:
It may seem like the weirdest bit of advice I can give you, but the thing that has helped me the most during this pregnancy is that I already had a body pillow and was used to sleeping on my side.  Oh, I know, all the beauty magazines say to sleep on your back because this prevents wrinkles.  But this goes COMPLETELY out the window in your second trimester, and it's best to be used to sleeping this way ahead of time instead of trying to teach yourself a new way to sleep after you're already feeling like an ungainly hippopotamus.  The more your stomach's in the way, the more difficult it is to be comfortable, and you're going to be TIRED during your pregnancy, so you don't want to waste time trying to find ways to get comfortable.

Actually I had an aunt give me a body pillow for my high school graduation, and I pretty much can't sleep without it at all anymore, even when I'm not pregnant, especially if I'm away from my husband.  If I'm traveling, I do everything I can to fit it into my luggage.  All the pregnancy books say sleeping on your side is better for all sorts of reasons.  Apparently it helps your kidneys to work more efficiently, which is more important when they're working for two.  One book said sleeping on your left side is better than right, but didn't say why.  If I had to guess I would think it's because your stomach is on the left, so this helps to prevent heartburn and such.  I personally tend to alternate sides through the night (heck I have to get up to use the restroom 2-3 times now, might as well switch sides each time).  Hopefully that'll be enough to at least make sure that my wrinkles develop somewhat evenly on both sides.

I haven't gotten to the labor and delivery part yet, though I'll admit the word episiotomy (and the reason some folks say you need one) scares me bat-shit crazy, but I've been told by several practitioners that walking and being in the best possible shape is the best thing you can do to prepare those muscles for what they need to do.  So my second best bit of advice is, get used to a regular exercise regimen ahead of time.  Oh, I'm not saying you have to be a world class swimmer, or climb Mount Everest, but get into the regular habit of doing something physical before you get pregnant.  You're going to be tired during your pregnancy.  You'll sleep a LOT (probably more than you ever dreamed possible) so if you wait until after I promise you'll never get started.  In fact, you'll probably cut back significantly over the course of your pregnancy.  My husband and I worked out regularly with the wii before I was pregnant.  Ok,ok, he was a lot more regular than I was, but I would still join him.  And we took walks around the neighborhood (about a 2 mile trek) pretty often as well.  There's one big hill in our neighborhood that I haven't done since I found out I was pregnant (and I walk a lot slower now than I used to even on the non-hills), like I said you'll cut back, not just because you're tired but as you progress you'll feel less steady on your feet and less comfortable on uneven ground.  But if we weren't in the habit of doing something physical before we would NEVER get around to it now.

I'm sure there's a lot more I should have done to prepare.  If you want to offer me advice on what's helped you the most (or what I should be doing in my third trimester) I'll be glad to take it (with a grain of salt of course) and let you know how it works for me.  If not in this pregnancy, maybe in the next.

Things Pregnancy has taught me:
Just because I was already doing a few things right doesn't mean I had it all together, AT ALL!  This pregnancy has taught me a lot that I think I'll take forward into non-pregnant life.  Not the least is...

How to Eat.
When you have a strange alien being living in your mid-section for any period of time, this does not go unnoticed by your other internal organs.  Your stomach's probably the first to take note.  I happened to have been offered a free consultation with a nutritionist shortly before I found out I was pregnant, so by the time my appointment rolled around I had a whole slew of questions to ask, and was in a good mindset to take her advice to heart!

If you're in the habit of skipping breakfast, skimping on lunch, and eating most of your food at dinner that's gonna have to stop with a quickness!  One thing I found was that if I let my stomach get to empty, I got nauseous.  If I let it get to full, I got nauseous.  If I ate anything to rich (I couldn't eat mac and cheese for the first trimester), I got nauseous!  If I didn't prep my stomach in the morning, I wouldn't get to keep my breakfast!  So I learned to snack on very little bits of food throughout the day.  What will work for you will probably be different from what worked for me, but I went through a LOT of ginger ale before figuring out that if I woke up and immediately ate a little bit of fruit, before showering or dressing or anything, then my stomach would be in much better shape by the time I got around to real breakfast.  Then I continued to eat tiny amounts at really close intervals throughout the day, a few crackers here, some almonds and dried fruit there.  If I brought my lunch I often ate half of it, and then saved the other half for a mid-afternoon snack.  Then I'd come home and have a snack before I even started fixing dinner.  So even thought the nutritionist said to aim for 6 small meals a day, it was often more like 7-8.

This became less necessity after the morning sickness stage (I think I'm down to 4-5 meals a day) but it still doesn't do well to let yourself get to hungry, or to full for that matter.  While I no longer have to completely avoid all-you-can-eat buffets, I still can't take advantage of them like I once could.  Grazing all day helps keep your whole digestive tract moving in the right direction, so having nine months to train myself how to eat will (I think) work well for me moving forward, especially as I try to lose the baby weight.

Learn how NOT to worry.
There's actually a stage in pregnancy, early on, that is characterized by a fear that every little twinge is a sign that something is going wrong.  Coming on the heels of my first failed pregnancy I spent a LOT of sleepless nights wondering if every little twinge was a sign that I was losing this one as well.  After 2 solid weeks of not sleeping through the night a single night, not only was I exhausted but I was a nervous wreck from worrying all the time.  I finally had to accept that even if the sky was falling, there was nothing I could do about.  It was less a matter of fatalism, and more a matter of self preservation.  I mean, pregnancy makes you tired enough on its own!  3-5 hours of being awake and worrying in the middle of the night does not help things at all!

Lastly, Everyone has an opinion, but take it with a grain of salt!
As soon as you start showing people will start coming out of the woodwork to tell you about the best things that you can do for your baby.  You'll get advice on the best morning sickness remedies, the best places to shop for maternity clothes, the best way to coordinate your nursery, and where to get the best deals on diapers.  Learn to smile and nod, because for every bit of good information you get, there will be at least a dozen piles of complete and utter nonsense!  Every pregnancy is different, and you have to do what works best for you!  I tried several "morning sickness remedies" that made me more nauseous than when I started.  The things that worked the best were often the simplest (plain ginger, lemon drops, and fruit) but these may not be the things that work for you.  I've had at least one friend who NOTHING worked for, and she just had to resign herself to three + months of misery with each of her pregnancies.  Compared to her, I was just grateful to have kept almost everything that wasn't fish down!

There is also LOTS of baby stuff out there.  YOU DO NOT NEED ALL THE STUFF!  I had a lady come up to me in the store the other day and tell me about this amazing high chair that she used for her baby from the time he could hold his head up until he was four years old.  I went home and looked it up, and it was over $300.  IKEA has a perfectly good high chair for $19.99, and why do you need to have a baby at the table when he/she can't even sit up yet?  If I want to start training her to sit at the table I'll hold her, or pull the swing up to the table, or put her in the car seat carrier on the table or something.  I DON'T NEED A FREAKIN $300 high chair!  I found out recently that my college roommate who had twin boys NEVER HAD A HIGH CHAIR and her kids are just fine.  They just never really decided they needed one, and her boys are wonderfully well behaved and didn't starve.  I have adopted a new mantra.  If Abraham Lincoln didn't have it when he was a baby, then I probably don't need it either, because he turned out just fine!  Oh, there are exceptions to that.  We thoroughly researched car seats, and got one that was a good balance of safety and usability.  Of course cars weren't invented when Abraham Lincoln was a child, and neither were dishwashers.  But I get all these lists of things that you NEED to have a baby, and I'm telling you my baby doesn't need three types of blankets and a white noise machine.  I swear these lists were written by people in marketing, just to get you to buy more stuff.

For heaven's sake, my baby's due in July, if I get to many snuggley sleep warming outfits for her she'll get heat stroke!  That's not to say that I'm advocating having a bunch of naked babies running around, but keep your focus on the basic necessities: something to eat, a place to sleep, and maybe something to keep warm (if you're not due in July) and feel free to tell everything else (politely) to stuff it!  Oh, and diapers.  I've been told we'll go through an inordinate number of diapers!

Keep in mind, my baby's not born yet.  This is just the philosophy that's helped me not to wig out up to this point.  I'm not there yet, and I'm sure there's a lot that I haven't taken into account, so if you can think of anything else I should be doing, feel free to offer advice.  I'll be glad to take it, with a grain (or 1000) of salt, of course.

Tuesday, March 6, 2012

Medical Research I'd like to see

Ok, this post is not going to be interesting to most people, but it's the kind of thing that I think of that makes me go Hmmmm.

So I've been thinking about our immune systems, how they work and how they could go haywire.  First let me say, I have no background in medicine other than getting sick and going to the doctor, and know very little about biology other than what I learned from my mom or in Biology 101 and 102 in college.  This basically means you should ignore everything I say from this point on, because I'm not at all qualified to be asking these questions.

I've been thinking of the nature of several illnesses that are seemingly treated as separate entities, but at a basic level they seem to be caused by immune systems going haywire, and I'm wondering if they could be related.  The three illnesses I've notices are allergies, Celiac disease, and type 1 diabetes though there could be others that fit this profile as well.

Allergies can include a wide range of reactions to a wide variety of substances.  For instance, I'm allergic to dogs, dust mites, mold, and a variety of pollens goldenrod being the most reaction causing.  My reaction to these various allergens is mostly nasal (though I've had hives once) and disgusting but relatively short term (assuming I'm not exposed for long) and can be easily medicated using Claritin (and ten years of allergy shots helped a lot).  I had a friend in college who had other various allergies to artificial scents and smoke and these causing her throat to close up and breathing problems.  I've also heard a lot recently about allergies to peanuts which can cause anaphylactic shock and death.  Allergies have been loosely linked to heredity, for instance my dad has mild hay-fever type allergies.  I have similar allergies, though more severe, and my mom and sister don't suffer from any significant allergies that I know of.  All of these reactions, though they range greatly in their severity, have one thing in common.  They're caused by an inappropriate immune response to a substance that in most people does not cause any immune response at all.  Basically exposure to these substances causes our immune systems to go haywire, and the immunologic response itself is what causes illness.

Celiac disease is something I'm less familiar with, though I've read a bit about it and have a cousin who suffers from it.  Celiac disease is caused by an intolerance for gluten (found in wheat, barley, rye, and products made from these grains).  If you have celiac disease, when your body absorbs gluten your immune system attacks the villi in your small intestines which are what absorbs nutrients in your food.  The more gluten you eat the greater the immune response eventually destroying the villi and possibly your ability to absorb nutrients.  Damage is irreversible and the only way to keep damage from increasing is to not eat gluten.  Celiac disease also tends to run in families though the exact mechanism of heredity is unknown.

The final disease I've been thinking about is type 1 diabetes.  I have an uncle and a brother-in-law who suffer from type one diabetes, and though I'm by no means an expert I've seen their management of this disease and how it affects their lives.  This type of diabetes is caused by the pancreas either partially or completely failing to produce insulin.  Though I suppose it's possible to suffer injury to the pancreas through some other means, the most common cause of pancreatic damage is that for some unknown reason the person's immune system simply attacks the pancreas causing permanent damage.  Damage can be partial or complete.  Some diabetics still make insulin, just not in sufficient amounts to process a healthy diet, which others no longer make insulin at all.  In milder cases a person with diabetes may be able to manage the disease with diet and exercise, but more severe pancreatic damage requires insulin supplements.  We know that the risk of developing type 1 diabetes runs in families, but what we don't know is what triggers the autoimmune response that attacks the pancreas in the first place.

If you look at my family as a whole you would think we're generally healthy with no serious diseases running in the family, but looking at the incidence of these three has gotten me wondering lately.  Could there be a connection between the autoimmune diseases even though reactions and symptoms are so very different?  I wonder if the tendency for autoimmune diseases is genetic, it's just that the immune reaction that causes the disease goes haywire in different ways in different people attacking my uncle's pancreas, my cousin's small intestines, and making me a snot wad.  I hear talk of a cure for diabetes quite frequently, but never have I heard of research to cure celiac disease (though I'm sure there's ongoing research) or allergies.  I'm wondering what kind of research into autoimmune response in general is going on, and if it's being related to the causes of multiple autoimmune diseases.

Food for further thought:  I was a very sickly kid.  I caught everything that went around, and strep throat was my Achilles heel (I would get it time after time after time some years).  There were years where I missed so much school from being ill that they thought about holding me back, even though my mom would pick up the school work I had missed from my teachers and I would do the work at home.  We knew I had allergies, but couldn't find any cause for me to be so susceptible to catching EVERYTHING that went around.  My pediatrician finally sent me out for labs to see if I had some sort of autoimmune disease, but they never could find any cause.  Eventually I grew out of being so sick, oh I catch the occasional cold or strep, but I'm a generally healthy adult.  I think we finally concluded that my immune system just couldn't keep up with my growth rate and it took time to catch up.  I now wonder if it was a different problem.  Maybe my immune system was so preoccupied with it's inappropriate responses to allergens that it was to overworked to deal with the actual pathogens that came it's way.  Could my allergies have actually made me more susceptible to other illnesses growing up?  Perhaps it wasn't a matter of growing into my immune system.  Perhaps it was the ten years of allergy shots that trained my immune system to be more tolerant of allergens and allowed it to focus on more important things, like the flu.

Thursday, February 2, 2012

My Traveling Red Dress Experience

The history of the dress
I bought this dress a little over seven years ago.  

It’s been worn exactly twice, and languishing in my closet the rest of the time.  It was bought for me to wear as a bridesmaid in a Christmas wedding, the wedding of two of my best friends who soon started trying to have a family.  After a two and a half year struggle with infertility they were finally able to conceive, and now they have two of the most beautiful twin girls I’ve ever seen (saw them just last week).

When my husband and I started our attempts to have a baby they, along with another close friend who has PCOS like me, were my inspiration.  From tests to treatments to disappointments they had been through it all before me, and held my hand (literally and figuratively) through it all.  Then four years in I started with a new group of fertility specialists and FINALLY got pregnant.

It was the last week in January 2011 that I wore this dress for a second time.  I’ve been deeply involved in music from very early on: sang before I could talk, piano lessons from age 3, music major in college, and through it all I’ve had debilitating stage fright.  I try over and over with mixed results to force myself to sing/play/speak in public.  That January, the same week I started new treatments for what was wrong inside me, I decided to work on the outside as well.  America’s Got Tallent auditions came to Atlanta, so inspired by theblogess and her red dress wearing encouragement I went to the auditions, red dress and all.  The good news is, I’m not bad enough to make it on TV.  The bad news is, I’m not good enough to make it on TV either.  But I made it through, and with that boost of confidence I didn’t embarrass myself to badly.

Only two weeks later I found out I was pregnant for the first time.  I was overjoyed, only to have a miscarriage three weeks in.  It was devastating.  I tried to see the good in all this.  I mean, at least this proved that I COULD get pregnant, something I hadn’t managed in four years of trying.  But to have our hopes raised and dashed in such short order, only to be followed by month after month of disappointment seemed more than I could take.  My self-image went to pot!  From January to September I had gained nearly 20 lbs.  Nothing seemed to matter, not how much I ate or exercised, I’m sure all the crazy hormones I was on didn’t help, so we decided to take the rest of the year off to focus on getting healthy and then decide how to face the new year.

In October I started having horrible lower back and stomach pain, similar to monthly cramps, but instead of a day or so and then my period they went on for nearly a week with no sign of change.  I finally realized that they were in the same location as pains I had had during my first pregnancy.  Turns out, I managed to conceive, no timing, no drugs, no idea how this happened after almost five years of trying everything under the sun.  I spent the next two months terrified to eat the wrong thing, exercise to hard, expose myself to any chemicals, anything at all.  I was so terrified of another miscarriage.  Add to that terrified to tell people I was pregnant again only to have it end in disappointment again.

The dress moves on
So when Jenny mentioned having a new red dress photo shoot a few days back, http://thebloggess.com/2012/01/the-traveling-red-dress-revisited/, I looked at my body and said, no way am I fitting into that dress.  But it got me to wondering, if I can’t wear the dress, who could?  I mean, it’s a beautiful dress, and it’s spent the majority of the last seven years crushed in my closet gathering dust.  So I offered it out.  This was the response I got:

I need this dress. My struggles are with infertility, and weight. I turned 30 back in June, and every day my hopes of becoming a mother just slip further away. My life is consumed by the tremendous booming of my biological clock. We can not get pregnant without IVF, but financially we are fish out of water. Asking us for $15,000.00 is like asking for a million. 


I wake up every single day, chocking back the tears and just feeling damn sorry for myself. I can’t seem to shake it. I don’t want to work, or be social, or even cook a meal for my husband. For the life of me, I’m trying to summon the will to do anything-absolutely anything. I haven’t allowed photos of myself to be taken in over 8 years, because I HATE what I see looking back at me. I’ve completely lost my own worth. And I need to find it again. I have to. I have to wear that dress.


I swear only God could have let this person see my little comment way down on theblogess’s website offering the dress.  To have this dress offer encouragement to someone else going through the same struggles I’ve been through means so much to me.  So as this dress is on its way to its new home in Idaho it goes with all the prayers and blessings and love I can send with it, for the next lady who will wear it, and the next, and the next.

Saturday, January 14, 2012

An open letter to US Bank

Dear US Bank,
When you call and repeatedly get our answering machine but never leave a message, it is our natural assumption that you have nothing good to talk about.  When you call and ask for a person and I tell you he is not interested in speaking to you, that is not an indication that you should call at a better time.  When someone is not interested in speaking to you and they have caller ID, your calls will not be answered at whatever time you call.

If you have something important to talk about, please leave a message.  Otherwise, quit calling 4 times a week!  Get a clue!

Thanks,
Someone who was woken up by the phone ringing this morning