Friday, July 30, 2010

Driving Lessons - For Wisconsin

Now I know that in the big scheme of things this isn't really worth getting myself all work up about, but I seriously about have a stroke every time I find myself driving through Wisconsin. What up with the left lane possession-phobia? Geeeyaaah!

Seriously, some basic common courtesy, highway driving etiquette is needed in this State! I'm sure that the majority of Wisconsinites are fine, wonderful people when they are NOT driving on the highway. When they are, they suck. So here are my suggestions for them:

1. The right lane is the lane you get to go whatever speed you like, really! No pressure.
2. The left lane, the one you like so much, is for PASSING. Sure, if there's no one around, hang out in that left lane all you want.
3. When another car comes along however, that would like to go just a smidge faster, please yield. Here are some finer points to yielding:
- DO NOT speed up only to slow down as soon as you encounter more traffic that makes it impossible for someone (me) to go around you.
- DO NOT speed up and block other cars into the right lane if they might venture to pass you on the right since you have refused to change lanes.
- If by some luck, the other drives does pass you, do not race down the road hunting the other down to prevent their speedier progress.
4. I promise, changing lanes is not difficult at all. Just a slight turn of the steering wheel usually does it. And yes, you can get back to your beloved left lane as soon as I go by, that car a mile ahead should not be a problem in the event they are going the same slowish rate as you (well, except for your sudden love of speed when other cars approach).
5. When there is traffic, sure, it may take awhile to move over, the car with the intention to pass should not hang out on your bumper or anything. As long as you are actually passing other cars in the right lane, that's cool. Just MOVE OVER once you've actually passed all of those cars. Please.
6. A turn signal is not a beacon to your inner toddler - yes, you must share the road and let a car that needs to change lanes to make their exchange/exit safely. You do not always have to be "first"

Since this lesson may not reach the majority of Wisconsin drivers, if any, and due to the fact that knowledge alone results in 0% change in practice, the following tips are for those of you from the other 49 who may find yourselves driving on a Wisconsin highway. You must understand the psychology of the Wisconsin Left Lane Lover. :
1. As long as you appear to want to get around them, they will go as slow as they like.
2. If you try to pass on the right, they will speed up.
3. You don't actually have to pass them if you stay in the right lane and it appears that you might get ahead of them. They will now go a rate of speed that is appropriate and you don't really have to go around.
4. However, with so many Left Lane Lovers, the right lane is generally free and clear anyway. You can drive in the right lane all day long most of the time without any obstacles.

Is there another route between Minnesota and Chicago?

Tuesday, July 27, 2010

The First Decade of a Millenium

This post takes its cue from a post by Sarah over at One Starry Night about change. Sarah shared some intense life events over the last decade and that she fears change. If you don't follow Sarah, I definitely suggest that you go check out her blog. She is a truly authentic person and I think that's why her photography is so amazing!
Well, her post got me thinking about my own reactions to change. I tend to embrace change and am always looking forward to "what's next?" I'm not sure what that says about me, maybe that I should take time to enjoy the moment and perhaps be more reflective about what has passed. Since I'm in the midst of some big changes right now, looking back over the last decade seemed like a great idea!!

2001 - In June I gave birth to my first son. It was a dream come true, except for the c-section. Even that was sort of a blessing in disquise. I returned to work the week of September 11th. I mourned that my little boy would grow up in a world fundamentally different from the one I'd known. At work, I started on my APIB reliability (Assessment of Preterm Infant Behavior) and went to my first NIDCAP Trainers Meeting in Skamania, Washington.

2002 - A good year for my family. In August I became pregnant again. Trainers meeting was in Colonial Williamsburg, VA

2003 - I gave birth to my daughter on her brother's birthday by CBAC (cesarean birth after cesarean - a term used to describe a "failed" vaginal birth attempt after cesarean). Probably one of the worst years of my life but as with most things, it really did serve to make me a stronger person. Another mark on this year was the sudden onset of optic neuropathy experienced by my husband while we attended the NIDCAP meeting in Estes Park, CO. This is typically a "first strike" symptom of Multiple Sclerosis. *knock-on-wood* so far so good for the most part!

2004 - I achieved reliability on the APIB and continued my studies to train under Heidi Als, PhD to become a NIDCAP Trainer. Trainers meeting was in Oklahoma City that year. "I loved that world" my 3-yo son said as we left - Trainers meetings are great for my family who get to play while I'm working away!

2005 - Achieved reliability as a NIDCAP Trainer ! Also became pregnant with my second son. A great joy to me as I felt like I was really getting another chance to do better for myself and unborn child. (Trainers meeting was in Connecticut - my colleagues from Holland were amazed to hear of the barbaric birth culture here "don't most people give birth at home?" they asked)

2006 - Started off with a bang and had my son naturally on his due date at the end of January by vba2c. That's vaginal birth after two cesareans. Getting there wasn't easy, and I had to search and search for a provider to "allow" me to labor. (looking back I wish I'd done a home birth) I did find a provider - right down the hall from my office. Trainers meeting in Sun Valley, Idaho - hey these are the only vacations I get!

2007 - Had my first miscarriage that summer. Agonizing experience. Meeting was in Combrit, France. Went on a 2 week trip through Germany and France with hubby. Lots of fun! First time ever away from the kids. We missed them terribly.

2008 - Had my second miscarriage that summer. Even worse experience than the first and fell into a deep depression that I'm maybe even just now starting to recover from. Meeting was in Raleigh, NC where I met Nils Bergman - the main speaker for the conference I just recently put together.

2009 - The year of existence. My husband went on a freak out mission and did some really crappy things, which maybe someday I'll be able to write about. Planned and hosted the NIDCAP meeting in Chicago. Really enjoyed event planning, so soon after, I initiated the planning for the Skin to Skin care conference this year.

2010 - A big year of change for me. Here's a few: starting grad school in the fall, dropped my percentage at the med center (will continue on as a NIDCAP Trainer) and started working part-time at the Erikson Institute. Trainers meeting is in The Netherlands later this year! Still working on the marriage with my new motto: Love is the Only medicine.

Wednesday, July 21, 2010

ACOG announces new VBAC guidelines

Wow, I can barely believe that this press release is real. I am really grateful for the hard work and advocacy from ICAN (International Cesarean Awareness Network) and all of the wonderful women out there that have had a vbac, tried for a vbac and those that simply wanted one and were turned away. It was you who all raised your voices, believed in what birth could/might be and brought awareness and HEAT to the powers-that-be. In this case it was American College of Obstetrics and Gynecology.

I know that this won't result in some miraculous reversal of vbac bans or defacto bans, but it is a big step in the right direction. Changing the hearts and minds of those who truly believe that vbac is "dangerous" will take a generation or more. I just pray that first, women will be sparred that scar but if they should have one, that it will be the only one. I pray that the struggles I had through my primary section, cbac (cesarean birth after cesarean) and the long journey to a successful vba2c will somehow be lessened now for others.

A facebook and IRL friend posted on this Facebook today and I think it is perfect for today!

"I am only one; but still I am one. I cannot do everything, but still I can do something. I will not refuse to do the something I can do."" Author: Helen Keller

I couldn't agree more!!

Tuesday, July 20, 2010

Challenging Paradigms - Part 1

Burning questions of the day: How best to approach issues where culture, nature and science clash to create disparity and disease? Can health care and mental health professionals be both public health minded AND individualized? Can we utilize research and best practices to support parents and children to live healthfully while also preserving individual choice? When does personal need, culture or tradition trump science and public health concerns? What happens when something challenges us to examine our current paradigms? Can we adjust those paradigms to care for individuals as well as groups at large?

This past week I hosted a conference on the science behind the benefits of skin-to-skin care from birth through the first few months of life for all babies with this conference having a special emphasis on the need for skin-to-skin contact for the smallest, most premature infants. One of our main speakers, Nils Bergman ( speaks to current knowledge in neuroscience, animal studies and his own randomized control trial of 1200 - 2000 gram infants who were randomized into a control group (standard small baby care = separation) and an experimental group (no separation) with the medical care provided being exactly the same. His outcomes found that the incubator destabilized infants while 100% of the infants without separation were stable within 6 hours. His overall conclusion - Incubators cause harm. He then goes into a mini history lesson about how incubators came into fashion and how the paradigm emerged that incubators were better than the mother's own body. He is actively challenging that assumption with his work and also challenges institutions to rethink how and why they do things the way they do.
Interestingly the physicians barely blinked when presented with this provocative message. Honestly I just don't think a message like that can fully sink in when one's paradigm is still firmly in the "incubators save babies" camp.
From an allopathic perspective, I sort of "get it". If you are trained to see concerns, worries and problems as something to be "fixed", then you might have a tendency to look to your bag of tricks from technology and/or pharmacology and not move beyond that much. Health care professionals tend to assume "normal" takes care of its self and, unfortunately, "health" is the big misnomer in health care. There are exceptions of course but those tend to fall into the gone-overboard category such as lack of access to VBAC in order to reduce risk of uterine rupture, militant recommendations for "safe" sleep to prevent SIDS, and others that typically become one-size-fits-all solutions in a misguided, impossible attempt to reduce/control all risks.

I wish more researchers and scientists would challenge us to look at our assumptions. Randomized controlled trials might be the gold standard but who checks on whether the paradigm that underlies the research question is still valid? In my opinion, most studies pertaining to maternal/child care ask the wrong questions or worse, ask questions that can never be validated under the flawed paradigm. If we are to make radical changes in HEALTH outcomes for infants, then we have to be able to look beyond the barriers of our current paradigms (that's fine for third world societies that don't HAVE incubators...well, OUR families would NEVER want to stay with their baby in the hospital for that long, breastfeed on demand, etc...) and start to challenge all of our assumptions. Of course most don't have the kahunas to take on that task. Paradigms and assumptions come wrapped in emotional ribbons.

Friday, July 9, 2010

Attachment Dentistry?

I took two of my kiddos to the dentist today to have some cavities filled. Apparently they inherited their dad's cavity-prone gene. Poor kids, this is my 7 year olds 2nd cavity. Her first was about a year and a half ago. The day I took her in for the filling, she was happy and unaware that going in to take care of her "sugar bugs" was any big deal at all. She climbed into the dental chair and was really doing okay until the dentist said, "now, I don't want you to be scared.." Great. What a stupid thing to say! She immediately began to cry and reach out for me so I sat at the edge of the chair and comforted her and reassured her. The dentist immediately started to say "if you keep crying, your mommy will have to leave, you don't want to make your mommy leave do you"? That woman was so anxious about filling this child's tooth that she spilled it all out all over my daughter! I told her, the dentist, in no uncertain terms "I'm not going anywhere. She just needs to be reassured". I still kick myself that I didn't walk out of there right then but we didn't and she got through the appointment. We never went back.

Since then, I've found a really wonderful pediatric dentist who takes the time to show the children all of the equipment, lets them explore, etc... until he sees that they are okay and comfortable. He's a relationship-based practitioner rather than a distraction practitioner, which I really appreciate because that's hard to find! (He's a little bit of eye candy for momma too, so bonus) I told him and his assistant today about what had happended with the last dentist threatening her with making me leave. The dentist took extra time and was great.

Just before starting the procedure he stepped out of the room for a minute and the assistant apparently felt the need to defend her unknown colleague . "We've done that too here, the kids usually stop crying. Lots of time they just cry because their mom/dad is right there, once they leave they are fine. And this one (the dentist) doesn't like the wrap either (some sort of child straightjacket) but once another dentist found out that you have to use them because the kid moved and she cut his cheek real bad".

My exact response: Please don't ever do that again then. A cut cheek will heal but, as you can see with my daughter, fear and anxiety from being threatened with the violence of abandonment, or worse, subdued and physically held down at the moment when a child needs security the most is emotional blackmail at best and abusive. Children don't cry or cling to their parent for no reason, or worse, as a way to manipulate you. They are scared for a reason and that reason should be honored and discovered. Don't ever do that to a child again. Please.

The dentist came back in then and she buried her head in her tasks and never said a word to me. My daughter willingly and happily had her tooth filled. The dentist said "I'm so proud of you" over and over. It was beautiful. I thanked the doctor and told him I appreciated that he had respected my daughter enough to give her his time and attention. I thanked the assistant too. I don't know for sure but I think a little seed of knowing took hold in her - I doubt she'll ever threaten a child again without at least thinking twice.

As a mother I see it all too often how deeply society believes the worst of children and how quickly violence is enacted upon children as some sort of solution. It is very insidious. I'm glad that things went well for my children today and that I also had a chance to maybe make a difference for another child in the future. I'm going to write a letter thanking the dentist for his compassion, he likely needs the support and encouragement to continue on this path. I'd like to also add in some references for him to share with the staff about being mindful in their work with children. Any suggestions?