Just in time? Maybe...

On Leap Day 2008, I had the privilege of delivering the seventh child of a local couple. The woman chose me to provide her prenatal care and attend her birth because her previous ob-gyn had missed the delivery of the last two of her children. It wasn't that her labors were too fast: She labored for hours under the careful supervision of the nurses, but they didn't call for the doctor until she was almost fully dilated.This situation is actually very typical in modern labor wards, and it brings up an interesting difference between obstetricians and nurse-midwives. Generally speaking, nurse-midwives make it their business to be present during a woman's entire labor and birth. Obstetricians, by contrast, are called when the woman is ready to push. While it is true that in a hospital situation there are nurses who are watching the monitor, and will offer support if they are able, they usually have other patients to attend to besides you. So why doesn't everyone choose a midwife? Many women fear that by choosing a nurse-midwife, they will not be able to get pain medication during labor. This simply isn't the case! Patients of nurse-midwives can have IV narcotics and epidurals just as patients of ob-gyn's. However, many women who choose a midwife do so because they feel that the extra support during labor will be enough to get them through the experience without pain medication.

On time delivery

My friend Shannon shared this with me last night:

A nurse in labor and delivery was checking a young expectant mother. "Is this your first baby?" the nurse asked.
"Yes," the mother-to-be answered calmly.
"Are you having any contractions or pressure?"
"No."
"Are you having any discomfort?"
"No."
The nurse was perplexed. "If you don't mind me asking," she said, "why are you here?"
"Because today is my due date!"

Making a Choice

Every decision you make - every decision - is not a decision about what to do. It's a decision about Who You Are. When you see this, when you understand it, everything changes. You begin to see life in a new way. All events, occurrences, and situations turn into opportunities to do what you came here to do. ~Neale Donald Walsch

A friend of mine sent me this quote a few weeks ago, as encouragement about a business decision I am making. Simultaneously, I am preparing for my child to receive a new treatment for a chronic illness. As I've reflected on my decision over the past few days, I realize it begs the question: What are the circumstances and decisions that shape my ability to choose healthcare for my child?

First and foremost, I am a mother. I love my children, and I want the best for them. When I found out my child had a potentially life-threatening disease, I was absolutely devastated. While I'd watched his health deteriorate for months, I did what mothers do best: kept him in the best possible state for nature to help him heal. I dressed his wounds and dosed his medicines, all the while praying and hoping that his situation was temporary. After four long months, he was finally diagnosed with severe Crohn's disease, and although I'd already pretty much assumed that is what was wrong with him, I was devastated. I did everything I could to learn about the disease and the possible treatments for it. I made myself crazy reading not only everything posted on the web, but also peer-reviewed academic journals.

I am grateful that as a nurse, I'm a part of the health care system, as I am able to understand complex information about the disease and I'm connected to people with expertise. But as a midwife, and a person who is passionately believes in non-intervention, I have also sought out alternative medicine gurus and read every crackpot cure out there. We put him on an elemental diet, made sure he had nothing artificial, eliminated everything from his diet that we thought would aggrevate his symptoms. We gave him probiotics, put him in the sun, force-fed him vitamins. Still he lost weight. His wounds didn't heal. His hemoglobin dropped to 7.

As a human being, I couldn't avoid hearing advice or opinions from literally every person I know. I've been asked prying questions about our heritage, our family medical history. Did I breastfeed? For how long? Did we vaccinate him? Did we use antibacterial soap? A friend insisted that he had celiac disease (her mother had it: same symptoms!!). Another suggested it was his nerves. Everybody knows somebody who was healed of Crohn's by taking vitamins, or visiting the Dead Sea, or stopping white flour, or getting accupuncture. A Shaklee salesperson kept me on the phone for an hour, insisting that she was cured of Crohn's by taking $300 worth of vitamins a month. My sister bought them for me.

Yet, none of those things made my child better. For four years we tried everything, and began adding medication after medication as he had exacerbations. At one point, he was on over 20 pills a day. When he finally developed a small bowel obstruction (while on steroids and Imuran), our doctor had a talk with me. " I know you don't want to do this, but I think it's time to consider Remicade."

More journals, more research. More advice. A friend who had a reaction. "You know, it causes cancer." My head spinning.

I've reviewed the options, and come to the only conclusion that makes sense to me. Those other things aren't working. I've done my due diligence. I've tried everything natural, I've allowed the doctor to step up the meds only when necessary, I've done everything in my power to help him heal. And he isn't. So it's time to try something else, something that's got the evidence to back it up, but something that's outside my comfort level.

The midwife in me says it's time to intervene. The nurse in me says it's time to try an evidence-based approach. The Christian in me is grateful that God has allowed a treatment that looks promising. The mother in me says I love him too much to watch him suffer.

It's time.

The worst. mom. ever.

If you have never had a kid on the swim team, stop reading. You will never be able to sympathize with the early morning practices, the endless meets, the drama! You won't be able to comprehend the bone chilling cold that occurs during the Ohio summer, when the sun goes down and your wet 10-year-old hops onto your lap in an attempt to thaw. You won't understand the drain on your wallet, one dollar at a time, as your child attempts to recover calories at the snack bar that he/she has lost during a race.

I, however, cannot miss a moment of the excitement. I rise every morning at the crack of dawn to cajole my children out of their warm beds and into their damp suits. I pad their palms with dollar bills and fill their gas tanks, so they can spend their summer mornings in the swimming pool. I dutifully go to work each day so that I can buy pool passes, and swim suits, and caps and goggles. And more goggles. And then more goggles.

I arrive at the swim meets at 4:45pm every Wednesday (well, 4:55pm), and I weave my way through the sea of chairs and blankets, picnic coolers and wet bodies, until I find a space on the (always damp) grass where I can place my chair. I sit close to other parents we chat mindlessly until a child, who has long since passed the age where they can comfortably fit on a lap, plops their wet frame on top of me and asks for money. I oblige, knowing they will disappear only until they are hungry, or cold enough that they need to find the lap once again. I do this each and every week, all summer long, no matter the weather. When it rains, we stand at the side of the pool and cheer, hoping silently that we will see a flash of lightning.....the absolute only thing that will stop a swim meet.

Despite this level of committment, I made a major faux pas tonight. **gasp** I missed 30 minutes of the swim meet. I will make no excuses: I wanted some time to myself. The meet was very close to my house, and I dropped the kids off for warm-ups while I went home to do nothing at all. I surfed the internet, answered some e-mails, and blogged a little while waiting for my husband to come home from work and go to the meet with me. Although the meet was slated to start at 6pm, I didn't even leave the house until 6:20pm.

By 6:30pm, all three of the kids had called me from their cell phones, and I came to the most amazing realization: They need me! They do know when I'm not there! They do care if I'm present! They need my money!! And I am the worst. mom. ever.

Blogging: Why do we love it?

I've decided to try my hand at blogging again, just as I've started a diary a few hundred times in my life. And while I love reading the blogs of others, I have to ask myself just why people want to share their private lives with the world? Why do people think anyone would enjoy anonomously creeping about, soaking up the frustrating details of someone else's mundane life? Why do they think anyone would spend hours secretly reveling in the fact that the life they read about is more screwed up than their own?

I've blogged briefly in the past (perhaps you saw those??), and when I read over them, I realized my life is decidedly mediocre, considering I have so many kids and a rockin' profession! I've blogged about my practice, and I would love to share the juicy tidbits and heartfelt stories I hear from patients every day. What limits me there (besides HIPPA) is the fact that whenever there is a really interesting detail, there will be a mother, a sister, a friend who will recognize the story. I've written about my children, but do you really want to keep hearing that I have the best kids in the world? I guess my favorite use for my blog is to sound off about the kinds of problems everyone has---a crappy schedule, spouses or colleagues who don't appreciate me, teenagers who think I'm an ATM, and the insane busy-ness that all moms feel at one time or another. By publicly ruminating on these details, I've come dangerously close to offending friends, family and co-workers alike. But when I seriously contemplate this, I realize that perhaps blogs can be a delightfully passive-aggressive way to bring them back in line (with my point of view) once again.

Of course, that's not the purpose of my blog, but then again, does it need a purpose? I think I'd just like to just entertain you with yet another imprudent opportunity to gaze into my life.