Sunday, June 29, 2008

Spot: Adopted

Friday night we ended up not cleaning our spot, because it looked like it might rain and our lazy bones were glad for the excuse. Instead, we got up early and did it Saturday. We jogged to our spot (a little over a mile), cleaned for just over an hour (in the heat and the bugs!), and then walked back. We made an impromptu stir-fry with vegetables and tofu for lunch (which was delicious!) and then ran a few errands by car--which we're a little ashamed of, but one of them was to drop off our bikes for a tuneup about 10 miles away, and so it seemed like the most reasonable option.

Here are some pictures from our cleanup:




Back Into The CVS Game

You may have noticed that I haven't been CVSing much at all lately. Coincidentally, there's also been a lot of disparaging talk lately on the internet about how CVSing (or playing the game at Walgreens or Rite-Aid, for that matter) aren't worth one's time or can't be used by people seeking healthy products. Check out the comments on this thread for some examples.

I would tend to disagree. In large part, I've cut down because the number of products that we use has really gone down. Toothpaste? Don't use it anymore. Deodorant? Same thing. Body wash? Nope. Lotion? Very little. Even the best deals on those things can't match the ease and frugality of using baking soda for just about everything :) And, we still have a huge stash of all kinds of medicine from back when I had hella surplus in my Flexible Spending Account when I worked at Iowa. (Expiration dates be damned! We use it all and it all works fine.) So I've figured it's probably better to "save 100%" by just staying out of the store! But, I don't think that those conditions apply to most people, even if they do buy the bulk of their groceries at Whole Foods or farmer's markets.

Lately, though, I've been feeling compelled to go back. Yesterday I was driven, out of allergy-induced desperation, to stop in and buy generic Claritin (which, luckily, was at least on sale from $16.49 to $9.99), without a single coupon or ExtraCare Buck to my name. And while I've always known abstractly that I could donate the items we don't use, I actually did it recently (donating our 8 boxes of extra toothpaste and several boxes of tampons, since I've switched to extraordinarily economical and environmentally-friend Keeper Cup) and let me tell you: it makes a difference to actually walk into a local homeless shelter and be personally thanked by the staff and patrons there. Since Matt and I like to give a certain percentage of our income to help people in need, it can be fun to see how incredibly far we can stretch those dollars, which (unlike our own shopping budget) aren't limited by the fact that we don't need diapers or toothpaste or Depends, regardless of how good the deals are.

So, I decided today was the day to get back in the game. I hoped to utilize a number of these deals and pick up some free-after-ECB Listerine, Band-Aids, and baby lotion, along with some cheap (after coupons and ECB) aftershave ($0.59), Q-tips ($1.19 for 500), men's deodorant ($0.19), and Kashi cereal ($0.50 a box!). All things that could be of great help to the homeless or us or both. We went to two CVS's (biking a total of 9 miles, including doing our grocery shopping and hitting Whole Foods and Bloom and Trader Joe's for free samples) and while both were out of the Listerine (that's what I get for shopping the June deals on the 29th of the month!), we did pretty well with the following two transactions:

Transaction 1: Reston CVS
Brut Deodorant x 5 at $3.19 apiece
Johnson's Baby Lotion sample size x 2 at $0.99 apiece

Subtotal: $17.93
Tax: $0.90

Used two $1/1 Johnson's Baby Lotion (any size) which were adjusted to a total of $1.98
Used a gift card with $11.90 (this is where I could have subbed in some ECB, had I been keeping current with CVS)

Paid $4.95 out of pocket and got back $15.00 in ECB's for the Brut.

Transaction 2: Herndon CVS

Kashi Heart-to-Heart Cereal x 2, on sale 2/$5
CVS Bandages, 40-ct, x 2 at 1.99 each
CVS men's aftershave at $3.39 (was marked $2.59 on the shelf but I didn't catch it at the register)
CVS lip balm with SPF (something the shelter had high on their request list) x 2 at 1.99 each
CVS cotton swabs 500 ct x2 at 2.19 each (I think we mistakenly grabbed the "500 for the price of 375" instead of the plain 500-ct which would have generated $2 ECB each...who could have known that?!)
Trident Gum (used as a filler so I could use my $4/$20 coupon) at 1.19

Coupons:
CVS $1/1 CVS Suncare (picked this up on a sunscreen sample at the first CVS and it worked toward the lip balm. I was kicking myself for not having picked up more!)
CVS $2/1 skincare (worked for the aftershave)
Kashi 2- $2/1
CVS $4/$20 for updating my email address

Came to $11.31 out of pocket (which is not the pennies that some people shop for, but it's still a bargain)

Got back $1 and $3.98 in ECB

So even with a couple of slipups on my part, and the stores being out of a couple things, my total was around $16 out of pocket and I got almost $20 back in ECB--not to mention a few things we needed (Q-tips and gum, plus the Kashi which was only $0.50 a box and which I really enjoy) and a boatload of things the shelter needed. They were excited to get them and we were excited to give them! And now that I have a good stash of ECB to get started again, we're planning to play the game pretty assertively now that we have a repository for all of the great deals on stuff we don't need! I wish I'd been able to take a picture of our haul, but we dropped it off at the shelter shortly after we bought it.

All of the coupons I used can be found via links from Moneysaving Mom. We quit getting the Sunday paper, despite the fact that the coupons made up for the cost, both because of our decreased need for packaged products and the fact that we hated the waste it generated in paper when we can just read the news online. Plus, 90% of our grocery shopping is at Trader Joe's, where coupons generally don't apply. BUT, while at the library today, I found out that they just THROW AWAY the coupon inserts that come in the papers that they subscribe to, so I'm hoping to get around the cost and waste issue of subscribing to the newspaper by writing the library a letter and asking them to hold the inserts for me. Here's hoping it works!

Friday, June 27, 2008

Friday Night Special

What are we doing tonight? Well, not long ago, Matt and I signed up to adopt a spot in Reston. We've decided that this evening will be our first big cleanup. So, picking up trash in 95-degree heat is the first thing on the docket. After that, we may be inclined to go for a swim. We love the pool near our house, and have taken to doing a kind of circuit training that involves sitting in the hot tub for awhile, standing in the "cool pool" for awhile, and repeat. It's not exactly exercise, but boy, it feels great!

Additionally, I've had a yen for some cookies lately, and it's been a long time since I've baked any. Incidentally, I have a wealth of overripe bananas right now, and no eggs, and this site claims that I can swap the former for the latter. I'm not one to mind a bit of banana taste in my oatmeal chocolate-chip cookies, so I'm going to give it a shot. Oh...and I'm out of oatmeal, so I'll be using oat bran. Well, this ought to be an interesting batch.

Tuesday, June 24, 2008

The Homebirth Choice

*Image from The Business of Being Born

I haven't blogged much about birth lately. This isn't because nothing is going on in birth politics; oh ho ho, quite the contrary. It's because so much is going on that it makes me tired just to think about it. But, because the things I've seen in hospitals have convinced me that only the most dire circumstances would lead me to give birth in a hospital, and the right to make that choice is currently under aggressive attack, I'll give it a try.

The American Medical Association (AMA) and The American College of Obstetricians and Gynecologists (ACOG) have passed a resolution to "advance model legislation" stating that the "safest" setting for birth is the hospital. Meaning, they are attempting to make it the LAW that the ONLY legal setting for birth is the hospital. Meaning IT WOULD BE A CRIME to birth your baby at home, or for a midwife or a doctor to attend you there. They state that this is in response to the "risk" created by celebrities' publicizing their homebirths (that would be one celebrity, Ricki Lake, in The Business of Being Born. Which, if you haven't seen yet, shame on you and go do so!).

Note that despite this fatherly concern they feel for pregnant women, they fail to comment on the far greater numbers of celebrities (Britney Spears, Christina Aguilera, Denise Richards, Victoria Beckham, to name a few...) who choose elective primary Cesareans--a procedure associated with far greater risk of death and injury to mother and newborn than an uncomplicated homebirth attended by trained personnel. On the other hand, this point is aptly made by Britain's Royal College of Nursing, who are quick to point out its potential harms. Could this be because in our healthcare system, elective C-section is associated with more convenience and higher fees for the doctors, while homebirth represents a potential loss of revenue? Anyway, you can read the whole resolution here.

Side note: it's interesting to me that doctors never talk about "birth," only "deliveries," perhaps an implicit way of staking their claim in a process that rightfully belongs primarily to the mother. Come on- if nobody was there to "deliver" the baby, was the baby still born?? Here, they insist on referring to homebirths as "home deliveries," perhaps a tongue-in-cheek reference to a snide and oh-so-professional bumper stickers ACOG gave out to members last year, which read "Home delivery is for pizzas, not for babies." No sir, no bias there. None at all. (On the other hand, midwives are fond of saying "Pizzas are delivered; babies are born." The verbage goes both ways.)

In other words, they would mandate it that the only place to deliver a baby is where doctors practice and get paid. As an old SNL sketch used to say: how conveeeeenient. When you read what other physicians, from this and other countries, have to say about the safety and desirability of homebirth, and consider the fact that just a couple of generations ago most people were born at home with a midwife, it's hard to conclude that this is motivated by anything but greed, spite, and a turf war.

Many eloquent responses have been written, including ones by concerned citizens and one by Ricki Lake (whose name has since been removed from the resolution) and Jennifer Block; but one of the best has to be this one from an obstetrician and member of ACOG. Please read it through, because it's worth it.

Douglas H. Kirkpatrick, MD
The American College of Obstetricians and Gynecologists
PO Box 96920
Washington, DC 20090-2188
Dear Sir:

I am a practicing OB/ GYN in southern California and Fellow of ACOG and recently was informed by midwife colleagues of your recommendation and encouragement for the AMA to lobby Congress for a law banning out of hospital birth.

Funny, that I had to hear of this decision from outside sources and was never approached by my college to see how I or my local colleagues felt about it. I have grave concerns regarding my organization taking such a stand. I think we are all agreed that ACOG has a statement regarding patients rights to informed consent and informed refusal. Yet, it seems with every decision our organization moves further away from that basic tenent. ACOG’s little “guideline” paper on VBAC in 2004 where the word readily was changed to immediately has had the chilling effect of doing away with VBAC options at hundreds if not more hospitals. Not due to patient safety, or the ideal of giving true informed consent but really, let’s be honest, to fear of litigation. I have seen how patients have become counseled by obstetricians at facilities where VBAC has been banned. They are clearly given a skewed view of the risks of VBAC but rarely told of the risks of multiple surgeries. If you think this is untrue you are, sadly, out of touch with real clinical medicine.

As to out of hospital birthing, please give me the courtesy of an explanation as to the data you used and the process by which an organization which is supposed to represent me came to this conclusion. Any statement saying that it is as simple as patient safety and that one-size fits all hospital birth under the “obstetric model” of practice should be applied to all patients is, putting it nicely, not really in line with what best serves all our patients. In many instances, hospitals are not safe, certainly not nurturing and have a far worse track record for disasters than home birth. Even when emergency help is nearby this is true. The focus of all of us in medicine should be on reigning in trial lawyers and tort reform and lobbying Congress for that. The best interest of the college members and the patients we serve would be for my organization to spend its time and energy on something that has true benefit. Removing choices from well-informed patients and caring doctors and midwives is wholly un-American.

So please send me detailed information on how ACOG decided outlawing home birth was a wise thing to do. You must have scientific data to take such a drastic stand. Please make it available to me so that I may share it with likeminded colleagues. I would also like to know the process by which this came to pass. Who first raised this issue and why? What committee reviewed all the data and did its due diligence in interviewing those of us with longstanding experience in backing midwives who perform out of hospital births. There must be a fine, non-confidential paper trail you can share with your members. Specific names of committee member who voted for this would be enlightening and I am requesting this information. I would like to know the background and expertise regarding out of hospital birth for each member who had a hand in the decision to go to the AMA.

We live in an odd era where once something is said or recommended by a legitimate organization such as ACOG it has deep ramifications never intended such as becoming fodder for trial lawyers trying to squeeze the lifeblood and dignity out of your members. Or forcing women to travel hundreds of miles in labor to find a supportive facility. Or even worse, to have them arrive in a VBAC banned hospital and refuse surgery. Can this be the best we can do for our patients? Remember, your VBAC statement was meant to be only a recommendation but quickly became the rule by which hospital administrators, risk managers and anesthesia departments of smaller hospital banned this option for thousands of women. An option, that in proper hands, was the safe and accepted standard of care for 30 years. In fact, you still have an ACOG VBAC brochure that recommends this option! For those of us working at smaller hospitals where VBAC was banned due to lack of emergency help (anesthesia, OR crews, etc.) there is a big question that has perplexed us that no administrator seems to be willing or able to answer. That question is: “If a hospital cannot handle anemergency c/section for VBACs, and most emergency are for fetal bradycardia, hemorrhage (ie. abruption) or sholder dystocia not for ruptured uteri, then how can they do obstetrics at all?” For they seem to still be able to have a maternity ward without in house anesthesia. Will someday ACOG, in their great wisdom but seeming disconnect from reality, make a “recommendation” that little hospitals stop providing obstetric services? Will this better serve women and their communities throughout America?

I am frightened and angered by what you have done in my name. Now I ask you to defend your position in encouraging the AMA to lobby Congress for another restriction on the freedom of choice that belongs to women and their families. Those choices include midwifery and the right to have the most beautiful and life changing event occur wherever best fits their desire. Midwives are well trained and required to have obstetrical backup. They have very special relationships with their patients and want the very best outcomes for them. They do not need me or you to police them. We have a habit in out country over the past 40 years of thinking we can legislate out stupidity. All that has done is erode the individual freedoms that belong, by birthright, to each of us. I would hope you trust your Fellows to know their specialty, their colleagues, and what is best for the patient as an individual. These decisions do not belong to politicians or faceless committees. You should have more faith in your members to give balanced informed consent. Again, my recommendation to you is to put all your considerable energy into changing our legal malpractice system. Those of us actually practicing medicne and caring for patients know this to be the greatest threat to the mission and responsibility we have chosen to undertake.

I look forward to your response and possibly the beginning of a meaningful dialogue.

Sincerely,

Stuart J. Fischbein, MD FACOG
Medical Advisor, Birth Action Coalition

I came across it via the Enjoy Birth blog, who also includes a link to an online petition you can sign opposing the resolution.

Honestly: I get it that not everybody agrees with homebirth, or would feel comfortable with it. (Which is why I would never propose, say, MANDATING it!) BUT, it sickens me to think that in a country ostensibly founded on freedom, we would allow physicians' greed and/or fear of the unknown to sabotage what studies have proven is a safe, not to mention cost-effective (certainly a consideration, in this day and age!) and family-friendly, choice for this most private and miraculous of events. A Canadian physician had this to say (from Jennifer Block's site):
I would invite ACOG to join the rest of us in the 21st century. Modern ethics does not equivocate: maternal autonomy takes precedence over medical recommendations based on beneficience, whether such recommendations are founded on sound scientific evidence or the pre-historic musings of dinosaurs. In the modern age, the locus of control has, appropriately, shifted to the patient/client in all areas of medicine, it seems, except obstetrics. We do not force patients to have life-saving operations, to receive blood transfusions, or to undergo chemotherapy against their will, even to avoid potential risks a hundred fold higher than any associated with home birth. In obstetrics, however, we routinely coerce women into intervention against their will by not “offering” VBAC, vaginal breech birth, or homebirth. Informed choice is the gold standard in decision making, and it trumps even the largest, cleanest, randomized controlled trials.

Science supports homebirth as a reasonably safe option. Even if it didn’t, it still would be a woman’s choice [...]

Andrew Kotaska
Yellowknife

And, compare ACOG's position with that of the physicians in Britain's Royal College of Obstetricians and Gynaegologists:
The Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists (RCOG) support home birth for women with uncomplicated pregnancies. There is no reason why home birth should not be offered to women at low risk of complications and it may confer considerable benefits for them and their families. There is ample evidence showing that labouring at home increases a woman's likelihood of a birth that is both satisfying and safe, with implications for her health and that of her baby.
I love how their position statement is carefully crafted and supported both scientifically and ethically. ACOG's and AMA's statements, on the other hand, come across as petty, spiteful, and paternalistic. "Homebirth is dangerous, you idiots...because I said so."

And to think I thought that dropping out of law school meant I wouldn't be involved in politics...

Desk Day

I'm even physically at my desk (one we came to through my parents, and which is a piece of furniture that we love), for a change--usually I do any bookkeeping/computer work/phone calls sitting cross-legged on the couch, where I'm most comfortable. Today I thought I'd mix things up and see if I wasn't more productive, and less inclined to stray from my intended tasks, if I were sitting in a hard chair at a real desk.

You can see how well that's going.

Actually, though, I have gotten quite a bit done today. First on the list was taking care of a $118 credit card bill I didn't remember charging. Closer inspection revealed that the two charges in question were a $39 annual fee for the credit card itself (which, in fairness, was disclosed when I signed up for the card), and a $79 fee for Amazon Prime.

I very vaguely remembered something about signing Matt up for a free trial of Amazon Prime, and a little digging revealed that I had done so in March, for a 3-month free trial, which then expired in June. They then "conveniently" charged our card to keep the service going. Which, again, I had known they would do, and had just been on the fence about whether to cancel it, and had a little lazy about remembering when. Amazon Prime is a service I really like and have used before, but as we sat and thought about it, Matt and I just couldn't see that in the next year, we would need $79 worth of urgent shipping. Plain old super-saver shipping will have to be good enough for us. We also found from experience what Amazon must know to begin with: having the free 2-day shipping is an enticement to buy things you might not otherwise, and that's something we really don't need. Fortunately, reading the fine print on our account details revealed that one can "cancel at anytime for a full refund, provided nobody has used your special shipping privileges." Done! $79 back in the account.

As for the annual fee, several sources on the internet reported that while companies will often waive a late fee or overdraft charge, they generally won't remove an annual fee. Well, I thought, you can always try, right? So I called Barclay, armed with the spiel that I enjoyed their card and their customer service, but that I would have to switch to another card if I couldn't get rid of this annual fee. The first person I talked to was very nice, but said I didn't "qualify" to have my fee waived. I asked whether there was anybody else I could talk to, and she transferred me right over to someone else, who promptly told me that she would refund the charge and cancel it for the future of my account, so I could "keep the card and continue to accrue benefits." Well, okay! So for all you other Googlers out there: A credit card company may reverse your annual fee. Just ask. A couple of times. Not only did I eradicate the entire credit card bill in a matter of 15 minutes, I theoretically saved myself an additional $39 a year from here on out. (But, I was honestly prepared to cancel the card if they wouldn't waive the fee. It earns miles on AirTran, which is a good airline but it doesn't fly much to anywhere we go regularly, like Cedar Rapids or Madison. We have used it to fly to other places, though.)

My next phase of business has been decidedly less satisfying and involves wading through the mountains of registration, insurance, medical history, and financial information needed to register myself for Shenandoah. They sent me a packet last month that needs to be returned by August, and so far I've come up with no fewer than ten questions that the packet raises but doesn't answer (questions like: it says I need to register--how, and for what?). I need to get in touch with the various hospitals I've worked at and schools I've attended to try to piece together my immunization history. And I need to send signed copies of my tax returns--hahaha, that should be simple enough!

Also on the docket: make an ophthalmologist appointment for Matt (done), send some mail(done), and back up our pictures (no small task, as you can imagine; therefore, merely in progress) to Picasa Web Albums in preparation to clean-install Windows on my computer--which is irritatingly slow and prone to freezing, despite its being new less than a year ago. Its speakers also seem to be blown, which, note to self, I should address with Dell before said year has elapsed.

Unfortunately, to borrow a line from Garrison Keillor's Wobegone Boy (which we downloaded from Audible after yet another accidentally-elapsed free trial, which we then promptly cancelled; note to self, must get better about that or else stop signing up for free trials; though honestly, I would pay to hear him read me the phone book, I really would): I would rather sleep next to a dead person than talk to Dell customer service on the phone. (He just says the part about sleeping next to a dead person; not the part about Dell.) It is the worst, and I repeat, THE WORST customer service I've ever experienced. Just don't get me started on that, okay?

Otherwise...all is very well here. I'm watching what I think are probably the two happiest cats in the world in the midst of a three-hour nap, so far, which is showing no signs of letting up anytime soon. In other news, if you can call it that, we've decided to stop watching 24 because we each feel that it has become less entertaining than it is just needlessly suspenseful, and was literally giving us trouble sleeping at night. We rent movies and TV shows to relax (hello, Cosby Show!), not to feel stressed out, and that is what it was doing to us.

With regard to movie watching etc, we've also decided to limit it just to the weekends. We've noticed our evenings feel shorter in front of the television than they do when we fill them with walks or books or cooking or just talking. (As Matt says, "It's fun just to sit around and love each other." Awww. Where did I get this guy?!) Other pleasures we've decided to relegate to the weekends: wine, espresso, and (for me) hot chocolate. All things we love, and reserving them for the weekends somehow seems to make them, and the weekends, feel all the more special than if we trotted them out every day. It builds a little anticipation, which is always a nice thing. And now that I sound like an advocate for abstinence-only sex education, I guess I'll sign off for now.

Sunday, June 22, 2008

The Light Last Week

As we came over the Bay Bridge on the way home from Assateague was just beautiful. Here are some shots of the way home (bearing in mind these were all taken from a moving vehicle):






We even got a rainbow.

The Weekend, Plain and Simple...


Friday Night
Friday night we were too tired to do much, as evidenced by the fact that we can't for the life of us remember what we did. I seem to recall that we took a bike ride out for Teeter snacks (the free samples at Harris Teeter grocery store), and then we probably fooled around on the internet until bedtime. At least, that's my best guess.

Saturday: Amish Country
Yesterday we went out to Amish country, to scout for a couple of rocking chairs and just generally covet the quality and simplicity of their lifestyle. We didn't come home with rocking chairs, but we did come home with some rocking produce--some of the tiniest, sweetest, and best strawberries ever, and the juiciest cantaloupe we've ever had. Pennsylvania is a gorgeous state, and we had a great time driving through the countryside and dodging horses and buggies every which way.

We had originally planned to camp Saturday night, but we were a little wiped out and the idea of packing for and planning a camping trip seemed too steep when we left Saturday morning. So instead, we just came home. We walked down to the nearby Tavern on the Lake at Lake Anne Village Center and enjoyed tapas and a drink, then came home and went to bed.

Sunday: Shopping and Cooking
This morning we got up and did a fair amount of shopping on our bikes--Target, Whole Foods, and Trader Joe's--and between that and a trip to the library, biked a total of 8.5 miles. Which made us feel a little better about ditching our run this morning.

Incidentally, the menu for this week is as follows:


2. Pasta with grilled veggies (asparagus, squash, and portabellas)
3. Quinoa salad with pitas; grape tomatoes
4. Mattar paneer; okra
5. Tamales; corn
6. Eggless egg (ie tofu) salad with pitas; lettuce/tomato
7. Hummus with pitas; potato wedges

Homemade Whole-Wheat Pita Bread
Where are we getting these prominently-featured pita breads, you may ask? From here. We made a batch today and thought they turned out really well. Mine didn't puff up completely, so I'm wondering how pockety exactly they will be, but the one we cut open to test did fine with the help of a sharp knife. They're soft and tasty and easy. I didn't photograph the process because Tammy does a nice job on her site already.

EDIT: Once you slit them open with a knife, they're very pockety indeed. See above, pita in action, as Matt fills it with eggs and sausage and salsa.

Homemade Whole-Wheat Crackers
Similarly, we made a batch of whole-wheat crackers today (love the ingredient list: nothing but butter, yogurt, and whole-wheat flour!), using up some homemade yogurt we'd had in the fridge for awhile. You can find pictures and the recipe here. Several commenters said they reminded them of Cheez-Its; the yogurt does give them a pleasant tanginess we enjoy.

We also made a batch of hummus, which is always a favorite here; and one of peanut butter, since we bought Tupelo Honey and a jar of strawberry-rhubarb jam (sweetened only with white grape juice!) from the Amish, and nothing goes with honey or jam quite like peanut butter.

We capped off the day with a trip to the library. We picked up some books about the Amish, Matt is currently investigating homebrewing beer, and we also checked out Clan of the Cave Bear, which we're planning to read together since we've now finished the incredible informative. On the list after that: the Little House on the Prairie books. We're hoping to pick up some tips!

Friday, June 20, 2008

Just Us

After a fun week running around the area with Matt's parents, we got them safely off today. The cats look a little puzzled that it's just us again. Here are some pictures from our trip to Shenandoah:





Other than that, tonight we're planning to go for a run to Trader Joe's. I think we're just going to grill some veggies over pasta for dinner--a little detox after a week of rich eating! This weekend, we're headed up to Pennsylvania Amish country to scout for rocking chairs, and we're hoping to do some camping on the way back. We'll keep you posted!

Special thanks to my brother, who helped me get the blog looking more bright and polished!

Wednesday, June 18, 2008

Assateague Island

Today we all drove out to Assateague Island. It was a beautiful day, sunny and in the 70's, though the water was too chilly for swimming! We got some great pictures of the wild ponies, and had dinner overlooking the bay. I'll let the pictures speak for themselves!








Sunday, June 15, 2008

Contrasts

Matt's folks are here, and we're having a lovely time with them. So far we've done the Holocaust Museum, the World War II Memorial, the Zoo, and the National Cathedral. I mapped our route yesterday, and we walked 10 miles! Matt and I work the next two days, and then we have a couple more days off with the parents. Shenandoah and Assateague are on the agenda for Wednesday and Thursday. Then Friday they'll head out. A week goes fast around here!

It's a little tough to be so recreational when Cedar Rapids and Iowa City are still in very grim shape, but everyone I've talked to is safe for now and nobody I know has been evacuated. The aftermath of all this may end up being the hardest part.

And finally, Kathleen is home from the hospital, and we're hoping for a recovery that's as quick and minimally painful as possible. Any advice on surviving bedrest?

Friday, June 13, 2008

Getting My Head Around It

More than anything, I'm thankful that my family is, for the time being, safe and on high ground.

But I'm still fighting shock at seeing pictures of the town I grew up in looking like a disaster area. Because it is a disaster area. Even knowing that the people I love aren't in immediate danger, I'm surprised by how my eyes well with tears every time I see a picture like the one above. I can't even articulate exactly why. 

Maybe it's because when we left, I assumed I'd always have the option to come back again and find everything right where I left it. Just before all the flooding started, Matt and I felt like we had come to terms with the fact that we intended to move back to the Midwest, sooner rather than later, and were pleased with the idea. We'd started fantasizing about hanging out at some of our old haunts again, and liked the idea of raising kids in an area that was so familiar to us.
That's still in the plans, but for better or for worse, I think it's safe to say that Cedar Rapids and Iowa City--the towns where I grew up, graduated college, became a nurse, got engaged--will never be quite the same.

That, and being so far away when it's all happening, are difficult things to come to terms with.

Words of Encouragement

In case anybody's interested, UI Hospitals offers a service where you can email a patient your get-well wishes. Since getting anything else in and out of Iowa City is pretty hairy these days, feel free to let Kathleen know you're thinking of her.

Let's Get Ready to Crumble

Being as the in-laws are coming in today, I thought the occasion called for something special. Something crumbly. I think technically this is actually a crisp, but that name had fewer possibilities for wordplay, so I took a little poetic license.

The recipe I (loosely) followed is this one. Usually I prefer a food blog, with pictures and witty commentary, but nobody I could find seemed especially interested in the humble crisp. So this is the recipe I went with, doubled, and I must say I'm pretty pleased with it. (And, as the site says, oddly, "Just by making it, the day becomes special." Well.) Here's my adaptation:

Strawberry-Rhubarb Crisp

Filling:

About 5-6 cups strawberries and rhubarb, chopped (choose your own proportion)

1/2-3/4 cup sugar (the original recipe called for a whole cup, which seemed like a lot, so I cut it down to 3/4; I think it would have been just as good with 1/2)

2 Tbsp cornstarch

4 Tbsp orange juice


Topping:

1 cup brown sugar

1-1/3 cups oatmeal

1 stick butter

2 tsp cinnamon

Scant 3/4 cup flour (I used whole-wheat)

Pinch of salt

3/4 cup nuts (optional)

Combine topping ingredients in a food processor and pulse until crumbly. (That's them in the background below.)


Combine chopped fruit and other filling ingredients in a 9x13" greased pan.
Stir until coated.
Pile on the topping.
Bake at 375 degrees for 40-50 minutes or until browned and bubbly.
Then just die of satisfaction.

Thursday, June 12, 2008

In Just Over 24 Hours...

Matt's parents will be here! We're super excited, and will keep you posted as to our doings and goings-on. I consider myself incredibly fortunate to have such fun and caring in-laws, and we can't wait to see them! We're going to have lots of fun.
On a more serious note, our hearts still go out to my brother and his wife, as well as everybody in Iowa and Wisconsin affected by this INSANE flooding. It's certainly a crazy time, and it's hard to be so far away.

Wednesday, June 11, 2008

Please Say A Prayer

For my sister-in-law, who was badly hurt in a car accident yesterday. We're thankful things weren't any worse, but she and my brother are both in our constant thoughts right now.

Monday, June 9, 2008

Update On My Armpits

They were a little dry and red. So I started cutting the baking soda 1:1 with cornstarch, and also putting a little olive oil in them after I shower (if this thing was not made for spraying olive oil in your armpits, I don't know what is), because I realized that constantly having all moisture absorbed from any area of skin is going to be irritating and drying. So now they're silky smooth and still smell great. As I carried a 4-1/2 year old all over DC yesterday (hot and sweaty work if there ever was any, especially in the 100-degree heat), she told me, "You smell clean." This is not the first time since switching to baking soda that I've heard this.

(What We Ate) This Past Weekend

Was a busy one. And a hot one. So how did we keep cool? By biking some errands on Saturday (the Farmer's Market and Trader Joe's), and babysitting on Sunday. How is that keeping cool? You guessed it: it's not.

We didn't need a ton from Trader Joe's on Saturday, but we got a prime bunch of basil at the Farmer's Market, and so we decided it was worth braving the 100+ degree heat index on our bikes to go out and get some Parmesan to make pesto. And boy, was it ever! We ate it on bread and crackers that day, and then we had it over pasta tonight. Pesto is hands-down my absolute FAVORITE food (though it's really more of a condiment--but not the way we eat it!), and it also has a lot of positive memories since it was one of the very first things Matt and I made together. We also busted out the old classic of a pesto-spread grilled cheese sandwich with tomatoes, along with homemade tomato soup. 

Tomato soup is one of those foods I've come to question why everybody doesn't just make from scratch--it's so fast and so easy and so...free of hydrogenated oils and artificial colors, and such. The way we make it is:

Homemade Tomato Soup

1. Dump a couple cups of canned tomatoes in puree (which is canned, I know, so not totally free of processing--but the ingredients list is refreshingly simple) in a pan. 

2. Add a tablespoon of brown sugar and a couple teaspoons of garlic. 

3. Puree with a hand blender (or you could do it in a regular blending) and bring to a boil. Add a pinch of baking soda to cut the acidity. 

4. Optional: If you want cream of tomato, combine about a cup of cream or whole milk with a couple of spoonfuls of the soup, stirring slowly, and then add that to the pot (which will prevent the milk from curdling). 
Done! And delicious! And you know (and like) exactly what's in it. Where has this been all my life?!

We love these canned tomatoes (or really, any huge cans of tomatoes) because they make such a versatile base for so many things: the tomato soup, spaghetti/lasagna/pizza sauce, Indian tomato-based sauces (such as for mattar paneer)...and they cost about $3, or less than $.50 a pound. There's not a ton we buy in large bulk anymore, but whenever we go to Costco (which is every few months now), we make sure to stock up because we know we'll use them. Highly recommended pantry staple!

Get a load of that slim ingredient list

Here's a closer look at those delicious sandwiches:



As far as the sandwiches go: historically, we pan-fried them in the classic grilled cheese (fried cheese?) way. But, as we became a little more calorie-conscious, we switched to baking them. This led to almost-abrasively crunchy crusts. This time, on a hunch, we first toasted the bread, then assembled the sandwiches and popped them in the microwave for 30 seconds. The result? Slightly softer, but still crispy bread, and perfectly melted cheese. We're sold! 

On Sunday, we babysat for friends of ours who were in town. For people such as ourselves, who live a relatively simple life with cats, chasing four kids around Washington DC was a definite change of pace. Especially in the heat. We agreed that it was a good experience...both in showing us how well we can work as a team, and also in reminding us that we're happy for now just being a couple.

Homemade Limeade

Hot and sweaty after a run the other day, Matt and I decided to use our lime surplus to make a batch of limeade. Or more specifically, a big batch of limeade concentrate that we can now utilize in making not only limeade, but ginger beer, margaritas, mojitos, and anything else 
calling for sweet limey goodness.

Not kidding about the hot and sweaty part

Juicing the limes

Making simple syrup by heating equal parts sugar and water

Adding the lime juice to the simple syrup

Add the appropriate ratio of water and enjoy!

We found that the ratios in the recipe made for a slightly sweet, syrupy limeade for our tastes. I would increase the ratio of plain water and according decrease the ratio of simple syrup. Otherwise, though, we give it a thumbs up!

Thursday, June 5, 2008

Fascinating Article On Segregated Childbirth

By a nurse who worked in a hospital in the deep South. Who came out on top may surprise you.

Nursing is WORK!

Physical, mental, emotional WORK. I was reminded of this acutely today as I faced a number of ethical challenges, as well as rigorous physical demands.

I was also reminded how much I'm coming to like some of my fellow nurses here, and what a unified front we can present if necessary. (AND of how little it can matter, but that's another story.)

I've picked back up Nursing Against The Odds and am reminded again how proud I am to be a nurse. Back in college, when I was pre-med, you couldn't have convinced me that someday I'd say that. I thought it was on par with being a secretary. (No offense to secretaries.) I think a lot of people probably still feel that way. But now, it's hard to remember that I ever viewed nurses as being anything but tough as nails. 

There are a number of nurse-midwives I've come in contact with who view their nursing education as a nuisance they had to get out of the way in order to become a midwife. Some never even practiced as nurses. They do their best to distance themselves from the profession, saying things like "I'm far less nurse than midwife."

I think they've got the wrong idea, though. If by "less nurse than midwife," they mean what I think they do, which is that they view themselves as somebody who's able to think quickly on her feet, make snap decisions under duress, rapidly form intensive bonds with people, and go to the mat advocating for somebody, then I would say they're able to distill the best of nursing--but I'll also say that they're given the advantage of some measure of power and a more forgiving environment (generally) in which to do it. By saying things like "Midwives are trained to lead, nurses are trained to follow," they're perpetuating a stereotype as old and tired as the one that says that only obstetricians can deliver babies. I know plenty of strong, smart, assertive nurses. I know that they're exactly what's needed (and in many cases, what is present) at the bedside. They're often the difference between life and death, and a hundred shades in between. And I'm proud to call myself one of them.

Tuesday, June 3, 2008

Time Misses The Point, Again

From The True Face of Birth, regarding the so-called "VIP concierge services" that TIME magazine tells us some doctors are now offering.

For only $15,000 cash, in addition to the normal charge for prenatal care & delivery, you can receive extra services such as:
  • limited number of patients, so the physician can devote more time to each patient
  • no waiting
  • longer office visits
  • round-the-clock availability via e-mail or cell phone
  • private birthing classes
  • one massage per trimester
  • optional home doctor visits
  • guarantee that the physician will be at the hospital for her patients' full active labor and delivery
So, you can pay the full cost for prenatal care & birth (with or without insurance coverage), plus an additional $15,000 to get these "extra special" services. Or you can pay $1,000-4,000 total (and less if your midwife accepts insurance) to get all prenatal, birth, & postpartum care and those extra-fancy services, and more, as the standard of care from your midwife.


Well said.

But nowhere in the article does TIME even mention the option of midwives.

They had a similarly one-dimensional article about elective Cesarean recently, summing up that elective surgery is "a pretty tidy way to conduct the often-messy business of childbirth"(one commenter on TIME's website retorted "Trust me: suffering the effects of major invasive surgery is not a tidy way to do anything") and referring to a spinal block as "local anesthetic," making it sound more like having a cavity filled than having your entire lower body numbed andparalyzed--see an excellent analysis of that article here.

Another article actually comes out and says that "Five hundred years later [after the first known successful C-section], surgical delivery seems as trifling as tooth extraction." HUH? It downplays the "increased maternal mortality" (YES THAT MEANS DEAD WOMEN) of elective C-sections and then describes vaginal birth in the following terms:
for most women natural childbirth is one of the most violent physical traumas they will ever experience, bar a serious accident or grievous assault. [Note: I don't even think that sentence is correct grammatically, and it certainly is dead wrong from a number of other perspectives.] The average length of labor for a first-time mother is anything from seven to 12 hours, but it can easily be 20 hours or more. During that time, she is wracked by contractions — a euphemism that doesn't even come close to conveying the violent spasms that take hold when the body reflexively tries to squeeze a baby through a narrow vaginal opening. The forces involved are such that when the baby's head emerges, it can do so with sufficient pressure to rip the mother's perineum and leave grind marks on pubic bone. In many ways, the act of giving birth resembles a medical emergency — in fact, if no medical intervention of any kind were made, up to 1 in 67 women would die in labor. Fear of birth pain is thus legitimate and it is no wonder that many women elect to have C-sections — especially when the procedure is over in about 40 minutes and feels no more uncomfortable, in the words of an anesthetist in one of Hong Kong's top maternity hospitals, "than someone rummaging around in your tummy."
The article was written by a man, please note.

Another memorable quote: giving birth without painkillers "it's like they're climbing Everest without oxygen," says Dr. Paul Tseng, a gynecologist at Singapore's Thomson Medical Center. Yes...painkillers and oxygen, they're exactly alike.


I am really speechless.

On a different note but related theme, the May 12th issue had an article about raw milk that concluded with the statement that placing trust in local farmers and the health of their cattle "might just be too much work for a glass of milk." TOO MUCH WORK? Getting to know your neighbors, especially when it has implications for your health, is too much work? I'll tell you what doesn't "work," and that's relying on the government to insure safety of the food supply via approval of the FDA, who continues to let MILLIONS OF POUNDS of contaminated meat slip by every year. I thought I recognized the limp and biased writing style of this article, and sure enough: brought to us by Alice "Choose Moms Choose Cesarean" (I am not making that up) Park. Unfortunately, she seems to be representative of the type of flaccid and uninformed approach TIME is taking to its articles these days.