Merry Christmas!

photo by krisdecurtis

It's hard to believe we're already leaving Iowa tomorrow! We've had a wonderful time hanging out with family, seeing some old friends, eating at some of our favorite restaurants, and just enjoying being in such old familiar surroundings again. It's sad to see how much of the state is still devastated by the effects of the flood, and it's hard to get our minds around the fact that the music school (where we met, fell in love, and each spent many hours over the years) is unusable and may be slotted for demolition soon.

On a more positive note, though, here are few highlights of our gastronomic tour of Iowa:

Christmas dinner with my family! Despite a few mishaps by canines who shall remain unnamed, the amazing turkey and stuffing and mashed potatoes and cranberry cider and apple crisp and pumpkin roll more than made up for having to bust out the steam cleaner for the carpets a time or two.

Miguel's: a bar in Cedar Rapids that makes some of the best pizza I've ever had. They only take cash and they don't deliver, but it's oh so worth it.

Lou Henri's: our favorite Iowa City breakfast spot (which also serves lunch). Delicious eggs, pancakes, banana bread French toast, everything. Eclectic hippie college-girl waitresses and local art for sale on the walls.

India Cafe: a small, cozy Indian buffet that has a more limited selection than many of the northern Virginia mega-buffets, but still has the best naan we've had anywhere.

Tommy's Restaurant: a greasy spoon I never hit while I lived in Cedar Rapids, but which was the favorite hangout of one of the old men I knew when I worked in assisted living. He wasn't wrong: we enjoyed a huge, greasy, delicious breakfast for cheap (breakfast platters start at $3.99).

We wish we'd had time to hit:
Thai Spice: our favorite Thai restaurant, which makes (among other things) a mean yellow curry.

The Sanctuary: wonderfully cozy pub that has live music and a bar on one side, and a nonsmoking restaurant with fireplaces on the other. Delicious pizza and all kinds of other delicious late-night food, plus extensive cocktail and beer lists.

The Wedge: unbelievably delicious gourmet takeout pizza, unbelievably affordable, and generous with even the more expensive toppings (like pine nuts).

The Atlas: fresh, local food that's not necessarily health food (see the buffalo chicken wrap); the best tomato bisque I've ever had; and the world's most incredible mojitos. Not that I could have indulged...

On a less-than-fun note, our passenger-side window got stuck down on a 20-degree day, necessitating Matt's taking the door apart (in the cold) and running it up with a battery charger, McGyver-style. Very smooth. At least it happened when and where it did, and he was able to get the window up, and it looks like it will only cost around $40 to replace the switch.

Next, we're excited to drive up to Wisconsin and spend a few days with Matt's family! We feel incredibly lucky to have two such wonderful (and flexible) families to share the holidays with, and these are particularly special to us since they're our last ones to feel like "the kids"...this time next year, we'll be the parents!

We're Here!

Photo by sirwiseowl

After 18 hours in the car, two successful runs with my funnel-jar urinal, and many hours of Laura Ingalls Wilder audiobooks later, we rolled into Cedar Rapids at about 1am central time (2am to us). Despite dire warnings, the road conditions weren't terribly bad (though I can say that having done my half of the driving during the day, on dry roads, back east), and ultimately we're glad to have avoided what was sure to be a nightmarish scene at various airports. Now we're excited to be back in the midwest and spend some quality time with our families and friends!

Wrapping Up

photo by Aunt Owwee

I just submitted my last paper for the term, which feels wonderful. It's even a week early. All in all, my first term at Frontier was challenging, but very doable. I'm almost excited to start again in January...though not as excited as I am to have a couple of weeks off!

We had a good weekend, if slow-paced. My nausea is getting better, but I'm still very sleepy much of the time, and Matt is wonderfully understanding about that. We ran a few errands, worked out a couple of times (which is going well--we're really enjoying the Y), and otherwise took it easy. Yesterday we thought we'd save a few dollars by running out to Aldi's (about 45-50 minutes away, in Maryland) to pick up some staples. We ended up getting out there just after six, both believing them to be open until at least 7, when in fact they'd closed at five. So they'd been closed by the time we left Reston, and we ended up stopping at a Safeway instead--saving absolutely no money, driving almost 2 hours needlessly, to shop in a bad neighborhood in the dark at a chain we have in Reston. The icing on the cake was that by that point we were both too tired and hungry to feel like cooking, so we ended up going out to dinner! We only got pizza, which was delicious and $25 out the door, but it just goes to show you that our adventures in frugality certainly don't always go as planned!

We also splurged to rent The Dark Knight from Hollywood Video, because the Redbox was out. The verdict? A total waste of $5! We're considering upping our Netflix plan (currently 2-a-month for $3.99, which suits us just fine when we're out and about) for the winter, since Hollywood can be such a ripoff and we'll be spending more time indoors.

I work twice this week and otherwise plan to try to get us ready to head back to the midwest this weekend! We're incredibly excited to see all of our friends and family, and it should be an awesome trip!

Odds & Ends

It's Friday, and life here is good. This past week I worked Tuesday and Wednesday, and was supposed to work yesterday, but Wednesday was such a frustratingly crappy day that I fervently prayed before bed that they would call me off, because I didn't feel like my blood pressure could take another 12 hours of it. The good Lord must have agreed, because sure enough, despite what looked like a skeleton crew scheduled for Thursday morning, they called me at 5:30am and told me they didn't need me. Hallelujah!

I'd already finished up my Pathophysiology class, figuring the test was the easiest part of wrapping up the semester and then I could get down to concentrating on the two papers I had due. I actually managed to knock one out yesterday, and I'm embarrassed to admit how much I'm actually getting into the assignments I was purportedly dreading. The one I did yesterday was a health management plan for the primary care of an 18-year-old female patient. The goal of the assignment is to get us to look at ALL the screenings/tests that are currently recommended for patients by various organizations, and then figure out which are actually justified by what's called "evidence-based practice" (EBP), which is just what it sounds like. The opposite of CYA ("cover-your-ass") medicine, which is what's currently practiced by a majority of doctors today and involves ordering every test and procedure imaginable in a twin effort to line their own pockets and prevent being sued. EBP says that to order a test, you have to have a valid reason for it and the evidence has to show that the benefits of the test actually outweigh the risks. Surprise, surprise: many don't. Even old standbys, like the breast self-exam (BSE) we've all been made to feel guilty for not doing, get stamped with an "I" for "Insufficient evidence to recommend as helpful" by the US Preventive Services Task Force, which is like the gatekeeper of evidence-based medicine in the United States. EBP is a relatively new topic here, but it's huge in places like Britain, where a single-payer healthcare system means that the country has a vested interested in preventive services, but only to the extent that they actually prevent, detect, or treat disease.

On a very related note, the CEO of UnitedHealthcare New Jersey (a major insurance carrier) has published an 0p-ed in a NJ paper about the true costs of early elective C-sections. One of the most memorable (and chilling) quotes from the article:

It turns out that in an audit of all UnitedHealthcare-insured babies admitted to the NICU in one market, 48 percent of all newborns admitted to NICU were delivered by elective admission for delivery including scheduled C-sections (cesareans), many taking place before 39 weeks of pregnancy, or full term.

So almost HALF of babies in intensive care are there because their parents, or their parents' doctor, chose to induce labor or perform a Cesarean BEFORE TERM. Note that he specifies that this is ELECTIVE ADMISSION FOR DELIVERY--completing excluding medical reasons for C-section or labor induction. I always like to tell my patients "The fruit falls when it's ripe." Imagine that! Kind of reminds me of the butterfly story. (And of course, I give the caveat: Cesarean can be a lifesaving operation and I'm glad that it's available. My dear husband was born by such a Cesarean and clearly I would be lost without him. We're talking here about purely elective inductions/C-sections before term, done only for convenience reasons.)

Anyway, I had a couple of questions about that assignment and ended up calling one of my professors to ask them, and we ended up having a wonderful dialogue about EBP and the frustrations of working in the current healthcare system and it really made me feel glad to have found a school that's working so hard to produce efficient, thoughtful, and effective healthcare providers. It makes me feel proud to be a Frontier student and a future midwife.

Having wrapped up that assignment, I've moved on to my last class, in which we're slowly working our way through a proposal to open a midwifery practice in the state in which we'd like to practice. Hometown girl that I am, I chose Iowa, and while sifting through the various documents and regulations initially filled me with dread, I'm enjoying it in spite of myself. The assignment really gives credence to the idea that someday I am really going to do this (somewhere), and I'll be glad I did a lot of the legwork (figuratively speaking) when I was working part-time and only 10 weeks pregnant, as opposed to a fledgling midwife with a two-year-old (and who knows what else!). So, yeah--for anybody looking into midwifery (or nurse practitioner, for that matter) school, Frontier has really got its crap together.

So that's what I'm up to. This weekend should be a good one; we don't have anything major planned, but we should start packing and preparing to drive back to the midwest in a week! We can't wait!

Washington Not-So-Mutual

This past week I received a notice in the mail that a credit card I held with Washington Mutual had been closed. To quote the letter I received: "Because the account has not been used in 12 months, we assume that you no longer have need for it and have closed your account." Also, it was closed back in NOVEMBER, but they sent the notice out three weeks later. WTF?! No "If you'd like to keep it open, please do the following," or any kind of way out, just "We assume." Well, we know where that gets you!

This really burns me up because it was a card I kept for two reasons: emergencies, and also because it gave me free access to my credit score, something that's worth a considerable amount to me, especially after my laptop was stolen last year. I called to see if there was anything I could do to change it, and they said "No." So I told the customer service representative, "I know this isn't your fault and you're just doing your job, but I just want to let you know that as a loyal customer who always paid her bills on time and who kept that card for emergencies, to find out that all of a sudden I no longer have that card to rely on for emergencies, and I was given no say in the matter, is really offensive, and I hope you'll pass it on up that the customers find this to be a very shitty public-relations move. I won't be seeking another card with your company and I will recommend that others avoid it as well."

I doubt she will, and she didn't seem very concerned about my offended dignity, but at least I said my piece. And included the word "shitty" while I was at it.

Weekend Recap

It was a good weekend, though it went by too fast. I could blame that on the fact that I didn't roll out of bed until almost noon each day, courtesy of the fact that I lay sleepless until 3am both nights, compliments of having worked nights last week--but time also flies when you're having fun.

We didn't do anything exceptional, because I've been way too sleepy for that, but we did hang out and enjoy each other's company, watch the remainder of the Planet Earth series, go to the Y for the first time (!), and also make a big pot of chili last night. We started out with our basic recipe, but added jalapenos and cubano peppers, as well as a pound of ground buffalo. Why buffalo? Because it was cheaper than anything else, and is supposed to be pretty good for you, too. It turned out delicious, especially with plenty of cheese, sour cream, and crushed crackers. So good, in fact, that we each ate a huge bowl, got up to do other things, and then came back and each ate another bowl about 20 minutes later. After that, we cleaned out the fridge (or rather, Matt cleaned out the fridge while I stood back and tried not to gag--not that there was anything particularly terrible in there but it still doesn't take much) and tidied up the kitchen and bathroom before deciding that was enough to make the apartment "feel" clean. Then it was off to bed, to try to salvage some semblance of a normal schedule on which to start the week.

Today, my goals are simple: get some schoolwork done, and not fall asleep! Easier said than done in the energy-sapping weeks of the first trimester. All in all, though, I'm feeling much much better, and should soon be getting on to the fun parts of pregnancy.

On the schoolwork front, I did take a test already today, closing out Pathophysiology for the semester and leaving me with just two papers left for the term. Those are both due a week from Friday, which should theoretically leave me plenty of time if I can keep my shoulder to the wheel and just keep working.

Y Not?

We've decided to join a gym.

This is something we've never done in our life together as a couple, always preferring to utilize the many forms of free exercise out there, especially ones that doubled as transportation. And when we lived in Iowa City, we qualified (as students/employees) to work out for free at one of the gyms there. We didn't do it often, but it got us through the winter months leading up to the summer we got married.

Now, however, neither of our jobs (nor my school, which is located in Kentucky) offers workout facilities. I've accepted that it's impractical and unsafe (not to mention gravely unappealing) for me to walk or ride a mile and a half to and from work in the pitch black, which it inevitably is, regardless of which shift I work. Matt still walks to work pretty often, but that doesn't do much for me--and Matt's not the one facing an unavoidably and extensively expanding midline in the coming months, either :)

So, given the fact that health and fitness are really important to us, and we also feel like it's a priority to have activities we can do together, we've decided to join a gym. Specifically, the YMCA. Here are a few of the other perks we're excited about:

-Access to a pool and a hot tub
-A variety of classes, including yoga and aerobics and several prenatal workout classes
-The fact that the YMCA is not just a well-furnished and relatively inexpensive workout facility, but also a force of good in the community

I get 10% off my membership for working at the hospital, and a "family membership" (for any more than 1 person) is $104 a month. So we're looking at around $90 for unlimited classes and workouts for both of us, which seems pretty reasonable. At this point, we're planning to join mainly through the winter months, and then see if we want to keep it going through spring and summer, though my hunch is that we'll go back to outdoor walking and swimming by summertime. We're looking forward to getting started!

Making a Good Thing Even Better

It's hard to improve on perfection, but I decided to try. Feeling the desire to make our standby cookies a little bit more nutritionally sound, I decided to try replacing half the butter with peanut butter, to boost the protein and fiber content. We also were out of oatmeal, so I used oat bran. They turned out great--big and chewy, though for some reason the dough seemed bent on trying to spit out the chocolate chips while they baked. Whatever. Looking back through the archives, I realize they're now more like these cookies, which we also enjoyed.

What's New Here?

Not much. I'm on the home stretch in my classes, but even that is feeling like a marathon when all I feel like doing is sleeping all day. But at least the nausea is gone (for now), and this too, I suppose, shall pass.

This morning we got free bagel breakfast sandwiches courtesy of the Einstein Bros. e-club. And it only says one per customer per visit, so if we wanted to, I think we could get them every morning until they expire in 12/7. Now, we happen to be MUCH bigger fans of Bruegger's (if I had a nickel for every night shift that ended in a warm egg-and-jalapeno-cream-cheese-bagel sandwich, I'd have a big stack of nickels), but free is free, so we weren't complaining.

The only thing I WILL complain about is that it seems like every time I order something at a bagel shop, they act like I'm crazy. "Can I get an egg and cheese bagel, but instead of the cheddar, can I just get cream cheese?" "So you want cheddar AND cream cheese?" NO, hence the clever use of the word "INSTEAD"?! ...And, of course, then it comes with cheddar on it anyway. You face the same thing down at the cash register: "I got an egg and cheese." "But wait, I saw them put cream cheese on this..." "Yes, instead of the cheese." "So you got two kinds of cheese?" PEOPLE! THEY'RE BAGELS AND CREAM CHEESE! PLUS EGGS! To be fair, I used to face the exact same weirdness at Bruegger's. I don't know why it's such a difficult request!

Happy Restonversary to Us!

The end of November marks a year that we've lived in Reston--which is the longest we've ever lived anywhere: we lived at our place in Iowa City for 10 months together, the DC apartment only 4. We've weathered more challenges here in the past year than we ever could have foreseen, but we've also packed this place with more wonderful memories than I could have imagined.

And what better way to celebrate such longevity and stability than by starting a family here?