October update

It's been a long couple of weeks around here. We've temporarily relocated three times in the past two weeks (with one more final move to come next Tuesday), including for a stint of four back-to-back twelve hour shifts for me back in Reston, and that has started to take its toll on all of us--especially Eden. The past few days, she's gone from her usual happy-go-lucky self to a screaming bundle of frustration who has no tolerance for-- well, anything. We were about at the breaking point yesterday, and then suddenly today, she was back to her smiling, giggling self. The only thing I can think of to explain it is that in our desperation, we committed to getting back on track with very regular nap and bedtimes and also more primal eating (the throes of morning sickness sent me fleeing into the arms of carbohydrates, which is about all I felt like I could get down at times). Maybe it's just coincidence, but since she's already doing much better, we aren't going to argue!

Also taking its toll are things like living in an extremely small space together (though we just upgraded to a 2-bedroom cabin, which we're thrilled about--no more litterbox next to the dining room table, or peeing in a cup or frying pan rather than barge through the bedroom into the bathroom and wake the sleeping baby), having few of our belongings, my extremely erratic schedule and sometimes long hours, my fairly constant nausea/vomiting/exhaustion, and the fixedness of our budget, which means few treats or indulgences with which to blow off steam. On the other hand, I told Matt I feel a little like the Israelites complaining about always having to eat manna--back when we were praying hard for a good clinical site and an affordable place to live, we had no idea how closely our prayers would be answered. (He did point out that we're paying for our experience, rather than having it fall from the sky.) Still, it has its uncomfortable moments.

But, on the whole, we're having a pretty good time. Upgrading to a 2-bedroom has already made our living situation seem much less stressful. Eden being in a better mood today has put us in a better mood, too. And fall is coming to Lancaster County, which means cooler weather and gorgeous scenery. As you can see from the pictures below, we're managing to squeeze in some fun of various kinds.

Still, I know we're all anxious for the time when our lives will be a little more stable. When exactly that will be is another issue, since once I'm done here there are still the issues of moving back to the midwest (to yet another temporary living situation), welcoming another baby, starting up a small business, and figuring out countless other things about a brand-new life back in the midwest. However, we're thankful that we'll have lots of helping hands nearby while we feel our way and figure it out.

Reporting in from Beaver Creek...

We're settling into life in our two-room cabin, and it's going surprisingly smoothly. While we did have to pare down our belongings when we got here and send more than we'd anticipated back with my parents to our storage garage in Iowa, we've mostly got what we need here and have been pleasantly surprised at how un-crowded we feel. Our setup does pose a few challenges; for example, the bathroom is off of the bedroom, and so our choices when Eden is napping are to hold it, drive to the nearest gas station, or wake the sleeping baby (we opt for one of the former). The laundry is coin-operated, and that makes for a considerable investment in quarters when one is cloth diapering. However, Matt has solved that dilemma by bravely handwashing and hang-drying ALL of our laundry. Surprisingly, it really doesn't take much longer! The grocery shopping options are also less varied, but that mainly means that there are fewer temptations (Trader Joe's vanilla ice cream and Pound Plus Dark Chocolate come to mind)-- which is a good thing, since we're trying to make it on a $40-50/week grocery budget that includes plenty of fresh produce, grassfed meats and dairy, and pastured eggs. In the past year or so, we've come to welcome limitations as a good thing in most cases, since we aren't very capable of placing them on ourselves.

I've been to two births so far, one Amish and one non-Amish. The midwifery practice I'm precepting with has been everything I'd hoped for. The midwives are all very different from one another, and I'm excited to think of everything I can learn from them in the next several months. I finally feel like I'm going with the flow, rather than the frantic paddling upstream I've always felt when working in a hospital setting. It's amazing how good it feels--it hardly seems like work at all.

Today, the weather is in the 70s (down from the 90s for the first time since we've been here) and we started the day with a long walk past cornfields, grazing cows, Amish farms, and a one-room schoolhouse. We're planning to go to the farmer's market when Eden wakes up, and run a couple of other errands. We're really enjoying the opportunity to sever some of our previous addictions to technology--by necessity these days, we're checking our email every couple of days or so, have no opportunity to watch TV or movies, and even turn off the radio when we're in the car. While we felt a bit stir-crazy the first day or so, we're settling into a slower pace of life where basic chores like washing dishes, cooking meals, doing laundry, and taking care of Eden are our life, rather than something we have to fit in around it, and I also relish the feeling of not having to compulsively rely on something to entertain me. A couple of recent articles I've read have made me committed to slowing down and learning to actually think and read and focus again (all things that frequent exposure to glowing screens tends to disrupt), and this is certainly a great place to learn how to do that!

Packing up

It's officially less than a week until we move to Lancaster County, Pennsylvania, where I'll spend the next 4+ months catching babies and Matt and Eden will spend long, outdoorsy days getting to know our new home. We're hoping that I'll be done by Christmas, but we've learned not to count on hard and fast plans, since ours have changed so many times--yet somehow always turned out better than we'd expected.

Life is about like this right now, but sub in clinicals, working, babysitting, preparing most of our belongings to go into storage for several months, trying to figure out what to pack to live in a 2-room cabin, and taking care of an insanely active 1-year-old.

It's sad to be leaving Reston and northern Virginia, where we went from a couple to a family and shared so many unforgettable moments. Not only have we walked circles around the trails of Reston with Eden in a sling or a backpack, but she now trots along them herself--obviously a big milestone. She's a native Virginian, and it's the only home she's ever known.

We also made our first "parent friends" here--people who'd only known us as a couple and who came to see us as Eden's mom and dad. They shared the pregnancy, admired our baby, and watched her play with their own babies. Corbin, Poet, Lyon, Max, Grace, Camryn, Asher, Camden and others have been Eden's first buddies too.

It will be especially hard for me to leave my nurse friends at the hospital--but then, it always is. What was supposed to be a temporary job while I figured out what to do next has wound up being a 3-year stint where I've met some exceptionally close friends, including Eden's godmother, who have witnessed my transformation from law school dropout into mother and almost-midwife. They've cheered me on, bared their own souls, and laughed at my filthy jokes. It's been an amazing time.

What's especially hard about moving now is that there's not quite finality to it, since we aren't going from point A to point B (which is Iowa, if I haven't said it out loud yet); we're going to point A-and-a-half first, during which I'll make occasional returns to point A in order to earn a little money, so that I don't really know what will be the last time I see people and so it lacks the epic finality that it did when we pulled down the driveway to leave Iowa the last time. In a way, it's sadder, because we always knew we'd be coming back to Iowa--at least sometimes. Once we leave Virginia, though--probably not.

Happy World Breastfeeding Week/National Breastfeeding Month from Eden and me

Almond meal pancakes

This is sort of a compendium of several almond meal pancake recipes out there. Why almond meal? Because since it's made of ground nuts (specifically, almonds--skins and all) instead of grains, it's mostly protein and fat instead of mostly empty carbohydrates. You can make your own, but since trader Joe's sells it for about $3.99 a pound, we opted for ready-made. Having had experience with cooking substitutes before--especially for pancakes, having made egg-free, milk-free, and now grain-free varieties--we were surprised and delighted with how "normally" the almond meal batter behaved. Some sources say to make your pancakes small, since these don't bind quite like regular pancakes, but we made ours in a cast-iron pan and didn't have any trouble at all. We doubled the batch and ended up with about 18 medium pancakes, and had no trouble finishing them off ourselves!

Almond Meal Pancakes

3/4 cup almond meal

2 eggs

1/4 cup milk

2 Tbsp melted butter

1 tsp baking powder

Pinch of salt

Drizzle of maple syrup

Mix all ingredients together, adjusting milk amount until desired texture is achieved. Make pancakes in the usual fashion, cooking over a hot griddle until appearing dry on the top. This method does not result in the same air bubbles that "floured" recipes too, but they do puff up and get less wet on the surface so you can tell when it's time to flip.

Little sicky

Few things make you feel like a parent quite so singlehandedly as waking up to the hot gush of a child's vomit across your dozing body. Nor subsequently getting in the shower with said child to hose off at 3:00 in the morning. And especially, nothing quite like being the only person in the world that the damp, feverish little bundle wants to cling to.

Eden has the stomach flu, complete with fever. I would probably characterize it as her first real illness other than a couple bouts of the sniffles. Interestingly enough, it directly coincided with the time period where my work and clinical schedule have signaled a distinct downturn in the amount of nursing she's doing, so I'm not really surprised that she's sick for the first time. I've sorely missed the nursing, as well as her in general, so it actually felt really sweet and nice to spend all night and then the entire day with her cuddled on my chest, doing nothing but that and snuggling.

I think she's actually on the mend, since she hasn't barfed since this morning, but she's still quite clingy and hot. Bring on the snuggling and nursing.

Crispy Rosemary Chicken and Oven Fries

While we love the idea of roasting a whole chicken and using every bit of it, quite frankly more often than not we don't get around to making stock from the carcass (or we do, but it gets shelved in the freezer for months at a time), and plus, good whole chickens are not exactly inexpensive. And now that we're actively trying to prevent having a surplus of things like chicken stock in the freezer before we move, the whole-chicken option was seeming less and less attractive.

Enter chicken thighs. At Whole Foods, we can get a dozen decent-quality, skin-on (and seriously, why would you want them any other way?) chicken thighs for under $7. Looking for a way to cook them, I came across this recipe, which is deceptively simple but amazingly delicious. Of course, we make substitutions--russet potatoes for the red, dried herbs for the fresh, and I leave out the garlic powder altogether, not to mention cooking it for 20 minutes at 475 instead of an hour at 375--but I'm grateful for the basic recipe, which turned us onto something so good we now have it a couple of times a week.

One of my favorite things about this recipe is how the chicken skin slides right off like a crispy, delicious little jacket that you can pop in your mouth as soon as the chicken hits the plate. MMMMMmmmm. One of the keys to really crispy skin, I've found, is rinsing the chicken and then patting it REALLY dry (most people use a paper towel, I use a clean kitchen towel). Seriously, where have these BEEN all my life? It literally breaks my heart to think of all the amazingly tasty chicken skin that must be wasted somewhere in the interested of satisfying the demand for boneless skinless shoe leather chicken breasts. And, I've had oven fries before and found them to be lackluster (as some of the commenters do on the above recipe), but I'm now convinced that that comes from a misguided attempt at trying to minimize the fat content. Liberally drizzled with olive oil, they're tender, flavorful, and delicious.

Here's the recipe, the way that I make it:

Crispy Rosemary Chicken and Oven Fries

6 chicken thighs, rinsed and patted very dry

4 small russet potatoes, sliced in half lengthwise and then into wedges

Olive oil as needed

Sprinkling of dried rosemary

Sprinkling of dried oregano

salt and pepper to taste

Preheat the oven to 475 degrees F (190 degrees C).

Pour a little olive oil in the bottom of two 9x13 pans. Place the chicken thighs, skin side up, in one of them, and the potatoes spread out in the other. Drizzle both pans with olive oil and then sprinkle with the dried herbs, salt, and pepper. Cook approximately 20 minutes or until chicken is done and fries are cooked (cook longer for crispy fries).

Hot and sour soup

We recently ordered a batch of beef bones so that we could make nourishing bone broth, because I was starting to have trouble with my stomach again. Well, we wound up boiling the broth (rather than simmering it) and it was chalky and cloudy and we had to use this crazy method to clarify it. It worked, interestingly enough, so then we were left with several quarts of now-clarified beef broth and had to figure out the best way to use it.

We eventually decided on hot and sour soup, which we loosely based on this recipe and adjusted to our tastes, ingredients, and to fit into our mostly "primal" diet. I'm not even going to presume to give many specific ingredient amounts, because I've realized after following a lot of recipes that people's tastes and ingredients are different enough that the measures are kind of irrelevant and everybody has to adjust them anyway.

Here's how I made it:

(Primal) Hot and Sour Soup

A few Tbsp of lard, butter, oil, or other fat

1/2 chopped onion

1 lb pork of any kind, thinly sliced across the grain

Several large handfuls of thinly sliced green cabbage

A few grated carrots

A pint of sliced mushrooms

A little grated ginger and about the same amount of minced garlic

Pinch of red pepper flakes

Soy sauce

White or other vinegar

1 quart beef broth

Heat the oil in a medium to large saucepan. Saute the onions until golden brown, then add the sliced pork. Cook until opaque. Add the other vegetables in the order given, 3-5 minutes apart, giving each a chance to cook and wilt slightly. Add the ginger, garlic, and red pepper. Pour in a few glugs of soy sauce, scraping the pan to deglaze it as you do. Pour in the beef broth. Add a few splashes of vinegar until the ratio of hot to sour is right. Adjust seasonings and salt to taste.

We thought this was absolutely delicious, and are planning to make a shrimp version this weekend with the remainder of the broth. Bean sprouts (as in the original recipe) would also be delicious.

A year ago tonight...

...we were settling in for our first night as the parents of a brand-new baby.

We never could have imagined then all the immeasurable ways that Eden would change our lives for the better, and it's impossible to overstate how much richness and joy she's brought to our lives.

We love you, baby girl.

We're still here (for now)

It's been a long time since I've posted, partially because we've quickly gotten extremely busy, and partly because so many things have been happening and changing so fast that anything I'd planned to post quickly became obsolete before I got the chance.

To make a long and repetitive story short, while I have been able to start getting some GYN clinical hours done and I'm very thankful for that, a clinical site for me to do births has never really materialized in this area. The closest option was doing them at a busy hospital close to two hours away. Both in birth setting and geographic location, this was far from ideal. Going to Clinical Bound strongly reconnected me with why I went to midwifery school in the first place--practicing homebirth. Both from the perspective of providing this option to women and families AND the fact that it nourishes my own soul in a way that I don't think the alternative can. I recently went to the How to Start a Homebirth Practice seminar put on by a local midwifery practice at the annual ACNM conference, and one of the key things they said was that at a certain point, you have to decide whether you want to be a missionary or preach to the choir. Put that way, it makes it sound like there's something noble and romantic about blazing a trail--and maybe there is, but in my own practice, I've found it to be an embittering and futile exercise, full of dead ends. I've concluded that trying to provide natural birth options to women who don't especially want them and in the company of doctors and other hospital personnel who are dead set against them is at best doing no good and at worst, burning me out by spinning my wheels. (Can you smell the burnout yet? It's been lingering in my nostrils for months now.)

So anyway, as we've long admired the Amish and loved taking trips up to Lancaster County, Pennsylvania, I was beyond thrilled to find an absolutely amazing homebirth/birth center/ hospital birth practice that agreed to take me on when our lease is up at the end of the summer. Not only is it the holy grail of clinicals, since I get to learn to practice in every possible birth setting, but I'll be doing so from a group of midwives with whom I share at least a majority of philosophies. Not to mention the fact that their clientele (70% old-order Amish or Mennonite)makes *us* look like a bunch of tech-obsessed yuppies in comparison.

Matt and I have actually both found part-time jobs up there as well (farming and birth assisting at homebirths!) and so all that remains is housing. We've actually found that trickier than we thought, but we're trusting that the right thing will come up at the right time. And the plan after I'm done with clinicals (hopefully by mid-December) is to move back to Iowa--back where it all began. Ironically, we left Iowa because I decided to become a lawyer because the political climate there was so hostile to homebirth midwives. Now, we're moving back in part because the laws themselves are actually more permissive than they are in most states (it's a complicated set of circumstances), and I should be set to do what I thought I'd never be able to: help bring little Iowans into the world AT HOME. (Including, I'm sure, a few of our own.) Unlike when we considered moving back a year or so ago (you know, like when I was getting teary just because we were changing apartments), we feel like we're really on the same page about moving and that we're both ready to go. We have some wonderful friends here that we will absolutely miss like crazy (especially you, April!) and that is our one big regret about leaving. Otherwise, though, it's always been our intention for our kids to grow up close to our families (in every sense of the word). Farming on at least a small scale is also still a dream of ours, and seemingly very possible there. And being within a couple of hours of our parents and all of our siblings? Priceless.

Cheesy baked cabbage

This is the answer I came up with to life without macaroni and cheese.

Cheesy baked cabbage

1 head of cabbage, shredded
6 carrots, shredded
1 stick butter
1 block cream cheese, softened
1/2 cup whole milk
2 tsp salt
1 tsp freshly ground black pepper
1 tsp ground red pepper
12 oz sharp cheddar, shredded

Melt the butter over medium-high head in a large saucepan. Add the cabbage and carrots and cook until tender crisp, about 5 minutes. Stir in the cream cheese until melted and vegetables are well coated. Add spices and milk and stir well until creamy. Remove from heat and transfer into a buttered 4-qt or 13x9" pan. Top with shredded cheese. Bake at 450 until cheese is melted and bubbling.

I'm already thinking variations--peanut/coconut curried cabbage, ham-mush-cabbage-casserole...more to come!

As you can see, Eden is a big fan!

Electronic Fetal Monitoring: "An appallingly poor test," says maternal-fetal medicine doctor

Read why in this excellent article from the Philadelphia Inquirer. I'm not only familiar with this research, but I've seen this exact scenario played out hundreds of times during my four years as a labor nurse. Just another reason we chose (and other families are increasingly choosing) homebirth.

Sugar waxing!

As you may have noticed, we don't eat much sugar these days. However, I was able to kill two birds with one stone today, one of which was using up some of that lonely sack of sugar we've had in our cupboard for ages.

The other? My need for cheap, sustainable, and effective hair removal. As most people have probably also noticed, this isn't something I've concerned myself with at all for the past, oh, two years or so. I've been rocking out completely natural for about that long in just about every way possible.

However, sometimes circumstances (such as a sister-in-law's wedding) call for a concession to popular culture in the body-hair-removal department. So, the search was on for an appropriate message to do so.

Matt and I don't really own a razor between the two of us anymore, and I've always hated the stubble much more than just having fuzzy legs (obviously). Plus, these days everything is both expensive and ultra-disposable, and neither of those made shaving a route I wanted to take. Back in my footloose and fancy-free days, before I was a mother, I used to enjoy (OK, wrong word) a good wax--eyebrows, bikini line. The hefty price tag meant I quit that about the time we started saving up for our wedding three years ago. I've dabbled with at-home waxing kits, but they aren't especially cheap either--and I always found them rather messy and skin-irritating, and the wax was hard to get off when I was done.

ENTER SUGARING.

my sugar wax cooling in the fridge

I am really that excited about it.

There are a number of different tutorials on sugaring, but I used this one. The basic recipe is usually the same--sugar, lemon juice, water--but some, like this one, utilize cloth strips, while others require cooking the sugar to the "soft ball stage" and then just pressing on the wax itself and pulling it off. The first method seemed a little more foolproof, so it's what I went with. What I did was:

Combine 1 cup sugar, 2 T lemon juice, and 2 T water in a saucepan
Heat over medium until foamy; hold it there (without boiling over) for about 5 minutes
Pour into a heatproof vessel and refrigerate until warm and sticky (about 15-30 min)
Cut an old piece of muslin or cotton into strips
Apply the sugar wax with a spatula to the area to be waxed
Press the strip down 2-3 times with the hair growth
Holding the area taut with one hand, quickly pull the strip off with the other.

Note: I could have probably made about 1/3-1/2 as much and still had plenty to do my legs, but I'm guessing it will keep awhile in the fridge.

Here's what I love about sugaring:

1) It's incredibly cheap--I used 1 cup of sugar and 2 T of lemon juice, plus an old piece of scrap cloth, for a cost probably under $1. Compare that to the ~$60 and upwards you would pay to get your legs waxed, or the $6-10 you'd pay for a home waxing kit, and you're saving some serious money. Even compared to shaving, the weeks of hair removal I'll get from this single sugaring can't be bought for $1 if you're using conventional razors.

2) It's really effective. While there are still stubborn leftovers that require a quick pass with tweezers, this is also the case for professional waxers, who also utilize the tweezers.

See for yourself:


3) It's long-lasting. I can't say yet how long it's going to last for me, but I'd anticipate at least a few weeks, and summer will probably be over before the regrowth gets serious enough for me to contemplate doing it again. What an investment compared to shaving!

4) It's so easy, and there are absolutely zero chemicals involved.

5) I hesitate to use the word painless, but compared with threading, tweezing, and waxing, it's the least uncomfortable method I've ever used, by far.

6) It's SO EASY to rinse off! Just plain water and that's it! Compared with wax, which you have to painstakingly rub off with oil (which then gets on your clothing), this was a total revelation.

7) Unlike shaving, your hair can (and should) be really long to start with! This might be a possible con for those who like to maintain that sleek appearance, but clearly I don't--so it's perfect for someone like me!

Here are some pointers I learned while doing it:

1) The sugar solution is easier and less uncomfortable to spread on when it's warm and runny, like warmed honey. (I used a rubber kitchen scraper to spread it on, and I poured it from the stove to a Pyrex measuring cup for use.) It also doesn't seem to work as well when it starts to get cooler and stiffer. Pop it in the microwave for 10-15 seconds and it will warm right up.

2) The efficacy really depends nearly entirely on how taut you're able to pull your skin before ripping off the cloth strip. For my calf, this meant smoothing on the strip, then using one hand to grab circumferentially around my leg and pull it as tight as possible, then ripping the strip off with the other hand. With, ah, looser body parts, you're going to want a second pair of hands or likely risk some serious bruising.

3) While your legs (or whatever) will look totally hairless, they may not feel as silky as freshly shaven legs will--since it doesn't scrape the surface, there are tiny hairs that may escape the wax, and it also doesn't provide the same level of skin exfoliation that shaving does. But then again, it also doesn't provide the ensuing bumps and redness, either. I had pretty much zero redness/rash following the sugaring of both legs, which is not something I can say for shaving or waxing.

Happy sugaring!!

The summer of slaws

photo by LaCheryl

I know everybody here is familiar with our (okay, my) fondness for food themes. Hummus, soups, salads, sandwiches, quiche...it seems like not a summer, especially, can go by without one.

I've decided that this summer will be the summer of slaws. I use that term sort of loosely, but basically to encompass the non-lettuce-based, often tangy vegetable medleys we've gotten into as of late. Coleslaw is one; this cooked vegetable hash is another. I found it one day looking for a way to cook brussels sprouts. I didn't expect much, but somehow all the ingredients really came together (especially after letting them rest for about 30min, which isn't called for but made all the difference) and it was just delicious. Here's the recipe:

Brussels Sprout Hash with Caramelized Shallots

• 6 tablespoons (3/4 stick) butter, divided
• 1/2 pound shallots, thinly sliced (I used yellow onions)
  
• Coarse kosher salt
• 2 tablespoons apple cider vinegar
• 4 teaspoons sugar (I used a couple of tablespoons of honey instead)
  
• 1 1/2 pounds brussels sprouts, trimmed
• 3 tablespoons extra-virgin olive oil
• 1 cup water

Melt 3 tablespoons butter in medium skillet over medium heat. Add shallots; sprinkle with coarse kosher salt and pepper. Sauté until soft and golden, about 10 minutes. Add vinegar and sugar. Stir until brown and glazed, about 3 minutes.

Halve brussels sprouts lengthwise. Cut lengthwise into thin (1/8-inch) slices. Heat oil in large skillet over medium-high heat. Add sprouts; sprinkle with salt and pepper. Sauté until brown at edges, 6 minutes. Add 1 cup water and 3 tablespoons butter. Sauté until most of water evaporates and sprouts are tender but still bright green, 3 minutes. Add shallots; season with salt and pepper.

As I think I've mentioned before, having some kind of cooked or cold vegetable dish makes our main-dish salads feel much more filling, and this one definitely functioned that way. I think you could probably give other cruciferous vegetables (broccoli, cauliflower) a similar treatment and it would be just delicious.

The funny thing about all this is that I've never liked coleslaw, potato salad, or other vinegary things until recently. I did love things that were tart and/or sour, but unfortunately my tastes ran more toward things like cherry pie or Sour Patch Kids. Now that I've made the effort to reorient my taste buds toward things that aren't pure crap, I've found that the tanginess of vinegar is amazing in egg salad, coleslaw, or the above "hash." Something else that works well in that role? Sauerkraut. We already eat it alongside our scrambled eggs every morning, and last night we whipped up a spur-of-the-moment skillet dinner comprised of onions, mushrooms, sauerkraut, and thinly sliced hotdogs. Might sound kind of crazy, but it was delicious!

Here are some of the types of recipes I'm hoping to try out this spring and summer:

Cabbage and lime salad with roasted peanuts

Broccoli slaw

Blue cheese coleslaw (scroll down)

Asparagus, peas, and radishes with fresh tarragon

And friends of ours introduced us to a wonderful corn, avocado, and shallot salad which is held together by sour cream and a little lime juice, and which never lasts long around here. We plan on making it at least once a week!

We're back!

Our trip to Kentucky was absolutely fantastic. While there was more screaming in the car than we'd like to have had (including an especially gut-wrenching hour and a half at the end of the trip home, following 8 hours of angelic behavior, and occurring prior to getting home and realizing we didn't have our keys, a long story I'll not revisit heere)--on the whole, the trip was wonderful and relaxing. I met up with an old (well, 1.5 years, since Frontier Bound) friend and made a great new one, and laughed more and harder than I have in years. Matt and Eden spent many hours together tromping up and down a mountain and through the woods, and we were able to eat three meals a day together (despite bringing much of our own food, we were actually impressed with the Frontier spread most days--seems as though there are a lot of people not eating gluten these days, so protein and fresh fruit and vegetables abounded) and spend most evenings together, too. It was nice to get away and enjoy such a beautiful setting for awhile. And last but not least, in terms of midwifery, Clinical Bound was, like Frontier Bound, incredibly inspiring. I learned a ton, and came back recharged.

Which is good, because I'll need it. The next few months might be somewhat grueling as I attempt to work and do clinicals and Matt leaves his job and we start providing childcare for a friend's baby. It's going to be a number of enormous changes in routine for all of us, and with that will almost certainly come stress. This is compounded by the fact that we STILL don't have a clear idea of where we're ultimately meant to live, or what exactly we're meant to do. We're trying to hang onto our faith, though, that if we just take it one day at a time, we'll eventually figure it out.

Freebies & hitting the road

We're getting ready to head out tomorrow on the closest thing we've taken to a family vacation-- driving down to Frontier in Kentucky for a week while I attend hands-on skills training prior to starting clinicals. (Oh, how it seemed this day would never come.) Since Eden is still mainly breastfeeding, she and Matt are coming along and we're making it a family affair! We're also planning to camp one night after we leave Frontier--either in the Smoky Mountains or Cumberland Gap, depending on how the whim strikes us after we leave!

Our changes in eating habits are still going along quite successfully--Matt's lost 15 lbs, and I've lost an additional 10 in the past few weeks; for comparison, it took me four months of counting calories and exercising daily to lose the first 10. We're feeling great, our grocery bill has actually shrunk, and we're looking forward to the farmer's market opening next month--at that point, we should be able to get almost all of our food either from there or the local farmer where we get our meat, milk, and eggs. We're also now eating in a way that could essentially be feasible if we were growing/raising our own food, which is a major long-term goal.

At this point, we've sort of transitioned from the GAPS diet--emphasis on bone broths, tight dietary restrictions--to the Primal Diet. I like the Primal Diet for maintenance because it offers pretty logical algorithms for eating--basically, eat like a caveman--versus the GAPS diet, which is a little bit more arbitrary (not that it isn't based on science, but it requires memorizing more than reasoning). From the site Mark's Primal Blueprint, here's somewhat of a breakdown:

Is it Primal?

You know the basics: Lean meats and vegetables are healthy, grains and sugars should be avoided. But what about everything else?

• Eggs – Yes (even raw eggs? Why not.)
• Nuts – Yes (Almonds, Walnuts, Soaking Seeds & Nuts)
• Seeds – Yes
• Coconut – Yes, in every way, shape, and form
• Coffee/Tea – Yes
• Whole Grains, Oatmeal, Brown Rice – No
• Beans & Legumes – No
• Dark Chocolate – Occasionally
• Red Wine – Occasionally
• Artificial Sweeteners – Not really, but not terrible [we don't eat these]
  
• Cheese – Not officially, but…
• Soy and Whey and Protein Powders – Depends [we don't eat these either]
  
• Chewing Gum – Depends

Here you can read about how this diet works for weight loss, effortless weight maintenance, and why the Food Pyramid results in an average weight gain of 1.5lbs/year for each American. (Hint: it's the 6-11 servings of grains!)

In that spirit, it's somewhat of a bummer that we won't be able to take advantage of many of the Tax Day Freebies--Cinnabon, ice cream--being offered tomorrow, but on the other hand, we look at that as a very good thing. We know our bodies will thank us for it! And,while we've mostly given up on coffee, even decaf, we do partake occasionally as a treat if it's free. And it's certainly a good time for that: we recently got two free cups from Corner Bakery (ongoing), we're going to Whole Foods (good April 14) later today, and are planning to hit several Starbucks (April 15 only if you bring your own reusable mug) on our trip tomorrow.

We'll be back in just over a week!

How are we doing?

I mentioned in this post a few weeks ago my goals for "spring cleaning" my/our lifestyle. One of the major changes we've made lately is to follow a restricted GAPS-style diet in an effort to jump-start our gut flora. (You can read more about the GAPS diet here, and the importance of healthy gut flora.) What does this look like on a day-to-day basis? Matt's following it more strictly than I am, but here's what we're eating now:

Breakfast:
Scrambled eggs (usually 3 each) topped with a pat of butter. Yum!
Tea

Lunch:
Me: Smoothie with homemade yogurt, frozen fruit, sometimes a cooked carrot or two, and coconut milk (for healthy saturated fat)

Matt: salad and a cup of homemade (chicken or beef) broth

Dinner:
Salad and broth, sometimes some kind of meat or eggs

We've also got probiotic capsules on the way (Bio-Kult) and will be introducing those soon.

We've both been amazed at how eliminating simple carbs and gluten have broken food's addictive hold on both of us. We'd heard people talk about how this way of eating actually made them more satisfied and less hungry, but it's hard to imagine for a couple of chowhounds like us (who really need something this restrictive or else we just give up and splurge). We do get hungry sometimes, but we're more able to make good choices about how to handle it, vs plowing through anything and everything that's available. We've each dropped several pounds and are feeling leaner and more in control. It's a good feeling!

We've also been hitting up the library frequently and I'm happy to report that I've already finished a book for March (The Mood Cure, which I found very interesting and a wonderful easy-to-understand resource on mood chemistry). I'm currently working through Nine Parts of Desire: The Hidden World of Islamic Women and The Politics of Birth, and Matt and I are reading Bill Bryson's (very funny) The Life and Times of the Thunderbolt Kid aloud. As you may recall, we did the same thing with some of his other books and enjoyed that immensely as well. As a result of our rekindled interest in reading, Food, Inc. has been sitting on top of our TV for several days, but that's not necessarily a bad thing.

NIH panel on VBAC, or: Give me liberty

Recently the National Institutes of Health convened a panel to examine the "issue" of vaginal birth after Cesarean (VBAC). Evidence was reviewed, testimonies heard, and a consensus statement released.

While cautiously optimistic that the issue was being reviewed at all, birth advocates had reasons to be concerned.

First, in 2006, a similar panel convened regarding the issue of Cesarean delivery on maternal request (CDMR). What they found was that there was "inadequate evidence to recommend for or against." Which is ridiculous, really, given that the risks of Cesarean to mother and baby are well documented, and they become even clearer particularly when there's not a potential medical indication and therefore benefit (such as resolving fetal distress, interrupting an obstructed labor, etc). So basically, they treated a natural process as having no greater weight than a surgical one and so came out stating that the scales were balanced. The ridiculous presumptiousness of assuming that they know everything there is to know about human labor and birth, that its impact on mother and baby and family and society at the time of birth and forever after is able to be scientifically measured and accounted for--and that even if it were, that the choice is theirs to make-- is outweighed only by the fact that in the case of debating VBAC, vaginal birth (which will happen, come hell or high water, as the natural end of a full-term pregnancy) is treated as the "intervention," something to be "done" as that which needs to be justified, while surgical delivery is treated as the control--the status quo, the "innocent until proven guilty." You can read more on the limitations of that panel's decision here.

Anyway. Henci Goer very cogently articulated the concerns going into the VBAC panel here. The Unnecessarean takes up the other end by articulating the concerns coming out of it. Both are very much worth reading, as are the comments; they contain a good deal of backstory on the lengths that doctors and courts are willing to go to in order to maintain control over birthing women's choices (some particularly sickening facts of court-ordered Cesarean cases, in paritcular), and one commenter shares the following quote from Sheila Kitzinger:

No one would deny that each infant and particularly every maternal death is tragedy to be prevented if at all possible, nor that modern obstetric care, which has developed in the hospital setting, has been at least partly responsible for the dramatic decrease in both maternal and peri-natal mortality over the past half century. But it is not necessarily perverse to question whether our present priority should be to reach minimum figures for peri-natal mortality at any price when this includes giving up things which free human beings have often felt to be more important than their own survival- such as freedom to live their own lives their own way and to make individual choices in line with their own sense of values.

Living out here as we do, in Virginia--home of liberty and rebellion in two major wars, the Revolutionary and the Civil War (not to wander too off-topic, but we recently watched Gettysburg and I was amazed to realize that far from what I learned in history, the Civil War was not about "OMG The South is racist," because the north was, too; it was about whether or not the states had the right to withdraw from a federal government making decisions they didn't feel were in their best interest. I'm inclined to believe that the founders intended that they SHOULD have this right, and so the whole outcome, viewed through that light, feels completely different to me) --I'm struck by the fact that this is exactly what "Give me liberty or give me death" MEANS. It doesn't have to mean death at the hands of the British army--it might mean facing down the (albeit very small) risk of a uterine rupture. Or the right to refuse chemotherapy. Or drink raw milk, or refuse vaccination. People have chosen the risks of freedom over the "safety" of relative captivity here for a long time ("ships are safe in harbor, but that's not what ships are for"), and parents have long been accepted as the proxy decisionmakers for their children, able to elect for one or the other on behalf of those too young to make the decision themselves, but this right is quickly being eroded, now beginning before birth.

So basically, while a small battle or two was somewhat won (recommending that ACOG drop its strict recommendation that only facilities with "immediately available" operating room personnel "perform" VBAC), the war (having any power to compel them to do so, plus the greater--central-- issue of a pregnant woman's right to what essentially amounts to constitutional personhood and self-determination--ie, informed refusal of surgery without regard to whether her physician "feels she is a good candidate") was not.

So. Henci Goer's signature line contains the quote below, which sums up the reaction to this latest news:

“You are not required to complete the work, nor are you free to cease from it.”
Pirke Avot 3:18

Let the work go forward.

Thanks for nursing

I casually joined the Facebook group "If breastfeeding offends you, put a blanket over YOUR head" some time ago. I only recently learned of the companion blog. They are currently featuring the above printable cards, which I think are completely awesome. I will probably print some out to have on hand, even though I think I have only seen someone else breastfeeding in public ONE TIME. Oh, well--it never hurts to be prepared.

What should you do if you come across a nursing mother and you don't have one of these at the ready? Make eye contact and smile at her. That's all. Don't: a) stare, b) grimace, c) say something rude, or d) hastily avoid eye contact and shield your children's/husband's eyes like you've just caught her urinating.

If all else fails--just ACT NORMAL. There's a crazy thought, huh?

Spring goals

One thing I meant to talk more about in my last post was cutting down not just on coffee, but on a variety of other substances that I find to be rather addictive. They're nothing earth-shattering; sugar is one, BAKED GOODS are another. Someone brought banana bread in to work the other weekend and I wound up polishing off half the loaf, knowing while I was doing so that it wasn't what I wanted to be doing. Even decaf coffee kind of functions that way--I find myself downing it mindlessly, then craving more. Whereas when I drink tea in the morning, it's more like "That was nice, now I'm done." There's a certain kind of reaction I have to particular things that keeps me from making level-headed decisions about them. Television and the internet are another. The kind of slothful, bloated, I-know-I-should-get-up-or-do-something-different-but-I-can't-make-myself feeling that I really don't care for. I love spontaneity, but there's something to be said for intentionality as well.

The antidotes? Again, nothing mind-blowing. Eating "decent food" that lacks such a strong binge potential. (Generally easy for me at home, where I plan the meals; much harder when I'm somewhere else with unlimited junk food!) Going to bed early (staying up late--another addictive practice) and even a little hungry now and then. Getting plenty of activity and exercise. Sticking to a routine and keeping the apartment as neat as I can. I'm happy to say that I'm back to my pre-pregnancy weight, but in a way, that's removed my impetus to exercise. I'm happiest and most energetic when I do, though, so I need to find a way to keep that up. I'm trying to spend less time on my computer in the evenings, since school means I spend a lot of time that way during the day.

Another way to engage in the real world in a mindful way is by reading actual BOOKS (and magazines). Even most of my course readings these days are online, and so actually holding a book and turning the pages are activities that have threatened to become obsolete for me. I've found this tends to make me rush, feel a little bit hyper, skimming to get through something versus reading it in order to know it or enjoy it. I see this tendency in myself and I don't like it. So I'm making an effort to check out books from the library, and I've actually changed two online subscriptions (great for reducing clutter and waste, but somehow not as satisfying or durable) to print (Mothering magazine and Midwifery Today).

Luckily, spring is coming and I'm also on break from school, so it should afford me some good chances to continue to energize my routine and myself. I've always liked doing seasonal rather than just new year's goals too, so in honor of the warmer weather, here are my spring goals:

1) Keep exercising 5 days a week
2) Go to bed before 10 and get up before 6:30
3) Keep tracking calories with The Daily Plate and avoiding addictive triggers like coffee, sugar, and baked goods
4) Stay off the computer in the evening
5) Read a book a month

Let's see how I do!

Slump lifted.

I'm pleased to say I pulled out of the slump I was in a few days ago. I let myself slump for the rest of that afternoon, then started strategizing about how to fix it.

One thing was setting a couple of concrete goals for the next day: I WOULD get up when my alarm went off, and go work out. I WOULD finish the chapter of notes I was working on. Taking "do I feel like it?" out of the equation seemed to help, and I did, in fact, do those things. And those successes gave me a boosts in other areas.

Another element was analyzing where my energy drains were coming from. One was getting lax about bedtime. For awhile I was pretty consistently going to bed before 10pm. Then I started picking up more evening shifts, staying up later, sleeping in later, then staying up later, etc. I'm working on that.

The other was caffeine. Matt and I switched back to caffeinated coffee around the time I went back to work, because I was up late working until 1 or 2am many evenings. One cup turned into two, turned into a couple of cups in the afternoon, until we were making a whole pot and drinking it every day (sometimes more). We figured out that at our peak, I was drinking around 6 cups a day and Matt was drinking closer to 10. I told him I remembered how after Eden was born, even though I wasn't sleeping much, I still had a ton of energy. I told him that I haven't felt like that for awhile.

The first day was hard. Talk about a slump. I oozed around the apartment with a throbbing headache and zero energy. Day 2 (yesterday) was better. Day 3 (today), I again have a headache, but my energy level is coming up again. I'm optimistic it will get even better.

So what do we drink in the morning? We started with tea (herbal or decaf), which is warm and tasty, but recently we stumbled onto Vanilla Steamers, and boy, are they good. A cup of warm milk, an egg yolk, a splash of vanilla, a sprinkling of cinnamon, and just a little maple syrup. It's like hot chocolate, but vanilla. Kind of like warm eggnog. Creamy, dreamy, nourishing, and filling, I think they're better than coffee. Even better still? We can also drink them before bed. Eden is a big fan, too!

Visit from Grandma Mary

We had a great time with Matt's mom this past weekend. The hardest thing about living out here is being so far from our families, but we're always so excited when they come to visit, and we were happy to see that Eden had no trouble remembering who she was and having a great time with her!

The last few days have found it really hard for me to concentrate on schoolwork. I don't know why. Remarkably, I have felt able to get things done around the house (which is a blessing, since one of our cats has been throwing up on the carpet after each feeding, and today while I cleaned that up, Eden found my full cup of coffee and "sent it sailing," as my mother would say, further adorning our cream-colored living room rug). It's just when I try to sit and get work done that I feel antsy. Probably some senioritis, since this is my last term of only classes; probably some spring fever; and probably some of the inertia that comes with being just past the middle of the term.

So I'm set to start clinicals in May. Here in Virginia. Our plans have changed about this so many times that I don't even know where to start. At the beginning of this year, we thought we felt the call to move back to Iowa, stay with my parents, and do my clinicals there. While part of me was brokenhearted to leave Virginia, part of me was thrilled to move back closer to our families, and almost all of me was thrilled to finally have things settled. A few weeks into it, however, one of my sites dried up and the other became...less than enthusiastic. The logistics of melding our household (two adults, a baby, and two cats) with my parents' (three adults, two to three dogs, and a business) started to seem increasingly difficult. Jobs did not appear promising. Finances began to look daunting. The final straw was finding out that despite the fact that I'm scheduled to attend Frontier's weeklong clinical preparation session (known as Clinical Bound) in April, if I didn't start clinicals within 16 weeks, I'd be required to repeat it (not easy or cheap). Getting started--and, of course, also finished--sooner started to seem like an imperative.

Making phone calls to find a preceptor around here didn't go much better this time than it had the first, but I did find a place doing office visits with a women's health nurse practitioner (allowed for certain elements of clinicals if a CNM can't be found) I know, and I'm thrilled about that. A close friend has agreed to watch Eden one day a week, so I'll know she's in good hands, not have to be away from her too much (other sites I'd talked to wanted me there full time), and still be able to work. Matt will be able to keep his job into the summer and so our finances should be all right. I've found a hospital in Maryland where I can start doing births starting in September, and from what I can tell, I should be able to finish up around December. That's a nice idea.

It's frustrating not to know what we'll be up to after that, but we're trying to resign ourselves to it. Every time we've tried to plan ahead, we've been brought back firmly in check by a change in circumstances. Evidently we're meant to live one day at a time, quite literally. This has put a strain on us, and our families and friends, but we're doing our best to deal with it.

I've been thinking lately about our diet. While overall it's quite good, I daresay better than most, it isn't perfect. We each have our own chronic health concerns that are not entirely resolved, and having Eden start eating table foods versus just effortlessly receiving perfect nutrition we don't have to think about has made me want to give her the very best start I can. Things like the GAPS program or the Maker's Diet seem to make intuitive sense to me, but we haven't figured out anything definitive yet. More on that journey yet to come.

Here's what's going on out here...

My "duh" file is getting full: Cesareans increasing, more women dying

photo by aka Quique

An increase in the number of (unnecessary) Cesareans means more women are dying, unnecessarily. Like so many other facts of modern life (don't get me started), a lot of people would like to see this information suppressed or distorted. But there it is. A striking quote from the study of maternal deaths in California: the current trend represents “the most significant spike in pregnancy-related deaths since the 1930s…it’s more dangerous to give birth in California than it is in Kuwait or Bosnia.” Don't think the problem is just California--they're just the first ones to be honest about it.

So much for the lifesaving benefits of modern medicine, so frequently touted when the safety of homebirth is questioned, as it often is in the media these days.

Kind of makes that live elective C-section on the Today show (the one the doctor characterized as "orderly, routine and scheduled for this timeframe, just the way these are supposed to go...as happens at countless hospitals all over the country,"--indeed) seem a little in poor taste. The doctor in this case notes that the Cesarean was scheduled--mind you, with no "trial of labor" first--"because in both of their families, babies run big and she was past her due date and those are two indications that a cesarean section is a lot safer than having a vaginal delivery."

I'm sorry, what?! With countless increased risks of morbidity and mortality to both mother and baby, there are VERY few situations in which a SCHEDULED ELECTIVE PRIMARY CESAREAN TO A HEALTHY WOMAN CARRYING A HEALTHY FETUS is "a lot safer than a vaginal delivery." As a matter of fact, her own professional organization notes that "the evidence does not support prophylactic [ie scheduled] Cesarean delivery for suspected macrosomia [large baby]," and studies have estimated that it would require over 1,000 such Cesareans to prevent one permanent birth injury (generally the concern over giving birth vaginally to a large baby). Even more sobering, if such a policy of rampant unnecessary Cesareans were enacted, for every 3.2 brachial plexus injuries (the most common birth injury, a kind of nerve damage to the arm) prevented, one maternal death would occur due to the complications of Cesarean. And I don't think there is a professional out there who could give you any kind of support for the statement that going past a woman's due date (or guess date, as it is sometimes known--because the 40-week mark is simply the midpoint in the normal "due month," which encompasses full-term deliveries anywhere from 38 to 42 weeks) is an indication for scheduled Cesarean.

Bad, bad medicine. And women are dying, literally, to bear it out. It makes me want to scream.

Meredith Viera (who gaily tells the woman that SHE had a Cesarean and so knows that she'll be "on her feet in no time") notes toward the end of the show, "They chose the right way to deliver, that’s sure… by c-section."

I'm sure glad I chose the WRONG way to deliver my 10-lb (2-oz) baby--one that isn't contributing to the rising toll of dying mothers.

Saturated fat: Does a body good

photo by Vicious Bits

First BPA, and now it gets even better. We'll just call this the winter of our vindication.

As evidenced by our shift to a diet heavy in cream, lard, butter, cheese, half-and-half, and whole milk, we came to disbelieve the association between saturated fat and heart disease awhile ago. Up until now, despite the fact that the science said otherwise, this mentality was considered pretty out-there and fringe-y (mainly because nobody was looking at the science, just parroting what they were paid to say by special-interest groups). Well, this morning at the gym I saw on the news that the mainstream media has finally picked up on the fact that studies have shown that there is NOT a link between saturated fat intake and heart disease. While "scientists" still rush to tell people to "increase their intake of vegetable oils," nonetheless, at least the beginnings of the truth have been sounded.

Food Renegade is one of my favorite health writers, and she explains here and here and here why the "low-fat (especially low saturated fat) = healthy" mantra is a myth. While the media hasn't yet gotten this far, the next step in all this is to understand why high cholesterol doesn't "cause" heart disease--AKA the "lipid hypothesis." You can go here to read one researcher's explanation--that cholesterol IS present in the arteries of people with heart disease, but only in the same way that firefighters tend to be present at fires. As she puts it, it would be ridiculous to blame the firefighters for starting fires simply because they always show up there! Instead, the role of cholesterol in repairing inflammation (caused largely by sugar and free radicals) explains why high levels of lipids are found in those with damaged arteries. It also explains why drugs like statins lower cholesterol, but not mortality. And, it explains why so many people's ancestors, like mine, lived to a ripe old age "despite (as doctors would have us believe) eating eggs every day, spreading lard on their toast, etc etc. In fact, it turns out that those humble, traditional foods are probably the exact reason WHY they lived to a sharp, active old age.

For me, seeing this on TV this morning was especially timely because our hospital's health fair is today and I was planning to pop by after the gym to get my cholesterol, blood pressure, and blood sugar checked. (Being part of a sea of people, with easy access to a number of exit points, is about as close as I like to get to the medical establishment.) I was practically jumping up and down with anticipation to see what the numbers would be, given my switch in the past few years from a lower-fat, vegetarian diet to a traditionally-based one that includes a lot of saturated fat.

Total cholesterol: 162
(Ideal: less than 200)

HDL ("good" cholesterol): 56
(Ideal: greater than 50)

LDL ("bad" cholesterol): 2.9
(Ideal: less than 3.5)

My random blood sugar was 86 (ideal: 70-14), reassuring given that I could be considered at high risk of diabetes based on my chunker of a baby. And finally, I was pleased to see that my blood pressure was normal because it has been elevated in the past (during nursing school, for example) and high blood pressure runs in my family. However, I was not surprised to see that it had normalized, as we have recently become believers in some of John Sarno's theories about psychosomatic links to pain, chronic illness, and hypertension, and feel that exposure to his work has helped us become healthier than ever. As was long the case for the contention that saturated fat does not lead to heart disease, Sarno's work has yet to be accepted by mainstream medicine--but to us, that's just one more reason to give it a closer look.