Thursday, July 13, 2017

Review: The Pediatrician's Guide to Feeding Babies & Toddlers

Many parents don’t realize just how complicated feeding young kids can be until they have a baby of their own. When should babies start solid foods? What are the best early foods? How do we minimize the risk of developing allergies?

pediatricians guide to feeding babies

These questions and many more are answered in The Pediatrician’s Guide to Feeding Babies & Toddlers, a compact guidebook written by a team headed by Anthony Porto and featuring pediatricians, dietitians, a lactation consultant, and a recipe developer.

This friendly, well-written book is divided into six main sections. The first five sections focus on particular time frames of child development0-3 months, 4-6 months, 7-8 months, 9-12 months, and toddlerswhile the sixth condenses many common medical concerns and questions into one concise chapter. Each developmental section talks about the basics of physical and cognitive development, answers some pointed questions, and gives guidelines for how much babies are generally eating. Each also offers a selection of recipes perfect for growing babies (or, in the case of the first section, perfect for lactating mamas and sleep-deprived new parents).

The first section, which focuses on the first three months, discusses both breastfeeding and formula-feeding relatively in-depth. While the authors make no secret of the fact that breastfeeding is the best option when possible, they also provide plenty of unbiased, non-judgmental information about using formula for families who need or choose to use it.

The second section is all about early solids, while the next few walk parents through the various stages of purees and finger foods that follow. While a number of readers will disagree with the book’s taciturn acceptance of starting solids as early as at four months old, this section and the ones following it are, overall, a well-balanced approach to the standard method of introducing a baby to solid foods. Parents will get advice on different stages of purees, including advice on making them at home, and every possible question is answered, including how to introduce them, what to look for when it comes to allergies, and even avoiding choking.

There is solid and standard nutritional information throughout, including nutrient guidelines and calories. Parents will love the recipes, which include simple single foods, intriguing blends, finger foods, and dishes for toddlers that the whole family will find themselves enjoying. These aren’t bland foods, either; the recipes are rich in complex flavors and spices that will get youngsters excited about “real” foods.

The final section really tackles the biggest medical concerns. While some of this information is discussed to varying degrees in other sections, parents who want to know more about constipation, eosinophilic esophagitis, reflux, celiac disease and gluten intolerance, allergies, and more will find their answers right here. There are also growth chartsboth CDC and WHOreference charts for avoiding allergies, and tables listing the RDAs of various nutrients for the different age groups.

There are some other elements of this book that some readers may disagree with, such as authors’ discomfort with baby-led weaning, their advice to seek a nutritionist before raising baby on “special” diets such as vegetarianism or paleo, and their stock-standard advice to start baby off with grains like oatmeal or rice, which many in natural parenting circles feel is harmful to the developing gut. Other readers may feel that a book like this only encourages the paranoia that for many surrounds baby feeding; introducing a baby to solids doesn’t need to be this complicated!

Still, the fact is that most parents do have a lot of questions about how to get their baby started with “real” foods, and The Pediatrician’s Guide to Feeding Babies & Toddlers does an admirable job of coming to the rescue. Readers will be reassured by the wide range of experience of the authorsall of whom are parents, tooand will enjoy the friendly tone and straightforward information. This is a practical book that many will learn a lot from.

*****

I received this book from Blogging for Books in exchange for an honest review. The opinions expressed within are completely my own.

Monday, June 12, 2017

An Rh Sensitized Pregnancy: Aftermath (Part 5)

At the end of it all, after all my worries about induction and further transfusions, my baby was born normally. Naturally. Spontaneously. (Well, mostly. I did have a membrane sweep.)

And four days prematurely.

After my son's birth, he spent some time with me, then was ultimately taken to the NICU. He was more or less fine at birth--clearly not anemic, no signs of shock, dealing great with the transition to being in the outside world. But because of my Rh sensitization, he would need monitoring for awhile.


Much of the next few days was a blur. I was recovering from birth, but despite my exhaustion, I barely slept that first night. Even without my baby in my arms, I was feeling the birth high! I eventually slept, but roused myself to use the breast pump every three hours or so. (I was determined to breastfeed! And determined that my baby would not drink a single drop of formula.) I visited the NICU frequently to see my little guy, and tried to nurse every time I was there.I slept as I could, and while I was sore, I never really needed pain medication of any kind.

I stayed in the hospital for two days, eating mediocre hospital food (although they get bonus points for having vegan options beyond side dishes!) and pumping and shuffling back and forth from the NICU to my lonely little room.

Coconut Baby, meanwhile, was in the NICU. Initial tests had shown his red blood cell count to be within the normal range, so he was definitely not anemic. His blood sugar was fine, although that'd be monitored for awhile due to my gestational diabetes diagnosis. Baby did, however, have an unknown quantity of my antibodies floating around in his system, and they were breaking down his cells at a faster than normal rate. The result? Jaundice. Baby's bilirubin count was very elevated, and still going up. At some point when I arrived for a visit in the NICU, he had been put on phototherapy, with two big sets of bili lights shining on him from above and a lighted blanket down underneath.

He had blood tests twice a day, to monitor his bilirubin level and RBC, as well as his blood sugar. He had to wear a little mask to protect his eyes from the phototherapy lights. He had an umbilical IV and a feeding tube, although for the first few days they switched him to IV nutrients (as opposed to my milk; instead, I steadily built up a stash of pumped liquid gold in the NICU fridge). He was so tiny, and there were so many wires attached to him, although I recognize that many NICU babies fared far worse. He was very sleepy, from the combination of being newborn, slightly premature, and jaundiced, but aside from that, he was doing well. Breathing fine, no temperature problems, no heart issues. I was barely allowed to hold him; he needed to stay under the lights.


I only got to spend two nights in the hospital, and after that I was forced to spend the better part of every day away from my new little squish. Although I tried to take the opportunity to enjoy being with my older boy, my heart felt torn in half. I continued pumping every three hours, and every day when I visited the NICU I brought all the milk I had made. Baby kept getting blood tests, kept receiving phototherapy. I tried to nurse when I was there, and he received my milk in bottles when I was at home. His bilirubin remained high, and the doctors warned us were were edging toward baby needing a transfusion after all. But instead of just giving him blood--he wasn't anemic, after all--they'd be doing an exchange transfusion. Essentially, the idea would be to swap out most or all of his blood for fresh blood, blood that didn't contain my antibodies.

It was a terrifying prospect.

Instead, we authorized the doctors to give him a dose of IVIg (intravenous immunoglobulin), which would help protect Coconut's red blood cells from my antibodies; this, in essence, would slow the breakdown of the excess cells, hopefully either lowering his bilirubin count or at least leveling it out for awhile so his body could have time to catch up with the load.We were told that IVIg is normally not particularly effective in cases of Rh disease, but that it was certainly worth a try. Anything to try to avoid an exchange transfusion.

Thankfully, it worked. Coconut's bilirubin dropped dramatically after he received the course of IVIg. He still had to stay on phototherapy, but they were able to remove one of the banks of lights. A few days later, we authorized a second dose of IVIg, which further helped his body get on top of things.

Finally, after eleven days in the NICU, Coconut was allowed to come home with us. The monitoring wasn't over just yet, though. He needed a blood test three days later, and then another four days after that. We continued doing weekly blood tests for weeks, monitoring his bilirubin (to ensure it kept dropping), his red blood cell count (to ensure it didn't drop), and his reticulocyte level (which was an indication of how quickly his body was producing new red blood cells). Those days were the worst part of Coconut's week; he hated the heel pricks (who could blame him?), not to mention getting his blood pressure checked and all of his other vitals taken.


Finally, though, when he was approximately six weeks old, the doctors released him. Officially. Bilirubin was nice and low, indicating that his body was able to handle it on its own. Red blood cell count was up, indicating that my antibodies were leaving his system. Reticulocyte count was way up, indicating that his body was finally making plenty of new red blood cells.

Six weeks after birth, my baby was finally free of the effects of my Rh sensitization.

In the end, I feel like I was really quite prepared for the issues I encountered during the pregnancy itself, although the reality of the blood transfusions was far more intense than I had thought they would be. Where I felt unprepared was when it came to the aftermath. No one had really warned me of the issues we'd be dealing with after birth; I had naively believed that once baby was born, he might need a transfusion if he was anemic but that would be that. I hadn't realized that jaundice was a major concern. No one told me my antibodies could linger in his system for up to three or four months. I was unprepared for the frequent, heartwrenching blood tests, or the reality of having a NICU baby.


We got through it, though. It was so much harder than I expected, but it was quite worth it in the end. Of course! Being Rh sensitized made for, quite frankly, a pretty awful pregnancy and birth experience. Thank goodness for the modern medical procedures that enabled this baby to come into the world and into my arms.

***

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Sunday, April 30, 2017

The Birth of Coconut Baby

When I was just past the 36 week mark, I saw my doctor for my final prenatal appointment.

Of course, I didn't know at the time that it was going to be the last one!


As has been par for the course in this pregnancy, I had an ultrasound first. Well, technically I had a biophysical profile, since it was followed up with a nonstress test. I wasn't expecting that, but as with so many things this pregnancy, I didn't question the necessity. I was high risk and in my final month, after all; if my doctor thought a nonstress test was needed, then I was just going to go with it. Besides, I'd already spent so many hours on the fetal monitors that twenty more minutes didn't even faze me.

Unfortunately, this particular ultrasound was not reassuring. Despite the fact that it'd been only about two weeks since my baby's last blood transfusion--a big one, and which we were hoping would indeed be the last intrauterine transfusion--baby's MCA reading (the measurement of how fast the blood was flowing in one of the arteries in the brain, which can be an marker for fetal anemia) was showing high. Not dangerously high, but much higher than my doctor wanted to see, especially so soon after a transfusion.

We did the rest of my appointment, and my doctor asked me to come back again on Friday for a follow-up ultrasound. We had already scheduled an induction for a few weeks away, aiming to get baby out around the 38/39 week mark (which is when they estimated another transfusion would be necessary), but my doctor warned me that the high MCA reading meant we'd be moving the induction forward by at least a week. Depending on how the ultrasound looked on Friday, we might need to induce that very day.

This obviously was not what any of us wanted, but I know how bad anemia can be for a baby, so I readily agreed. We'd hope for the best on Friday, and plan for induction the following week. I told my husband and he told his job, and we all planned as best we could.

I then asked my doctor if we could sweep my membranes at my next regular appointment. In case you've never heard the term before, a membrane sweep involves a doctor (or midwife) doing a cervical exam, and then if conditions look favorable (meaning, a certain amount of dilation has already occurred and the cervix is already somewhat effaced), gently lifting the amniotic sac away from the cervix. If the body is close to being ready to go into labor, this can sometimes kick things into gear. At the very least, we were hoping to encourage my body to keep making the hormones that would continue to thin my cervix out so that induction would be more likely to be successful.

My doctor agreed that it sounded like a good idea. "I can sweep them today if you want," she offered. And so she did.

Neither of us expected it to actually work, though!

The sweep itself didn't hurt at all, which I was a bit worried about. It was uncomfortable, sure; cervical exams always are. But it didn't hurt. Before I left her office, my doctor warned me that I might experience some spotting, and that some crampy feelings were normal after a sweep. So I didn't think anything of it when I did indeed find a bit of bloody discharge, or when I noticed cramps during my middle-of-the-night bathroom runs. It felt like menstrual cramps, exactly what I was expecting based on what I'd read.

The cramps did get a little worse as the night progressed, but they were nowhere close to bad. Certainly not anything I couldn't sleep through. They didn't feel like labor contractions. It was just the sweep, that's all.

Sometime the next morning, they did start feeling a bit more like contractions. Similar to my first birth, I at first assumed that I was finally feeling the Braxton Hicks contractions. After all, I had been having them for weeks. Regularly. They had caused problems leading up to the last cordocentesis and transfusion, after all; they'd been so regular that the doctors had put me on magnesium sulfate to try to slow them down (but to no avail). So surely that's all these contractions were. I was finally starting to feel them.

...Or maybe it was early labor?

A few hours later, I lost part of my mucous plug. It was at that point that I started to take things seriously.

My contractions started to get a little more uncomfortable. Still nothing I couldn't function through. I took my older child to swim class, where I found myself swaying my hips through the contractions. I was still able to drive, but sitting still was getting a bit uncomfortable.

I downloaded a contraction timer app to my phone. Bug and I went home to have lunch, and the contractions were getting worse. When I finally started timing them, I found they were coming every 4-6 minutes, and were about 30 seconds long.

The husband and I scrapped our plans for doing some baby gear shopping at Target. We went out for an early dinner of Thai food (spicy!), but my appetite was already starting to fade, and I ate barely any. I debated calling labor & delivery for advice, but my contractions were getting longer and stronger. I opted instead to just head straight to the hospital.

The drive to the hospital sucked. There was traffic, and instead of 20 minutes we were in the car for at least 45. I couldn't lean back in my seat. But sitting up straight and leaning forward (as much as one can lean forward with a big belly, anyway) were uncomfortable, too. I kept timing the contractions, and they continued at about the same pace, although they were 45-60 seconds long at this point. Every time one hit, I did my best to wiggle as I could, trying to work through them, but that's hard when you're strapped into a car! I found myself thinking fondly of my son's birth, which took place at home. Why would anyone choose to drive to the hospital while already in labor?!? I knew the nature of my pregnancy meant that a hospital was the best place for me and baby--whom we had been calling Coconut--but I couldn't help but be a little wistful for the idea of another home birth.

When we got to the hospital, I was checked in and shown to a room. I changed from my pants into a loose sarong; no hospital gown for me! They put me on the monitors and I waited for someone to come check my progress. I had put into my birth plan that I wanted to minimize cervical checks, but I was okay with a few of them (emphasizing that consent was required!). When the doctor finally came in, I was a bit disappointed to find I was only at a 5. I had already been at 3 the day before, when the membrane sweep occurred. And I'd been having contractions for hours already! The rational, birth-obsessed part of my brain tried to counsel me about the dangers of putting too much stock in exams--your cervix is not a crystal ball, after all, and just because the progress seemed slow didn't necessarily mean that I'd be in labor for days. Those contractions were working, and they were likely helping baby get into a good position and doing other things not readily apparent by the surface numbers. I was definitely in active labor; no doubt about that! Never mind the numbers!

And then further bad news: Coconut was technically coming prematurely (by four whole days), and so the doctors wanted me on the monitors continuously. My room had a nice, deep tub for laboring in, but clearly I wouldn't be using it. I was stuck with bouncing on the yoga ball, moving my hips, and being massaged by the soothing hands of my husband and doula for pain relief.

The nurse put in a heplock, and it was a sign of how far I'd already drifted into the haze of labor that I barely even cried. It took two tries, and I cried a bit for the first attempt and barely even flinched for the second. (For the record, getting an IV always makes me cry.) I just kept doing my thing.

Time passed. I bounced on the ball, tried a few different positions for labor. I couldn't move far because they didn't have wireless monitors, but I ended up ultimately finding my place on the bed, kneeling and leaning against the raised backrest. Husband and doula massaged my lower back as I moaned and swayed through contractions. Husband also fed me ice chips and offered coconut water. I had actually brought snacks to the hospital, intending to eat despite their silly, outdated nil per os rule, but I wasn't hungry at all by that point. I could barely drink and suck on the ice.

As time passed, I started to get exhausted. It was evening, past dinner. I hadn't eaten since lunchtime, and I had no interest in eating. My husband tried in vain to get our son to fall asleep. (Did I mention that he was there? Bug was super interested in being present at the birth, so we ultimately decided to bring him with us!) I continued working through contractions. Time became rather hazy.

The contractions were hard, and I was feeling discouraged. I was starting to feel flushed, but then I was also feeling cold at times, too. (Transition, anyone? The rational part of my brain recognized it, but I didn't say anything aloud because I didn't want to get anyone's hopes up, least of all my own.) I was in pain, and I was so very tired. I started to doubt myself. The contractions seemed nonstop. I couldn't get any real rest in between them, and my limited range of motion made it feel like I wasn't coping well.

I asked for pain meds.

Not an epidural, but something short-acting, just something to take the edge off so I could rest a bit. I wasn't sure I'd have enough energy for pushing if I didn't get some rest.

...And the nurses told me no.

When the nurse came in, it was apparently pretty clear to her that I was past the point of medication. She offered instead to check me, so we could see how far I was.

No one was more surprised than me to hear that I was at a 10!! I was given "permission" to push whenever I wanted. I realized I was feeling a little pushy, but not much, nothing like I remembered with my son's labor/birth. I tried bearing down a bit, but I was just so tired, and it's even harder to push when your body isn't helping you out.

So instead, I opted for an intervention: I gave the nurse the okay to break my water. I had been hoping to let that happen on its own. With my Bug, my water didn't break until literally a split second before I pushed him out. I was secretly hoping that this baby might be born in the caul, since Bug had been so close. But it was not to be. I wanted this baby out, and I wanted him/her out now! Under the circumstances, breaking my waters seemed a small price to pay.

According to my husband, the nurse soon returned with a rather scary-looking tool. I have since described a standard amnio hook to him, and apparently the tool they used at my hospital was not that. Regardless, they broke my water, and I soon felt a gush all over the backs of my legs and feet (I was still kneeling on the bed).

The difference was immediate.

With one of the next contractions, I felt an intense urge to push. And by urge, I mean my body started pushing, and there was absolutely nothing I could do to stop it at that point. My husband says that you could see the difference in the contractions, in how my belly looked once that urge to push set in. I sat up as straight as I could on my knees and pushed! I groaned as I pushed, trying to keep my noises deep and my jaw open and loose.

I pushed for another contraction or two. Apparently, I was making rapid progress, because the nurse asked me if I could try to slow it down a little. I don't remember my exact words, but my response was a resounding no! I guess no one expected baby to come quite so quickly after my waters were broken, and most of my birth "team" (on-call OB, more nurses, NICU pediatricians, etc.) was not yet in the room.

Since there's obviously no way to stop a baby once it's coming, the nurse apparently yanked the "call the nurse" remote out of the wall, which sets off alarms in various parts of the hospital. I was lost in my labor haze, so I didn't notice as the room flooded with people. Another push, and baby's head was out. I immediately felt a sense of relief, but I wasn't done yet. One more strong push, and baby was earthside!

It was 10:28 P.M. No wonder I was so tired!


I fell against the bed in relief, so glad to be done. I don't know who caught him, but my husband got to see him before me, and he quietly announced to me that we had another son! My firstborn, apparently, was standing by, completely enthralled with the process. Someone milked the cord, getting my potentially anemic baby as much of his blood as they could in a short period of time. The cord was cut, and the NICU pediatricians gave him a quick once-over before giving the okay for me to hold him. (Because of my high risk pregnancy, my Rh sensitization, they wanted to make sure he was not visibly anemic or in shock.) Someone helped me to sit down normally, to lean back, and I got to hold my precious new boy in my arms.

Everything was still very hazy at that point. I know I held him for about thirty minutes before someone told me I needed to try to birth the placenta. I think the pediatricians took my Coconut again for a few minutes while the nurses helped me into a squat. A few pushes brought the placenta out, and then I reclined again and greedily reached for my boy.

I gave the okay for someone to give me a small infusion of Pitocin at that point, to ward off any potential excess bleeding. I nursed my littlest boy while my husband and bigger (but still little) boy crowded around.

Other immediate postpartum stuff happened, but I can't remember what all that was or in what order it occurred.. Placenta was examined, and I received the okay to take it home with me (or, rather, to send it home with my husband). My bottom area was examined; I had one small tear, but it was very much a surface tear, not even bleeding. I opted not to suture it. I switched my baby to my other breast and nursed some more. I ultimately allowed the vitamin K shot, even though I had been planning to decline in favor of drops. Coconut Baby got his Apgar score: 9/9. Bug started showing random things to the baby and trying to explain what they were; he was taking his role as big brother seriously right from the start! My doula took a few pictures, and eventually, quietly, bowed out. D bagged up the placenta and put it on ice. I kept nursing, cuddling, absolutely amazed at this new little person I had brought into the world.

Coconut Baby was 6 lbs., 6 oz. He had a full head of hair and the tiniest hands and feet.

After an hour or so, the NICU pediatricians unfortunately had to take my baby away. He wasn't in immediate danger from my anti-Rh antibodies, but he did need to have some lab work done, along with frequent monitoring, and his temperature was a little low despite being skin-to-skin with mommy.

The room slowly cleared out. D took Bug home (it was after midnight by this point), Coconut was in the NICU, and the nurses cleaned me up a bit and arranged to move me to a recovery room. My arms were painfully empty, and the birth haze had lifted enough to remind me just how exhausted I was. Still, I was wired, and I sent out some text messages and called the moms to announce the good news.

It had been a hard birth, much harder than I remember Bug's birth being. But I did it, and despite the circumstances--being stuck in a hospital, tethered to the fetal monitors, high risk pregnancy turned late preterm birth--the birth was pretty much everything I could have hoped for. Very few interventions, and those that did occur were with my full consent. Natural, medication-free vaginal birth. Almost immediate skin-to-skin, and nursing in the delivery room.

Beautiful, perfect baby. My rainbow after two losses and a high-risk pregnancy. Bliss.

Thursday, April 13, 2017

An Rh Sensitized Pregnancy (Part 4)

Just the other day, my baby received what will hopefully be her/his final blood transfusion before birth.

So. Worn. Out.

By now, you'd think I'd be an old hand at this. This was transfusion number three, after all. Five days after another procedure day, although that one was just a cordocentesis. Just. I swear, I could draw constellations on my belly and arms from all the needle marks right now. My poor arms, in particular, seem to finally be getting visibly tired of being pincushions; the blood draws from both of these most recent procedures have left bruises, and that's unusual for me. Bruises that are still faintly visible a week later. Normally, I handle blood draws like a champ. I've had a lot of them this pregnancy, after all.

Each one of these procedures is an all-day affair, with me arriving early for my ultrasound and blood draw #1 (there are always at least 2 blood draws, and 3 this time around), then spending hours waiting for the actual transfusion procedure. The wait usually has more to do with the blood bank than anything; when providing blood for an intrauterine transfusion, blood for a baby still in the womb, they do their homework and make sure the blood is the best possible match, the purest and cleanest available. Most days, as a result, the transfusion doesn't happen until after lunch.

In the meantime, I get to have an IV inserted (honestly, one of the worst parts; I cry every time) and spend some time on the fetal monitors. When I'm lucky, I only get monitored for 20 minutes. The last few appointments, I've been apparently having hardcore Braxton Hicks contractions. As in, very frequent, apparently pretty intense, although I have yet to actually feel a single one. Consequently, I've had the non-pleasure of spending hours on the fetal monitors. I've gone through several books, wasted more time scrolling Facebook than I care to admit, and played a ridiculous amount of phone games. All the while stuck in bed (is this what a standard hospital birth feels like?!?), wearing my hospital gowns (I always demand two, one for the front and one for the back), requiring permission for even the simple need to get up and go use the bathroom.

Oh, and because of those contractions, they've put me on magnesium sulfate for an hour or two leading up to the procedure, in the hopes of reducing the duration and frequency of them. Woooo, something else in the IV.

I really, really hate IVs.

Apparently, magnesium sulfate has no effect on me though. Because the contractions didn't stop, or even slow at all. It didn't make me sleepy, or light-headed, or overheated, or physically unstable; the nurses were quite surprised that I was, in fact, still capable of walking to the bathroom on my own (although they insisted someone accompany me). The only side effect I noticed was that my vein up above the IV kind of hurt while the magnesium was going in.

Also because of those contractions, I've had to consent to several cervical exams. They don't hurt so much as they're just awkward and uncomfortable, but I do understand their need to verify that I was not, in fact, in labor. Because I totally wasn't. Yes, I am ever so slightly dilated (good to know? Except I don't care, because cervical exams prior to labor tell me absolutely nothing about when labor will actually start, assuming it gets to start on its own. As the natural birth community reminds me, my cervix is not a crystal ball), but that's absolutely normal for being in my third trimester. I'm only half effaced, and baby is still very high up.

No other real signs of labor, anyway. Baby shows no more reaction to my Braxton Hicks contractions than I do. No decels. No discharge, no fluids leaking. Definitely not in labor, but I consented to the exams anyway. Like a number of other things in a high risk pregnancy like mine, this wasn't worth fighting about. I've got other, more important areas where I need to stand my ground.

And have I mentioned yet in this post that I'm not allowed to eat or drink in the hours leading up to the procedures? Yep, our old friend nil per os rears its ugly head. Sure, I can sneak a bit of water when nobody is looking, but once my water bottle is empty, I'm stuck. Sure, I can sneak a mid-morning snack (and yes, I totally usually do; research shows that aspiration during/after general anesthesia is relatively rare, and rarer still is it actually life-threatening... I'll take my chances, thank you very much), but there's no way I could get away with a full lunch. Even if I wanted to.

Anyway. The procedure itself usually takes about an hour. An hour on the table, being poked in the abdomen with needles. An hour of listening to the medical speak surrounding me. An hour of yoga breathing. An hour of keeping my eyes closed, even though the room is kept relatively dim so that the doctor can see the ultrasound screen. An hour of keeping the tension confined to my hands so that the rest of my body can stay loose. An hour of breathing in the essential oils I rubbed into my hands prior to the procedure (a blend of geranium, lavender, Roman chamomile, ylang ylang, and lemon, in case you're wondering), letting their scents keep me calm.

Then I get to spend a few hours in recovery, monitoring the baby's heartbeat as well as watching me for signs of premature labor. (After all, these procedures necessitate puncturing my uterus with a needle! No one would blame it for getting irritable.) Because my baby is so wiggly, they've had to give medicine to sedate her/him these last few times, which means that part of recovery is waiting for baby to wake up and start moving again. We already know by heartbeat that baby is fine, but the doctors want to know that there's movement, too. As do I, of course!

It's all for this little squish!

But now, hopefully, the transfusions are over. Done. Baby is tanked up with fresh blood and hopefully good to go for a few more weeks. We're down to the waiting game now. Soon enough, this baby will be earthside and all of this--the stress, the appointments, the blood work, the unpleasant procedures--will have been worth it. We're counting down the days.

No one is counting down more fervently than I.

***

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Wednesday, April 12, 2017

Review: The 4X4 Diet

Personal trainer Erin Oprea never set out to create a “diet” program or write a book, and she certainly never thought she’d have devoted celebrity clients.

But there’s a reason for her popularity. She helps clients–and now readers–develop a clean eating style using just four principles, and her simple workouts make exercise both fun and effective.

In The 4X4 Diet, Oprea lays out the basic principles that she uses to keep herself and her family fit, and which also keep her clients coming back for more. The book is separated into four sections. The first is a part introduction, part motivation. The second details Oprea’s rules for eating clean: no starchy carbs at night, less sugar, less salt, and less alcohol. These four rules are accompanied by explanations of why they’re necessary, and readers will appreciate Oprea’s straightforward and simple reasoning. She also provides a list of necessary kitchen items and a number of recipes that will help readers get started with healthier eating right away.

The third part focuses on the workouts. Oprea’s workout of choice is the tabata, which is essentially a mini-workout made up high-intensity exercises alternated with short rest periods. String a few of these together and the result is a workout that is still relatively short (following her advice means working out for less than 30 minutes) but surprisingly effective. Oprea provides three levels of tabatas, with numerous examples of each level; there are detailed instructions on how to do the moves, making them accessible even to fitness newbies, and there are plenty of pictures.

Part four puts it all together into an actual diet plan, although Oprea is quick to remind readers that this is a lifestyle change, not a temporary “diet.”
“All of this can be done in just four weeks. Each week, you’ll incorporate a new clean eating habit and slightly more challenging tabatas. And each week, you’ll feel cleaner, leaner, healthier, and stronger. That momentum will keep you going not just for four weeks straight but for the rest of your life.”
There are pros and cons to this book. Readers will love her simple rules, as well as the fact that she embraces “cheat” meals. At the same time, the meal ideas she offers are pretty heavy on eggs and meat, so readers who dislike those foods, or who choose not to eat them for other reasons, may find themselves struggling with how to make it work for them. Her rules are good ones, though, and a clean diet like hers could very well aid in weight loss, so long as readers actually stick with it over time (and minimize those “cheat” meals). The workouts are extremely challenging, and some readers will love jumping right in, while others might have a hard time staying motivated. It’s wonderful that she only uses very basic equipment; readers can either work out at home and have to buy only a few things, or do the workouts at their nearest gym.

Overall, the book is quite short, which will help those interested get started with their new lifestyle right away; a large chunk is devoted to the individual tabatas, which don’t all need to be read through before beginning the program.

For those who need help improving their diet in small ways and who want a simple–but challenging–workout plan to get started with, The 4X4 Diet is a great resource.

*****

I received this book from Blogging for Books in exchange for an honest review. The opinions expressed within are completely my own.

Thursday, April 6, 2017

Review: Boobin' All Day... Boobin' All Night

Every new mom has been there.

Baby sleep. That thorny, difficult issue.

We all want to know how to help our babies sleep longer. More. We want to know the best ways to soothe. We want to know the best place for baby to sleep. We want reassurance that nighttime waking is okay, and that we’re handling it correctly. Should we be night weaning? Sleep training? How much sleep is enough?

We want to know that our baby is, in fact, normal.

Meg Nagle, renowned IBCLC (lactation consultant) and blogger at The Milk Meg, is here to provide that much-needed reassurance. Her book, Boobin’ All Day… Boobin’ All Night is a short, sweet bit of sanity in a world that has way too many sleep trainers and baby whisperers.

This is not the bestest, most complete book on baby sleep ever. (My suggestion for that would be The Gentle Sleep Book by Sarah Ockwell-Smith. More complete, yes, but also a much longer read. It’s worth it, but don’t say you weren’t warned.)

Boobin’ All Day… Boobin’ All Night is a relatively short book, ideal for the sleep-deprived parent who just needs help NOW. Meg covers the essentials. She helps parents understand why it’s completely normal for breastfed babies and toddlers to wake up so much. She talks about why breastfeeding–or boobin’, as she prefers to call it–is often the most surefire way to soothe said baby or toddler, and how breastfeeding to sleep is absolutely not a bad habit. She talks about co-sleeping and bedsharing, and offers guidelines on how to bring baby into your bed–safely–so that everyone can get more sleep. She talks about how routines can work while nursing on-demand, caffeine, the breastfeeding-at-night-causes-cavities myth, and more. She has a relatively in-depth chapter all about night-weaning, for when it’s truly the best option or when it’s simply the right time. She provides all kinds of ideas and methods, tips and tricks that might help parents out with whatever challenge they happen to be facing at any given moment.

Through it all, Meg offers personal anecdotes, warmth, humor, adorable pictures, and plenty of encouragement, which we all need sometimes. Meg has a lot of experience with breastfeeding, both as a lactation consultant and as a mother, and her experience shines through in this lovely little book.
Feel confident in mothering through breastfeeding and cuddling during the day and at night, just as nature intended.

*****

I have been in no way compensated for this review. The opinions expressed within are completely my own.

Tuesday, March 21, 2017

Review: Birth Work As Care Work

These days, more and more pregnant people are starting to spend time researching birth before actually giving birth. They’re researching where they’ll give birth, who their care providers will be, who their support team will consist of.

And yet, as a society we still have a long way to go. A long, long way.

It’s easy for those of us who benefit from societal privileges to be completely blind to the advantages we have. It’s easy to forget that some birth givers don’t have access to the “good” hospitals because of location, insurance, or financial means. For some pregnant people, a higher risk of unwanted interventions or unnecessary surgery is unavoidable. For some, home birth is not an option. For some, hiring a doula is either impractical or impossible. For some, prejudice is faced at every turn due to skin color or gender identity.

For some, it’s a blessing simply to be able to give birth without being chained to the bed.

There are many issues that those who perform birth work need to be concerned with. Midwives, doulas, and childbirth educators are always learning, always reading. A new book to add to the “to read” pile is Alana Apfel‘s Birth Work as Care Work: Stories from Activist Birth Communities.
This anthology delves into a lot of sensitive ideas that are not often discussed in more mainstream birth communities, although there are certainly individuals and groups out there that are working in these areas.
“Ultimately the anthology is conceived as a platform through which to honor birth–in all its forms–as itself a profoundly radical act that holds the potential for deep transformative change.”
For example, many sections discuss the idea of white privilege with regards to birth, although those aren’t the exact words used. But there are discussions about how birth is experienced by racial minorities, and how marginalized groups have less options and less choice, and often face a certain amount of judgment simply for who they are. In addition, these people must sometimes deal with more affluent birth workers–because birth work often tends to draw in white, wealthier women–and the stigma of being “saved.”
“One such problematic narrative relates to the language of ‘choice’ within modern maternity care. The danger of celebrating the rise of choice within transactional birthing environments lies in masking ongoing forms of coercion that result in a denial of choice for marginalized communities and those with less access to the kinds of choice-making power enjoyed by more privileged counterparts.”
Also discussed is how birth is shaped by a person’s gender identity. Sure, plenty of white, hetero, cisgendered women give birth every day, but that doesn’t mean that birth is restricted only to straight women or even to those who identify as women. This book is sure to get readers thinking about ideas that some may have never encountered before.

And of course, Birth Work as Care Work talks about some of the issues that are widely known about among birth workers of all stripes, such as how the institutionalized medical model of care affects birth outcomes, the value of midwives, our society’s implicit (but not always well-deserved) trust in medical professionals.
“People see their doctors as authorities with complete control over their bodies and their babies–to the extent that they expect to be raped. The word rape might sound extreme, but I am quick to point out that when someone does something to your genitals without your consent, that is rape.”
Readers will get an overview of some basic herbal medicine–just a discussion of herbs, but no recipes–because of the importance of reclaiming medicine for ourselves. There is also a wonderful, straightforward glossary: the “Political Dictionary.” This gives readers an easy understanding of some terms they may be less familiar with, which makes this book even more accessible to everyone.

There are discussions of how doulas can serve different kinds of pregnant people, and readers will learn about groups they may not have heard about before: volunteer doulas, prison doulas, doula training programs, doulas that work in areas of reproductive health not normally associated with doulas at all (like abortion or adoption).

There are also a number of birth stories, which readers will love. Birth is beautiful, and these stories celebrate it in all of its messy, myriad forms. This is the kind of birth the author and others are fighting for, and readers will enjoy getting to experience it up close.

Overall, Birth Work as Care Work is a book that will leave readers thinking and questioning, and perhaps wanting to get involved (if they’re not already). This is a fascinating and thoughtful collection of stories, questions, and essays, and a book that any birth worker would benefit from picking up.
“Transformation happens when we come together and meet each other where we actually are, not where others perceive us to be.”

*****

I received this book from the publisher, PM Press, in exchange for an honest review. The opinions expressed within are completely my own.

Thursday, March 16, 2017

Review: Harvest

Do you ever find yourself wondering what to do with some of those more obscure fruits or veggies that come in your weekly CSA box? What does one do with quince? How about huckleberries?

Or what if you decide to be a little adventurous in your own gardening endeavors? How do you harvest rhubarb? When is the best time to plant herbs like oregano, feverfew, or lemongrass? Where do poppy seeds even come from?

Or perhaps you're just looking for some unique ways to utilize nature's bounty. Did you know that you can make a lovely floral arrangement using artichokes? Or that you can make delightful seasonal salads composed entirely of herbs?

If any or all of the above describe you to some degree, be sure to check out Harvest, a gorgeous hardcover book by Stefani Bittner and Alethea Harampolis. This is not your standard cookbook, and it's definitely not a normal gardening book. Instead, it contains some basic growing info on a wide variety of plants that are harvestable in the early growing season, mid-season, and late season. Some are common garden plants, while others might be ones you've never even thought about adding to your own yard. Some, like lilac, are plants you may not have realized were edible at all.

The recipes, meanwhile, go beyond kitchen creations. There are also ideas for floral arrangements, teas, personal care products, and more.

Each plant is featured in a four-page spread. One page features a full-page, beautiful color photograph of the plant, while the second discusses growing instructions and how to harvest the usable parts. The final two pages include a recipe of sorts and a photograph of the recipe results.

What makes this book stand out is the uniqueness of the recipes. Everybody has heard of making rhubarb pie or rhubarb jam, but pickled rhubarb will be a new concept for many. We all know berries are delicious to munch on or turn into traditional preserves, but have you ever heard of a shrub? A shrub is a type of beverage made by preserving fruit with sugar and vinegar, and readers will learn how to make a delicious huckleberry shrub. Persimmons make a delicious snack, and the branches pruned every fall can be turned into a gorgeous wreath.

This book is just packed with ideas! Harvest is definitely a great addition to the library of any gardener, or anyone who is just looking for unique ways to work with plants.

***

I received this book from Blogging for Books in exchange for an honest review. The opinions expressed within are completely my own.

Friday, March 10, 2017

An Rh Sensitized Pregnancy (Part 3)

Somewhere between 30 & 31 weeks

 About 28 weeks into my pregnancy, my baby started to show potential signs of anemia.

At that point, we'd been doing weekly ultrasounds for quite some time (I've honestly lost track of how long exactly). Half of those ultrasounds were at my normal doctor's office, while the other half were in the hospital where I've been seeing a different specialist, one who has a lot more experience with my particular medical condition (Rh sensitization).

As I explained in my last post on this topic, they've been monitoring four things in particular:
  • the MCA, or how fast the blood is flowing through a particular artery in the brain (faster blood flow = thinner blood, which could indicate anemia)
  • the presence of hydrops, or excess fluid around certain organs or under the skin
  • swelling of liver or spleen, both organs that deal with old red blood cells (larger organs = baby's body is working harder to deal with the red blood cells that my immune system is attacking)
  • level of amniotic fluid

Any of these is considered a soft marker for anemia in a baby or fetus; the presence of two or more of these signs is much more indicative of a problem.

At about 28 weeks, the MCA shot up. Before that, it had been staying on a nice curve (it naturally increases speed as baby grows) well within the "acceptable" limits. They've been tracking it on this nice-looking chart (I wish I had a picture of it to share, but I do not) that shows my numbers and what's considered both too slow and too fast. As my doctor once explained, a high MCA doesn't necessarily mean anemia, but he's never before seen a baby with anemia whose MCA wasn't above that acceptable limit. So once my baby's MCA became borderline too high, my doctor immediately ordered cordocentesis. Yes, it was only one of those markers mentioned above, but when dealing with fetal anemia, it's much better to be conservative and to do more tests than it is to watch and wait.

Because one of the potential risks of cordocentesis is early delivery, I was required to have two shots of a corticosteroid ahead of time, which helps speed up the development of baby's lungs. I had the first after that fateful 28 week ultrasound, and the second on the following day at my regular hospital. Both are shots to the butt, so I probably don't need to say anymore about the unpleasantness of it.

Cordocentesis is known by several other names: fetal blood sampling, or percutaneous umbilical cord blood sampling (PUBS). It's a test used to detect certain abnormalities in a baby or fetus; in my case, the goal is to obtain the baby's complete blood count (CBC), a number that can be obtained within minutes, which then indicates, among other things, how many red blood cells baby has (red blood cell count, or RBC). A low number for RBC is a definite marker for anemia. Additional blood tests are also done with the sample collected, but I'm not sure what all else they did.

So here's the basic procedure for cordocentesis. It's an outpatient procedure, so I wasn't checked into the hospital. I got to stay in my regular clothes. They created a sterile area around my stomach with drapes and cleaning solutions, then gave me a shot of local anesthetic to numb the area. Using ultrasound as a guide, a larger needle was inserted through my abdomen and into baby's umbilical cord. Then they took a few small vials of blood, did the red blood cell count with some of it, and kept the rest to be sent to the lab later. The initial CBC did not show that baby was particularly anemic, so that was that.

After the procedure, I had to spend 20 minutes being monitored electronically; they were watching baby's heart rate, to make sure baby had no issues from the procedure, and they were monitoring me to make sure the procedure hadn't set off contractions.

There are definitely risks to cordocentesis, but they're generally pretty small. There's a risk of internal bleeding, hemorrhaging even, since they are sticking a needle inside me and inside baby's umbilical cord. There's a risk of preterm labor. There's a risk of baby reacting badly to the procedure, which might necessitate immediate (cesarean) delivery. There's a small risk of baby dying. But those risks are all small, and (in my mind) they were definitely outweighed by the benefits of knowing for sure if baby was anemic or not.

We spent the better part of the morning in the hospital, then left, ate lunch, and headed home.

The following week, I went back for my normal ultrasound (I'll be getting all of my scans at the higher risk hospital from here on out). Apparently, the MCA had jumped up further above that acceptable limit, so my doctor came in and told me that after cordocentesis the following week (which was already the plan, since we needed to see how baby was holding up over time), it was almost certain that we'd be doing a blood transfusion as well.

Intrauterine blood transfusion. It's exactly what it sounds like: a blood transfusion to a baby (or fetus, depending on how far along the pregnancy is) while it's still in the uterus.

Suddenly, my upcoming appointment was a whole lot more nerve-wracking. My appointment time was moved up and I knew it would be a longer day.

Of course, I now realize I really had no idea what to expect from this new procedure. Sure, I had talked to specialists and read everything credible I could get my hands on, but the theoretical just didn't quite match up to the reality. I assumed they'd do it all at once, cordocentesis followed immediately by intrauterine blood transfusion, and that since they wanted me to arrive sooner it'd all be done fairly early. Instead, we spent pretty much the entire day in the hospital.

The morning started with a blood draw for me (yay?), followed by the usual ultrasound. MCA was still high; still no sign of hydrops, stressed organs, or abnormally high amniotic fluid levels. Then, I was checked into the hospital. Formally. Intrauterine blood transfusion carries much the same risks as the cordocentesis does, but the numbers are higher. This time, the procedure would be inpatient, performed in one of the operating rooms just in case there was an immediate need for a cesarean.

I was brought up to labor and delivery and checked in. We managed to sneak my husband and son up (well, bend the rules a bit might be a better description; the hospital recently instigated a "no visitors under 18" rule, and technically my son wasn't supposed to be there at all. If I had known that, both of them would have just stayed home all day!), and I was put into a labor room. I had to change into a hospital gown (ick) and they gave me an IV (double ick; also: ouch). I was not allowed to eat or drink anything (yay for nil per os? Except not, since it's an outdated and non-evidence based policy) because of the slight risk of immediate delivery under general anesthesia. They wiped my belly down and shaved it (also in case of cesarean). They had me sign lots of consent forms. They even wanted to give me a catheter, but I managed to put that off unless actually necessary, since it literally only takes a few minutes to do. And they put the monitoring belts on me. I was all but prepped for a cesarean.

So there I was, stuck in bed for HOURS, waiting until the blood was ready for the baby (and for me too, just in case). My husband and son got to stay for part of it, but once they left to get lunch, they couldn't come back. Finally, at some point after lunchtime, they were ready. I at least got to walk myself over to the OR, where the setup was much the same as with the cordocentesis. Sterile area on my belly, drapes, me lying there crying (because that's what I do when I'm anxious). Lots of doctors and nurses crowded around. Ultrasound machine on, and a quick scan to make sure everyone knew exactly where they were aiming. The local anesthetic, which my doctor described as a "bee sting," hurt a lot. The needle through my abdomen hurt even more (because I was only numbed on the surface).

Not a lot of pain from the procedure itself; instead, I felt a lot of pressure and tugging. I kept crying off and on, but I tried to focus any tension I had on gripping my kleenix box (since I couldn't hold my husband's hand this time; next time, I'm bringing a stuffed animal!) so that I could keep the muscles in my belly loose. Lots of yoga breathing, and I like to think that the essential oils I applied just before leaving my room helped me stay calm, too.

Turns out baby was more anemic than last time, but not as anemic as the doctor was expecting her/him to be. Consequently, the blood transfusion was rather small; they just gave baby a little boost with some fresh, thick, healthy blood. Everything was all over relatively quickly, thankfully.

I was walked back to my room (yes, at least I got to use my own legs again!) for recovery. After an hour on the monitoring machines, I was allowed to eat lunch (which my wonderful husband brought, although my nurse had to go downstairs and get it from him), and the simple fact of consuming real food made me feel so, so much better. I hadn't been lightheaded or anything before, since I'd been receiving IV fluids, but there's something to be said for a good, hearty salad and a nice chunk of bread.

Apparently, the norm for intrauterine blood transfusions is to continue monitoring mom and baby for at least three or four hours post-procedure. I managed to talk them down to two hours; I wanted to go home and be with my family, and there were absolutely no signs of distress in the baby or pre-term labor in me. And it's a long drive home. So after a few dull hours of sitting in bed--monitoring belts attached, peaceful music on the TV, book in hand... you'd be surprised at how weird and boring this was for me--I was finally able to sign my discharge forms. The dreaded IV was removed, I got to put on my real clothes again, and my little family and I began the long drive home.

And guess what? Before too much longer, I get to do it again. And probably again a few weeks after that. And again every two or three weeks until baby is term enough for induction to be safer than another transfusion. This is the reality of an Rh sensitized pregnancy. It's not pretty. It's far from fun. But it's necessary to keep baby healthy and strong. Ideally, I won't be induced until 38 or 39 weeks, but we'll see how the reality plays out.

***

See more:

Wednesday, March 8, 2017

Review: Healing Your Body Naturally After Childbirth

If you go to your nearest bookstore, you will no doubt find an extensive selection of pregnancy books: general guides, week-by-week or even day-by-day books, books geared towards "natural" mamas, books that appeal to "cool" mamas, books for dads, books that tell you what to expect if you're a beginner or going for a VBAC,books that tell you what to eat.

What you won't find are books that deal with the postpartum period.

Well, there will be plenty of books related to your baby during that period: breastfeeding, baby sleep, doctor's visits and vaccines, milestones, natural remedies, raising boys or raising girls, how to soothe your babies and what to do with them.

What's missing are books related to you during those first few postpartum months.

And just think about everything your body has been through in the past ten months. You've grown not only an entire human being, but also a brand new organ (your placenta) and an expanded blood supply. You've gained weight. You might have been through hours of intense labor. You might have a tear in your bottom area after pushing that baby out, or you might be recovering from major abdominal surgery.

Surely, you deserve to focus on yourself for a bit, too.

So pick up a copy of Healing Your Body Naturally After Childbirth, and start learning about the steps you can take to take care of yourself!

Jolene Brighten is a naturopathic doctor who truly knows what she's talking about. In particular, she has an extensive knowledge of how pregnancy can affect a woman's thyroid and adrenals, which is a subject that many care providers sadly know little about. She uses her knowledge about the topic to educate readers, providing information about both hyper- and hypothyroidism, as well as adrenal dysfunction. She talks about treatment options and provides effective--and safe--natural remedies to help women take control of their own health.

Dr. Brighten provides similar information on a whole host of postpartum topics. Breastfeeding mamas will appreciate ideas for natural ways for soothing hurting breasts, remedies for thrush, and recipes for making your own lactation tea. Mamas who gave birth vaginally will surely find comfort in an herbal sitz bath and appreciate knowing what supplements they can take to help ease postpartum discomfort. C-section mamas will be thankful for her recipe for an herbal wash to help keep infection away.

There are ideas for dealing with common postpartum complaints: constipation, "baby blues" (and information about how to distinguish between simple blues and actual depression), low energy, vaginal dryness, stress, and more. There are recipes for all kinds of teas, soups, and smoothies, and even body scrubs for self-care and delicious cookies. There supplements that will help with all manner of healing. There is information on postpartum nutrition, including how to support yourself through breastfeeding.

The information in Healing Your Body Naturally After Childbirth will make a tremendous difference in the postpartum experience of any new mama, and as such is highly recommended for both expecting mamas as well as those who have recently given birth. Midwives, doulas, lactation consultants, and anyone else who works with pregnant women will find great value in this book as well.

New mamas deserve to know how to take care of themselves while they heal from birth and adapt to new parenthood. This book helps fulfill that need. So do yourself--or your partner, or your clients--a favor and dive right in.

*****

I received a copy of this book as a gift from the author, although not with any expectation of a review, positive or otherwise. The opinions expressed within are completely my own.

Tuesday, February 28, 2017

Review: Happy, Healthy Pregnancy Cookbook

It's no secret that a healthy diet is extremely important during pregnancy. Every pregnancy book ever devotes a substantial section to food: how much, which nutrients, what to avoid.

Okay, but what should a pregnant mama be eating instead?

There are plenty of lists of pregnancy superfoods out there, but some readers want just a little bit more guidance. That's where a book like Healthy, Happy Pregnancy Cookbook can help!

This little book is a great guide to the best ways a woman can nourish her body during pregnancy. The beginning talks about basic stuff: weight gain, superfoods, vital nutrients, ways readers can encourage themselves to do more cooking. The real "meat," as it were, of this book lies in the recipe section.

Registered dietitians Stephanie Clarke and Willow Jarosh offer readers more than one hundred recipes that will nourish women during this important time. These are recipes that are well-balanced and include a wide variety of vegetables, fruits, grains, and meats, and thus plenty of nutrients for a growing baby.

Better yet, the chapters are organized by common pregnancy symptom. Feeling nauseous? Try some Avocado Toast with healthy fats and B vitamins, or Quinoa-Veggie "Cheeseburgers" with plenty of protein without the smell of cooking meat. Fighting off cravings? Satisfy your sweet tooth with Peanut Butter, Apple, and Chickpea Breakfast Cookies. Third-trimester heartburn got you down? Recipes like Confetti Sweet Potato Hash or Lentil and Pumpkin Soup will provide a hearty sense of satisfaction while avoiding common triggers like onion or tomatoes.

Healthy, Happy Pregnancy Cookbook has such a thoughtful, useful premise, and it's full of recipes that will appeal to the whole family. This book is sure to be enjoyed by anyone who is struggling with eating well during pregnancy, anyone who is hoping that some dietary changes might alleviate common pregnancy symptoms, and anyone who just wants some new ideas to pack in the nutrition.

Saturday, February 18, 2017

Review: Tox-Sick

In this modern era, we are literally surrounded by poisons.

That's one of the primary messages that well-known author Suzanne Somers wants readers to take away from her new book, Tox-Sick: From Toxic to Not Sick. Not only are we surrounded by poisons, but our bodies are, quite simply, becoming overwhelmed by them. Decades of exposure to pesticides, genetically-modified food, chemicals in carpets and furniture and cars, fluoride in water, unnecessary medications, and more have taken a toll on the bodies of many once they reach the tipping point. People are feeling tired, bloated, foggy-headed, achy, and sick.

If you're ready for a change, like Somers was, read on.

Tox-Sick delves into many of the biggest health issues we face today, issues that many people aren't even aware of (unless they've been directly affected). Somers gets into some of the deeper causes of cancer, and discusses how detoxification is necessary to avoid (or beat) it. She talks about toxic mold, why it's become such a problem in recent years, and what to do if you encounter it. She talks about nutrition, and how the "low-fat" craze has not done us any favors. She talks about antibiotics, and how they wipe out the good alongside the bad. She talks about what supplements you should be taking to support your immune system, your liver, your thyroid, and the rest of your body.

Most readers will find themselves learning a lot, and there's a good chance that a number of book titles will be added to the "to read" list. The majority of the information in Tox-Sick is delivered via interviews between Somers and various health professionals, experts who have ventured off the beaten path and have found themselves specializing in true health care. Many of these doctors have written their own books, which will no doubt be sought out by readers who recognize themselves and their problems in these pages.

To be honest, though, the fact that so much is told through interviews is one of my biggest problems with the book. While the information in Tox-Sick is fascinating, the Q&A format makes for rather tedious reading at times. I understand that Somers wanted a lot of this information to be coming directly from the experts, but I still can't help but feel that there must have been a better way to accomplish this than through verbatim interviews. As a copyeditor, I'm also a little bothered by the lack of proper citations. There is a "Further Reading" section at the end, as well as a bibliography, but it would be nice to know which specific sources were used for each chapter.

Overall, this book doesn't quite live up to my expectations. Somers missed a lot of opportunities to educate readers on some big issues. Tox-Sick is written to be provocative, yes, but it also toes the line on a number of topics that readers would benefit from knowing more about. One example is fluoride. Somers makes a point of telling readers to avoid fluoridated water, but doesn't go into any detail why; the mainstream audience that this book is intended for likely doesn't know much of anything about fluoride except what their dentist has been telling them for years. Another example is vaccines. Several times, either Somers or her interviewees allude to the toxins within vaccines, at one point even talking about how "over-vaccinating" has made us sicker. That's as far as this book dares to go, but there is still a lot left unsaid here, a lot that readers might be curious to know.
"Within hours of emerging from the womb, a newborn is given a dollop of antibiotics in the eyes, injected with the hepatitis B vaccine, with known neurotoxic properties, and jabbed with a vitamin K shot, which contains 9 mg of benzyl alcohol. In 1992, Golding published concerns that vitamin K injections could be associated with a doubled risk of malignant disease in children, particularly leukemia. While there have been considerable doubts about whether the association is coincidental or casual, the controversy has never been completely resolved."
All three of those "standard" newborn procedures are quite controversial. In some circles, anyway. This is just another missed opportunity to dig deeper.

In the end, though, Tox-Sick is a good read, packed with great information that will hopefully get people thinking and inspire them to take charge of their own health. The personal stories that Somers presents from her own family are heartbreaking, and the case studies from some of the doctors will give readers hope for their future. This is a great introduction to a number of issues that many don't even realize they're affected by. Here's hoping that Somers can help turn the tide.
"It's time for us to grow up and realize that nobody's going to save us; we've got to save ourselves. It's up to each of us to control the amount of our individual toxic exposures. To live and thrive, we need to truly think about every product we use and every bite of food we take."

*****
 
I received this book from Blogging for Books in exchange for an honest review. The opinions expressed within are completely my own.

Thursday, February 16, 2017

Review: Punderdome


Puns are a way of life. For some people, anyway.

For some of us, the puns just flow. Puns about food, puns about jobs, puns about current events. If you fall into this category of people, a game like Punderdome is right up your alley.

This game is literally all about puns. Making them, laughing at them, judging which of them is funniest. The game play goes in rounds, with the person leading the round--the Prompter--changing each turn.Each round starts with a Quick Pun, which is simple Q&A style pun: "Why did Mozart and Bach get in trouble in school?" While a sample answer is provided ("They were caught passing notes."), players might be able to come up with something more creative.

The centerpiece of each round is the prompt section. The Prompter has two cards which each contain a single-subject prompt: pets, dieting, presidents, farting, putting on a play, facial hair. Each player than has 90 seconds to create a pun linking those two words together. The instructions offer advice for making puns for newbies, and there is also a card that contains examples for those who need an idea of how to combine topics.

So it's a simple game. The real question: is it fun? Heck yes it is! Well, if you're good at puns, it is. Or if you're just good at creative thinking. Or even if you're just opening to working on developing those punny skills. For many, it could very well take a few rounds of gameplay (or alcohol?) to get in the right mindset so that the puns are flowing. For others, this kind of wordplay is easy as pie. But Punderdome has the potential to be lots of fun for anyone who dares to give it a shot.

*****
 
I received this game from Blogging for Books in exchange for an honest review. The opinions expressed within are completely my own.

Tuesday, February 14, 2017

Review: Against All Grain Celebrations

Paleo is a relatively new way of eating, and despite the abundance of blogs that have jumped on board with the idea, many who follow Paleo have a hard time with family get-togethers. This is all the more apparent at this time of year, with Thanksgiving and the winter holidays right around the corner.

 Blogger Danielle Walker has been there, and she knows exactly how you feel. Over the years that she's been running her blog, Against All Grain, Walker has shared all kinds of recipes that readers have utilized for birthdays, picnics, and holidays. In her new book, Danielle Walker's Against All Grain: Celebrations, she shares a diverse collection of tested and true recipes that are certain to help readers navigate any number of parties and, well, celebrations.

The book is organized by occasion, with each holiday or gathering offering a complete meal spread. Valentine's Day has ideas for fun, child-friendly foods (Cupid's Arrow Pancakes, Lunch Box Love) as well as a more adult dinner for two (Cabernet-Braised Short Ribs with Parsnip-Turnip Puree, Salted Caramel-Chocolate Panna Cotta). Baby showers, wedding showers, or other fun summer get-togethers can be celebrated with Lemon Lavender Bundt Cakes or Ahi Tartare on Taro Chips. There are plenty of different cake options for birthday parties, delicious BBQ recipes for a game-day cookout, and a Thanksgiving spread that features all the classics (Green Bean Casserole with Crispy Shallots; Smoky Candied Bacon Sweet Potatoes; Braised and Roasted Turkey; and, of course, three kinds of pie).

Every single recipe fits into a Paleo diet (although readers are always able to substitute ingredients as fits their individual eating habits). Every recipe is grain-free, gluten-free, and dairy-free; many are egg-free, nut-free, or nightshade-free, and a number of them can also be utilized by those who are following SCD (Specific Carbohydrate Diet) or GAPS (Gut and Psychology Syndrome Diet).

Readers are going to LOVE this cookbook! The instructions are all very straight-forward, there is extensive information about the ingredients Walker uses (for those who are unfamiliar), there is helpful information about ingredient substitution and making dishes ahead of time, and nutritional data is even available about every recipe on Walker's blog. Whether you are gluten-free, grain-free, or full-on Paleo, this book will make every holiday and family gathering so much easier.

*****
 
I received this game from Blogging for Books in exchange for an honest review. The opinions expressed within are completely my own.

Friday, February 3, 2017

An Rh Sensitized Pregnancy (Part 2)


It has long been a mantra of the natural birth birth community that "women's bodies aren't broken." And long have I subscribed to that idea, since I was pregnant with my son and even through both of my miscarriages.

Even now, I still believe it, at least in the sense it was originally intended. Our bodies do indeed know how to give birth, for the most part. When left to their own devices, most women with low-risk pregnancies will go into labor on their own, and given enough time and the right support, birth will eventually happen with no or minimal intervention.

The key word there, of course, is low-risk. More than halfway through a high-risk pregnancy, my perspective on the general not-brokenness of my body has changed.

Almost 26 weeks!

When your baby is in danger from your own body... When your own immune system views your baby as a threat that it may eventually do its best to eliminate... Well, excuse me if it feels sometimes like my body is indeed quite broken.

***

About three weeks ago, I missed a phone call from my doctor, and was rewarded with an ominous-sounding message: "I need to talk to you about your most recent titer test."

We all know that if the news had been benign, she would have just said so in the message. Heck, for most of my blood tests, I never received any kind of call at all, as my doctors apparently subscribed to the idea that no news is good news. So when I received a call regarding my latest blood test, and that call came not from a nurse or the most recent OB I had seen but from my perinatologist (high-risk doctor), you'll forgive me for immediately assuming the worst.

Well, it wasn't the worst, but it wasn't good, either. My titer--my blood antibodies against Rh(+) blood--had just jumped up. For the first few months of my pregnancy, those antibodies were barely detectable, and now they were suddenly in the range that meant I--and more importantly, my baby--required more intensive monitoring. My doctor immediately referred me to a new doctor at a new hospital, an hour away but where they had more experience dealing with Rhesus isoimmunization.

So a few days later, the whole family set off on a long morning drive to see someone new. I had another ultrasound, just as extensive as the typical "anatomy scan" already done at my normal hospital just a few weeks prior, and more bloodwork done, since apparently every new hospital wants to type my blood and establish their own baseline when it comes to my antibody count rather than just relying solely on the medical records they have received for me.

Then, we sat down to talk with the newest high-risk doctor on my team and to get an idea of what we could expect from here on out.

The current prognosis: baby is not in danger. Yet. But we will be monitoring her/him much more closely for the remainder of my pregnancy.

The current prescription: more ultrasounds. Lots more ultrasounds. Weekly ultrasounds.

Monitoring the MCA

It looks like, for the foreseeable future, I will be alternating between my "normal" hospital and the higher-risk hospital for those ultrasounds. Most of them will be rather quick and to-the-point, checking just a handful of things that may or may not indicate anemia:
  • The velocity of the blood flow through the medial cerebral artery (MCA), which is one of the arteries in the brain. If the blood is flowing too fast, it's an indication of the blood being too thin, which is a potential marker for anemia. It doesn't mean baby is suffering from anemia in and of itself, but as the doctor explained, there is a range considered normal; a faster blood while flow doesn't necessarily mean anemia, every baby he has encountered who had rhesus-disease-based anemia also had a blood flow that was above that average range.
  • Hydrops fetalis, or a buildup of excess fluid (edema) in at least two parts of the baby's body. The places the ultrasound technicians are looking are in the lungs, in the stomach, and around the baby's heart.
  • Swelling of baby's liver or spleen. The liver handles the decomposition of red blood cells; if my immune system is attacking the baby's blood and damaging baby's red blood cells, the liver will be working overtime to deal with the aftermath. An enlarged liver is a sign that baby's body is having a hard time keeping up with the damage my immune system is dishing out. Likewise, the spleen plays a role in disposing of old red blood cells, and an enlarged spleen can indicate that the spleen is working too hard to keep up with what's being demanded of it.
  • The amount of overall amniotic fluid. An excess of amniotic fluid (polyhydramnios) is another indicator that Rh disease is starting to become a problem.
Every ultrasound I get will be checking those things, and if the doctors see any combination of things to concern them, then I will potentially face more invasive procedures to verify if baby is actually suffering from anemia (via testing a sample of baby's blood taken from the umbilical cord), and then to treat baby (via intrauterine blood transfusions) if that is the case.

The good news is that, barring some sort of complication (there is approximately a 1% chance that, during an intrauterine blood transfusion, a problem will necessitate baby's immediate delivery), I will most likely be able to keep baby inside until she/he reaches term. If blood transfusions become necessary, they will have to happen every three weeks or so, but the doctor specified that they aim to time them so that the final one happens around 35/36 weeks; baby may still require induction if labor doesn't start on its own before 38/39 weeks (note that my son came at 37 and a half weeks entirely of his own volition, but every pregnancy and every baby is different, so who knows how long of a gestation this baby would choose if left to her/his own devices), but an induction at 38/39 weeks is infinitely preferable to an induction at 34 or 36 weeks, as I was initially told was a possibility.

My second high risk doctor doesn't seem interested in doing any further blood work; as he says, my titers are already up and so we will step up the monitoring in response, and it doesn't really change anything to know exactly what the titers are at in the future. On the other hand, my primary high risk doctor (who I will now be seeing for all future regular prenatal checkups, instead of OBs and nurses from the standard OB/GYN group) sees value in continuing to monitor my titers; while they're in a concern-causing range now, and have only gone up in the past few weeks, it would be a good sign if they either stabilized or started to decrease again. So it looks like I get to continue being a pincushion, but only part-time.

***

So we'll see how things go from here on out. Optimistically, ultrasounds will be the extent of baby's additional monitoring, everything will continue to look normal, and I'll be able to go into labor naturally and have the nice, normal birth I want. But that is far from a guarantee at this point. There's still a pretty high likelihood that induction will be necessary, and a slight chance still of a premature baby if complications occur at some point.

All in all, a high risk pregnancy is the pits. It's unpredictable and completely out of my control, which makes it that much more stressful for me; about the only thing I feel I have any control over at this point is keeping baby's sex a secret until birth, and even that is in danger should any individual ultrasound technician forget my wishes and reveal the sex during one of my many upcoming scans.. For the time being, I am trying to remain focused on my joy at having this baby in my uterus, my excitement at eventually getting to meet her/him, and the knowledge that I have a solid team of doctors overseeing my care and doing everything possible to ensure a healthy outcome.

That's about all I can do. Stay strong, little baby! We're more than halfway there!

***

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