Expectations when You're Expecting

A recent conversation with a friend gave me the chance to sort and organize my thoughts about how a woman’s preconceptions about labor affect how she perceives the sensations of labor as they are happening. I felt like I was fairly eloquent in that conversation and I hope that my attempt to transcribe my thoughts here will come out as well.

The short version of it all is that every woman and every labor are different. But I believe (and have heard quite a few birth stories which vindicate the belief) that most women get the labor they expect. It may not be the labor they planned for, it may not be the labor they wanted, but at least to some degree it was probably the one that they expected. “Expected” may not be the best word…in some cases perhaps it is more accurate to say that they get the labor that they feared…but that is actually precisely what I am getting at: if a woman has negative expectations (or the fear of certain negative things happening) I think that her body will probably get the message, and she is much more likely to have a negative experience.
(As a note, yes I realize that there are various complications which can affect the realities of labor, regardless of the woman’s mindset…chemical induction or augmentation of labor tends to cause more intense contractions, a poorly positioned baby can lead to back labor which by all accounts is much harder than laboring with a better-positioned baby, and if the mother is tired or stressed or inhibited for other reasons those can all affect labor too...So of course I make these comments merely as general observations. Since we’re on the subject of complications though, it is also worth noting that many of them, including things like poor positioning and induction, can be avoided in many cases, so it’s worth being educated enough to avoid those complications if at all possible!)
I can only speculate of course. I cannot get into the inner psyche of another woman and determine what kinds of thoughts and preconceptions were in her head prior to labor. I only know what my experience was, and what other women have told me about theirs. Based on those though, here is what I have concluded:

Women tend to fall into three main groups in their perceptions of labor

• Those who expect pain, and either plan for medication or else take classes to learn coping techniques to deal with that pain. These women may take classes that promise painless birthing or totally relaxed birthing, but if they still expect labor to be painful, then (in my opinion) no amount of practicing techniques is likely to remove the pain from their labors. (One woman I know practiced her birth hypnosis routines faithfully and told me that in labor she was completely relaxed but still in the worst pain of her life. Complicating factors aside, I am left to wonder if the psychological was part of that.)
• Those who expect no pain, in spite of avoiding medication, and may even plan to relax though the whole thing (typically because they have taken a class that told them they could). These women usually use words like “surges” or “rushes” instead of “contractions” because they find them more positive. I confess I’m slightly skeptical of this group because, unless she’s had a painless labor before, I’d be surprised to find any woman who genuinely expects labor to be painless.
• Those who expect work, which will be intense, and may include hurting (like a serious workout), but not ‘pain’ in a negative sense of the word. They don’t mind hearing the “hard labor” stories, nor using words like “contraction” (it IS an accurate description of the uterine motion, after all), but they perceive it all through the lens of ‘work’ rather than the lens of ‘pain.’ They gear up for labor as for a marathon, and they don’t mind getting down and dirty because they know that they will also get the high that comes from completing the race.

Those who know my personality can probably guess which mindset I chose, and guess what: I got precisely what I expected. Labor was a lot of work, it was tiring, and after 12 or 15 hours it got pretty hard. I remember the thing that ended up being the most helpful during contractions was for my husband to repeat to me over and over “you can do anything for one minute,” because you know, I could! At the moment of the “ring of fire” (just as the head squeezed through) it hurt like crazy…but those few seconds passed in, well, seconds, and then I had a baby to hold. I have no hesitation in going into my second labor with the same mindset. I think back to Stephen Gaskin’s quote about labor being heavy, and that if you’ve never done anything heavy (or hard) in your life then labor is going to be thoroughly overwhelming…but if you’re not afraid of some hard work, then what’s to fear about labor?!

29 Weeks

First of all, it has been a really long time since I've posted pictures. My apologies, but see I've been busy. First I sorted my entire household into "stuff we will need during the summer" and "stuff that can sit in storage" and "stuff to sell/leave behind." Then I packed/mailed/sold/left it. Then I spent a week and a half on the road, including 12 hours on ferries and 16 in the car and 5 on a jet. Then I spent two months in another state, 3000 miles from home (oh, wait, without a home...) where the weather was rediculously hot. I put dozens of hours of work in at my house (you know, the one I own, which isn't the one I live in). I found new renters for that house, and chased down an apartment for us to move into when we got back up here. Then we spent another 5 hours flying back up here, and 4 hours driving to our new city. Since then I've spent two weeks unpacking and organizing my new home, along with about 12 hours worth of traveling to other cities to do things like get the rest of our stuff from storage or *ahem* buy a couch. All the while I've been chasing a toddler, trying to get him to sleep through the night, helping two kids get settled into a new place, helping one kid get ready to start at a new school (including riding the bus which he's never done before)...
All of this is why I feel tired I think...more tired than at this stage of the last pregnancy anyway. I don't think being 3 years older is enough to make me feel this much more tired...but then again, who knows.
In any case, here are some photos:

28 wks with Bear ~~~~~~~and~~~~~~~28 wks with Eagle

And one showing the belly (cuz I know you all thought I'd been stuffing a pillow in there all this time)...complete with stripes. I haven't gotten any new ones this time...not yet anyhow. Fingers crossed that Bear gave me enough stripes that I won't need any more! (I look kinda tired or something...hmm...wonder why that is...)


And now for a few minutes on the progress of the little guy...
He is 15-16 inches long, and about 2.5lbs. He can open and close his eyes, hear us when we talk to him (or even when we don't), and he has started being interactive!
His wiggles are no longer "little flutters" like when he weighed mere ounces. Instead he is able to push things right off my belly, and his movement is easily visible from the outside! He's big enough that if I lay on my side for a while I can feel his spine...if I prod around a bit I can push on his bum (which of course moves his whole body, and tends to press his head into my bladder, so I find it just as annoying as he probably does!). I've also been able to locate hands or feet a couple of times (I can't tell which, but they are small, bony, and he always punches me when I grab them!)
Names are still under debate...we think we've found a first name, so that's something, but for some reason we are really struggling with a middle name this time around. Oh well, at least we have something to call him besides "little brother" and "the baby"...but I will feel better when we have his whole name figured out.
In the meantime, I am meeting with a couple of local care providers, so within a week or two I'll finally know who is going to be attending me for this birth. It's a weird thing to not get that figured out until the last 10 weeks, but I guess this pregnancy has been weird in a lot of ways. ☺

Some Things are Heavy

I admit that the English teacher in me cringes at the grammar in this quote, but I think the message is a very good one, so I have left it intact rather than try to say it myself.

"If all your life you never do anything heavy, there’s certain passages in life that are heavy. Having a baby, for instance, is one. If you be a total paddy-@$$ all your life, they’re going to have to knock you out when you have your kid, because you’re going to be too chicken to have it. And if you do something that builds character ahead of time, you’ll have enough character that you can have that kid, and it will be a beautiful and spiritual experience for you."
~~Stephen Gaskin (husband and co-midwife of Ina May Gaskin)

Truth is Stranger than Fiction

I may have mentioned how we didn't have a couch...we went to a great deal of trouble making arrangements to be able to get one. There was no where in town to get one, and we had difficulty finding one elsewhere that was not ridiculously expensive. Once we finally located one we could afford, the store did not deliver down to our city (80 miles away), and our van was not large enough to bring it down ourselves. We finally were able to make arrangements with a third party to bring us our couch, and we were only able to arrange that because he was already bringing down our mattress box spring, and we were paying him for it all.
So, skip to today...after a week and a half of waiting the day finally arrives when our couch will arrive! It's a small sectional (cheaper than a sofa/love combo), and of course comes in two pieces. Each portion is wrapped, but our delivery man and his son unwrapped the first and lugged it up the stairs, and then went back for the other half. I was standing in the living room looking at the half sitting there, and then I glanced down at the remaining half which was now being unwrapped on the trailer. I looked back and forth several times then ran out the door and told him to wait a minute before bringing it up, because, well, this is why:
Do you see what I see? Yeah, they sent us two right halves and no left half of the couch. I called the store (that doesn't deliver to my town), told them who I was and where I was from, then informed them of the mistake and asked what they intended to do to fix it. I thankfully was already speaking to the manager, and he hemmed and hawed for a few minutes and then told me that he'll bring me the proper piece on Friday and swap it out with the wrong one.
And they don't deliver to our city. Ha. I betcha he's wishing now that he'd just done it himself!!
In the meantime, we are only sitting on one half of the couch, and I've covered the other half (the half that's going back) so that nobody will sit on it and it can't possibly get damaged during it's 5 days in our house.
And we shall see if they make it down on Friday. They had better, or they will be getting a phone call from a very irate and hormonal pregnant woman who wants a whole couch to sit on darnit!!!

Sunday Inspiration: Calming the Storm

This is an excerpt from the chorus of a song. I don't know who wrote it or even the lyrics of the rest of the song, but I find this bit very inspirational so I wanted to share it.

Sometimes He calms the storm
With the whisper "Peace, be still"
He can settle any sea
But that doesn't mean He will.
Sometimes He holds us close
And lets the wind and waves run wild.
Sometimes He calms the storm
And other times He calms His child.

"Natural Cures 'They' Don't Want You to Know About" by Kevin Trudeau

I had been hearing of this book for some time but never read it. I remember seeing part of an interview a couple of years ago and basically what Trudeau said was "there is a cure for ___ but I can't tell you what it is cuz they would sue me, so you will have to read the book to find out." He repeated this about a half dozen ailments, and I came away with the feeling like this guy is out to sell books and may or may not have anything very helpful to say therein. I'm always sceptical when someone says "you have to buy the book to find out" you know?

Well, apparently a friend of my in-laws saw something about the book and was impressed and got the book for them. They have some (little) interest in natural health, and my father-in-law read the book...or at least started reading it...I don't know whether he actually finished it (there was a bookmark just a few chapters in ☺) His conclusion was that the guy is out to sell books, (that makes two for two here) and he was very sceptical of the content of the book.

So while we were staying with them, my father-in-law asked if I had read the book, and I said no. He asked if I'd like to, and I said um, sure. So he gave it to me. As I started reading I noticed several things immediately:

1. Trudeau says a lot of things that I've heard before about both natural and mainstream medical practices--some of these things I agree with and some of which I've never seen evidence for (more on that in a moment).


2. He is convinced that the medical community as a whole is in one giant conspiracy to keep us all sick so that they will make money.


3. Throughout the book, he has a very unprofessional writing style. He repeats himself a lot, saying the same things and talking in circles around topics (while often not really making a discernable point). He also writes in a very defensive manner ("I would tell you but they would sue me and burn this book, I have the letter from the FTC that says so"). Worst of all though is point 4.


4. He does not provide references or sources or verification for anything he says. This is very troubling to me--why should I trust him over anyone else when I don't know his sources?! He says that on his webpage he has all the references about which study he means when he states that "a study was done which found ___." However he never gives even a simple "In [year] an article appeared in [publication] about a study which said ___" in the actual text of his book. Even if I've heard the same information from other sources, not documenting the source is unprofessional and (in my opinion) just plain fishy. In fairness I should note that he does have two chapters of the book ("Not Convinced?" and "Still Not Convinced?") where he gives lists of articles and books which he says validate the things he is saying. Still though, unprofessional and just poor writing.

If you have been a reader here for more than about two days you probably know that I am a proponent of natural medicine, or, rather, that I'm a great proponent of taking the path of least-intervention whenever possible (which usually leads me down more 'natural' paths).

Here are some things where I agree with Trudeau:

• Medical 'fact' is (and always was) not really facts. It is merely the educated opinion based on the knowledge and research of the time. (Bloodletting was once a cure-all, bodily fluids were considered to be composed of four humors, and in the 1920s smoking was touted as healthy...clearly medical facts change with time.)


• The medical world (drug makers + doctors) makes their money off our being sick.


• Being sick all the time is not normal (he suggests that the annual flu or even the 'common cold' shouldn't be common in a healthy individual, and that all the bigger stuff from diabetes to impotence to cancer should definitely not be common).


• In spite of numerous new drugs and new treatments, the population of the USA is more sick than ever, including still dying of cancer at the same rate as we did 50 years ago (and being infected with it much more often).


• Mainstream medicine treats symptoms, not causes, which is why it doesn't work very well (why we stay sick, or why the drug may solve one problem while causing another).


• The medical world in general (from drug researchers & manufacturers to the FDA) is out there to make money, so if something simple and cheap and (most importantly) non-patentable (ie, natural) comes along that solves the problem, they will try to dismiss or even squelch it so that it doesn't cut into their bottom line.


• We see advertising for mainstream drugs (and not for natural cures) because that's where the money is--and the TV/radio producers don't want to lose the hefty amounts of advertising funding that they get from the pharmaceutical companies, so they won't advertise the little guys who are in conflict with them.(You may remember my little rant about this topic in my recent post on healthcare reform


• The medical associations are out there to protect the doctors (including their incomes)...not to protect the patients. Therefore, when you see a statement from the American Medical Association (AMA), American College of Obstetricians & Gynecologists (ACOG), American Academy of Pediatrics (AAP), etc, you should remember that they are looking out for the doctors, not for you, and thus the statement should be taken with a grain of salt (and verified with your own research if at all possible).


• There are effective natural (non-patentable) alternatives to mainstream medical treatments/drugs, but we don't hear about them because of the reasons listed above. These options include things from vitamins, supplements, herbs and homeopathic drugs, to chiropractic care, parasitic cleanses, exercise routines, and special diets. (Please note that I think some of these options hold more water than others...but I do agree with the basic premise that there are effective alternatives to much if not all of mainstream medicine.)


• A great deal of what we eat, drink, breathe, and come in contact with in our daily lives is putting toxins into our body, and reducing exposure to those toxins (and working to eradicate the ones already within us) will improve our health. (He feels that most if not all health problems stem from toxins in our bodies, nutritional deficencies, or stress.)

He goes on to present a list of ways to eradicate (or at least reduce) our personal exposure to toxins, improve our personal nutrition, and reduce stress. I find that I agree (to varying degrees) with much of his toxin list, and almost all of his nutrition and stress lists. Honestly, I don't know that the rest of book is worth reading, but I would recommend the chapter with those lists.

Some things where I don't agree so much:

• All drugs (prescription or non-prescription) are intentionally made with negative side effects in order to keep us buying more drugs/treatments. Trudeau even goes so far as to suggest that some fatal drugs are knowingly released so that the manufacturers can get a few years of income off them before they are pulled from the market--because the money matters that much. (On the one hand, yes, I agree that most of these drugs have scary side-effects, which is why I am typically skeptical about them--especially new ones--but I don't agree with the notion that they are made that way intentionally...it's a little bit too conspiracy-theory for me.)


• All those working in the world of mainstream medicine want us to stay sick so that they will stay in business. (Sorry, but I just don't believe that every little family practice doctor is that malicious...yes I can easily believe it about the CEOs of big pharma, but not about every single researcher or doctor out there.)

As I said, he's got a massive conspiracy theory complex going on. I think he has some good advice about specific lifestyle/nutrition choices, and based on what I do know of natural medicine I think most if not all of his advice there is probably pretty good too. However the book is so poorly written that he discredits himself with almost every word.

"Home"

It's a curious thing, what makes a place Home. I don't mean home (with a little 'h')--a place where you return to every night. I mean Home (with the big 'H')--the place where you can always go (WILL always go) in your mind, the place you will always think of as where you are from (regardless of how long you lived there, or how long since you left).
For most of us, I think Home starts as the place where we were raised--but only if we were raised in one area for most of our formative years. For me, that was western Washington until I was 26 (in spite of living several other places). Then in that summer I moved somewhere and discovered that I had come home to a place I'd never been before (to borrow a phrase from John Denver!), and from that time onwards Alaska was Home. However Pelican still was not Home. Yes, I lived there for two years, and there were a number of things I liked about the place...but I was ever so ready to leave when we left, and I feel no desire to return.

We have now been in our new home for a whole 10 days though, and I have the feeling that this place may be Home.



As for a brief moving update... most (but not all) of the boxes are unpacked.
We don't have a couch or a desk or any dressers or shelves.
We did buy a bed for us, but the boys are sleeping on the floor (they seem to prefer that a lot of the time even when they have beds, so we're waiting for october and the PFDs to buy their beds).
My in-laws are bringing the remainder of our boxes up in two weeks, and until then I have only a half-stocked kitchen (two pans and no measuring cups/spoons!) and three bath towels for a family of 4 (I'm not about to buy more though when I know they are coming in the boxes).
Getting into the apartment (between moving expenses, rent, deposit, etc) has left us basically totally broke...so I'm cooking on a SERIOUS budget right now. It makes things interesting, if not always exciting. ☺
Wolf is enrolled to start school next monday, Hubby has already been to 4 days of inservice meetings and has 4 more till he starts teaching, and Bear is, um, skipping a lot of naps. Yeah, he'll get settled in better once school starts and we have a more normal routine. ☺

Weaning the Bear

I wanted to wait until we'd actually finished our weaning process, and then give it a little time to see how things went for the next few weeks as well...but I promised I'd report on how weaning went so here it is. ☺

I mentioned at the time that I did not make the decision to wean hastily. I had already been working on night-weaning (on and off) for several months, and I took the time to talk with other mothers who had weaned children of this age, as well as with mothers who had tandem nursed toddlers and newborns. It was around the first of May that I made the firm decision to wean.

Here is what we did:

PHASE ONE
We chose a date near the end of the month (the day we were leaving on the ferry) and started prepping him for it. "You are a very big boy, and I know you love nursing, but you don't need it." "When we drive the car onto the big boat and go away on the big boat then we won't have nanu anymore."
I cut out all nursing except naptime and bedtime. We had mostly done this previously, but for the times when he did ask, I worked on distracting him--offering him other food or drinks, finding a toy, etc.
Next, I cut the nap and bedtime nursing sessions to 5 minutes. Yes, I watched on my watch. I told him that we could just have a little bit of nanu, and I gave him a "one minute warning" as we were getting to the end. We did this for about a week. In the meantime I became a stickler about the night-weaning...as I said we'd worked on it before, but I started wearing a bra to bed again so he couldn't nurse without waking me--and it worked to help me wake up enough to remember that I'd rather hold a sad baby for a little while than have him keep nursing...
It was in the first couple of days of this phase that I did have some engorgement (ie, being full of milk because he wasn't nursing it out) but that was one day of discomfort and then my body adjusted to the lowered production.
As we cut back on the nursing, we made sure that other things were part of the bedtime routine--brushing teeth, saying prayers, a story, a song, some snuggles...I'd been doing this somewhat before, but I was more diligent about it as I started really focusing on cutting out the nursing.
This all lasted for about a week.

PHASE TWO
I cut the bed/naptime nursing to 2 minutes (again, by my watch) and did that for about another week...maybe 4-5 days.
We also concluded night-weaning in this phase.
I did notice at this point that as I nursed him less, I became less tolerant of it as well. Tender breasts has always been a pregnancy symptom of mine and I had feared that it might affect him nursing, but in the early months I rarely noticed tenderness when he nursed. As my body got less familiar with the sensation though, it got more sensitive to it I guess. So as I shortened the nursing times I told him--very honestly--that the nurns hurt and we could only nurse for a very short time. He was not excited about this, but was concerned about my pain (he kissed the nurns a few times) and didn't really complain about the changes.
I did notice this week that his appetite really increased. I'd noticed it a little before, but especially with the night-weaning finalized he started eating really big breakfasts (I guess he'd been nursing more in the night than I'd realized!)

PHASE THREE
I stopped the naptime nursings--I cheated a lot by putting him to bed with movies this week, but hey, it worked. I also cut the bedtime nursing to 1 minute by the clock. He often would tell me that he wanted some more, or that he "needed da nanu." I told him that the nanu hurt, and that I knew he loved it, but he didn't need it. Then I'd cuddle him and sing to him all the more.
Again, 4-5 days for this phase.

By the time we reached Weaning Day, he was not nursing anytime except bedtime, and then only for (literally) a minute. He usually needed snuggles for quite a while to get to sleep, but he was not nursing, which was the goal. He had gone to sleep for several naps (and even a couple of bedtimes) without nursing and even without mommy--usually thanks to movies but sometimes with daddy cuddles instead.
The ferry departed Pelican around 4pm, and it arrived in Juneau late, so I wanted to be sure that Bear had a good nap. Knowing that we would not have night-nursing that night, I did nurse him down for that nap. Being the last time, I let him nurse as long as he wanted (he only nursed about 10 minutes before he conked out).

AFTERWARDS
For the first couple of weeks he frequently asked to "just hold dem," which I allowed if we were cuddled in the bed, and he periodically tried to sneak little sucks when he thought I wasn't looking, which I did not allow. Ironically it was 4 days after W-Day that he woke up in the middle of the night barfing, and so I allowed him to nurse again a bit that night because I know that nothing is as good for a sick tummy as some good mama milk. By morning though he was ok and we resumed our weaned status.
After about a month I started discouraging the "holding dem" thing even in bed. He became quite the master of sneaking a hand into my shirt to hold them anyway, and expressed annoyance and frustration when I pulled his hand back out. I started taking preventative measures (mostly just putting my hand in the way) to ensure that he wouldn't reach in for them anymore.

So where are we now? He's not nursing, my milk finally dried up (it took a month or so), and he only tries to reach into my shirt occasionally. He doesn't talk to me about the act of nursing, although he does talk about "da nurns" in reference to the anatomical parts. In the tub he pointed out his own nurns and was thoroughly amused by them. Since little brother will be coming in only about 3 months, I'm going to start occasionally mentioning that babies nurse...we continue to celebrate how big Bear is, so I don't think he'll confuse himself with the baby in that regard, and I hope he won't be jealous, but who knows. I guess we shall just have to see!

Monday Answers--Dealing with Direct Disobedience

You know the kind...where you say "Johnny come here" and he gives you an evil look, shouts "no" and runs the other way. I'm not talking about when they forget to follow through, or didn't understand the request or were not capable of doing the thing properly...we're talking about wilful, intentional, disobedience.

My question: how do you handle direct disobedience? My 2-year-old sometimes completely ignores me, and then I don't know what to do, and i find myself raising my voice. Sometimes the situation is urgent as I have my hands full with my newborn at that moment, and I really need my toddler to do something, and at that moment she choses not to do it ! Normally she does her best to cooperate, but there are these moments when she wants to see what happens when she won't do what's asked of her...

This is a really hard question, and I don't know if I have a satisfactory answer. (I would love to hear comments from others who have ideas about this too!)
When I was a kid we got spanked for this, and considering that "obedience is the first law of heaven" I never felt like that was inappropriate. A hefty punishment for a hefty crime, right? But as I've written here, I no longer believe in spanking, so that means I need some other solution.

My current approach has several parts, and is different for children who are at different ages.

First of all (for kids of any age) I try to avoid the problem in the first place.

• I try not ask them to do things that are not important. If it's merely annoying to me rather than an actual danger to them, then I try to get over myself and let it go.
• I try to avoid problems in the first place by child-proofing my house and that sort of thing. When kids do get into things that they shouldn't, I try to use distraction to re-direct them into more appropriate activities.
• If possible, I try to make requests rather than give commands--simply asking nicely "will you set the table" or "please get ready for your bath" not only gives a good example to our children of how to treat people, but it also tends to make them more willing to comply. After all, don't you find it easier to do something when you're asked nicely?!
• If they don't respond the first time, I ask nicely again, but add their name to make sure they have heard me and to give it a little urgency: "Wolf! would you please set the table now, we are eating in 5 minutes and it needs to be done."

When I do need to give a command (which happens in cases where there is imminent danger, or where asking nicely didn't work), and when they don't heed my command, then my response varies depending on the age of the child.

• With a toddler, I basically help them comply. "Bear, please come here" is followed by "Bear, come to mommy now" and then I go to him, take him by the hand or arm, and bring him to where I had been. As I do so I explain that when mommy asks you to do something, you need to do it, and that I will help him learn how. Obviously when they get older (old enough to run away fast enough to avoid capture for example) then this doesn't work anymore...but thus far it seems helpful for helping him learn the concept in the first place. Is it really inconvenient for me sometimes? Sure. I've wakened the sleeping baby in my lap or had to step away from conversations in order to go help my child do what I had asked of them, but I think obedience is an important thing so I think it's worth it.
• With an older child it gets harder. In cases where I can still help them comply, I often do, but obviously physical force becomes an impossibility (and not a very respectful practice anyway) so mostly I end up trying to help them develop their own motivation for obedience. I try to help them understand why it's important to obey. I remind them that I try very hard to only ask things that are important, and then ask them to try very hard to obey when I do ask something. I empathise with how frustrating it can be to do something you don't want to have to do. I explain how I feel when they disrespect me by ignoring something I've asked of them. I remind them about what the scriptures and prophets teach about the importance of obedience. Depending on the age and personality of the child, we may discuss what the scriptures say about punishments for disobedience (Wolf is in an age of wanting to know exactly what God says he'll do if you don't follow this rule or that one). I remind myself that my goal is not to raise a bunch of little automatons, but to raise thinking people who will do the right things because they want to, not because they fear punishment. So the truth is that sometimes when my 9yo stomps off to the other room there is not a darn thing I can do about it at the time...so I let it lie for the moment and make a point to talk to him later in the day and address the topics mentioned above.
• When it gets to teenagers, well, I don't have any of those yet. I have no idea what I will do at that point. ☺
  

So there it is, my current take on dealing with direct disobedience. Like I said, I would love to hear your thoughts on it. This is an issue where I don't always feel like my methods are effective, but I'm just not sure what else to do (without breaking the basic rule of respect that I believe in so strongly).

Additional questions always accepted...I'll answer them when I get settled into my new place and have internet again!)

Friday Feel-Up

I know I completely neglected this last month. Naughty me!!!
But I remembered this month!
There's no time like the present to do your breast self-exam. ☺

26 Weeks

Ahh, week 26--that means we're entering the third trimester now! Less than 100 days to go till we get to meet this kiddo (give or take!)
We are on the road (in the midst of getting settled into our new place in Alaska, so there's not much of a post...more coming when we are settled. ☺

An Observation

I need to stop being such an efficient packer.
About three months into our marriage we decided to go on a camping trip. Hubby collected the gear we needed and started putting it into the car...he got most of it in but then I pointed out that he had not left space for the cooler (which of course needed to go in last) or for Wolf. Hubby suggested that I try...so we pulled everything out of the car and piled it on the driveway. We fetched several more items that he had forgotten, and I proceeded to pack it all into the car...leaving space for the cooler AND for the son.
Ever since then I do all the packing, be it boxes or vehicles or anything else, we both just know that I can fit a lot more than he can (a LOT more, like, at least 50% more).
Unfortunately, this has led to the not-infrequent recurrence of what happened today: we collect a large pile of stuff that needs to be packed, and then Hubby turns serenely to me and says "you can get that all in, right?" and goes on his way...
And somehow I always seem to get it all in.
It reminds me of a moment in Star Trek where the captain asks Scotty how long it's going to take to have the engine fixed, and Scotty says it will be at least a week. "That's no good, we need it done in 4 days," Kirk announces. "Yes sir," answers Scotty with a twinkle in his eye. In that moment realization spreads across the captain's face as he says "Do you always double your estimates?"
"Why of course sir," responds the engineer "otherwise how could I keep making miracles?!"

Monday Answers--Health Care

Today I'll be posting the first of my answers as explained here. I don't know that I will always do this weekly, but if you ever leave a question in my comments, I do read them all, and I do try to answer them!

Today's topic is universal health care, aka single-payer health care, aka socialized medicine.

Well, here's a doozie: What's your take on the potential for universal
healthcare? It's been on my mind a lot. Always interested in hearing more
thoughts and opinions.

There is a bill currently facing our congress which has lots of people screaming about socialized medicine and loss of patient rights and all kinds of other things...I will start off by saying that I have not read the bill. I would like to actually (in spite of it being over 1000 pages)--I'd like to see what is really in it--but I have not read it yet. So, the best I can do today is answer with my thoughts about the concept in general, and then my feelings on what I do know of the bill.

Point #1--I think that socialized medicine is a whopping lot better than the capitalistic system we have right now. If you didn't read it when I linked it last fall, I would encourage you to read the post my husband made here. He lived in Norway for two years, and has some personal experience with socialised medicine. Or maybe go read the post my cousin wrote here. He lived in Switzerland for several years as a child and then in Germany for two more as an adult. Both of them heartily favor socialised medicine because they have seen how well it works. The WHO statistics seem to point quite clearly to socialized systems as the best if you look at their chart of the world's healthiest countries. Yes, it is true that the system will run into problems if it is underfunded (as it is in Canada, Ireland or the UK--the places where most of the horror stories come from), but, if it's properly funded, then you'll probably end up with something like France (#1) or the Scandinavian countries...
Yes, I did say 'probably'...this is because I realize that we have a very big country, and there is a lot of diversity in terms of proximity to care providers, health education, and other things which might affect the fair rationing of care. A socialized system--one which provides free care to everyone--will have to insist on a certain amount of taking turns, and it's true that sometimes people will have to wait for things like surgeries that (in fairness) shouldn't wait. So I think that a dual system makes sense: have a public option available to everyone--for free of course, but still have a few private options available. The private sector--as with education--would cost more, but if you had the money you could get things faster and/or get things which were not deemed 'necessary' but which you wanted (say, for example, an extra ultrasound, a vasectomy, or most cosmetic procedures). Honestly, I think some sort of combination like that probably makes the most sense.

Point #2--My understanding of the current bill is that it's not socialized medicine at all. It is actually an attempt to reform a capitalistic system. I don't know that I think it's ideal, but reform definitely seems in order, and I think this sortof plan is likely to go over with the American people much better than a truly social one.

• In my understanding, the bills calls for making efforts to cut waste by demanding that medical practice be evidence-based (rather than marketing-based). Well hallelujah! Unfortunately the research isn't always clear--sometimes one study directly contradicts another--so determining which evidence to use as basis for medical practice may be complicated...but I think that the bill is making a push in the right direction at least.
• The bill will determine the value of the doctors' time, which will probably cut the incomes of many of them (what's not to love about that?! I would like to see people enter medicine because they want to help others, not because they want to get rich). I recently heard the complaint that this is "putting a value on humans" but we've been doing that for years with minimum wage...I think it's a healthy change.
• The bill will offer an alternative to private insurance, so that everyone will be able to get some kind of insurance that they can afford, whether it's private insurance for the richer, public insurance for the middle class, or publicly-funded insurance (medicaid) for the impoverished. It would force insurance companies to change their policies so that they couldn't drop someone just because they got cancer and suddenly became expensive. In other words, it would provide insurance to everyone (but everyone would have their choice of insurances), as opposed to the social model of scrapping insurance and just giving everybody free care when they walk in the hospital doors.
• The government will push hard(er)--require?--people to get preventative medical care, including vaccines. (Um, they kinda 'require' vaccines already and if you don't believe in them it's pretty simple to get an exemption...) Although I expect more people would probably go in for routine check-ups, I don't see this making a difference in our right to make choices about our care, so again, I don't see a problem.
• One complaint I've heard is in regard to the rationing of care is that the elderly or those who have chronic/fatal conditions would likely be pushed to the end of the list for certain surgeries and treatments. It's a matter of doing the liver transplant for the guy who's 46 instead of for the guy who's 86, (regardless of how long they've been waiting or why they need it), because the former is likely to get more good out of it. On the one hand I can appreciate that that sounds a bit heartless, on the other hand I look at how many people are currently unable to get the treatments and surgeries that they need, and I think that if we're not going to be able to save everybody, it does make sense to try to save the ones who have the greatest life expectancy first.
  

A few other things that I think need to happen--and I don't know if they are in the bill or not (mostly I think not):

• It needs to be a whole lot harder to sue doctors for malpractice. Yes, it needs to be possible, but it needs to be harder. There should be more mediation and arbitration required before litigation is possible. With that in place, malpractice insurance prices should come down, and thus doctors fees should be able to come down.
• Costs should be the same for everybody. In other words, there should not be a pre-negotiated preferred rate for insurance companies but another (higher) one for people who pay out of pocket. There should not be preferred and non-preferred providers (with different rates of coverage). I suppose it's fine if one doctor wants to charge a little more than another, but I'd like to see it more like grocery stores...milk may cost more at one place than at another, but it's not much more, and the prices are public knowledge.
• It should be illegal to advertise for pharmaceuticals of any kind, or to anyone. In other words, when the drugs are released, doctors should receive information (brochures perhaps) detailing the contents, purpose, and side-effects of the drug. The doctors can then choose to add it to their repetoire or not. Meanwhile, there would be no drug lunches, no free palm-pilots given to doctors to encourage them to prescribe one thing over another, and none of those horrible ads which stealthily proclaim "this drug may change your life, (and it may kill you)...ask your doctor about it today!"
• The whole drug testing/approval process needs to be longer. In the rush to get new things on the market, the FDA has streamlined things so much that in my opinion most things are insufficiently tested before being released to the public (I think the frequency of drug-recalls for serious injuries and deaths validates this view). Anyway, I think a good option would be to do the testing as they currently do, and then release the drug as a "phase B testing" option, where patients (with their doctors) could choose it with the understanding that it had been through initial testing but was still considered experimental. It would be an informed consent sort of thing. New drugs would have to be in this phase for a minimum of 2 years (or x number of people trying it) before they could have final approval and be released for general usage. I think this would cut back on a lot of the lawsuits by helping protect and inform the population about things that have only had minimal testing, while still allowing them access to new formulas as soon as possible.

A final thought:
If you are scared about the idea of the government having control in our health care, I would ask you to think about the other things they control in this country: roads, the postal service, schools...I'm not saying that all those things are perfect, but would you really rather pay for private courier service when the post office provides free mail delivery (usually to your door) 6 days a week? Go ahead and complain about 40-something cent stamps, but remember what you'll pay to send the same thing via FedEx or UPS. Nationalizing a system can save costs and improve service (in my humble opinion), and I think that socialized medicine--or yes, that bill that's in the house right now--may have flaws, but it's a darn sight better than what we have right now.



(Feel free to leave more questions...I'll get to them in coming weeks!)