Motrin "Phantom Recall"

I haven't been able to find Motrin at any of my usual stores. Finally, I asked the pharmacist at Target, and she said it was recalled, but there's plenty of generic (i.e., ibuprofen).

A quick Google search later yielded McNiel Consumer Healthcare's attempt at a "phantom recall."

"The company at the center of a massive recall of children's Tylenol and other popular over-the-counter products tried to perform a "phantom recall" of defective Motrin by sending contractors around the country to buy up the medicine from stores without alerting regulators or the public, according to the chairman of a Congressional committee investigating the company."

Pathetic.

Washington Post article: Maker of children's drugs accused of hiding Motrin recall from public

Why It's My Choice

Funny thing is I didn't expect the intensity of the comments posted so far from my prior post. Naive? Perhaps.

Funnier yet, two of the three posters sent me to ICAN-Online, which is the website I referenced in that very post.

The point of concern with the commenters is that I am allowing my obstetrician to decide how I will deliver M2 (i.e., VBAC or C-Section). However, I don't consider myself an unknowing participant in this endeavor. I've read up on VBACs, spoken to people who have chosen in favor and against them, and I have developed all sorts of opinions that are completely independent of my doctor's. My first labor has a lot to do with where I am today, so I'll start there.

I had a doula, and every intention and expectation to follow through with a drug-free childbirth. I expressed my desire for as little medical interference as possible in my birth plan, though I was not interested in going the route of using a midwife.

My doctor began seriously suggesting that we induce at week 40, but my husband and I stalled until week 41. At that point, I was put on pitocin and she broke my water, only to discover there was meconium in the fluid (descriptions on Natural Childbirth.org and Kids Health.org). This was potentially due to my pregnancy having gone into week 41, although I suspect that's debatable. She did an amnioinfusion (diluted the amniotic fluid with saline to wash meconium out of the amniotic sac before the baby has a chance to inhale it at birth), which was to be one of many bags I was hooked up during my labor. Being hooked up to various bags prevents you from moving around, which in turn prevents you from dealing with your pain in a medicine-free way. I labored through the night with the help of my doula, but after 7 hours, I was exhausted and there was no position in which I didn't feel pain, even between contractions. I went for the epidural. After that, my doula stayed and helped us get through things, emotionally and physically. At one point, we were informed that during contractions, our son's heart rate was normal, but on the low side of normal. They took me off of the pitocin to see if that remedied the problem, but it didn't. What it did do was slow down the contractions. Between the slowing of the labor and the concern over my son's heart rate, the doctor "seriously" suggested a c-section. I don't know about you, but if someone says your baby's life is in danger and you should really have this done to help him, I'm not about to point to my birth plan and remind them of how much I really don't want a c-section.

So, he was born kicking and screaming, and hasn't stopped since. While a c-section was the one thing I truly didn't want, I genuinely couldn't put my preference above the well-being of my child. And I can't say that I truly blame the doctor, either. Being an obstetrician comes with it's set of troubles, which includes soaring malpractice-insurance premiums. It's an environment which impels a conservative approach (i.e., better safe than sorry).

I seriously considered going to a new doctor, but in the end, I guess you could say my reason to stay with the same doctor was the age old reason: better the devil you know than the devil you don't. When I was pregnant last time, I asked her all sorts of questions, including her c-section rate (~15%). And since I have no way of knowing how another doctor might have handled the same situation, how can I know things would have turned out different. What I do know is that my recovery went very well, and I haven't experienced any real pain or complications from the surgery. I've spoken to a few people who have not been so fortunate. I don't really like her bedside manner, but now that I know the nuances of her demeanor, I can take her "matter of fact" approach with a grain of salt. That, and I can mock her accent...it's hilarious.

Besides that, I know that a lot of doctors will not do a VBAC. She said she was open to the possibility, and quelled my concern of uterine rupture by saying the rate was well below 1%. But it's still a serious concern of mine. I know women who've experienced it, and it's not something I'd like to deal with first hand.

Maybe I'm just trying to make lemonade out of these lemons, but I can find merit to a VBAC and a c-section. My body has not really experienced labor, so there would be new and wonderfully painful things to recover from there. I have friends and family who seriously worry about a VBAC. I try to reason out why it's possibly safer than a c-section, but I can't help but think of the little things that can go wrong. Rare? Ya. Impossible? No.

Either method isn't making me jump up and down with excitement. But I'm not pregnant because I want to experience labor. I'm pregnant because my husband and I want to share our meager little home with a kid. We're doing that existential thing where we breed because we can and that's what we're biologically meant to do. Well, maybe that's an argument for another day, but my point is that I never cared about the empowerment or experience of labor, I just want to assure the safety of the baby and me. If I can still pick up and hug my toddler after the fact, that's just gravy.

Quick, Quick!!

A lot of stuff has come to a head because my doctor is concerned about the size of M2. MetaToddler was expected to be about 9 pounds when he was born at 41 weeks, but he was 7.11 pounds. So, ya...the docs were wrong. I've expressed my preference for a VBAC, and my doctor is willing to let it happen, but only if it happens by week 39. In other words, I have until this weekend to go into spontaneous labor. Otherwise, she's calling the game.

I have some friends and family horrified at the thought of a VBAC. But my reasoning is simple. A c-section is major surgery, something I'd prefer to avoid if at all possible. And perhaps more important, my recovery time would be significantly greater than with a regular birth, forcing me to deal with a serious recovery, a newborn, and a two-year-old. I'd prefer to be able to get back to my life sooner than later.

I suddenly feel so behind on my nesting. We have our car seat, assembled crib, laundered clothes , and various other readied things. I've made a few frozen meals to have on standby for those rough first few weeks. I don't have anywhere near as much as I did the last time, which is unfortunate. Oh well. We'll have a few easy meals on hand, and a few reliable favorite restaurants that deliver, so we should be fine on the food front. Sleep is another issue all together, but nothing you can do about that beast.

Le sigh.

I've had to accept that I won't be able to go to the farmers' market for a while. It's my weekly thing, and since I'm likely to have a c-section again, I'll have to forego seasonal treats for recovery. This is hard. Well, I'm finding a few things hard this time around. Before, I wasn't as involved in cooking, cleaning, and obviously, parenting. It was just MetaDaddy and me, so I cooked several meals that were frozen into two person portions, but no stress. I had gained much more weight, and couldn't clean, so MetaDaddy was doing all of the cleaning at home. And well, there was no one to parent.

This time, I've slowly had to accept that I couldn't keep cleaning to the level that I felt appropriate, so per MetaDaddy's insistence, we've had someone come over once a week to help out. We just have to maintain it, which isn't easy, but nowhere near as bad as cleaning it in the first place. And she's pretty meticulous, which I truly appreciate. Not as meticulous as I am, but hey, I'm a self-admitted PITA.

Also at MetaDaddy's insistence, we've also gotten a referral from a few friends for a nanny. Everyone loves this particular person, and our circle of friends have known her for years. MetaDaddy's concerns stemmed from knowing how hard the c-section was on me last time, and he's worried about how I'll manage at keeping MetaToddler happy while caring for M2. After all, it's me and the kid(s) alone all day. So any extra help will go a long way. I kept putting it off, and eventually, he won. We have a part time nanny. It's just so hard to give up caring for MetaToddler 100% that I can't easily let go. But I want to be fair to him and avoid his feeling neglected. He doesn't go to day care or preschool, so it's all me. And if I can't give 100%, well...boo! He's been getting used to the nanny over the past few weeks. She keeps up pretty well, so he's getting a lot of attention and excitement from her, which I'm having a hard time providing these days with my size and all.

So ya...if I don't go into labor over the next few days, it's c-section #2. I mean, it's not like in a perfect world I would go for a regular birth. In a perfect world, I'd aim for an "oh, it's a baby!" thing where it just magically appears after months of jabbing me in the ribs and bladder. Either way, another August birthday is about to hit the MetaHome.

We'll keep you posted on the deets.

Women Paying for Health Insurance

I'm so terribly offended by this phenomenon that I can't quite make enough sense of it. Per this article, women are charged more for health insurance than men, at least on individual policies. Group policies have enough people pooled together that the insurance company can spread the "risk" among everyone, thus negating the need to charge different rates for each insured person.

But insurance companies are in business to make money. Their actuaries crunched the numbers that concluded women are riskier to insure. Their results lead Blue Shield to deem "Hack and all other women are somehow more accident-prone, or more likely to break a bone, or more susceptible to costly ailments."

Come on? How many women do you know that walk around in casts? MetaDaddy broke his collar bone, and spent much of his childhood recovering from head dings and other random boy mishaps. Prior to my c-section, my worst injury was a bump on the head from a flying flute bumping me. Who was at the other end of the flute? Some clumsy guy. Go figure.

I was curious to know why we women are so dangerous. I came up with a few theories, and the article countered each one. Keep in mind that the article is referencing Blue Shield's policies in particular, although they do throw in some data from other insurance companies as a point of comparison.

• It's not about pregnancy because the policy in question doesn't cover pregnancy and maternity care.
• It's not about seeking more preventative care because that should make them better insurance risks. Someone in the article questioned whether or not the actuaries are assessing how much insurance is used vs. true risk. Interesting point.
  
• It's not a "women live longer" issue. As the article points out, on average, women pay more than men up until the age of 60, at which point the trend reverses and men are charged more than women. That said, men are "viewed as a lesser medical liability than women, who live longer on average because they tend to eat right, exercise more frequently and take better care of themselves." How contradictory can you get?
  

So, keep that in mind if you're shopping around for an insurance policy and you're a young, healthy woman. Even though you're likely a lesser risk than the clumsy slob down the hall who snowboards once a year and hasn't seen his ankles since Y2K was all the rage, you might still be paying more than him for the same insurance coverage.

Warning Against Mommy's Bliss Nipple Cream

Sometimes, it's hard to find out about potentially vital information unless you're reading blogs. It would be so easy to miss a little blurb here or there.

I nursed my son, and early on, it was painful. One source of relief was using a 100% lanolin nipple cream that was provided to me by the hospital. Per CNN (via Baby Toolkit), the FDA has warned women against using a similar product, Mommy's Bliss Nipple Cream.

"The cream, promoted to nursing mothers to help soothe dry or cracked nipples, contains ingredients that may cause respiratory distress, vomiting and diarrhea in infants, the agency said."

I'm assuming the product hasn't been recalled because it's not medical, hence not under FDA's jurisdiction, much like all other herbal remedies. However, the company has stopped selling the cream. Anyone who feels their child has suffered adverse effects should contact FDA's MedWatch at 800-332-1088.

Around the Internet

Office Depot Coupons via Dealcatcher - I like the Sharpies on page 3...$2 for a 12 pack. But beware the hands of kids.

Antibiotics do little for inner ear infections - Personally, I hate using antibiotics unless absolutely necessary (e.g., mastitis). The more you take them, the less likely they'll work when you need them. Yes, but you know I'm paranoid. This study found that "antibiotics don't significantly prevent fluid buildup in young children with inner ear infections." However, the article does go on to say:

"'To the best of my knowledge, physicians generally don't prescribe antibiotics for acute otitis media in order to prevent middle-ear effusion; they prescribe them to bring about more prompt resolution of the infection and of its symptoms, especially pain," said Dr. Jack Paradise, a professor of pediatrics and otolaryngology at the University of Pittsburgh School of Medicine and a pediatrician at Children's Hospital of Pittsburgh."

A bit of research to think about if you find yourself dealing with your child's ear infection. Though I truly hope you don't.

Employees at this Walgreens Distribution Center Are More Than Disabled - A Walgreens distribution center in Anderson, South Carolina employs 700 people, 40% of whom are disabled. It's an inspirational story, but it really makes you think about why it's a rarity. The workers interviewed for the story love their jobs. They're loyal and devoted. How is it that there are people who are willing and able to work, but can't find an unbiased chance?

Vaccines for Babies

Vaccines are a tough bag. Here's the CDC's chart of recommended immunizations for babies. But if you have an infant or toddler, I'm sure you've seen it once or twice ;-)

Well, unless if you're like us. We discussed vaccines with our pediatrician, and agreed to hold off on vaccines for MetaBaby. Not because we're cheap, irresponsible, or optimistic. In fact, it's the opposite. All of the vaccines that today's babies are expected to cope with are grueling. They're young, immature systems are put through the wringer enough without adding the unnecessary burden of so many shots. At least that was our thinking.

Because I nursed him exclusively from birth, he was protected by the immunizations I've been given over the years. That said, if I hadn't nursed him, we obviously would have given him shots from day 1. But we were comfortable in understanding the protective qualities of breast milk. We've also been very protective of his health, and have been observant of anything out of the ordinary. He's been fine. He got his first shot at the age of 12 months, and he's slowly been given more.

So he has relatively little experience with shots. And they haven't really bothered him. I sit him on my lap, distract him for the prick, and it's over before he knows anything happened. We leave the doctor's office all smiles. And although he has a bump on his upper thigh for a few days after, he's otherwise fine.

However, I know it's likely this reaction will change after a while. And perhaps because it's been a while since I've gotten vaccines, I didn't realize all of the potential pain associated with shots. I figured it was just fear of the sharp something heading towards tender skin.

Kathryn, over at Ryn Tales has two great tips on minimizing pain for vaccinations.

1) Apply ice to the area for 20-30 seconds prior to the shot. I've never heard of anyone doing it, nor have I thought of it myself. But reading this was a truly "duh" moment.

2) Much more complicated for my monosyllabic verbal abilities. Use the Ventrogluteal Site for Intramuscular Injections. For several reasons, the traditional buttock or upper-middle thigh area are not the best in terms of safety and/or pain management. However, despite the excellent description, I couldn't tell you exactly where it is, so here are a few photos to help put the pieces together.

"The ventrogluteal site is relatively free of major nerves and blood vessels, the muscle is large and well defined, and the landmarks are easy to locate. It is an excellent IM [intramuscular] injection site, even in infants. Simply place the palm of your hand over the greater trochanter (hip joint), index finger over the anterior superior iliac tubercle, and middle finger along the posterior iliac crest. Inject perpendicular into the center of the V formed by the separated fingers."

I know I'll be discussing this area for a shot the next time we go in. We'll see how it goes. But take a look at it for the yourself. If your little one seems to suffer with shots, why not do what you can to keep the pain to a minimum? A lollipop can only do so much, after all :-(

Week in Review

Well, maybe not a whole week, but I need to just get it all off my chest while it's fresh.

• I got a papercut that was blindingly painful. The thing about papercuts is that they mildly freak me out, especially after watching Swimming With Sharks. A quick, sharp, searing pain that can be caused by something as mundane as opening an envelope. I'm so paranoid about them that I haven't had one in ages. Years? So when I got one this past weekend, I...well, I squealed. Possibly screamed. It really hurt!! I'm pretty sure I saw blood!! Anyway, my point is that sometimes people get papercuts, and despite being so trite, we can't help but share our pain. Hence, I, like Madame X, am sharing my pain.
  
  
• As you read the following, keep in mind that MetaDaddy has been away all week on business. It couldn't be avoided, and though he suggested coming back early, I insisted he stay because of a presentation he'd been working on all month.
  
  
• MetaToddler got sick on Saturday and couldn't keep any food down. But as I posted here, he was much better on Sunday. It's funny how when you don't appreciate the delicate nature of a toddler's stomach, it can come back to bite you. So Monday afternoon, he got sick again. And the water and bland diet started once again. The tiniest amount of water every 45 minutes. After doing that twice, he was noticeably hungry, so I gave him some dry toast, of which he only had half. This from a tiny little guy who can eat a 6-inch pita bread with hummus as a snack, then eat dinner. Needless to say, I didn't push more on him. He went to bed and slept through the night.
  
  
• That night, wouldn't you know it but I found out for sure that he had a stomach bug as opposed to having eaten something dodgy. I was sick all night. I woke up every hour starting at 2:30 until about 7:30. Honestly, I probably should have just gotten up since I suspect I was more nauseous while lying down than sitting up.
  
  
• Tuesday was a sad day indeed with me despondently lying on the sofa with the TV on to distract MetaToddler from the kitchen. He kept going in asking for food, but he didn't know what he wanted. Crackers, bananas, toast, and rice were mostly just sprinkled all over the floor. We didn't go out at all, and though I felt terrible at not even taking him out for a walk or short drive, I genuinely didn't have the energy. So, we just quietly rode the day out, and I suspect he finally learned that he can climb the sofa on his own. Darn!
  
  
• Today we're better, but still taking it easy. Had to cancel some plans, and will probably cancel plans for tomorrow since I hear a stomach bug can last at least 3 days after recovery per the CDC:
  

  "People infected with norovirus are contagious from the moment they begin feeling ill to at least 3 days after recovery. Some people may be contagious for as long as 2 weeks after recovery. Therefore, it is particularly important for people to use good handwashing and other hygienic practices after they have recently recovered from norovirus illness."

  The last thing I want to do is get any of our friends sick!
  
  
• All of my down time let me finally to finish "Mostly Martha." It's in German, which means reading, but eh...nice for a change. The story wasn't new, but it was a well-done chick flick without being too cutesy or schmaltzy. And the lead, Martina Gedeck, was really well cast. She's a perfectionist head chef at a fancy restaurant, and her career is her life until her sister dies in a car accident, leaving Martha to care for her 8-year-old niece until her father can be found. When a confident new chef is hired to replace her very pregnant sous chef, she struggles to maintain order in her once seamless life. It was recently remade here as "No Reservations" with Catherine Zeta-Jones and Aaron Eckhart, which didn't strike me as interesting as the original. Honestly, they seldom are. If I'm feeling daring one day, maybe I'll watch to compare.

Enough whining. It can only get better from here, right? OMG...I hope MetaDaddy doesn't get sick!!! Note to MetaDaddy: DON'T. TOUCH. ANYTHING.

Caffeine During Pregnancy

When I was pregnant with MetaBaby, I remember hearing either (1) don't drink any caffeine or (2) drink one or two cups per day. It was ambiguous, but since I wasn't hooked on caffeine, I just gave it up cold turkey. It was only really difficult on those days when I struggled in waking up...ugh.

But now there's a study confirming the dangers of caffeine during pregnancy. The strange thing is that caffeine in moderate amounts is actually dangerous.

"They found that women who consumed 200 milligrams or more of caffeine daily — the equivalent of two or more cups of coffee or five 12-ounce cans of soda — had twice the risk for miscarriage. Moreover, the study found that even those women who consumed less than 200 milligrams of caffeine daily had about 40 percent increased risk for miscarriage."

That's huge!

More important, 200 milligrams is hard to quantify because it can vary based on various things like the size of the cup of coffee, the roast of the bean, and how the coffee is brewed.

NPR's article listed the caffeine content of some of the more common sources of caffeine, which I found eye-opening.

Coffee & Energy Drinks
Starbucks Latte, 16 oz.: 150 mg
Coffee, brewed, 8 oz.: 95 mg
Red Bull, 8.3 oz.: 76 mg
Espresso, 1 oz.: 64 mg
Instant coffee, 8 oz.: 64 mg
Coffee, decaf, brewed, 8 oz.: 2 mg

Tea
Black tea, 8 oz.: 47 mg
Green tea, 8 oz.: 30-50 mg
Herbal tea, 8 oz.: 0 mg

Sodas
Mountain Dew, 12 oz.: 54 mg
Diet Coke, 12 oz.: 47 mg
Dr Pepper, 12 oz.: 41 mg
Pepsi, 12 oz.: 38 mg
Diet Pepsi, 12 oz.: 35 mg
Coca-Cola Classic, 12 oz.: 35 mg
Barq's Root Beer, 12 oz.: 23
7Up/Sprite, 12 oz.: 0 mg

Other
Excedrin, Extra Strength, 2 tablets: 130 mg
Hershey's Chocolate Bar, 1.55 oz.: 9 mg
Hot cocoa, 8 oz.: 8 mg
Chocolate milk, 8 oz.: 6 mg

Bracing Myself

Sometimes I do things that I regret as soon as it's too late to back out.

I'm getting braces.

I'm in my 30s, with a husband and kid, and I'm getting braces. Funny enough, I just heard a story on NPR about adults who go to the trouble and expense of cosmetic dentistry. One person said she had braces as a teenager, but now at 53, her teeth have reverted back to their crooked positions. Apparently, teeth have a good memory. Maybe they can help me find my phone the next time it's ringing during MetaBoy's nap.

And here's another article where a 47-year old woman detailed her experiences with braces...after forcing her son to endure the torture. He had his fun with that ;-)

But I digress.

Some background. Obviously, I didn't get braces as a teenager...otherwise, I probably wouldn't be posting about this. My teeth are only slightly crooked, but they're pretty compacted. How bad is it? I hate flossing because it leaves my teeth hurting for the rest of the day. So I floss infrequently and at night. I've also come to notice that since my upper molars don't sit flat on my lower molars, my lower teeth are wearing down at an angle, which will likely lead to problems down the road. Oh, and one tooth is crooked and bothers me aesthetically. However, there's no way I would do this if it was just for that one tooth. I'm just saying.

A couple of other reasons for giving in to this ridiculous whim of mine:

• My orthodontist said it should take about 8 months, which really didn't seem like a significant time commitment...at the time.
  
• We had enough FSA money left over in 2007 that it was worth looking into what we could benefit from spending it on. This was added to the fact that our dental plan is pretty generous with orthodontia.
  
• I'm not working, which means I don't have to convince people to respect my authority despite my height, gender, and youthful appearance. Braces would not have worked to my advantage at work, so this is as good a time as ever to follow through with it.
  
• My husband's theory is that if I'm happy, everyone's happy. Truly the mark of a smart man.

As for the gear, I chose braces over Invisalign, which are a series of trays that fits over your teeth to slowly move them into place. While I was a candidate for them, my orthodontist pointed out that they take longer and are on average only 80% effective. He's had patients who need braces for a couple of months after Invisalign to attain a healthy bite. That meant that it would have costed more, taken longer, and might not have yielded final results.

Soooooo...here I am.

This past week, I had spacers put in, which are 8 teeny tiny rubber bands inserted between 4 molars. They're put in place with floss, which was actually a challenge because it's hard enough to get floss in at the best of times. Nevermind if you're leaving little rubber bands behind. A couple of days after I could feel my teeth had moved because my bite feels misaligned. Between that and the movement of the teeth in general, chewing is actually quite a challenge right now. I can't chew anything hard. I can hardly chew soft things, mostly opting for MetaBaby-soft food. An interesting side-effect is that I truly appreciate Boogie's teething pain more than ever. I also shrink at the thought of people who go for years with dental pain, and don't get it fixed. MetaDaddy apparently spent 10 years chewing on one side because he was avoiding a root canal. Yes, a root canal sucks. But 10 years of chewing on one side? Seriously?!?

Had I known the pain was going to start once the spacers were in, I would have had a ridiculous buffet send-off of hard, sticky, chewy foods like steak, ribs, apples, gum, cucumber...ugh, and how I miss salad.

Next week, the hardware.

Hospital Fine Dining

I sure wish the hospital I had MetaBaby in had fine dining like this. It would have made for 3 much tastier days (the first day was ice chips -- there's no such thing as fine dining ice chips). The segment on ABC stated that about 20% of hospitals now have restaurant quality food. There are even food competitions for the chefs.

Here's the dish, per ABC news.

A menu sampling:

Kaiser Permanente Hospitals:
Crisp Garden Salad
Ancho-Citrus Marinated Loin of Pork - Served over an essence of Natural Jus, paired with Cinnamon Stewed Apples. Comes with Barley Pilaf and Steamed Broccoli.
Seasonal Fresh Fruit

University of Washington Medical Center, Seattle:
The Evergreen Salad - A fresh baby green salad with your choice of grilled salmon, julienne of chicken breast, grilled vegetables or tofu. Served with balsamic vinaigrette.
Lemongrass Pork Loin - A taste of lemongrass, fresh ginger, lime juice and soy sauce -- cooked to perfection.
Chocolate Torte

Inflammatory Breast Cancer or Mastitis?

If you're not nursing, but you have mastitis-like symptoms, have you considered getting checked out for Inflammatory Breast Cancer? It's different to the mainstream breast cancer we've been trained to inspect for because there is no lump, but it's just as lethal. Here's a 6 minute video clip from ABC News with some good info.

Inflammatory Breast Cancer

WhyMommy at Toddler Planet, who is currently fighting IBC, is doing a world of good by helping get the word out.

If something doesn't feel right, get it checked out. Something to keep in mind as we go through our daily struggles to avoid falling behind on work and family affairs.

Event: Families and Allergies

Here's an interesting event for parents of kids with allergies.

Food Allergy Day at the Zoo

The Zoo joins forces with the UCLA Food Allergy Clinic to present a day of education about food allergies, featuring talks by experts in pediatric allergy and immunology, exhibits, cooking demonstrations, and parent networking. Activities and games for kids are also planned, as are face painting, videos, and, of course, the animals. Access to the zoo is free to those registering before September 30.

Date: Saturday, October 6, 2007
Time: 10am-4pm
Cost: Adults $7; Children $4

Via Go City Kids

Mastitis

I wish I knew all of the "what ifs" about nursing because it wasn't an easy start, let me tell you. Let's get in the "way, way back machine" and start at the very beginning. When I started nursing, I just went with the flow (tee hee...flow) and let MetaBaby nurse away. He latched on well and was doing a great job. I had a lot of milk -- possibly too much milk. At some point, just after I was recovering from my C-Section, I got a lump on my breast. After doing a lot of research online, I discovered it was probably a plugged duct, which Dr. Sears describes as follows:

Sometimes a milk duct leading from the milk-making cells to the nipple gets plugged, resulting in a tender lump beneath the areola. There may also be a wedge-shaped area of redness extending from the lump back towards the wall of the chest. Unlike mastitis, the pain comes and goes with a plugged duct, and unless the duct is infected, you will not feel generally ill. If left untreated, however, a plugged duct may become infected, resulting in mastitis, infection, or a breast abscess.

I tried the following methods to clear the duct, which were a combination of tips I read online, as well as suggestions from my lactation consultant.

• Nursed from the affected side first at every nursing session.
  
• Pressure massage the lump in the direction of the nipple.
  
• Apply moist heat compresses or take a shower before nursing.
  
• Wear a non-restrictive nursing bra.
  
• Treat self like you have a cold: get a lot of rest (nurse baby in bed), drink fluids, take echinacea, lecithin, and extra vitamin C & E.
  
• Position nursing baby's chin towards plugged duct.

Despite my best efforts, the lump only got worse. I didn't have a fever, so my lactation consultant and I were consoled in knowing that I didn't have mastitis. She really helped me exhaust the natural methods to clear the duct. While I really didn't want antibiotics, in the end I had no choice. I started on them on a Friday, and the next day, I noticed there was an abscess in the affected area. It turns out that I not only had mastitis, it had developed into an abscess, which in case it's not obvious, hurts like you would not believe. A portion of it drained that weekend, and I went to see my ob/gyn on Monday.

She was pretty nonchalant about it until she saw it. She gasped in what I can only assume was horror, and sent me straight to the surgeon two floors down. He took a look and sent me to get an ultrasound to see how much fluid was left and if it was worth draining. It turns out there wasn't much left, but he was pretty concerned, so he drained it to allow the area to heal properly. Out-patient surgery...eek! The sound of that scared me, but it turns out it wasn't too bad. It was quick, and MetaBaby was cooing in his stroller a few feet away. I won't say it was painless, but it didn't hurt as much as the abscess, so I just coped. I went back for a few follow ups and it seemed to have cleared up pretty well. Once I stop nursing, I need to go back and get a mammogram to evaluate the health of the breast when it's off duty and milk free.

The moral of the story?

• You can have mastitis even if you don't have a fever or flu-like symptoms.
  
• When you start nursing, avoid engorgement as much as possible. Allow you're baby to drain each side well, but don't use a pump to finish the job as this will impact your milk supply.
  
• Cabbage leaves on your breasts serve to reduce your milk supply. They're great to relieve engorgement, but do so sparingly so you don't overdo it.
  
• Wear a bra that doesn't dig into any sensitive areas, and avoid underwires entirely, or at least until after your milk supply settles.

Dr Sears' list of mastitis symptoms:

• Part or all of the breast is intensely painful, hot, tender, red, and swollen. Some mothers can pinpoint a definite area of inflammation, while at other times the entire breast is tender.
  
• You feel tired, run down, achy, have chills or think you have the flu. A breastfeeding mother who thinks she has the flu probably has mastitis. Mothers with mastitis will sometimes experience these flu-like symptoms, even before they get a fever or notice breast tenderness.
  
• You have chills or feel feverish, or your temperature is 101F or higher. These symptoms suggest that you have an infection.
  
• You are feeling progressively worse, your breasts are growing more tender, and your fever is becoming more pronounced.
• With simple engorgement, a plugged duct, or mastitis without infection, you gradually feel better instead of worse.
  
• Recent events have set you up for mastitis: cracked or bleeding nipples, stress or getting run down, missed feedings or longer intervals between feedings.

Potential causes, per KellyMom:

• Engorgement or inadequate milk removal (due to latching problems, ineffective suck, tongue-tie or other anatomical variations, nipple pain, sleepy or distracted baby, oversupply, hurried feedings, limiting baby's time at the breast, nipple shield use, twins or higher order multiples, blocked nipple pore, etc.).
  
• Infrequent/skipped feedings (due to nipple pain, teething, pacifier overuse, busy mom, return to work, baby suddenly sleeping longer, scheduling, supplementing, abrupt weaning, etc.).
  
• Pressure on the duct (from fingers, tight bra or clothing, prone sleeping, diaper bag, etc.).
  
• Inflammation (from injury, bacterial/yeast infection, or allergy).
  
• Stress, fatigue, anemia, weakened immunity

The Pump Station's list of possible causes:

• Missed or irregular feedings and/or an unusually long interval between feedings.
  
• Pressing the breast to provide nostril space for the baby.
  
• Wearing a tight or poorly fitting bra that impedes milk flow.
  
• Having an overabundant milk supply and insufficient breast drainage.
  
• Practicing vigorous upper arm exercise.
  
• Extreme exhaustion.
  
• Rapid weaning.

I hope none of you ever have to deal with any of these issues, but you're better off if you know what you're dealing with. That said, this post is only a reflection of my experiences. Be sure to contact your doctor if you have any serious symptoms because time is of the essence. The sooner you resolve the problem, the less drastic your course of action.

Note: October is Breast Cancer Awareness month. Go check out Mom's post at What Works For Us on breast cancer facts and statistics. The numbers are staggering.

Parents Mag Sept 2007

If you're anything like me these days, getting through a magazine is such a feat that it feels like it should require some sort of medal at completion. If nothing else, cake, pie or a muffin. Unforunately, I'm still waiting for my muffin :-|

That said, the information I walk away with is always worth the effort. In case you're still trying to get through Parents Sept 2007 issue, here are some things I found especially enlightening.

Get rid of your old computer - Donate unwanted but still working computer equipment to the National Cristina Foundation, which provides used computers to disadvanted people in your community.

Homemade Stamps - 3 ingredients: the plastic top of a laundry detergent bottle, a sponge cut into a fun shape (e.g., square, heart, circle), and a glue gun. Glue on the sponge to the bottle top, which serves as a handle, dip in paint, and stamp away.

Prescription Errors - As with adult prescriptions, kid's presciptions can have errors. It might be the wrong pills, wrong dose, or something else, any of which can be a serious medical hazzard. Always check the prescription for accuracy. Don't sign a consultation waiver until you're either satisfied or you've seen a pharmacist, especially if you've never used the medication before. On that note, don't sign anything unless you've read it; you might be signing to decline meeting with a pharmacist. Per Parents, 15% of kids receive a presciption drug with a potential dosing error, according to a study in The Journal of Pediatrics. Here are some questions to consider.

Pick Fresh Apples - Find a local farm to pick fresh food at Pick Your Own, as well as a lot of great food facts.

Sears Kid's clothes - A warranty for all kid's clothes: "If an item wears out before your kid outgrows it, Sears will either repair or replace it with the identical item in the same size or, if it's unavailable, a similar item of equal value in the same size." Just take the article of clothing and your proof of purchase back to Sears.

Fun Sandwich Bites - Cut a sandwich into fun bites with an apple slicer.

Sandless Sandbox - If you don't like the idea of sand in your kid's sand box, fill it with dry oatmeal instead. That way, if he eats it, all he got was a little more fiber ;-)

Flying Delays with Kids - If you're stuck in an airport with your little one, ask for kid-friendly activities in the terminal. Las Vegas' McCarran Airport has a mini control tower and tunnel. Orland Airport has a 3,000 gallon fish tank. We might be using this one soon :-) Cheap Flights listed more on this pdf.

The Island

Life can be unfair...her second miscarriage

Some medical professionals can be completely void of feelings...her ultrasound tech

People can be selfish...her boss

Others can be kind ... go be kind

The Island

How to Crush a Pill with Spoons

James was kind enough to comment on an important caveat that I failed to include in this post. Not all pills should be crushed because it can change how the pill was intended to work, and that can be dangerous. Here's a link that addresses the topic. As such, you should speak with your doctor or pharmacist before crushing pills. But if you get the green light, the technique I mention below is a cheap and easy method.

Thanks, James, for pointing out my oversight.

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We used to do this to give our cat her medication. It worked really well, though she still knew the medication was in the food and thus avoided it.

Take one spoon and put the pill in it. Take a second spoon and place on top. Crush.

Breastfeeding on Codeine

Are you nursing? Are you taking codeine? NPR reported on a recent FDA advisory to doctors and nursing mothers cautioning on the mother's use of codeine for the sake of nursing babies. If a mother is a "supermetabolizer," her body will break the drug down into its active form, morphine, too quickly. The morphine then floods the bloodstream, which "can cause drowsiness and interfere with breathing," potentially resulting in an overdose in the baby. It's rare though (1 reported death), and no other medications that include codeine (e.g., cold medication) have reportedly EVER caused any problems.

"If you're a nursing mother taking codeine, call your doctor if you're having difficulty taking care of your baby," Kweder says. "It could be a sign that you're metabolizing the drug more rapidly than most people."

It's the most widely prescribed postpartum medication, and the agency is NOT trying to eliminate its use. However, since 1-10% of people metabolize codeine rapidly, the article says there's reason to be cautious and watch for baby's reactions. There are genetic tests, but they're very expensive and not widely available. Mom's are better off getting the lowest dose of codeine for the shortest amount of time.

Overall, it sounds scary, but it's not a life-altering concern. Be cautious and observant with your baby. The article's suggestion to "call your doctor if you're having difficulty taking care of your baby" is a bit generic. What new parents get home and say "wow, this is much easier than I thought." Babies are difficult to take care of, full stop. But as with anything, if something doesn't seem right, call your doctor; that's what s/he's there for. And as your baby gets older, it becomes easier to see when behavior is out of character.

Generally, I try to take the least amount of medication needed (dose and duration) for my sake, and moreso now that I'm nursing. I take a daily vitamin. After a terrible bout of mastitis, I was taking lecithin for a while in hopes of keeping the ducts clear and flowing, though I stopped after a while with no ill effects. I've taken a bit of cold medicine during the worst part of my cold (twice since MetaBaby was born), though I try to keep that to a minimum because my doctor said antihistamines reduce a nursing woman's milk supply (true or not, why tempt fate?). The only other thing I take is Tylenol for my occassional migraine, which just barely lets me get by.

Another Reason to Love Olive Oil

Harold McGee is an interesting guy. He's just fascinated by the science of food, and how it's transformed in the kitchen. He's written a few books, the most popular of which is probably On Food and Cooking, and blogs when the moment strikes. He's the guy who steered me towards capers in salt instead of capers in vinegar, which opened up a world of possibilities for me. I long for his rare but insightful posts, and I think I'll have to cross my fingers in hopes of getting his book for my birthday (yes, sweetie...I'm talking to you ;-).

One recent article in the NY Times got me thinking about the healthful qualities of olive oil.

"The sensations of bitterness, astringency and pungency are caused by members of the phenolic family of chemicals. Phenols also have antioxidant properties and so help to protect the oil from going rancid. Whenever you taste an especially peppery oil, it’s an indication that the oil is rich in olive extracts and relatively fresh."

But wait, it gets better. Dr. Gary Beauchamp, an ibuprofen connoisseur, did about 5 years of self-funded research along with a few other contributors and found the phenolic chemical in olive oil, which they named it oleocanthal. "They showed that oleocanthal is even more effective than ibuprofen at inhibiting enzymes in the body that create inflammation."

"In their 2005 report to the journal Nature, the team noted that anti-inflammatory drugs like aspirin and ibuprofen appear to have long-term health benefits, including reduction in the risk of some forms of heart disease and cancer. They suggested that the oleocanthal in pungent olive oils might be one of the things that make traditional Mediterranean diets so healthful."

So, I wonder if it helps if you have a headache? Well, even if it doesn't, it sounds like it might surely contribute to healthy living in more ways than I thought. So a glass of red wine, some dark chocolate, and a bit of olive oil...Cheers!

Before I sign off, Mr. McGee's additional notes on storing olive oil from his blog.

• Heating olive oil reduces the levels of most phenolic compounds.
  
• Pepperiness gradually fades as an oil ages. [I assume this means it's potential health benefits might be reduced as well]
  
• Don't save a good olive oil because the balance in flavors is temporary; enjoy it while it lasts.
  
• Store in a cool place protected from light to slow its aging.

Inflammatory Breast Cancer

There are so many unknowns in our lives. We do what we can to stay informed and be cautious with those things we care about. Health is one. For years, for example, it was assumed that women's health issues were to be equally compared to men's, which is why women's strokes often went misdiagnosed. It turns out that women experience different symptoms to men during a stroke, leading doctors and nurses to miss the window of opportinuty for effective treatments.

But then there are other diseases that we might feel we understand. If you have a lump in your breast, get it checked out. But what if you don't have a lump? Below, Why Mommy's post at Toddler Planet on her experience. That rash...that inflammation...that nuisance...it was cancer.

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Inflammatory breast cancer

We hear a lot about breast cancer these days. One in eight women will be diagnosed with breast cancer in their lifetimes, and there are millions living with it in the U.S. today alone. But did you know that there is more than one type of breast cancer?

I didn’t. I thought that breast cancer was all the same. I figured that if I did my monthly breast self-exams, and found no lump, I’d be fine.

Oops. It turns out that you don’t have to have a lump to have breast cancer. Six weeks ago, I went to my OB/GYN because my breast felt funny. It was red, hot, inflamed, and the skin looked…funny. But there was no lump, so I wasn’t worried. I should have been. After a round of antibiotics didn’t clear up the inflammation, my doctor sent me to a breast specialist and did a skin punch biopsy. That test showed that I have inflammatory breast cancer, a very aggressive cancer that can be deadly.

Inflammatory breast cancer is often misdiagnosed as mastitis because many doctors have never seen it before and consider it rare. “Rare” or not, there are over 100,000 women in the U.S. with this cancer right now; only half will survive five years. Please call your OB/GYN if you experience several of the following symptoms in your breast, or any unusual changes: redness, rapid increase in size of one breast, persistent itching of breast or nipple, thickening of breast tissue, stabbing pain, soreness, swelling under the arm, dimpling or ridging (for example, when you take your bra off, the bra marks stay – for a while), flattening or retracting of the nipple, or a texture that looks or feels like an orange (called peau d’orange). Ask if your GYN is familiar with inflammatory breast cancer, and tell her that you’re concerned and want to come in to rule it out.

There is more than one kind of breast cancer. Inflammatory breast cancer is the most aggressive form of breast cancer out there, and early detection is critical. It’s not usually detected by mammogram. It does not usually present with a lump. It may be overlooked with all of the changes that our breasts undergo during the years when we’re pregnant and/or nursing our little ones. It’s important not to miss this one.

Inflammatory breast cancer is detected by women and their doctors who notice a change in one of their breasts. If you notice a change, call your doctor today. Tell her about it. Tell her that you have a friend with this disease, and it’s trying to kill her. Now you know what I wish I had known before six weeks ago.

You don’t have to have a lump to have breast cancer.


P.S. Feel free to steal this post too. I’d be happy for anyone in the blogosphere to take it and put it on their site, no questions asked. Dress it up, dress it down, let it run around the place barefoot. I don’t care. But I want the word to get out. I don’t want another young mom — or old man — or anyone in between — to have to stare at this thing on their chest and wonder, is it mastitis? Is it a rash? Am I overreacting? This cancer moves FAST, and early detection and treatment is critical for survival.

Thank you.