At the end of every winter I tend to get a little ornery and generally cranky. I usually discover this when I am complaining to Sara about some deficiency in our lives, "How come we haven't been on a vacation by ourselves in almost 10 years...I need to put about $1500 in my car...How come we're always struggling...I wish we had the money to go skiiing," and on and on. At this point Sara usually points out that I always feel this way at this time of year, and that spring will be here soon, and we will be able to get outside and do some of the stuff that is inexpensive but brings us happiness.
One of the things I like most in the warmer months is my little garden. People are always surprised and amused by my interest in plants and the natural world, particularly within the confines of a city. To me its a natural outgrowth of a life spent living in the city, but valuing the natural world and the time my family spent outside. I call this urban ecology. This year I've been reading Four-Season Harvest by Eliot Coleman. This is a great book about how to lengthen the growing season to the point that you can get fresh vegetables out of your garden all year long, even in a climate like New York. My favorite thing about this book is that it uses logical, simple, and inexpensive methods to maximize the amount of fresh vegetables you can grow all year long. With a combination of composting, cold protection, choosing realistic winter crops, and working within existing natural systems I think I can produce fresh vegetables all year long.
In thinking about this, it has occurred to me that there are ramifications across our lives if this becomes a reality. I want to make sure that we have balance. I believe in moderation in all things. If you wanna eat bad, great, but make sure you go play some ball. If If you want to drink a few beers, great, but you probably shouldn't do it everyday. Conversely, if you want to eat healthy, great, do it, but it doesn't make you morally superior, and you should loosen up sometimes. All this to say: We generally eat healthy food, but it will involve doing some things differently. For instance, we will have to figure out how to make use of leeks and endive, vegetables that will grow in the winter, but we have no real tradition of eating or cooking, and figure out how to incorporate them in our daily diet. Another adustment will be the care for the garden, instead of working outside for a few months of the year, it will be a less intense burst but more constant type of work. I think it will be a great thing for the family to do together. I love the fact that my son will pick up a shovel and think of it as a fun time to spend an hour shoveling snow with his dad.
We'll have to see how this goes, adding twins to a family doesn't seem to leave much time for urban agriculture, but I hope that if we set realistic goals it will happen. I'm going to start by re-invigorating my composting system and building a cold frame out of some scrap lumber I have laying around and scavenged old windows.
Who knows when I'll get on the blog again, but hopefully I'll have something to add soon, and if all goes well, next February I won't be complaing about my life. But, to be honest, I don't know if I'll have time to complain a year from now.
-Nick
Sunday, February 21, 2010
Tuesday, February 16, 2010
What I now know about Clubfoot
We got our in-utero diagnosis of baby A having a clubfoot for the first time on December 3, 2009. After all we had been through with the miscarriages and then the beginning of this pregnancy with baby B having less fluid and a smaller sac and no one expecting him to make it really (except me- I just knew he would) I was dying to get through our level II ultrasound with no problems. Ha. I asked 200 questions during that ultrasound. I was anxious to know the sex of the babies, but moreso I was anxious to know if everyones brain looked alright and their kidneys and their stomachs. And all of those were fine. Then the radiologist came in and I thought we were done. I will never forget the feeling when he turned and said "we think there is something you should know." Then he told us that he thought baby A had a clubfoot and that it could potentially be related to other genetic defects, like Down Syndrome or Spina bifida. I tried so hard not to cry. But by the time I was waiting for the lady to make my follow up appointment, I was in tears. I did not want to tell anyone and I just wanted the whole thing to go away. It did not help that we could not get a good view of baby A's heart so we had no idea if there were other genetic defects or not.
The following three weeks went by in a blur. It was getting close to Christmas and we had last minute things to do. I refused to speak with a genetic counselor. I had previously done that when we received genetic testing and it just scared me. We weren't going to terminate and I have a sister with Downs so I just wanted to concentrate on Christmas and making life as happy as I could for Gavin and for us.
Our follow-up appointment was December 24, 2009. I expected to hear that his foot was still affected and it was. The radiologist was cold and almost argumentative with Nick who is never really argumentative with anyone. The radiologist walked in and all he said was, yep, at your last appointment we told you your baby might have a clubfoot and I am telling you now, he definitely does. Nick was asking what made the diagnosis definitive and what made this appointment different than the last and the radiologist kept replying that now he definitely has a clubfoot. All he wanted to know was how they knew for sure now and did not know for sure 3 weeks prior. Needless to say, I wanted out of there fast. We were told the baby would need to have a fetal echocardiogram and it just so happened that the pediatric cardiologist that we were being referred to could see us that day. He did and both of the babies hearts looked great and normal. What a sigh of relief on Christmas eve!
Once Christmas was over, I could begin my frantic research about clubfoot. I first spoke with moms on the clubfoot support board on babycenter.com. I was told about a Yahoo group called nosrugeryforclubfoot, which I joined as well. Immediately, I found that moms and dads of children with clubfoot are so supportive. It made me feel better immediately and I was able to ask questions and get an idea of where to begin. I was informed that the current method of treatment was started by Dr. Ignacio Ponseti in Iowa and it consists of a series of casts that basically adjusts the babys foot a little a time until a satisfactory level of correction has been reached. These casts are done over a 9-12 week period and thereafter the childs feet are immediately placed in braces to make sure that the correction stays and a relapse does not occur. The braces are worn for 3-4 months for 23 hours per day and thereafter the baby is weened off the braces during his awake hours but will continue to wear the brace during sleep until 3-4 or potentially 5.
The cause of clubfoot is not really known although it is thought to be due to genetics or the environment. I initially thought that the environment meant occurrences that happened outside of the pregnancy- like taking medication or having had a drink prior to knowing I was pregnant, since both of these things took place and I am having a child with clubfoot. However, I have since been told by at least one pediatric orthopedist that environment refers to the womb and whether or not the baby has space or is pressed up against the mother's uterus. I have also learned that in boys that have one clubbed foot or unilateral clubfoot with no other genetic markers, the cause is usually not genetics. However bilateral clubfoot and clubfoot in girls more often means that it stems from genetics.
I learned that over the history of treatment for clubfoot there have been many trends. From casting to surgery. Dr. Ponseti is not the first doctor to cast. However, he is the first to cast in this method with this series of casts. Current trends seek to avoid surgery as much as possible and if necessary, parents hope only for an in-office tenotomy with no general anethesia. We hope the same.
Our first appointment with who we hope to be our pediatric orthopedist is Tuesday March 2. We will be attending our meet and greet with the doctor as well as seeing the clubfoot clinic at Hospital for Joint Disease in NYC. We will see all different stages of casting and braces on many different children and have the opportunity to meet and speak with the parents of these kids. I think it will be a learning experience and hopefully will ease some of our fears regarding what is coming. I will keep you posted!
The following three weeks went by in a blur. It was getting close to Christmas and we had last minute things to do. I refused to speak with a genetic counselor. I had previously done that when we received genetic testing and it just scared me. We weren't going to terminate and I have a sister with Downs so I just wanted to concentrate on Christmas and making life as happy as I could for Gavin and for us.
Our follow-up appointment was December 24, 2009. I expected to hear that his foot was still affected and it was. The radiologist was cold and almost argumentative with Nick who is never really argumentative with anyone. The radiologist walked in and all he said was, yep, at your last appointment we told you your baby might have a clubfoot and I am telling you now, he definitely does. Nick was asking what made the diagnosis definitive and what made this appointment different than the last and the radiologist kept replying that now he definitely has a clubfoot. All he wanted to know was how they knew for sure now and did not know for sure 3 weeks prior. Needless to say, I wanted out of there fast. We were told the baby would need to have a fetal echocardiogram and it just so happened that the pediatric cardiologist that we were being referred to could see us that day. He did and both of the babies hearts looked great and normal. What a sigh of relief on Christmas eve!
Once Christmas was over, I could begin my frantic research about clubfoot. I first spoke with moms on the clubfoot support board on babycenter.com. I was told about a Yahoo group called nosrugeryforclubfoot, which I joined as well. Immediately, I found that moms and dads of children with clubfoot are so supportive. It made me feel better immediately and I was able to ask questions and get an idea of where to begin. I was informed that the current method of treatment was started by Dr. Ignacio Ponseti in Iowa and it consists of a series of casts that basically adjusts the babys foot a little a time until a satisfactory level of correction has been reached. These casts are done over a 9-12 week period and thereafter the childs feet are immediately placed in braces to make sure that the correction stays and a relapse does not occur. The braces are worn for 3-4 months for 23 hours per day and thereafter the baby is weened off the braces during his awake hours but will continue to wear the brace during sleep until 3-4 or potentially 5.
The cause of clubfoot is not really known although it is thought to be due to genetics or the environment. I initially thought that the environment meant occurrences that happened outside of the pregnancy- like taking medication or having had a drink prior to knowing I was pregnant, since both of these things took place and I am having a child with clubfoot. However, I have since been told by at least one pediatric orthopedist that environment refers to the womb and whether or not the baby has space or is pressed up against the mother's uterus. I have also learned that in boys that have one clubbed foot or unilateral clubfoot with no other genetic markers, the cause is usually not genetics. However bilateral clubfoot and clubfoot in girls more often means that it stems from genetics.
I learned that over the history of treatment for clubfoot there have been many trends. From casting to surgery. Dr. Ponseti is not the first doctor to cast. However, he is the first to cast in this method with this series of casts. Current trends seek to avoid surgery as much as possible and if necessary, parents hope only for an in-office tenotomy with no general anethesia. We hope the same.
Our first appointment with who we hope to be our pediatric orthopedist is Tuesday March 2. We will be attending our meet and greet with the doctor as well as seeing the clubfoot clinic at Hospital for Joint Disease in NYC. We will see all different stages of casting and braces on many different children and have the opportunity to meet and speak with the parents of these kids. I think it will be a learning experience and hopefully will ease some of our fears regarding what is coming. I will keep you posted!
Friday, February 12, 2010
Picnic night tonight
Sometimes its very rewarding to have created something in your life that not only makes things easier on you, but seems so special to your child. I think back over Gavins life and the first thing that I thought of (which is not new to anyone but him) was "soda-juice". A combination of seltzer and 100% juice that totally satisfied his "need" for soda because, he simply thought he was getting it. Even at 5, soda juice is a good thing. Currently, there is picnic night. Picnic night was started about two years ago I would say. It was a Wednesday tradition, because I just do not feel like cooking on Wednesdays. I dislike Wednesdays. They feel like the longest day of the week to me. So I would come home and if it were cold I would make grilled cheese and tomato soup and if it were hot, it was veggie sandwiches of avocado, tomato, red onion and lettuce with balsamic and cut watermelon. All of these things were packed up like we were going on a picnic, put into a picnic basket that grammy bought (my mom) and we would arrive at the livingroom floor, where we spread out a blanket, sit on the floor and eat. Yes, I could have taken these outside during the summer months and sometimes we did, but for the most part, after a long day at work, the livingroom floor worked just fine. And Gavin loves it. Now, its not so much a Wednesday tradition as it is on request. Every couple of weeks or so, Gavin will say, "it should be a picnic night" and so it is. Tonight is grilled cheeses and tomato soup and for me green pea, because that is what the pregnancy craving calls for. I will most likely be able to get down on the floor, but maybe need some assistance getting up! And it will be simple and fun and I am looking forward to it. Maybe I will even serve soda-juice. We shall see.
Thursday, February 4, 2010
Just waiting on the babies....
Again, I let too much time go by without updating. I am currently 7 months pregnant with the twins. They are boys. For a while we were told one was a boy and one was a girl, but eventually we got a good look and it was clear, there was a penis there. I was disappointed for one second that my daughter was gone and then I got over it. I love my boys! We are so excited. Their arrival is about 7 weeks away now. If they have not come on their own by March 30,2010, then they are being evicted that week. Nick and I have decided April 2, 2010 is a good birthday.
One of the babies will be born with a clubfoot. It happens a lot with boys and it happens a good deal with twins due to the cramped nature of the womb. At first I was pretty upset and worried that it was an indication of something wrong genetically or something more serious, but after having a fetal echocardiogram on both of the babies, we were told that because its unilateral and because their hearts and other organs all look normal, its most likely just the foot. I still pray daily that that is the case. No matter what, we already love these two munchkins so much it does not matter, but one always hopes and wishes for a healthy child.
The process to correct his foot is lengthy. Very soon after being born, he will have his first cast. The casts are changed every 5 days to a week and there are many casts in a row as long as the foot is responding to the treatment. Thereafter, we may have to have a tenonomy (where the tendon is cut) and the final cast which remains on for 3 weeks. Not terrible. The baby will then have a brace and special shoes that he will wear for 3-4 months about 23 hours a day. After that we ween him off the brace, but he will still have to wear it during naps and sleep until he is about 5. After that, you hope and pray that there is not relapse. I have learned so much about clubfoot lately that I will do a seperate post about that at another time.
I am really excited because this weekend is my baby shower!!! I did not really have a shower with Gavin. My mother-in-law threw me a party in St. Louis after Gavin was born and everyone gave us gifts for him. It was a shower of sorts. Gavin came so soon after we were married and so close to Christmas that it would have just been horribly greedy to have had a shower. And boy am I glad that I did not!!! I need another one of everything for these babies! We have gotten some things but do not have all that we need. Of course, we are expecting a blizzard on Saturday, so we shall see what happens! Either way, it will be a good time.
One of the babies will be born with a clubfoot. It happens a lot with boys and it happens a good deal with twins due to the cramped nature of the womb. At first I was pretty upset and worried that it was an indication of something wrong genetically or something more serious, but after having a fetal echocardiogram on both of the babies, we were told that because its unilateral and because their hearts and other organs all look normal, its most likely just the foot. I still pray daily that that is the case. No matter what, we already love these two munchkins so much it does not matter, but one always hopes and wishes for a healthy child.
The process to correct his foot is lengthy. Very soon after being born, he will have his first cast. The casts are changed every 5 days to a week and there are many casts in a row as long as the foot is responding to the treatment. Thereafter, we may have to have a tenonomy (where the tendon is cut) and the final cast which remains on for 3 weeks. Not terrible. The baby will then have a brace and special shoes that he will wear for 3-4 months about 23 hours a day. After that we ween him off the brace, but he will still have to wear it during naps and sleep until he is about 5. After that, you hope and pray that there is not relapse. I have learned so much about clubfoot lately that I will do a seperate post about that at another time.
I am really excited because this weekend is my baby shower!!! I did not really have a shower with Gavin. My mother-in-law threw me a party in St. Louis after Gavin was born and everyone gave us gifts for him. It was a shower of sorts. Gavin came so soon after we were married and so close to Christmas that it would have just been horribly greedy to have had a shower. And boy am I glad that I did not!!! I need another one of everything for these babies! We have gotten some things but do not have all that we need. Of course, we are expecting a blizzard on Saturday, so we shall see what happens! Either way, it will be a good time.
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