Ponderings

Here's what's running through my head lately. Things tend to get stuck there and run around, chasing each other for days/weeks/months, and I intend to write about them but then I'm not really sure what they're doing wandering around anyway and all that jazz. So here's the short list. I really liked when Mrs. T over at A Plus Effort wrote her "I'd blog about" list a bit ago so you get subjected to mine.

HeLa cell deal reached after years of yucky theft and invasion of privacy
You've heard of Henrietta Lacks whose cancer has been so good at growing that they are the basis for almost all of the cellular research that's happened? African American gal who had a cell sample taken and used without her permission whose family is finally getting some recognition of all the bad stuff that was done and some say in how her genetic material can be used by science. A little bit of justice.

The Things They Carried
This book is one that resounds through my life, probably because I am often packing and unpacking bags and boxes and trying to order the far-too-many things around the house. Or because it's good. Or because it has totally changed how I think about reality. In case you haven't read it, just go read the first of the short stories. It's about soldiers in Vietnam and the first story lists the things they carry, physical and emotional and why for a few things. I find it echoing around in my head pretty often, just a line here or there.

Baby Veronica
Oh the awfulness of this. On the one hand, I'm not so sure that if you can't communicate exactly what he's signing to the father of your unborn child, you get to have any say in what happens to her because it isn't cool to deceive people even if they haven't been supporting you/the pregnancy/anything and that father ought to get another shot. On the other hand, I dislike hijacking Native kids from their families and culture because of whatever. On the third hand I'm heartbroken for the adoptive parents who had this little girl and then didn't and then have her again and what a mess. And beyond that there's the issue of identity and when are you a part of a group and when aren't you and all that complexity.

I think when it comes down to it, I think birth mothers are the boss and that often it should be mostly ok to cut non-supportive birth fathers out of the decision-making process.

Whiteclay NE
We watched the movie The Battle for Whiteclay in one of my classes and I have nightmares about it (the town, not the movie so much itself). It's a really awful and kind of intractable situation. Dry reservation borders Nebraska and this "town" has a couple grocery stores and 4 places that sell beer. Nebraska is afraid to create laws to deal with the problem because it might become a slippery slope and the rest of the state could get over-regulated. Pine Ridge reservation has trouble deciding what to do and has few to no resources to do anything anyway. People die and nothing changes and who knows what is next? The intersection between the colonized and the colonizers who continue to take advantage of those they elbowed into a disadvantage is a really hard place, but it's also good to recognize. It makes me think a lot about a class I took where we read literature written in English from outside the US (India, Jamaica, Africa) and especially Ngugi wa Thiongo from Kenya who writes about the colonization of the mind. In other words, when the colonized get told they are less than the colonizers for generations, the mind gets colonized too and even with nobody around to oppress them, the colonized can't help but react in those ingrained ways of thinking of themselves as not worthy of good things or power over their own lives.

Senioritis
I am done. I hate school so much and I am ready to be done right now. Most of the time. Actually at times I'm really enjoying this semester, just not the setting up rotations part of it. Blech. I'm also getting fed up with things so much faster, like vague questions on exams that we are supposed to read the prof's minds and know were actually more specific (if you mean to ask a specific question, fine, but actually write the specific question then...).

Weekly update: a big ole summary post

Reminder: email me at mizfuturepharmd at g mail (dot) com if you want the password. I really do mean to move the blog eventually. I do.
http://mumpharmd.wordpress.com/2013/09/05/the-grand-summary/

Emotional regulation

I think this concept of keeping your emotions in check is interesting. I'm not sold that it's actually an ideal thing but it is what has been known as "proper manners" for some years now, possibly as long as people have stayed put. Maybe it's just me but when I walk all day, I don't hold back with those around me at all.

Anywho, I read this interesting article about how private schools refer children who don't sit still to OTs to learn how to sit and how it's awful we demand our children conform so tightly to school rather than school meeting kids where they are and adapting our teaching to their development. The public school counterpart to this "there's something wrong if your kid can't do super sitting still structure" is sending boys and especially boys who aren't white to special ed to get a diagnosis. 

I get why it is helpful to learn emotional regulation. Absolutely it is helpful for kids to be able to keep a lid on their tempers. But it's hard to see the other extreme of emotional regulation at school in my kid. She is so successful at boxing in her emotions outside the house that she hides them almost completely. After a day of no emotions expressed, she is a lit stick of dynamite most nights just waiting to blow up without warning. 

I worry about the kid, honestly. If she can never tell the other kids when she's upset or hurt or mad about something, how can she manage in the world? Yes there are times to contain your emotions but being an emotionless Vulcan is too far. Expressing emotions in the moment is a big part of being human. To a point. I get so mad when people can't have a rational discussion without bringing their entire emotional baggage to the table. It is hard to work when emotions about the past totally inform every single sentence of the conversation. There I'd say it is fine to have emotions but you have to contain them when they impede the discussion at hand. Have a good bedside manner and use it when needed. 

I guess that developing an appropriate level of emotional regulation is going to come later. I really hope it does. The other big problem our kid has is being super shy. Shy doesn't matter at daycare obviously and she got over it or around it in preschool because the group was small enough. In a classroom of nearly 30 kids with hundreds on the playground, it is hard for her. She has no willingness to ask to play or to start a game herself. None. We keep explaining it to her and she keeps not getting it or is too scared to try and also afraid she will "get in trouble" if she admits she's scared. She has some bizarre personal definition of what constitutes "in trouble" that includes anything we talk about that she doesn't want to talk about or worries about. 

So for now I think we will attempt to manage and hope that in time she will find a niche or at least a place she is safe enough to stop being so completely defensive. I just wish we could be done with being read the "I hate you and I hate it here and can't we just live at our old house again?" pre-riot act biweekly (followed by some rioting and sobbing). So if you think you could just move with a 4 year old, know that it will be miserable and try not to do it. Ugh. I hate that it's likely we may move after I graduate, just in time for her to have settled in here. Sigh. 

Being broke is complicated

We just found out today, 3 weeks after the spouse's last paycheck, that there will be unemployment. Phew! And now, a month or two later, the spouse has a job! That pays exactly what unemployment did! Wait...

That said, we are right broke. My MIL and her sister offered to take the kid school clothes shopping so we of course said yes. The trick to this is, of course, that my kid now has a wardrobe that shows she belongs to one class (the one where brand new clothes from designer shops are possible). Does this matter much to the other kids in kindergarten? Probably not. To the parents though, it might. It is hard for me to see a weeks' worth of groceries get spent on clothes for a 5 year old. It was in the back of my mind to return most of it to see if we could get cash to spend on something else. Obviously that's a pipe dream but the thought is there. This fancy clothes shopping also means that she got 3 or 4 outfits, not the 10 or more I could have gotten at the thrift store for less money, so we will have to find some money for a few more things to be properly outfitted. 

I have never really understood the point of not wearing any "new school" things before the start of school. Today we had an overtired kid meltdown for a half hour about wearing the brand new tennis shoes to t-ball and I caved, mostly because I think waiting is silly. Her other shoes don't really fit anymore and the new ones are rainbow-y and her very favorite and it was my MIL who forbade wearing them to t-ball and she won't see the t-ball dust on them anyway. 

The spouse pointed out that it's about first impressions, the shiny new awesome clothes. Sigh. 

Then there's the bind where you take what you can get. We put a child bike trailer on our festive holiday list a few years ago and a fancy one, a double that you could get an infant deal for and that had a roll bar (so if the bike falls, the trailer doesn't roll with it). A family member was gung ho about getting us one, but not the one we wanted. Eventually we determined that it did have the roll bar, and the kid was almost 3 and after miscarriage 2 the infant adapter deal seemed less important, so we accepted it graciously. And now we have a bike trailer we can't use for Little Monster so we can't bike to the grocery store and we wind up driving instead.

And the clothes. A helpful family member got the kid a pink plaid dress with a tiered ruffle skirt and a corset bodice. It isn't like you could say, "Why thank you for getting my child a sex worker outfit! I'm sure it will be... fun for role-playing or something?" or even "No thanks, I prefer my small child look like one and not a sex worker." I wish I had taken a picture before I gave the thing away, but I didn't. Here's my sketch because it is just that amazing. But remember, black and pink plaid, pink spaghetti straps, pink ribbon corset-style back, more flounces than I drew (like 5ish).

And of course, food. If you were wondering what teetering on the edge of food insecurity looks like, it is us right now. We eat lots of pasta (that I only ever buy on sale and stockpile) and lots of rice and whatever else we can scrounge on our little budget. I think black bean burgers and rice are going to be a multiple times a week thing for the foreseeable future. The kid has to eat at school because there's no way we could afford to feed her 2 more meals a day. She gets free breakfast and lunch. The upside of this is that she eats more things with peers to influence her into it. The downside is that she sometimes eats PB & J every day all week. We are wrestling with a potential new food problem but it's really hard to identify because she eats whatever she wants at school and we don't get a good report from her, nor do we have any idea what ingredients were in whatever she ate. So far we haven't tried super hard to figure it out but mostly that's because of the risk of needing to send her lunches if school lunch (and breakfast) really is causing all the new problems.

I guess I'd say that right now, I have coped adequately and it isn't so stressful to know how close we are to financial wreck and ruin. We (well, mostly I) have been hoarding food for a few years now because of the last time we were this broke and wandered into the land of "adults get 1-2 meals a day" level of food insecurity. We have enough food stockpiled that we could eat just what we have for at least 3 weeks, maybe up to 5 or 6 weeks. It wouldn't be things the kid likes very much but it would be edible. It's just a habit now to ensure I feel a little bit more secure. This summer we didn't buy any groceries besides milk for 3 weeks and we did fine. Now we're back up to stockpile levels and I like knowing that we have a cushion before we have to worry about what to eat.

When you're thinking about food stamps and food assistance and why people need help, remember it isn't much we're talking about. It's the difference between eating 1 or 2 meals a day and 3. It's the difference between the extra stress of cooking only cheap food instead of healthy food (have you seen how much organic food costs? $5 for a single green pepper? Yipes!). It's the difference between getting the car fixed when it isn't yet broken and when it is suddenly un-drive-able. Isn't it helpful to support people when they most need it? Isn't it nice to know the security net is there to catch you if you fall because of an illness or a lost job?

Pumping part 2: on the road again

Building up a stash

My strategy was to pump on the other side when the baby had slept for more than 4 hours while she nursed on the other side, starting at about 3 weeks old. We didn't know for sure when she'd start daycare (or that it would only last 6 weeks) so that's why we started then. If we'd had longer until childcare, I probably would have waited until closer to 6 weeks to get serious about pumping (If I'd known I had 12 weeks of leave or something). My other strategy for stockpiling milk is to note any time I leaked and pump then (that's how I picked that time in the first place) and no skipping weekend pumping. I have an attack let-down so pumping with nursing means I get more than I would just pumping, but I think the same is true for most folks. For me it was crucial/helpful to stick to an approximate schedule so I can train my body when to produce more.

One thing to note is the shape of a lactation curve. I know, I know, we don't like to think about dairy animals and moms producing milk together, but I think it's useful here. On the bottom it's weeks since giving birth, and this is a cow curve because she's done at 10 months to have her next calf at a year from the first one's birth (poor livestock).

 Here's the thing: it's wicked hard to increase your supply after about 2-4 months (this curve is a bit sharper than I think most people curves are so stretch that top bump to about the 10-12 week mark). In those early days you can convince your body to feed twins (or come close) if you pump enough or nurse the baby enough. Afterwards your body just isn't responsive nearly so much no matter what you do. So if you are going back to work and going to pump, start early not only to build a stash but to be sure to build your supply enough that when you pump less than baby nurses you still get enough.

I've heard lots of women say "I had low supply" based on pumping, and I'd say that's untrue. Pumping doesn't actually reflect how much milk you're making. Left alone with a baby, I produce more milk than she needs. If I'm pumping, I don't get the same amount she drinks from a bottle unless I pump one time more than she eats which is miserable. MISERABLE. On her normal daycare day/day with the spouse, she eats 4 times so I should really pump 5 times to hit the same volume... for a half hour each time... UGH. Still doesn't mean I have low supply, just that I am bad at pumping. It takes a lot of very specific manipulation to clear my cloggy ducts. Compared to the tech that's available for livestock I feel like our pumps are terribly lame and technologically pathetic. That's why I think there's no reason to declare low supply based on what you pump. If your baby isn't growing, you have low supply. That happens, absolutely, but don't get too judgy based on pumping alone. Also note if you are taking a thyroid med, doses too high of it can stall your milk production so be sure it's carefully monitored. ::end soapbox::

Car tactics
The car adapter for the pump is awesome. I really liked the quiet of my car as opposed to a study cube in a hallway indoors. With my pump, electric or car worked equally well while batteries worked less well. When it was cold out, I assembled as much of the pump set up as possible indoors. I'd then set things out on the dashboard, get the heat running if needed, and get on with pumping. A cardigan or a zip-up sweatshirt is really handy for sneaking around if someone walks by while I pump. I don't own a cover so I never used one and those things are so obvious that everyone knows exactly what you're up to, but if I'm just sitting in my car, nobody really gives you a second glance. Garish nursing cover? Makes people stare (or it makes me stare because whoa are those bright/ugly/tent-ish and distracting).

Indoor sneaky tactics

My college has two places to pump (officially), each a 20 minute walk from where my classes are, so they are non-options for me (20 minute walk, 30 minutes to pump + 5 minutes set up and clean up 20 minutes back = more than the hour between classes). Usually I am parked much closer (3-5 minute walk) but sometimes it is cold/windy/raining so I find somewhere indoors to pump. I make good use of the sweatshirt to hide the sides/hands holding things (nope, no hands-free fanciness for me... alas). I also set my drip towel under my pump. It makes a terrible racket left to its own devices because it doesn't sit level (or no surface I've ever found is level enough) so this cuts the huge noise down to what might be a noisy laptop. There are study cubes with sides that work well enough. My personal preference is to get a study room in the library. Some college libraries have group study rooms you can rent for just one person, others you actually need a group so you could bring a friend to sign into the thing with you. Currently we have "media viewing rooms" that you can check out for just one person and it works well enough. I wind up sitting on the floor because the main outlet is behind the TV console and the other one is hard to access and get my power cord to reach from a chair (and the chairs are terribly uncomfortable). These are sound proof so no worries about being loud or a noisy audio book. If I have time I set up my laptop to run its screen saver where I can watch all the pictures of the baby scroll by. She's getting so big! Sheesh!

Airplane management 

Coming soon after my fabulous week-long field trip. Field trip! Wahoo! Also terrifying! I will say that keeping milk fresh rather than my usual freezing strategy was the way to go because I had stuff thaw on the one flight with pumping I've taken so far (and there was a delay in flight too so my pitiful ice supply wasn't enough to keep it all frozen). Also since that was a time we traveled with the baby it was very confusing for the security guys as to why there was bottled milk and a baby, but after a few minutes they decided it was innocent enough even if it didn't make sense to them. Sigh.

Feeding the baby

I thought I'd quick touch on how Little Monster is doing at eating things. 

She's still nursing 7-11 times a day (at least 2 are comfort since she spits up like crazy afterward) and is now eating at least one meal of solid food a day. We are doing baby-led weaning, which amounts to "feed the baby whatever you adults are eating."

She started seriously grabbing for every bite we took at about 5.5 months (so almost 6 weeks ago) and we decided it was time to let her have solids. We gave her some bread crusts to start with and she was thrilled. The next day she got a peach and ate about a third of one. Actually gnawed it and swallowed it. She'd have gone for more but we ran out since we thought she'd stop after only a couple slices. Whoops!

Since then, Little Monster has had green beans, apples, oranges, pasta with a bit of butter and cheese, and a trip to the local Chinese buffet where she ate very well. She got a chicken drummy, half a spring roll, a good bite of egg roll filling, some celery (not a hit), hard boiled egg, green beans again but fried, and an ice cream cone. So far she had a kind of scary reaction the second time she tried oranges she turned red, got some hives, and had some trouble breathing but it was solved by some bena.dryl. Otherwise things are going well!

Just feeding the baby is so much simpler than fancy mushes for just the baby. I am a big fan.