Wednesday, July 7, 2010

My little green thumb girl.

Rowan and I put a sweet potato in some water to grow into a pretty plant a few weeks ago. Today we decided to plant it. It is so wonderful to share an experience like this with her. To be able to watch nature grow and contribute to it. Also she gets grow food for her family that is obviously organic. WOW my almost 3year old is providing clean healthy food for her family. That is just AWESOME! Rowan thinks this is the coolest thing ever.

Sunday, June 20, 2010

Premature Forward-Facing?

Premature Forward-Facing is what I think it should be called. Extended Rear-Facing (ERF) is what is it called now. ERF is what should be the norm.  Should we not do what is safest for our children and keep them rear-facing for as long as possible? 

Happy Girls! 
Rowan 3yrs 30lbs Sunshine Radian XTSL
Kiernan 22.5lbs Britax Boulevard suggest:
Rear-facing is the safest position the child can ride in.   It is strongly recommended that all children stay rear-facing beyond the minimum requirements of 1 year and 20 lbs. Children should not be turned forward-facing until they reach the maximum rear-facing limits of a convertible seat (that allows rear-facing to at least 30 lbs).  These limits are either the maximum rear-facing weight limit or when the top of their head is within one inch of the top of the seat shell, whichever comes first.  While most parents are aware that they must keep their children rear-facing "until they are AT LEAST 1 year old AND 20 lbs", very few are told that there are significant safety benefits when a child remains rear-facing as long as the seat allows.  For most children, rear-facing can and should continue well into the second year of life

I hear all the time how a police department or a fire department will install seats and turn a convertible seat around because the kid is 1yr AND 20lbs instead of keeping the seat RF until its max. These departments need to be informed of what is recommended by the AAP "Toddlers should remain rear-facing in a convertible car seat until they have reached the maximum height and weight recommended for the model, or at least (yes it says at least which is the minimum) the age of 2."  Then if the parent request the child to be FF then educate the parent. But they do have to follow the law which is one year AND 20lbs if the parents insist after being informed of the benefits of ERF. 

Safety experts and the American Academy of Pediatrics recommend that children remain rear-facing as long as possible and never travel forward-facing before they are 1 year old and also weigh at least 20 pounds to reduce the risk of serious neck injury and lifelong disability. All new convertible seats available today allow a child to remain rear-facing until they weigh up to 30 or 35 lb, depending on the model.
When the child is rear-facing, the head, neck, and thorax are restrained together by the back of the CR in a frontal crash. There is little or no relative motion between the head and torso that could load the neck. If the same child were facing forward, the harness would restrain the torso, but the head and neck would pull and rotate forward, leading to the potential for serious upper spinal injury (ie child may become paralyzed or worst case death).
There are many misunderstandings and misconceptions about rear-facing vs. forward-facing that lead even the best intentioned parent or pediatrician to believe a child is "safe" facing forward when he is still very young. These come from obsolete ideas and advice that may still appear in older pamphlets and pediatric literature and are not the current recommendations of the American Academy of Pediatrics.
Real-world experience has also shown that a young child's skull can be literally ripped from her spine by the force of a crash. The body is being held in place, but the head is not. When a child is facing rearward, the head is cradled and moves in unison with the body, so that there is little or no relative motion that might pull on the connecting neck.
The most common misunderstanding is that a child is ready to travel facing forward when his neck muscles are strong enough to support and control his head. However, when a car hits something at 25 to 30 mph, it will come to a stop at a negative acceleration rate of from 20 to 30 G. Because of the time lag between when the vehicle stops and an occupant stops, and the fact that the head of a forward-facing adult or child is still free to move relative to the restrained torso, the head may experience as much as 60 or 70 Gs acceleration for a brief moment. Even the strong neck muscles of military volunteers cannot counteract such forces. Instead, the rigidity of the bones in the neck and strength of the connecting ligaments (not the muscles) hold the adult spine together and keep the spinal cord intact within the confines of the vertebral column.
Very young children, however, have immature vertebrae that are still partly made of cartilage. These are soft and will deform and/or separate under tension, leaving just the spinal cord as the last link between the head and the torso. According to documented research, autopsy specimens of infant spines and ligaments allow for spinal column elongation of up to two inches, but the spinal cord ruptures if stretched more than 1/4 inch. Real-world experience has shown that a young child's skull can be literally ripped from her spine by the force of a crash.
Another aspect of the facing-direction issue that is often overlooked is the additional benefit a child gains in a side impact. Crash testing and field experience have both shown that the head of a child facing rearward is captured by the child restraint shell in side and frontal-oblique crashes, while that of a forward-facing child may be thrown forward, around, and outside the confines of the side wings. Field data show better outcomes for rear-facing children than forward-facing children, even though most CRs are not specifically designed to protect children in side impact.

A lot of parents feel like their child will be uncomfortable with their legs all squished up against the seat. BUT if you watch a child sit on the floor you will notice they draw their legs up as it is more comfortable for them.  What about the safety of their legs in a crash? Well there are no documented cases of legs or hips fracturing in a crash because of extended rear facing.  My thought on it is if my kids leg breaks I can fix that. If their spine breaks and they are paralyzed which is not something I can fix nor can I bring them back from death. 

Child car seat advice questioned:

Ask any parent about graduating their infant from a rear-facing car seat to a forward-facing one and you’ll likely hear this common refrain — at least 20 pounds and at least one year (although some estimates say a full 30 percent of parents go against this guideline and actually face their children forward earlier).

This advice is generally what our doctors tell us and it’s the car seat safety mantra that’s been drilled into our heads from organizations such as the American Academy of Pediatrics and the National Highway Traffic Safety Administration.

Two years ago, however, the American Academy of Pediatrics quietly added this wording to its guidelines: If a car safety seat accommodates children rear facing to higher weights, for optimal protection, the child should remain rear facing until reaching the maximum weight for the car safety seat, as long as the top of the head is below the top of the seat back.

There’s a growing body of evidence, however, that this lesser known guideline, which is considerably different from the well-known minimum guideline, will soon take center stage.
“In Scandinavian countries it’s common to keep children rear facing up to 3 or 4 years old and there’s some good data there that proves it’s effective,” says Chris Sherwood, a research scientist who is studying the issue at the University of Virginia Automobile Safety Laboratory. Yet, until recently, Sherwood says there was not U.S. data to prove that keeping an older child rear-facing would result in significantly less injuries.
As part of a project sponsored by the federal Centers for Disease Control and Prevention, Sherwood and colleagues recently completed a study looking at the benefits of keeping children in car seats that face rear. Sherwood’s research is now undergoing the necessary stage of being published and peer reviewed but the outcomes look intriguing.
His study, presented at a recent meeting of the American Academy of Pediatrics, involved 870 children under age 2 who had been in either rear-facing or forward-facing car seats at the time of an automobile accident. He found that the children in forward-facing seats were more than four times as likely to be injured in side crashes as opposed to the children in rear-facing seats. The study also found a small but not statistically significant benefit for facing rear in frontal crashes.
“The findings from the other countries and in Chris Sherwood’s work, although preliminary, should be considered carefully,” says Kristy Arbogast, associate director of field engineering with Traumalink at Children’s Hospital of Philadelphia and a leading researcher in the field. Arbogast notes that in general the newest evidence appears convincing that keeping children facing rear longer is probably the safest way to go.
Why is rear-facing safer?Since the 1970s with the introduction of the first seat belt and child safetyseat laws, there’s been an increased focus on how to make children safer in cars. In the last decade improvements have been made in computer modeling and child-size crash test dummies to give researchers a clearer understanding of what happens to children in car crashes.
What we know is that children aren’t just pint-sized adults. Their anatomy differs significantly from an adult’s and puts them more at risk for certain serious injuries. 
“The biomechanics of their necks facilitate the birth process — there’s a lot of flexibility in a child’s neck compared to an adult’s,” says Arbogast. “The youngest kids have a neck or cervical spine that doesn’t have the strength to withstand the forces they’d experience in many crashes.”
When a child is placed in a rear-facing seat there is less chance of trauma to the highly 

vulnerable neck and head areas during the most common crashes. Arbogast notes, too, that even older children — up to age 12 — still haven’t fully developed. They — along with adult passengers — would also probably be safer sitting rear-facing. Of course, this isn’t feasible. Adults and older children won’t do it or they can’t because the car seats won’t allow it. So the question safety experts are trying to answer now is how long we can get our very youngest children to do it.
The answer is a lot longer than many parents might think, says Kathleen Klinich, a senior research associate at the University of Michigan Transportation Research Institute.

Left to right Austin 6months, Rowan almost 3yrs, Kiernan 1yr

Girls dinner out!

Today I got the privilege to go out to dinner with my two beautiful girls. Rowan asked me before nap time if we could go to a restaurant and I told her we could for dinner. So we went to a fantastic restaurant called Taco Boy. I found this restaurant though my Summerville Natural Mom's group. The food here is just amazing. It is so fresh and delicious. They use local products when available.  The take home boxes are cardboard and the kids cups are biodegradable.  I love a restaurant that is moving towards bettering this earth.  They can have my money any day. I ended up getting the Shrimp Tempura Taco and the Grilled Chicken Taco. The girls got a Chicken Quesadilla.  The girls entertained themselves by playing with playdough.

Can you guess what it is?????

Well if you guessed POOP you would be RIGHT!
Yes she made Poop at dinner with her purple playdough. 

Then the wonderful Rowan requested to go on a bike ride. SOO WE DID! Got the drink and lovey and off Mommy rode to burn off her two tacos. ;-)

Wednesday, March 17, 2010

Noodle Boob

Noodle boob? How did this name come about? Well... about two and a half weeks ago I found a mass in my left breast. My first thought was "A mass in my breast? This is not good at all." So with this discovery I try to massage it while pumping at work because of course I am at work and it is Saturday the first day of my two day weekend. I get home and call Jodi to tell her and I start nursing Kiernan with her chin towards the mass. A difficult challenge as she is 21.5lbs and really tall funny to see her in the football hold. I continued working the next day doing the same thing. Monday Jodi did the therapeutic heat ultrasound to get deep heat to the mass. At this point my pain would come and go and was tolerable. By tuesday night the mass would grow from 1/3 my breast to 1/2 my breast as the ducts would get backed up throughout the day.

Wednesday morning I called the OBGYN to have a breast exam knowing I needed an ultrasound. I saw April the PA and she ordered an ultrasound just a few hours later. I left Rowan with my mom as they had their special Mimi lunch out time and I took Kiernan to the ultrasound with me. I became thankful for my stroller as at times it was painful to hold her. Kiernan learned to drink from my camelback spill proof straw cup, the kind you have to bite and drink at the same time. It was my only means of keeping her quiet and entertained there. Ok well it did not last long as she was screaming and another ultrasound tech came in and held her for me while I receive the ultrasound. I was then able to get up get dressed and hold her which still did not calm her down. Thankfully my breast was not hurting at this time as we were bouncing and walking. The radiologists came in to tell me the news that he found an 18mm tumor which he believes because of its shape, size, my age, and BFing history that it is a fibroadenoma.

Fibroadenoma of the breast is a benign fibroepithelial tumor characterized by proliferation of both glandular and stromal elements. The typical case is the presence of a painless, firm, solitary, mobile, slowly growing lump in the breast of a woman of childbearing years.

The radiologist says the typical course is to do followup ultrasounds every 6months or do a needle biopsy. The needle biopsy is the only way to confirm exactly the diagnosis and ultrasounds every 6M to track the size to make sure it is not something else would be crazy expensive and outrageous in my mind. I dont even go to the doctor regularly let alone go get expensive ultrasounds to watch a mass grow.

SO the next step was to leave and call lance to let him know and for us to decide what to do. Not exactly the call I really wanted to make. It is hard to tell the man you love that there is something actually wrong with you and that it could be really serious. After discussing it with lance we decide that the biopsy is the route we want to go. I also let our families know and everyone is very concerned but I wait to tell my grandparents as I will see them in person the next day. I called April and left a message for her to call me as I already had the results from my ultrasound. She called me the next morning and also let me the know the tumor is tiny but there is also a mass which is believed to be swollen breast tissue which consumes 1/3 of my breast. I get an appointment with the surgeon Dr. Lafond one week from then as I am heading OOT that day thursday and not coming home until monday evening.

We Travel to Florida which the 6.5hr trip takes 8hours. Sigh... The kids were great but the stopping to nurse, stopping to pee pee, and then the long stretch your legs for dinner stop sure does make for a long trip. I was super thankful for the car DVD player that we borrowed from Michelle R. Once we arrived I got the kids to bed and then broke the news to my grandparents. I brought a printout of what exactly the tumor was believed to be for my retired surgical room nurse grandmother. With our stay here my pain is increasing and so is the size of the mass. By the end of the day every day half of my breast is hard and very painful. I am icing in between nursing heating right before nursing and nursing with their chins towards the affected area. I am nursing Rowan all day, which she LOVES, because I need that breast drained completely to avoid mastitis. I am taking everything herbal possible to reduce the swelling so that it is not as painful and to avoid mastitis. My mom and grandfather even go to tim buck two just to find me some raw honey. Over and over every day I am working so hard to make my breast feel ok and avoid mastitis. Monday morning we drive home to Summerville. I drove to keep my mind busy. But with all of the vibrations from the car I was in mass amounts of pain. Who knew your breast jiggled so much with just driving in the car. We are driving and driving and driving. Kiernan is fussing in the back and we are not long before our stop. At which i am so ready to stop because I am hurting so bad. I am trying to comfort her by talking to her and passing pacifiers but I just knew she was wet and wanted to be changed and probably hungry. Well we finally pull over and i check her and her diaper is dry. I pull off her diaper and pants and let her walk around right beside the car. My little angel then squats and pees right there in the parking lot. I cant tell you how proud i was of her for holding her pee pee for so long to make it to the next stop. She had her milk and I then let mom drive as I was in too much pain to drive any more. We have a nice lunch later with my dad and off we are to home again. We stop once more when we hit summerville to buy some allicin as I had already been taking some garlic but this is super garlic (aka antibiotic and antifungal).

Lance, the wonderful dad he is, took Rowan to her gymnastics class (which means he has to participate/help) Monday night when we returned. I know Rowan enjoyed her alone time with Daddy. Tuesday rolls around and all i can think about is Wednesday and how I am ACTUALLY looking forward to going to a doctor. Most of you probably dont know that we dont go to physicians unless it is something we are unable to treat at home which means our kids are not vaccinated and do not attend well baby visits. The only thing we do is yearly GYN visits. So I go to my visit with Dr. Lafond and he examines me and I ball like a baby. I am in so much pain that when he manipulates the mass i can do nothing but cry and I just want to jump out of my skin it hurts so bad. I have never had pain this bad before. I could only think of one more thing that would hurt worse and that would be to hack off one of my appendages. There is nothing in this world that can describe the pain I had when he examined me. And of course I start to leak. he reaches for a gauze to blot my nipple as he is worried about this fluid leaking from my breast because he forgot I was breastfeeding. I don't blame him for forgetting I am balling on his table and he apologizes immensely for hurting me and says it needs to come out asap. The earliest I can get it scheduled is Friday at 4:30 which fits great with our schedules. My mom would not be working and Lance would only need to take a half day of work as I needed to check in at the hospital at 2:30.

Thursday rolls around and I am feeling worse. That morning the hospital called and I gave them my history and information. They let me know what we needed to do for friday and that I needed to be NPO after midnight. I now start having a fever and the size of the mass is half my breast and not going down. The pain is not going away any more. I don't remember much of this day. What I do remember is that I kept forgetting what I was doing or things people had said which I thought was odd. I later realize I was becoming septic. Lance comes home from work and gets all of his sub stuff together. I decide this night that he needs to take off all day tomorrow which turns out to be great that I knew this. By night time I am a little nauseated which I chalk up to the pain.

Friday I wake up at 0430 so nauseated and in so much pain I am unable to sleep. Then I start with the uncontrollable vomiting but there was nothing in there so just heaving. I wait until 0800 to call the doctor thinking that maybe the office opened this early. I was wrong. The oh so pleasant answering service said they would call the doctor and let him know but did not think he would call me back. I have never had an answering service be so rude but maybe it is because I always call when I am the nurse not the patient. Well they were wrong and he said that I needed to head to the ambulatory care center. So I jumped into the shower. After sweating all night because of the pain and fever I did not want to be at the hospital all day feeling disgusting as well as in pain. I had already nursed Kiernan, gathered my breastfeeding supplies and reading material. Lance gathers things to occupy his time at the hospital and my trash can (cant go far from that). We make the 13min trip to the hospital and check in. Even though we only had to wait 30min it still felt like an eternity. Lance was bored all day at the hospital as I slept the day away until my surgery that evening. The anesthesiologist lets me know that I will be intubated for the surgery. I remember going out into the hall saying good bye to lance. Vaguely remembering moving over to the operating room table. Next thing I remember is waking up in recovery and thirsty. My oxygen sats kept dropping to 94% in which I would just take a deep breath and they would go up again. I think I was just lazy breathing with anesthesia still in my system. I am no longer in pain the first time in 2 weeks. :-) After about 10min of being awake in there I moved out to lance and they give me something to drink. My bp is 80?/40? which is on the low side of normal for me with my next bp it gets up to 90?/50? and they give me my discharge orders and I am able to go home. That night the drainage is quite a bit and we have to change the dressing.

There was so much infection in my breast I was left with a penrose drain. A penrose drain is a soft rubber tube left in to drain to avoid fluid accumulation. I was not allowed to pick up anything heavy. Post surgery I have only had soreness no pain, no memory loss, and no nausea or vomiting. Twice a day dressing changes with my husband, mother, and mother in laws help. Oh and not to forget my mini nurses help. LOL She has to watch every dressing change.

This Wednesday I got my penrose drain removed and found out the preliminary results were that the tumor is a fibroadenoma and the mass is a fibrous mass. I am still treating myself for the infection and flushing from one hole down to the other with twice a day dressing changes. I also added some steri strips to part of my incision that is not as approximated as it should be. All in all I am healing well, no longer in pain, and do not have cancer.

I have felt so loved and blessed these past few weeks. I have had so many wonderful people praying for me and my family. I have also been given so many meals that we did not have to cook the week post surgery. My wonderful family and neighbor Anna have helped me with the upkeep of my girls and the house. God is so good to send so many wonderful people into our lives.