Teen Violence

I will step aside from my usual blogging on personal and childbirth issues this last day of 2005 and look instead to something that concerns every parent, teen violence. As many of you know Toronto is mourning in the wake of an innocent teen who was slain during a Boxing Day shootout on Yonge street. I personally, as a mother of a just-turned-14-year-old, am concerned about the increasing violence we are seeing in teens today.

In my research, I found that Family First had commissioned Wirthlin Worldwide to conduct a survey of 500 youth between the ages of 13 to 18. The results might surprise you. They found that 54 percent of those teens surveyed agreed, "Violence in music and on TV encourages youth violence." Fully 66 percent of 13-14 year olds were even more convinced that it was a factor. Indeed, the vast majority of teens (86 percent) who agreed that violence in entertainment encouraged youth violence believe "There should be efforts to reduce the amount of violence in music and on TV." How ironic, as teens are by far the largest consumers of popular music and television programs that depict violence.

But that isn't all.

68 percent of our teenagers believe that "Youth are more likely to be violent
and commit crimes when their fathers are absent from the home." Teens also
identify strong marriages as a deterrent to youth violence. Overall 72 percent
agreed that "Mothers and fathers with strong marriages are less likely to have
children or teenagers who are violent and commit crimes." Young teenage boys in
particular seem to be crying out through this survey for a stable home life.
Fully 85 percent of males aged 13-15 surveyed said that strong marriages were
important.

Teens are incredibly perceptive and had solid answers to this dilemma too. Far from recoiling at parental authority and advice from parents, kids see them as an important part of the solution. Their top three solutions, in order are:
1. Parents who commit to marriage and stay involved in their kids' lives.
2. Positive role models who participate in kids' lives.
3. Teaching moral principles to youth.

Let us ponder the conclusion of the survey as we embark on a new year...

Youth violence is a scourge that speaks sadly about the present state of our
culture. But the attitudes of our children should offer us great hope. Far from
being nihilistic, self-absorbed, and operating in a moral vacuum, our kids seem
to have a better grasp of this problem than we might think. The teens we
surveyed identified the root causes of youth violence and several solutions.
Perhaps our first step in curing this cultural cancer is to listen to their
prescriptions.

Happy New Year everyone!!!

Fetal Testing for Down Syndrome

I will preface this blog post with the fact that my cousin's daughter was born with Down Syndrome, Trisomy 13 to be exact. Yet she is such a joy at four years old! Anyone who has not spent time with a child, or adult, with Down Syndrome... and I mean really spent time with them... has not experienced the joy of innocence, simple happiness that these precious people can bring to your life.

I November, the Washington Post reported on a first trimester screening test for Down Syndrome. Stein reported, "The eagerly awaited study of more than 38,000 U.S. women -- the largest ever conducted -- found that the screening method, which combines a blood test with an ultrasound exam, can pinpoint many fetuses with the common genetic disorder 11 weeks after conception." Fergal D. Malone of the Royal College of Surgeons in Dublin, who led the study published in the Nov. issue of the New England Journal of Medicine, found that 87 percent of Down babies were identified using this earlier method. Wow, that leaves an unlucky 13% with a false positive rate.

Now in a perfect world, this would simply provide parents with additional time to come to terms with their child having Downs Syndrome and prepare accordingly for his or her birth and life. Sadly, this very likely will not be the case. CNSNews reported in April on a Grey Journal study showed, “that many pregnant women receive only negative information from medical professionals when a prenatal diagnosis reveals a potential for giving birth to a baby with Down syndrome.” It went on to explain, “Pro-life groups blame what they call the "culture of death" for the legal system that upheld… abortions on unborn babies thought to have Down syndrome and other birth defects.” This it will be no surprise that, “in recent years, studies have shown the abortion rate of Down syndrome babies is estimated at 80 to 90 percent when prenatal screening reveals the possibility or probability for the condition.” Folks, that is 8 or 9 out of every 10 babies who have been diagnosed, accurately or not, with Down Syndrome.

With that in mind, let me close with a true story. Two of my cousins (sister and brother’s wife) were pregnant at the same time, both had at least three ultrasounds. One was told her baby had downs syndrome and was strongly counseled to abort her baby (they chose not to). The other was told her baby was perfectly healthy. The first cousin's son was perfectly healthy and the second cousin's daughter has downs syndrome… the very cousin I prefaced this post with. Now, if my cousin who had been counseled to abort would have, we would have lost a healthy, normal baby boy and his parents would have suffered the grief of that decision their entire lives.

Coached Breathing Doesn't Work During Pushing

Reuters reported today what many birth professionals have long known, "Pregnant women coached through their first delivery do not fare much better than those who just do what feels natural." The study, published today in the Gray Journal (American Journal of Obstetrics and Gynecology) found "the difference has little impact on the overall birth, which experts say can take up to 14 hours on average" when "women who were told to push 10 minutes for every contraction gave birth 13 minutes faster than those who were not given specific instructions."

While I doubt that this study will suddenly stop all of the nurses from yelling pushing instructions at mothers who suddenly are found to be at the magical 10 cms dilation, it is important that this information is available for professionals and expectant parents. This procedure of coaching mothers to attempt to forcibly exhale with the nose and mouth closed to the count of 10, taking a deep breath and doing it again is called the Valsalva maneuver. Named after Dr. Antonio Valsalva (1666-1723), the Valsalva maneuver was an original method of inflating the middle ear which is still practiced today. It is also used as a diagnostic tool to evaluate the condition of the heart and is sometimes done as a treatment to correct abnormal heart rhythms or relieve chest pain. Its use in obstetrics started when heavily medicated mothers couldn't feel the urge to push and it was believed the Valsalva maneuver would speed descent of the baby and hasten delivery.

The World Health Organization's Care in Normal Birth, Chapter 4 explains the risks. The practice of encouraging sustained, directed (Valsalva) bearing down efforts during the second stage of labour is widely advocated in many delivery wards. The alternative is supporting the women's spontaneous pattern of expulsive efforts (exhalatory bearing down efforts). These two practices have been compared in several trials (Barnett and Humenick 1982, Knauth and Haloburdo 1986, Parnell et al 1993, Thomson 1993). The spontaneous pushing resulted in three to five relatively brief (4-6 seconds) bearing-down efforts with each contraction, compared with the 10-30 second duration of sustained bearing-down efforts, accompanied by breath holding. The latter method results in somewhat shorter second stages of labour, but may cause respiratory-induced alterations in heart rate and stroke volume. If the woman is lying flat on her back, it may be associated with compression of the aorta and reduced blood flow to the uterus. In the published trials mean umbilical artery pH was lower in the groups with sustained bearing down, and Apgar scores tended to be depressed. The available evidence is limited, but the pattern emerges that sustained and early bearing-down efforts result in a modest decrease in the duration of the second stage, but this does not appear to confer any benefit; it seems to compromise maternal-fetal gas exchange. The shorter spontaneous pushing efforts seem to be superior (Sleep et al 1989). It goes on to state in Chapter 6, under Practices which are Clearly Harmful or Ineffective and Should be Eliminated, "Sustained, directed bearing down efforts (Valsalva manoeuvre) during the second stage of labour (4.4)."

Getting back to today's article, "Women in both groups experienced about the same number of forceps use, Caesarean deliveries and skin tears, among other complications. Less clear was whether extra pushing encouraged by a coach could lead to bladder trouble. In an earlier study, the researchers tested bladder function in 128 of the mothers three months later. While such problems usually resolve on their own over time, women who had been coached had a smaller bladder capacity and felt the urge to urinate more often, they previously found." I also question if Valsalva pushing can also be implicated in causing or aggrivating hemorrhoids. We have all seen mothers with broken blood vessels in her eyes and face from pushing wrongly, universally a result of coached pushing.

The argument for Valsalva pushing is that a mother with a complete epidural and/or intrathecal block cannot feel the urge to push. Certainly her uterus will continue to contract and bring her baby down, but the effects are much more muted when not accompanied by the spontaneous bearing down women's bodies were designed to bring baby into the world most efficiently with. This begs the question, will staff have the patience to allow fetal descent before Valsalva or at least allow a more physiological second stage with open glottis pushing in shorter stints? Rarely in my experience. Turning over patients is always a priority in modern day obstetrics and with high epidural rates, rarely is a woman allowed to "labour down" as we have come to call the time from full dilation until crowning after an epidural placement where the mother is left alone to let her uterus bring baby down. Instead mothers are made to push for hours, exhausted and shaking, while her baby's heart rate dips ever lower because of the lack of oxygen caused by the unnatural pushing efforts of coached breathing. I hope we learn from this that normal physiological second stages work and do not need to be fixed by clocks and coached breathing.

Increased Cesarean Rate for Low-risk Women Contradicts National Goals and Guidelines to Improve Maternal and Infant Health

The Coalition for Improving Maternity Services (CIMS) is concerned by the continuing escalation of cesareans and by new findings: the increasing cesarean rate in the number of low-risk women who give birth for the first time and in the number of low-risk women who are having repeat operations.

Ponte Vedra Beach, FL (PRWEB) December 27, 2005 -- In 2003 the U.S., cesarean rate reached an all-time high of 27.1%, according to the Centers for Disease Control (CDC). Physicians performed 1.2 million cesarean sections at a cost of $14.6 billion in hospital charges. This cost did not include the physician fees. In 2004 the cesarean rate climbed even higher, to 29.1%.

The Coalition for Improving Maternity Services (CIMS) is concerned by the continuing escalation of cesareans and by new findings: the increasing cesarean rate in the number of low-risk women who give birth for the first time and in the number of low-risk women who are having repeat operations. A low-risk woman is defined as one with a full-term (37 completed weeks of gestation), singleton pregnancy with a vertex presentation (head facing down) and no medical complications at the start of labor.

“Increasing cesarean rates contradict and affect two key national health objectives of the U.S. Department of Health and Human Services,” states CIMS's Chair, Nicette Jukelevics. “Those objectives are to reduce the number of low-risk women who give birth by cesarean and to increase the number of mothers who breastfeed their babies.” In 2003 one in four low-risk women gave birth to their first child by cesarean section, an increase of 30% since 1996. That year the repeat cesarean rate for low-risk women (women eligible to labor for a VBAC) was an alarming 88.7%, an increase of more than 25% since 1996. Healthy People 2010 objective is to reduce first cesareans for low-risk women to 15% and to reduce repeat cesareans to 63%.

Compared to vaginal birth, cesarean delivery compromises womens' health. Complications from cesareans put women at increased risks for infection, hemorrhage, blood clots, bowel obstruction, adhesions and placental problems which can complicate future pregnancy and birth. Women who give birth by cesarean are at higher risk in a subsequent pregnancy. Reduced fertility, preterm birth, low birth weight, and uterine rupture are more likely in a subsequent pregnancy after women give birth by cesarean.

The CDC (Guide to Breastfeeding Interventions) documents the protection, promotion, and support of breastfeeding as a critical public health need. The CDC identified labor analgesics, epidural anesthesia, and cesarean section as maternity practices that have negative effects on breastfeeding. These practices affect the infant's behavior at the time of birth, which in turn affect the infant's ability to suckle in an organized and effective manner at the breast. A cesarean born baby is less likely to be breastfed and to benefit from the positive health outcomes associated with breastfeeding.

The Healthy People 2010 objective is for 75% of mothers to initiate breastfeeding, for 50% to continue exclusive breastfeeding at 6 months, and for 25% to continue breastfeeding until at least 12 months. The increasing cesarean rate puts this objective in jeopardy. The American Academy of Pediatrics Policy Statement, "Breastfeeding and the Use of Human Milk," documents irrefutable advantages for infants, mothers, families, and society from breastfeeding. Advantages include health, nutritional, immunologic, developmental, psychological, social, economic and environmental benefits.

Although the rise in cesareans for low-risk women was seen in women of all ages, and racial or ethnic groups, surprisingly the number of healthy teen mothers who gave birth by cesarean increased by 35% since 1996, greater than all other age groups. In 2003 almost 17% of childbearing women under 20 years of age had a first birth by cesarean.

Given the nationwide lack of maternity care services supporting VBACs in the US, CIMS anticipates that the overwhelming majority of these young women will have repeat operations in a subsequent pregnancy exposing them to continuing health risks and complications they otherwise would not experience with a vaginal birth.

In its ongoing efforts to improve birth outcomes CIMS is sponsoring the Fourth Annual Evidence-based Forum at the Radisson Hotel, Boston, February 23-25, 2006. The three-day event, Mother-Friendly Childbirth: Closing the Gap Between Research and Practice features Dr. Christiane Northrup well known obstetrician and author, and Michelle Lauria, MD of the Northern New England Perinatal Quality Improvement Project, a consortium of maternity care providers, hospitals, and insurers in the states of Vermont and New Hampshire which encourages and supports VBAC.

The Coalition for Improving Maternity Services (CIMS), a United Nations recognized NGO, is a collaborative effort of numerous individuals, leading researchers, and more than 50 organizations representing over 90,000 members. Promoting a wellness model of maternity care that will improve birth outcomes and substantially reduce costs. CIMS developed the Mother-Friendly Childbirth Initiative in 1996. A consensus document recognized as an important model for improving the healthcare and well being of children beginning at birth, the MFCI has been translated into several languages and is gaining recognition around the world. To learn more about the Mother-Friendly Childbirth Initiative, go to http://www.motherfriendly.org.

Contact:Rae Davies, Executive Director
Phone: 1-888-282-CIMS
Fax: 904-285-2120

Lawsuit for Premature Caesarean

In my promise to peruse obstetrical blogs, I came across Kevin, MD's Blog on prophilactic cesarean for PROM (premature rupture of membranes) & breech presentation. It seems the premature delivery caused the baby adverse health consequences for which her mother is suing the attending physician and the hospital. See Kevin's Blog & NWAnews article for more information.

There are numerous responses to Kevin's blog. Though some go completely off topic, I agree with the inanity of many medical lawsuits and the subsequent CYA tactics physicians and hospitals undertake to reduce their liability risks. Believe me I have heard them all when it comes to obstetrics. But let us look more closely at this case, from my laymans point of view. Mom admits inlabour with PROM. Baby is found breech and mom continues to labour as they call the physician. The physician, upon hearing both ROM & Breech, orders a caesarean over the phone. Now, let us look at the risk/benefit ratio of surgery to vaginal delivery.

Baby is breech, but we don't know actual presentation (frank, footling, complete). There was no infection (already assessed) and an ultrasound four days earlier proved prematurity (reports don't reveal how many weeks gestation). Uumbilical cord prolapse would most certainly have been ruled out (via FHT) as this was not an emergency given the reported reasoning for the surgery. So we have a mother labouring normally preterm with no infection, no cord concerns and a breech presentation. The real risk of a cord concern is now low given that her water has already broken and the cord didn't descend with the waters release. Yes there will always be a risk of nuchal cord, short cord, etc. but these are managable with a skilled attendant.

This leaves one thought. The physician doesn't have the skills to attend a breech delivery. Completely plausible in today's cut-when-breech mindset in obstetrics based on an imperfect Canadian breech trial. I continually find it shocking that even obstetricians don't have breech experience when they are the so-called experts on high risk deliveries. I can somewhat excuse the delivering family practitioners who are unable to gain that vital experience, like I witnessed at a rural Canadian hospital some years ago. My client was sectioned despite her clearly textbook perfect breech labour (no meds, frank breech, quick labour, baby already "bumming" on admitting) by the family physician who was also the head of obstetrics in that hospital. This physicians fear was palatable when ordered her cesarean and he literally ran out of the room after voicing his decision, leaving everyone in the room shocked. Yes physicians are human, I am the first one to admit that. I have seen firsthand the effects of PTSD on attending physicians who had experienced a previous bad outcome. But compassion comes with humanity, especially when in the office of healing, and I am left wondering if the physician in the story above did not have a similar fear or lack of experience. My heart goes out to everyone involved in this sad case.

YWCA Women of Distinction Nomination

Well the cat is out of the bag, thanks Claudia! I have been nominated for the YWCA's Women of Distinction Award for "significant contribution or outstanding achievement" in Health, Social Sciences & Social Services. I am honoured, humbled and still pinching myself for your thoughtfulness Claudia. I hope to see you too at the Gala Awards in June!

Three Princesses

Christmas was a blast and the kids had so much fun spending time with their cousins over the holidays. I posted earlier this month about the princess dresses and indeed they were a hit with the three girls. Here are the three princesses with my maternal grandmother Alice Skalin who is soo proud of her great grandchildren, all seventeen of them.

Breanna is in Cinderella's pink ball gown, Olivia is in Snow White's blue ball gown and Taylor is in Sleeping Beauty's magnificent caped gown with the red and blue bodice.

Here is the gang opening presents. Clockwise from top left, Taylor (my youngest sister's daughter), my dad Reg, Eric (my eldest), Grama Skalin, the back ofOlivia's head (my younger sister's daughter), Breanna and me (the back of our heads), and Brendan (my youngest son). To the immediate right of the picture is a couch & chair with my sisters and our collective husbands. Behind the camera are my aunt and uncle (Mom's sister and her husband), my Mom and Ryan (my middle son) who took the picture.

The Spoils of... Partying

Just look at our little princess, post-Christmas party! Cookie decorating, Piñata breaking and the subsequent stash of candies she has been working steadily through (see bag of candy she is holding and the wrappers strewn over the floor) were only the start. We also played pin the nose on the reindeer, watched a Charlie Brown movie, and she didn't realize she missed the gifts - which we left for tomorrow (so much to do, so little time!). A happy princess indeed.

Quiet Waiting Turns to Feasting

Advent, a season traditionally reserved for prayer, fasting and anticipation, is quickly closing as we prepare for Christ's Masse, or the celebratory feasts commemorating the birth of Christian Saviour Jesus Christ.

As the eve of Christmas fast approaches, I hope each of you is ready and relaxed. Here, the cookies have been baked by the children with care and the presents are wrapped and stuffed under the tree. The outdoor Christmas lights never did make it up, but the decorating the kids have done inside more than makes up for it. I did get my cards all mailed this year, though some didn't make it out until last week.

Here is the Christmas picture I sent to family this year. It was a challenge indeed to get four children all looking at the right place at the right time with even a semblance of a smile, I hope you like the result! Left to right: Brendan (5 1/2), "pony", Breanna (2 1/2), Eric (14) and Ryan (11 1/2).

As we will be spending time with family and friends over the next few days, I wanted to blog now to avoid missing sending a Christmas message to all of you entirely. Our family would like to wish each of you a wonderful, amazing and peaceful Christmas celebration with your families and an incredible 2006!

Intelligent Design

Today marks an incredibly sad day in US history as a Pennsylvania judge rules that intelligent design cannot be taught in biology because it smacks of creationism. Intelligent design holds that living organisms are so complex that they must have been created by some kind of higher force. This is in direct contrast to evolutionism, a theory developed by Charles Darwin (1809-1882), whereby man - and everything else - evolved because of random heritable genetic mutations (changes).

Associated Press writer Martha Raffaele reports, "A six-week trial over the issue yielded "overwhelming evidence" establishing that intelligent design "is a religious view, a mere re-labeling of creationism, and not a scientific theory," said Jones, a Republican and a churchgoer appointed to the federal bench three years ago."

OK let's get the facts here. Two scientific theories are in direct contrast to each other. One is stating that we evolved into what we are today and the other stating that a higher force created us. So why not teach both? Simple question. Because one is believed to be a 'religious concept' and as such "violates the constitutional separation of church and state." Wow.

So what you are saying is that simply because one theory is based on our needing to believe in a higher power, my children would not be taught that there are two theories to our existence on earth? Well, there is yet ANOTHER reason I am homeschoooling. I encourage my children to learn to challenge and study and come to their own conclusions, WITHOUT government censuring based on symantics. My 14-year-old is studying Biology this year. We are learning using Apologia's curriculum and exploring both theories. Believe me, he is learning with all the science (or lack thereof) supporting each theory - and no government censuring. It is his right to know.

VBAC Today

From moment my family physician and an obstetrican decided that a caesarean was needed during my first labour, despite all evidence to the contrary, my whole world has revolved around caesarean and VBAC issues. The trauma I experienced from that decision effects me to this very day, though now it is in positive ways instead of the intensely negative ways it haunted me for years previous. My eldest son's caesarean delivery was fourteen years ago this month and I now see his birth as a blessing.

VBAC (vaginal birth after caesarean) was a viable and even preferrable choice for all women who had experienced a previous caesarean in the 1990s. With the low risk of 7 women in 1000 possibly experiencing a uterine rupture and 5 out of those thousand babies being compromised by complications resulting from a uterine rupture, VBAC was stronly encouraged. A high success rate, especially for women planning an HBAC (home birth after caesarean), ensured a low caesarean rate for women, physicians and institutions.

Then a funny thing happened. Obstetricians in the US found that their promise, to ensure a healthy baby with every pregnancy, was backfiring on them. They found that women, when faced with a fetal demise or compromise were suing the very physician who promised perfection. Interesting how that works. But instead of providing a better educational support system for their patients, they chose to limit their choices... severely.

With an already rising caesarean rate ACOG (american college of obstetricians and gynecologists), the trade union representing US Obstetricians and Gyaecologists, decided that despite the evidence to the contrary women wanting a VBAC could only labour in hospitals equipped with 24-hour ORs. With a primary caesarean rate already over 20% (despite WHO's recommendation that any caesarean rate over 10% increases the risk to both mother and baby because of a surgical delivery) this would automatically skyrocket the caesarean rates and would greatly increase the risks to mothers and babies. Well the CDC just reported an almost 30% caesarean rate in the US and an infant mortality rate so horrible the US ranks at 36th in the world.

Canada is no better, their own caesarean rates are rising right along with the US even though their organization, the SOGC (Society of Obstetricans and Gynaecologists in Canada) is much more evidence based in their guidelines. Given that they rank 22nd, and with socialized medicine, this is deplorable.

Here I am, mired in the statistics of it all, while I watch women shattered by their forced caesareans and yet I also see the miracles women experience in this dire pro-caesarean medical nightmare who have amazing VBAC births.

Case in point, last week a wonderful, well-educated woman went into labour with the complete support of her physician for her planned VBA2C (vaginal birth after two caesareans). Yet upon entering the hospital, she was told she would have to undergo another caesarean simply because her pro-VBAC physician was not on call. She is now recovering from her surgery and the nicked bladder she received because of her unnecessary surgery. She has a lot of healing to do, both physically and emotionally. In the same city another mother scheduled her ERCS (elective repeat caesarean section) based on her scaregiver's fear of uterine rupture which was then placed on her. Upon admitting was found to be in labour and she gave birth vaginally later that day despite her initial decision to birth otherwise (though she was thrilled).

Where is the logic in this? Women fight and fight for their right to birth vaginally, only to be coerced into surgery, or worse, given no choice. It is indeed a sad and scary time for birthing mothers. It is these very mothers that I support. Emotionally, informationally and physically during their pregnancy, after their births. It is their perinatal professionals that I train to support them, educating them about the unique fears and hurdles scarred mothers face. It is my passion to provide that support, information and training. So thank you to my self-focused, arrogant physician who wanted his weekend free the Friday I was in labour with Eric.

Morbid Obesity

The other night I was watching a documentary on the "750 pound man." I know, I know... I watch so little TV as it is and I am watching that? Well for me it was more of wanting to know what it is that leads a person to morbid obesity and, in the case of John, the person profiled in the documentary, what kept him bed-ridden for 7 years. I mean obviously he had an enabler, but I wanted to know more about the whole dynamics of this. I learned some very interesting things and the answers to many of my questions.

1. What caused him to be bed ridden? I couldn't understand someone simply diving into bed one day and laying there, day after day, growing heavier by the minute. In John's case, he was at home when his knees suddenly gave out on him and he crawled to his bedroom and his bed to heal his knees. His knees never supported him after that.

2. Why didn't he lose weight? I know, the obvious answer right? Well I was surprised at some of the obvious answers to this. First, when a person is bedridden, they have very little control over life and one of the few things they can control is what they eat. Given that someone has to provide for them, emotionally it is a very difficult situation complicated by a level of depression (on everyone's part) and in the case of his enablers, wanting to give him something to help him emotionally too. The second one was even more obvious now that I think about it, a person who doesn't move doesn't use many calories. Once a person is not moving, muscles waste away reducing the caloric expenditure even more. Even a strict diet (which would be devastating emotionally) would yield a very slow weight loss because of the lack of calories expended.

3. Who was supporting him, both financially and well, food-wise? His wife and sister did, both of them wanting the best for him and loving him very much. He had complex health issues which further complicated his condition, the biggest one being diabetes, and they were constantly trying to stabilize his body nutritionally and his blood sugar levels, but were unable to do so. Given that, both of his enablers were obese (not nearly to the extent he was though) and love to them also equaled food. A difficult situation with, I doubt, few supports from the community.

4. Why didn't he exercise? In watching the footage, they home he was in during the documentary (he was living in a nursing home that specialized in obesity) tried to support him with physiotherapist support. But at 750 lbs he was only able to be in one position. His muscles had wasted away and he was no longer able to move much beyond pulling himself with his arms a little. To lay on his back made him breathless because of the crushing weight of his abdominal fat, to the point that his ribs were ready to break. Being in one position (on his left side) made it difficult to exercise at all.

5. And finally, what is morbid obesity? The definition is a BMI (body mass index) of 30 or more which is essentially double your ideal body weight.
I watch as my sister very slowly creeps into obesity as I slowly from the cusp of the very same and I want to help understand better the complex reasons for this so that I can better support her, after her precious baby is born in February that is! What a reason to want a healthier lifestyle than for your children. I know there is more to it than that (like the sleepless nights and constant demands of a newborn that play havoc on even the most dedicated), but I want to be there for her too. I love you sis!!

Family and Community

I have been thinking about this a lot lately, the dynamics of modern day families. Family togetherness is vitally important to me as I view the family as the first community, from which all relationships develop. A close-knit family teaches children the vital skills of communication, empathy, sharing, and... well, the skills needed to succeed in life.

I have always felt strongly about families being close, including eating together, spending quality time together, and working together. For me, this includes NOT having a TV in every room (where individuals can simply move to another TV set to find the programming they prefer), sharing bedrooms (why do we insist on separate bedrooms for our children when we as parents share a bedroom with or spouse?), and sitting down to share a meal together as much as possible for at least one meal a day. Oh and don't forget doing chores together, cooking together, sharing fewer great toys rather than many seldom-used toys, and playing together.

Well, in our house, things are getting a bit frustrating for me. It started with my learning that my husband is a TV-a-holic. In the almost 20 years since our wedding things have changed a bit, with me relaxing about TV watching and my husband watching less while being more discerning about what he watches. However, it really started to slide with the purchase of a second TV that was for our family room and would be for movies and Game Cube use only (no satellite receiver). I agreed, seeing it as a place we could go as a family and watch a show together with... and allowing me some peace from Game Cube play while working in the kitchen (right off the living room).

Fast forward to today where we have three TVs, a Game Cube, an X-Box (which I railed against to the bitter end because of the violence of the games for this system), and two computers (one a laptop). The worst allowance on my part in all of this was the family room TV moving to our room when we moved here (with an unfinished basement, we had no other place for it). It was with the agreement that it would move out of our room the instant our family room was finished. Yeah right. Allan, the former TV-a-holic has always had difficulty falling asleep and finds TV as a way to relax and allow sleep to come sooner. With his crazy work schedule he often is up until 1 or 2 in the morning unable to sleep, having to work at 7 or 8 the next morning. Well he now says it’s easier to fall asleep while watching TV in our room. I know the reality of that, it doesn't matter where he watches TV, he is still up to the same time... but with the TV in our room, it disturbs my sleep - and I general sleep like a rock. But I can't convince my husband of this and am at a loss, not to mention I can’t lift the darn thing to move it myself.

More importantly, I am also seeing our family spending less time together. Rather than discussing and negotiating about what we will watch or do, individuals gravitate towards their own space, or TV, to do or watch what they want rather than spending time together. I also see how this affects relationships, where a "me" mentality develops rather than a "we" mentality needed for interpersonal relationships. I see this most poignantly in our third son who struggles with language delays and his strong personality providing even more concern as he struggles to communicate.

We will be spending much less time from this point doing individual activities and much more time communicating, negotiating, sharing, and being with one another. And I will do everything I can to move that TV to it's proper place if I have to roll it down the stairs. "If Mom's grumpy (from lack of sleep), ain't nobody happy!"

Pretty Princess

Yesterday saw my last Christmas shopping journey to Wal-Mart and what insanity that was! Brendan wanted everything he laid his eyes on, to the extreme. Mommy was not a happy camper dealing with his constant whining and only by virtue of this being our last trip did I not leave the store. Eric and Ryan were great, focused on getting what they needed for their "$20 gift" (more on this in a minute) but Breanna kept cart hopping, in and out, from one cart to another (we usually bring two, one for the two littles and one for purchases). That added interest to the frustration, believe me.

This last shopping trip included three dress-up dresses for Breanna, Taylor (my sister's 5 yo daughter) and Olivia (my other sister's 3 yo daughter). Princess dresses to be exact, Cinderella, Snow White and Sleeping Beauty. Breathtaking things they are, all flouncy with a full skirt and crinolines, satin and lace. Well I knew in a heartbeat which one my little princess wanted, the pink one. Cinderella she will be and it will be a very well used dress as she loves to wear her dress up clothes all the time.

Well, Princess Peanut (aka Breanna) found the darn things this morning in my hiding place under my bed. I would have had them wrapped already but I can't find boxes that fit them in all their crinoline wonder. So she quietly and quickly stripped down and doned her new find, so very excited and so very happy. Christmas happens but once a year... well apparently not at our house this year. I didn't have the heart to take it away and immediately plan B was hatched. I would let her wear it today and wrap it to be opened again, and I am sure just as happily.

She changed after lunch, wanting it "cleaned" because of a slight spot of ketchup on the sleeve and I obliged her, putting it carefully in the laundry room per her request. Now to clean and wrap it, along with the other two, quickly before she remembers it again!

Now, about the $20 gift. My family every year has each adult member (my two oldest boys opted in to the fun this year) buys and brings a $20 gift. We put the whole lot into the center of the room and using a deck of cards, go around the room opening each gift as we go through the deck (ace of spaces first, king of hearts last - if we have that many there). Now you have a choice when it is your turn, open an unopened gift or take one of the already open gifts and give an unopened gift to the person you took the gift from. It is loads of fun!

Liberal Government and Day Care Spending

I rarely discuss politics except with close friends, and never in a heated matter, but with an election coming up things have been interesting. My almost 14-year-old was very excited last week when he read in the news about the GST going from 7% to 5%. I explained to him in somewhat of a nutshell about campaign promises, why we are facing an election in the new year and of course that is tainted by my own beliefs about our current governments, both federal and provincial. I told of promises kept (Klein's debt elimination), blatant lies (Liberal promise to scrap the GST entirely) and the compromises in keeping promises (reduced spending in Alberta) that frustrates us in some ways.

Well, I will not be shy in my dislike of politics and the smoke and mirrors that fog almost every issue. One thing that does piss me off royally is the blatant spending of the Liberals. As we spiral further and further into debt, Martin pledges an additional $6 billion for day care over the next five years. To me this is just another way to further degrade families. Mothers who want so desperately to stay home and parent their children are instead forced to work in order to make ends meet far too often today. Why can't this money go towards families, who can then choose to spend that money as they wish, towards daycare or towards paying bills so that children can have parents instead of surrogates? I know why, because government doesn't trust its citizens to spend that money wisely. Well we need to only look to our federal government for a role model, right? NOT!

I know this is a long-held debate, but I do know that as a stay-at-home mother who makes difficult choices every day that impacts her children because of her lack of income, it isn't fun. Could the Liberals support families for once Paul Martin?

Fake Formula in China

It deeply grieves me to read of infants who die at the hands of companies who knowingly produce substandard infant formula. It is all about saving a buck and at the expense of the innocent. Yesterday Associated Press reports that two factory officials that produced the nutritionally compromised Lezichun brand formula were jailed.

Yet what grieves me much more is the fact that infants are receiving infant formula at all. In studying the Chinese culture and it's beliefs surrounding the perinatal period, I see many reasons why. But with such a rich history and formula only available in the last 50 years, could they not look back and seek the wisdom of their ancestors? Can they not see that mother's milk is the best for their precious children, especially in light of the huge formula problems that plague their country right now? Twelve infants have died from substandard knock-off formulas. Or in the case of the Guiyang Sanlian Milk Company, repackaging out-of-date formula to keep them on the shelves last year. Heck, even Nestlé was accused of compromising their formula by not using whole milk. Their answer:

Nestlé China pointed out that it deliberately used skimmed milk in its infant formula because whole milk is considered to contain too much protein for young babies to digest. It also said that added fatty acids, minerals and vitamins were a necessary addition to create a balanced nutritional content. AP 18/03/2005

I won't go there in terms of what formula is made of (anyone using or considering using formula should be very well aware of the crap that goes into it) or of Nestlé's own blatant marketing strategies that are compromising babies every day (a great expose on this can be found in Dr. Jack Newman's breastfeeding books). Mother's are "sold" on the idea that formula is just as good, yet in the end can't afford the huge cost of formula .

Mothers and families have to realize the choices they make are important, none more so than those surrounding the beginning of life, as it sets the stage for their child's entire life. Children are resilient, that is a fact, but smart choices by parents is essential for their health and well-being, and none more than during the first three years when brain development is at its peak.

Eating Well

I am ready to do this, return to a healthier weight. I am just barely tipping the scales of obesity and though am down 10 lbs since moving here (removing stress = less eating), I do have a ways to go. It is funny, but I rarely see myself as heavy, contrary to my husband who has always seen himself as overweight, even when he wasn't. Every dream I have I see myself as slim, flexible, strong and healthy. I have never, ever dreamed of myself overweight and indeed most of my waking days I don't feel overweight at all... unless I am dressing or (shudder) shopping for clothes. Even that has become much easier since I found Cleo (www.cleo.ca) which carries great fitting clothes for my body type (big hips and a small, short waist).

But I digress. Ann Douglas blogged about EATracker, a free nutrition and activity tracker from the Dietitians of Canada. I have had fun playing with it today apparently I eat properly (for the most part) but don't exercise enough. Welcome to being a Canadian in winter. In the same breath, I love exercise. Especially free weights and circuit training (keeps things from being boring). However, I have not been disciplined enough since spring to keep a regular exercise routine together. Given that, being a mom/wife/volunteer/business owner keep me off my laurels enough that I was active enough to get a "green star" today. We shall see what the future holds! Check it out for yourself.