I’ve been a freelance writer for about a dozen years and have written for pretty much every women’s magazine out there. Before kids, I used to write a lot for Marie Claire. I pitched every one of my stories — that is, I came up with the idea, wrote it up, and it was approved and assigned by the editors. One of the ideas came about after a friend had her first baby. Afterward, she confided, she was having problems. Any time she laughed, coughed, or ran, she leaked urine. I did research for her and realized that her pelvic floor muscles were probably stretched out or damaged from pushing for more than three hours. It was a story, I decided, and I pitched it to my Marie Claire editor. Here’s an excerpt from the letter (yes, an actual snail mail letter since my editor wanted to see clips, too) I wrote:

Thank you for taking a look at my pitch on vaginal strength and gynecological physical therapy, which I sent to you today via e-mail. As I mentioned in my e-mailed pitch, the researchers I’ve spoken to such as Dr. Lauri Romanzi, a uro-gynecologist at Cornell University-New York Presbyterian Hospital say American women are missing out because few know that their vaginal problems can be solved using directed Kegels, biofeedback, and other physical therapy methodologies. This leads to needless suffering just because doctors and most media outlets are squeamish about the topic. I’d love to be the one that breaks down these barriers and helps let Marie Claire readers in on the secret.

Completely crappy letter, but hey, I was just a wet-behind-the-ears kid. But I digress as usual. The story was assigned, but not exactly in the way I envisioned. The title of my story morphed from “Get a Stronger Pelvic Floor,” to “Best Orgasm Ever!” You can read it here. There’s still advice and info that stands the test of time. The testers were two of my karate pals and me, of course. And I got to go into Dr. Glazer’s New York City office, get uro-dynamic testing, and take home a vaginal biofeedback machine. It was fairly awesome. (I remember being very offended that I was “strong” but lacked “endurance.” In layman terms, my pelvic floor muscles were strong, but got tired quickly.)

Anyway, fast forward a half a dozen years and I was pregnant with my second child — you know, after my first child that weighed in at 8 pounds, 5 ounces at birth and who has a giant head. I got the flu. Twice. I had HUGE issues. Every time I coughed, I leaked. (Sorry for that TMI.) I blogged about it. Anyone who is having similar issues should definitely read that post, Whiz Bang, You’re Wet (Or How Not to Pee Your Pants).

As my story and the book, The Bathroom Key, show, there are millions of women suffering with urinary incontinence but they don’t have to be. There are treatments and exercises and help available. You just have to be willing to talk about a problem that could seem a little embarrassing. In this case I think we as women need to take a page from men. They are more than willing to go into their doctors’ offices and tell them about weak urine streams and erectile dysfunction. Why should we be afraid of talking about a little leaky urine?

Have you ever had a problem with bladder incontinence or any other pelvic floor issues? Did you seek help? How did that go for you? I’d like to know.

I was lucky. After the doctor cleaned the wound and cut back some of my toenail she told me that it was probably broken (of course) and that although it was still bleeding a lot, the bleeding would stop within a few hours. She bandaged it up, and was about to send me on my way when she asked how I had found out about her office. I told her that I walked around on her practice for more than a decade. I wasn’t kidding. I have orthotics and they are printed with her practice’s name and number. How old were my orthotics really, she wanted to know. Old, I said. I had them for at least 15 years. That’s when she told me that orthotics have a “shelf life” of a couple of years. She told me I should replace the ones I had, and suggested that I do it when I followed up with her in a week for a pinky toe recheck. Why not, I figured.

The next Saturday I went back to the foot care practice. The doctor checked out my black and still-painful toe, and then told me that her office had checked and my orthotics would be covered 100 percent. If I wanted them, they could do the exam right then and there. The kids were at their Saturday morning events, so I jumped at the chance. Oh, there would be just one thing, her assistant added. I had to get x-rays because, and I quote, “it is a requirement of your insurance carrier.” Hmmm. I was skeptical, but I figured that a doctor’s office — my doctor’s office — wouldn’t lie to me. Soon after I found myself standing on an x-ray platform. A week or so later I got the detailed bill from the insurance company. My re-check, x-rays, and orthotics cost my insurance company $960. An hour-long visit netted the practice almost $1,000 once they threw in my $20 co-pay.

Okay, so earlier this week I get a call from the podiatrist’s office. My orthotics were in, and the woman on the phone wanted to set up an office visit to have me pick them up. I’ve worn orthotics for years, I explained, I don’t need or want an office visit. And then came more or less the exact words the doctor’s assistant had said at my first visit: “Your insurance company requires an office visit before we can give them to you.”

I had my in-laws here when they called, so I didn’t want to argue on the phone. However, this time, I wasn’t just taking their word for it. And so earlier today I put in a call to my insurance company. Guess what? Not only were they lying about the office visit, but I didn’t need x-rays, either. I was mad.

I called the office and spoke to the receptionist. I wanted to come pick up my orthotics, please, I said. She reiterated her “insurance requires it” speech, and said the doctor had to “put the orthotics” in my shoes. I didn’t even let her finish before letting her know that I knew she was being less than truthful with me. I told her I had just gotten off the phone with the insurance company, and there was no such rule. Finally, I told her that I was not wasting $35 (my co-pay went up this year) to have a doctor slide inserts into my shoes. She was quiet for a second before taking my number and saying she would have to “check” with the office manager first. And now I’m waiting to hear back.

This is another example of why I feel like we all have to be our own medical advocates. The Republicans and Democrats can bitch all they want about class warfare, but the real battle is happening in doctor, dentist, and therapist offices across the country. Payments have gone down, paperwork has gone up, and we are bearing the brunt of both. We get tests we don’t need so doctors can boost their per-office visit fees. We wait for HOURS because they rack ‘em and stack ‘em, piling up patients so they don’t have any downtime in case someone should cancel. They charge us for copies of our medical records, something that should essentially be free since we OWN them. They spend less and less time with us and get mad if we ask questions. (Exhibit A: The midwife who told me, after my miscarriage, that her office might not be for me since I dared to question her treatment plan.)

People, we are the only ones who can mitigate these issues. We MUST be vigilant so we get the best care at the most reasonable charges. We have to stop blindly taking medicines, submitting to testing, and filling out paperwork. (For example, you shouldn’t give your Social Security number to your doctor’s office unless you’re receiving Medicare or Medicaid.) We have to be willing to question why, and if we’re not satisfied with the answer, we have to keep asking — and in some cases someone else — until we are. Whew. I hate being all soapbox-y, but this stuff really, really makes me crazy.

I cannot WAIT to see what happens with my podiatrist, one who was recently given a Best Of award by a local newspaper. Will they hold my orthotics hostage? Will they waive my co-pay just so they can bill my insurance company? I’ll let you know.

I wasn’t surprised since, as a child I spent half my life drinking pink Amoxicillin and chewing baby aspirin. Still, I calmly explained that no, I didn’t give her anything since having a fever is actually a good thing. It’s the body’s way of fighting the infection. Bringing the fever down would be like putting a muzzle on a guard dog. A silly, silly idea.

The fever persisted into the afternoon so, after my webinar, I stopped into the pediatrician just to let them take a look-see. She didn’t have any other symptoms, but she was complaining that her lower belly hurt making me wonder if it was a urinary tract infection. The doctor did a thorough exam with Little Girl sitting and screaming in my arms since she is terrified of the doctor. (That’s another blog post — an after effect of her liquid stitches experience last month.) The doctor also got a urine sample and cultured it. At the end of the exam, my doctor said Little Girl probably had a virus, sending me on my way without medicine, I might add. She did say I could give Little Girl Tylenol or Motrin if she was complaining a lot or was unable to sleep, but otherwise keep doing what I was doing: giving her lots of fluids, keeping her quiet, and encouraging her to rest.

Tonight around 11 p.m. my phone rang. It was my mom. Again, she asked if I had given Little Girl anything for her fever. This time, I couldn’t help myself. Apple iPad in hand, I pulled up the American Academy of Pediatrics (AAP) website and read something to her. Back in February the organization came out with a new clinical report — Fever and Antipyretic Use in Children — that spoke to the use of fever reducers. From the report (I added the bold):

Fever, however, is not the primary illness but is a physiologic mechanism that has beneficial effects in fighting infection. There is no evidence that fever itself worsens the course of an illness or that it causes long-term neurologic complications. Thus, the primary goal of treating the febrile [with fever] child should be to improve the child’s overall comfort rather than focus on the normalization of body temperature.

Bottom line: Parents should not give Tylenol or Motrin — should not try and bring the fever down — unless the kid feels so terrible that they can’t sleep, eat, and drink. If they’re just a little hot, parents should let their immune system do what it needs to do. I’ve always done this for myself, too. I try not to take anything when I have a fever, instead picturing my germs sizzling and dying in my own internal sauna. (What do you expect? I’m half delirious with fever!)

Of course, I also follow common sense rules. I watch that the fever doesn’t go too high (for me that cut off is 102.5) and that everything else is okay. The patient, whether it’s me or my kids, must be drinking, urinating, and not in any pain that interferes with their normal personality. I also make sure the patient can sleep, since rest is so important when you’re fighting a virus or infection.

Little Girl went to sleep at 7 p.m. I’ve checked on her every few hours, and she seems cooler than she was in the morning. She hasn’t woken up (so far) and she hasn’t developed any other symptoms. I will keep a close eye on her, though, especially over the next few days and go back to the doctor if the fever lingers past the weekend or if she develops any symptoms that make me nervous. As for the bottle of Tylenol that my mom keeps pushing? I’m keeping it ready, but hoping, like the AAP suggests, I don’t need to use it.

The study asked 209 Washington State pediatricians about their overall willingness and “comfort” to use an alternative immunization schedule, something I believe in myself. The results were fairly surprising, at least for me. Almost two out of three (61 percent) of the doctors surveyed said they would be comfortable using an alternative schedule if parents specifically requested one. That’s welcome news, and news that should be out there: It’s okay to question or delay vaccines as long as you know the risks and benefits upfront.

I have three problems with the current vaccine schedule. First, kids are given a lot of vaccines starting at a very young age — birth for most. Second, most of the vaccines that doctors stick into kids are not required by law for entry into school. Finally, I think we’re vaccinating against diseases that — for those with healthy immune systems — aren’t going to hurt kids should they get them. In fact, I believe that kids should get sick sometimes. It’s good for the immune system.

As to the first issue: How is it that a minutes-old baby needs a Hepatitis B shot if its mother does not have the disease? Sure, I know doctors will say that the mother could have contracted the disease between the beginning of her pregnancy when she is tested for Hep B and the time she gives birth, but how likely is it really? The next set of recommended shots — and I do mean “set” since it’s FIVE shots — comes at two-months-old. At that time, doctors can give, based on the AAP’s recommendation, shots for rotavirus, haemophilus influenzae type b vaccine (Hib), pneumococcal conjugate vaccine (PCV), polio, and a combined shot of diphtheria, tetanus and acellular pertussis vaccine (DTaP). So basically seven different shots at one time. For a two-month-old. Two months later you get the same shots again. At six months, you’re looking at another rotavirus shot, another Hep B shot, DTaP, Hib, PVC, polio, and possibly a flu vaccine. All told, the kid’s had 19 shots and a cocktail of more than nine diseases injected into his or her system before they can barely sit up. And here’s the rub: Many of those shots are not required for school, and the AAP’s schedule calls for 15 more vaccines before the age of 6.

Here in New York kids need three doses of diphtheria, three doses of tetanus, three doses of polio, two dose of measles, one each of mumps and rubella, three doses of Hep B, and one dose of chicken pox. (No Hib or PCV, I might add!) By kindergarten. Kindergarten. Not by six-months-old. By kindergarten. Here’s the link to the AAP’s recommendations and the link to New York State’s requirements so you can check out the disparities.

This makes me ask the question: why? Why so many vaccines so young for kids with healthy immune systems? Of course, I am not a doctor. I’m just an educated, concerned parent who makes my own decisions. From my research I know that there are plenty of parents out there who are making their own decisions, too. Parents who say no to Hep B shots for babies. Parents who decide to wait six months between shots and keep the number of shots given in a single day to one or two. Parents who skip the shots that aren’t required by law. There are even people who choose not to vaccinate at all.

So what’s your take on this? I have a final FYI for those considering delaying: If you do delay, you might be interested to know that the AAP study also found that the doctors surveyed said there were three shots that they would not delay: Hib, PCV, and DTaP. My girls never got Hib or PCV, and I do not regret my decision.

Vaccines are a tough and loaded topic these days, so I will ask both sides of the debate and those who are in the middle to please speak respectfully to each other if you do choose to post here. Thanks.

My beautiful neti sitting in my bathroom.

Little Girl came home on Monday with her first preschool cold. No sniffles, just a cough. She’s actually really good about covering her mouth with her elbow, but she’s also only three. Sometimes she coughs on Mommy.

Yesterday I started getting that tell-tale burning in my sinuses as well as a pain behind my left eye that always leads to a cold. I do not have time for a cold. I have dinner out tonight with friends and a play with the girls tomorrow and a six-page white paper to write. I do not have time to be sick. I went into preventative action.

My first order of business: Using my neti pot. Don’t know what a neti is? Check out this post — one of the first I ever wrote — about the proven scientific benefits of using a neti pot, which is essentially a little teapot that you use to pour water through one nostril so it can come out the other. Since I first wrote that post, there’s been more research data to support the use of neti pots including this one proving its effectiveness for children from the University of Kansas School of Medicine and this one from the University of Padova in Padova, Italy. The Italian study actually that found that using a neti eliminated the bacteria staphylococcus aureus (better known as staph) in study subjects’ noses. Okay, so I used it and, I will not lie, because I wasn’t feeling good it was not a pleasant wash. It burned.

I also made sure I ate lots of cold-fighting foods yesterday. I had two bowls of soup, which has been found to have cold-fighting properties. I went with a tomato-based chili for lunch. (Tomatoes are high in vitamin C.) I had chicken soup for dinner. I also loaded up on garlic, adding two cloves to the chili I made.

This morning I feel better. It’s amazing, really. Was it the neti? Was it the food? Was it a combination of the two? I’m not sure, but I’m hoping that it sticks. Just to be on the safe side I am going to neti again this morning. It can’t hurt, right?

What’s your favorite cold-fighting cure? Have you ever used a neti pot? Even more important: Do you have a good chili recipe? Mine came out blech but I ate it because I couldn’t stand the thought of throwing out all that expensive organic chicken and beans. By the way, this post is how I am participating in this week’s Real Food Wednesday and Fight Back Friday, two awesome blog carnivals dedicated to promoting the use and consumption of — what else? — real food.

We went back and forth to the doctor about 10 times including twice to the after-hours facility. A virus, they told us. A cold. Allergies. Until finally my doctor proclaimed that she thought Big Girl had pertussis or whooping cough, as it is more commonly known as. The doctor swabbed Big Girl’s nose, and told us to sit back and wait. In the meantime, the doctor said she should get started on a course of HARSH antibiotics. They couldn’t halt the cough, she said, but would absolutely make sure she couldn’t pass it along to anyone else. (People with pertussis cough because the bacteria release a toxin, which paralyzes the cilia — the little hairs that sweep out bad stuff — in the trachea. They cough once the mucus and junk gets so thick that even paralyzed, the body knows it needs to get it out.) She took that medication for ten days twice a day along with a yogurt smoothie to keep her intestinal tract healthy. After the semi-diagnosis, she stayed in the house for five days until we knew she was clear. And I prayed every day that she hadn’t previously exposed someone who had an infant at home, since even vaccinated people aren’t safe from pertussis. The shot is only 60 percent effective. (See stories here and here that show the majority of people who get pertussis during an outbreak are vaccinated.)

When the baby developed a little cough that sounded “whoopy,” I medicated her, too. And my husband also got drugs when he started coughing. Interestingly, I never got the cough, which was weird because I was pregnant, and I picked up every little thing when I was pregnant with Little Girl. Anyway, Big Girl’s results come back negative for pertussis. Little Girl’s results (I had her swabbed, too) got lost at the lab. (Don’t even ask. I cried at the Long Island Children’s Museum when they told me that.) My husband’s swab was negative, too. However, my doctor and I, well, we still think it was pertussis, especially since I truly believe I was spared because I had a really, really bad case of pertussis as a child. I have what doctors call natural immunity.

The worst of the cough is over, but, as I expected, she is still coughing on and off, par for the course with pertussis. (If it was pertussis, she should cough until mid-October since it lasts up to three months.) I feel so bad for her when she coughs. Drugs — even if I was a medication type of person — don’t do anything. However, some recent research shows that there might be a fix for her cough. For anyone’s cough, really, and it’s more effective than any medication out there: a spoonful of honey.

The study was out of the Pennsylvania State University and compared the effectiveness of honey with drug dextromethorphan, found in over-the-counter cough medicine. There was a third study group that got nothing at all. The researchers made the dextromethorphan taste like honey so kids and parents couldn’t tell if they were getting the drugs or the actual honey. The study measured, “Cough frequency, cough severity, bothersome nature of cough, and child and parent sleep quality.” The results were pretty astounding.

“In a comparison of honey, [the drug treatment], and no treatment, parents rated honey most favorably for symptomatic relief of their child’s nocturnal cough and sleep difficulty due to upper respiratory tract infection. Honey may be a preferable treatment for the cough and sleep difficulty associated with childhood upper respiratory tract infection.”

Last night, hoping to ease her cough, which happens mostly at bedtime, I broke out a brand new jar of local honey that I picked up at Whole Foods. Big Girl, however, was not inclined to take it. I suffered through about five minutes of blech, ugh, grrr, nooos before giving up. We’ll try again tonight, and I’ll let you know how it goes.

This post is how I am participating in this week’s Real Food Wednesday and Fight Back Friday, two awesome blog carnivals dedicated to promoting the use and consumption of — what else? — real food.

Hallmark meant she cared...

I got a card in the mail today from a neighborhood woman. I told her about the miscarriage when she called to ask me to send out an email for a local organization. At the time, she was so sweet, telling me how sorry she was for our loss. We got off the phone and I felt comforted. Like she really got it. She meant what she was saying, and truly hurt for me.

The card itself was really sweet, too.

“Thoughts of you are gently wrapped in little prayers for heaven to smile on you, angels to watch over you, and happiness to fill your heart again.”

This was not the only act of kindness in my life. Today, for instance, I got a call from the mom of one of my religion kids. She apologized for taking so long to call, and wanted to know how I was feeling. I was so touched. My friends have been rallying around me, too. Calling, emailing, texting. “Just thinking of U today, Ka. Hope you are doing well.” I got that text around 7 p.m. this evening from an old, old friend.

In the past — when people I knew battled adversity — I always felt bad that I wasn’t doing MORE for them. What could a card do? What could a call do? Would my baked ziti really change anyone’s  life? I should have thought back to my first miscarriage in July 2005. (That baby, due January 2006, would be six right now.) Right after I miscarried there was a knock on the door. One of the people I consider a “bestie” was standing there holding a pint of Ralph’s Italian ices. Jelly ring flavor, which is a favorite. She looked really uncomfortable and told me she didn’t need to be invited in, but she wanted to do something to show me she was thinking of me. Later on, I ate those ices and cried over the baby I had lost. It sounds morbid, but I’ve never forgotten that small, kind act. I don’t think I ever will.

Anyway, the point of this rather depressing blog post is that yes, small acts of kindness and heartfelt sympathy really mean something. I feel more whole knowing there are, for instance, super-busy people who will drop everything in their Manhattan office, asking me where they can call me. And people who email me constantly, checking in and making sure I am okay. And I can’t forget my entire GROUP of writer friends who sent me their phone numbers and commiserated with me. Those who shared their own stories of loss and grief to let me know that they understood. That I am not alone. And what about the woman who only knows me through our kids — and hadn’t spoken to me for more than a year –  but offered to come over and help me clean up my yard so I could just sit and rest because I NEEDED my rest? How could I forget her? Or family member who texted me four simple words, “I am so sorry,” making me feel warm inside even while tears streamed down my face. (That one was especially meaningful since that particular family member has many, many more never-born babies than I do.) I was equally as humbled by the friend who constantly told me to drop off my kids or said she would come and pick them up as well as her husband, who knows how I feel about hugs but still wrapped his arms around me to tell me that he cares. Or my brother, who actually CAME to my house and hung out, which is something he rarely does. And my mom, who stopped nagging and just took care of me, bringing me meals and watching my kids. My in-laws, too, who raced to the hospital at 4 a.m. to bring my kids home and have been attentive and worried during the whole process.

Yes, this entire experience has sucked really, really bad, but it definitely brought me clarity. It shows me how many amazing people I have around me — more than I realized. It also showed me who I should care about, and who I needed to remove from my life. Finally, it reminded me that an act of kindness, however seemingly small, can be huge to the person on the receiving end. And for that I am glad. It was a true silver lining on what was really a hurricane-sized thunder cloud.

The miscarriage was so horrific that I had my husband rush me to the ER. I sat there in the middle of the night stanching the blood with a big, fluffy towel, trying to remain calm in front of my kids, who were sleepy yet questioning sitting in the backseat.

There was so much blood, so many clots. I was terrified. During the seven hours I was at the ER, my hemoglobin dropped from 14 to 10. I was given three bags of fluids and had two open IVs in case they needed to give me blood. That’s how bad it was. Still, when I went home I was able to relax a bit since the clots had stopped and it looked like the “products of conception,” as the doctors so nicely put it, had been evacuated. The horrible, painful sonogram done by the evil (IMHO) sono tech found just clots left inside. I would continue passing them, said the doctor, who told me to follow up with my office and see a doctor — not my midwife.

Okay, so I called my office, telling them what the practice’s covering ER doctor told me. I showed up for my 2 p.m. appointment yesterday and — what’s this? — I’m told I am seeing the midwife, who I love, but is obviously not a medical doctor. I balk, but stick around. What else can I do? They send me into the sono room. I can see there are still dark patches inside, which are clots, the sono tech says. Is that bad, I ask. The tech tells me I have to talk to my midwife, but that clots can sometimes be passed on their own or reabsorbed by the body. Okay. So I go and talk to my midwife who tells me that she wants me to take Cytotec. (I find out later that this is simply one drug company’s brand name for misoprostol, a synthetic prostaglandin E1.) She wants me to take 200 mg every six hours for five days. It will cause contractions — “heavy contractions” — that will expel the last of the debris from my uterus. Oh, and it might make me bleed “a lot.”

I’m already feeling woozy from my lack of hemoglobin. I really don’t want to bleed heavy again, so I go home and start doing research. First thing I find is that what my midwife has prescribed is an off-label use for Cytotec, which is only approved by the FDA for the treatment of ulcers. I also find a treatment guideline that suggests, for an incomplete abortion (another way to say incomplete miscarriage), the dosage should be one 600 mg dose. The closest thing I see on that treatment guidelines related to my dose is for a “missed abortion,” which is basically when the baby stops growing but bleeding has not occurred. In that case, the dosage is 200 mg every six hours for two days. Hmmm. The whole heavy bleeding thing is freaking me out so much that I call over to the office asking for clarification. I explain what I’ve read, and how I know this is an off-label use of the drug, meaning it isn’t approved by the FDA. The girl who answers the phone puts me on hold and comes back with the following message from my midwife: “Diane says that she gave you the dosage she gave you, and if you aren’t comfortable with that then maybe this isn’t the practice for you.”

I am crushed. I am blown away. How could my midwife dismiss me this way? This is someone who gave me her cell number when we were waiting for a heartbeat. She was going away, but wanted me to text her when I got the results. Someone who hugged me when I was scared because my husband was less-than-thrilled about the pregnancy. I love her as much for the way she’s taken care of me this pregnancy as I did for her championing for me back when I was giving birth to Little Girl. I am hurt and scared and feel like I am being dismissed because I dared question her medical authority. Not one to slink away and just do what someone says without getting an answer to my questions, I called over to the main office. (This is a big practice with offices all over Long Island.) I speak to the patient care woman, who used to work with my husband at his old job. I tell her the whole story, even emailing her the links I read and she promises me that the doctor I saw in the hospital will call me back that night. She never did. I went to bed heartbroken and feeling very alone.

This morning I called back to the practice again. Kathy, the woman I originally spoke with, avoids my calls. I get Regina, one of the desk people on the phone. Regina, who has been there every step of the way with this pregnancy so she knows the deal. She tells me that the medical director wants me to come in. Is he going to do another sono or an exam, I ask her, because if he’s just having me come to chat I’d rather pay my $20 co-pay and just talk to him on the phone. I am still lightheaded, and don’t have someone to drive me to Garden City during rush hour. (And sit around the two hours I know it’s going to take to actually see this guy. The practice is notorious for making people wait and wait and WAIT.) She tells me to try and find a ride.

In between calls I reach out to another practice and spoke to a nurse. She is puzzled as to why I am getting Cytotec because I am still bleeding. “Your body is trying to expel what’s left. Why are they giving you anything yet?” We agree I am going to come in tomorrow to see the doctor there — the doctor, which is what I was told to see in the first place.

Okay, so I make a half-hearted attempt to get a ride. Anyone I would have asked has their own issues today. Work, sick children, etc. So I call back and tell Regina that I can’t get a ride, and that I will be getting a second opinion tomorrow at another practice. But I still want the results of my blood tests. Has my hemoglobin gone down more? She tells me she will try and get the results, and she will report in to the medical director about what I said. And that’s that. I am waiting for my results.

This has been a horrific summer. The pregnancy was a shock, but one that I was very, very happy about once my husband got on board. (He was initially scared and upset.) Still, as happy as I was, I never let myself get too excited about the pregnancy. I never expressed happiness at midwife appointments. First, there was no fetal pole. Then the heartbeat was slow when we did see one. I went through this once before, and I was heartbroken when I miscarried. This time, the emotional pain was worse. I haven’t cried so hard or so long as the night they told me the heartbeat stopped. I wanted that baby with all my heart and soul, but I think I knew from the start it was not meant to be.

Right now, the fact that my once-loving, caring, fabulous midwife has dismissed me for asking simple questions — and the fact that she couldn’t even be bothered to get on the phone with me to do it herself — is also breaking my heart. As someone who has issues with the whole area down below it takes a lot for me to trust someone. It’s pretty easy to dash that trust into little pieces, and that’s exactly what’s happened here.

Anyway, I didn’t write about my pregnancy earlier in the summer because I figured I’d never write about a miscarriage if it did happen, and I’m of the wait until the second trimester to share camp anyway. I probably would have stuck to my initial inclination if my midwife and medical practice had treated me with the respect and care I deserve as a woman, a customer, and a human being. The lesson, of course, is that we still have a LONG way to go before medical personnel get that patients are CUSTOMERS and PEOPLE. We are not a number on a chart or “a case,” as I was called this afternoon while talking to Regina. It sucks I have to find another doctor, but there are plenty of gynecologists and midwives out there. There has to be someone who will see me as more than just a co-pay. I just have to find her.

Note to anyone who knows me and is reading this missive: Some of you know what’s going on. I told my close friends when I got the bad news that the baby died. Those who didn’t know: Don’t talk to me about it and don’t talk to anyone else about it. If I didn’t tell you personally, I don’t want to talk to you about it. I don’t know how to say that more nicely, so I will just leave it at that.

Grapes make an excellent snack -- as long as you make the choice.

It costs more to eat well, according to a research study out of the University of Washington.

Hoping to see what effect the new U.S. dietary guidelines would have on a family’s pocketbook, researchers –  including Pablo Monsivais, acting assistant professor at the University of Washington and part of the Nutrition and Obesity Policy Research and Evaluation Network — evaluated hot much extra it would take to meet the new guidelines. (A quick aside: Prof. Monsaivais had already concluded back in 2009 that a better diet, which means a diet that’s richer in nutrients than calories, is more costly, and mostly consumed by those who are better educated.)

Research, according to newspaper and online reports, found that “eating more potassium, the most expensive of the four nutrients, can add $380 to the average person’s yearly food costs.” It also costs more to meet the fiber and Vitamin D guidelines. In addition, researchers confirmed that you can lower food cost by getting more of your calories from saturated fats and sugar.

Researchers want the U.S. government to back up the new guidelines with advice, and tell people how they can get the biggest bang for their buck. Me? I’m not so sure this would do very much. People know, for example, that bananas provide a good helping of the blood pressure-lowering, heart-helping nutrient potassium. I just don’t think it matters. Sure, they could eat a banana for a snack — bananas that cost about $.19 each or $.29 each if they are organic — but most choose not to. It’s sad, but I truly believe we as a society have been conditioned by marketers and advertisements and huge, honking supermarket end caps that a snack of say, potato chips is a much better alternative. I mean, who really thinks about potassium aside from pregnant women and mothers of small children?

I know I sound very cynical, but I have spent the better part of a week interviewing people who were morbidly obese, and I got an earful about what brought them to the brink of death. (These were really, really sick people with multiple co-morbidities like high blood pressure, diabetes, heart issues, sleep apnea.) Every one of those interviews confirmed something to me: It’s just far too easy to overeat bad food because eating bad food makes us, at least for a moment, feel good. The rush of sugar and chemicals dopes us into feeling good. The ultimate self medication. And that bad food is often the cheapest and easiest to find and get.

All of the people I interviewed are now closer to “normal” weight. (Although with two-thirds of adults and one-third of children being overweight, what’s really normal anymore?) They have made big changes in their lives. They all cut out processed carbs, chips, candy, sweets. They eat lots of lean meat, vegetables, and whole grains. They exercise. Not coincidentally, they all feel great. The co-morbidities are gone. And many of them are a little bit angry that they were duped into eating garbage to begin with.

This is not the first time I’ve written a story about weight loss. In the past, every single expert I’ve interviewed told me the same thing about weight loss: Calories in, calories out. That’s how you get slim, that’s how you stay healthy. If you eat, for instance, a Trader Joe’s chocolate biscotti (150 calories for a single small cookie) you’re probably still be hungry after you wipe the crumbs off your chin. However, if you eat a huge cup of organic red grapes (about 100 calories as well as fiber, vitamin C, iron, B-1, manganese, and calcium), you’re not as likely to be hungry. I know this firsthand. You’re also closer to your goal of eating more antioxidants like the anti-aging resveratrol.

And so we are back at the beginning. Yes, it’s cheaper and easier to eat garbage. It takes lots more time, a little more money, and a lot more effort to make good food choices. But I am convinced that the government can’t help us with this. It’s up to every person to make his or her own choices. Yes, I think it would be great if, for example, the Food Stamp program would make it more difficult to buy high calorie processed foods, and reward recipient for buying fruits and vegetables, but I don’t see that happening any time soon. How about you?

Contamination occurs in a number of ways. For instance, if someone preparing a hot dog doesn’t wash their hands after going to the bathroom or someone picking food in a field decides to pop a squat and drop a deuce among the veggies rather than making a trek to an outhouse or Port-a-Potty someone you can catch their bug. (Sounds gross, but for those workers who are paid for what they pick a 10-minute poop break means lost cash.) If meat is the source, the E.coli may come directly from the feces of the animal in question. Slaughterhouses are dirty, nasty places, and if an animal poops itself as it’s being electrocuted and that feces gets on the carcass….well, you get the picture. Contamination also happens if the cow’s intestines (filled with E.coli) make it into the ground beef mixture.

Meat that is contaminated can be rendered safe by cooking it thoroughly — bringing its internal temperature up to at least 160 degrees Fahrenheit. You can also mitigate risk by washing and peeling riskier vegetables such as sprouts and spinach, and cooking them as well. And it should go without saying (but I’ll say it) that everyone should wash their hands thoroughly before handling any type of food or eating it.

To date, researchers haven’t figured out where the latest outbreak of E.coli is coming from. They’ve been testing a variety of vegetables including sprouts and cucumbers, but nothing has come back positive yet. As a result, officials are warning people, asking them to avoid eating leafy vegetables and raw tomatoes. For us here in the States, this should be a wakeup call about the way our food is produced. Meat shouldn’t be factory farmed. Vegetables should be picked by people who are allowed to take bio breaks. Me? I’ll just stick with what I’m doing: Buying fresh, locally-sourced meat and vegetables, most of which is organic. I’ll also keep reminding people that if they are sick, they should take extra care with handwashing for at least two weeks after their infection. People don’t realize or don’t know that most stomach bugs take several weeks to leave the digestive system even when there are no symptoms present. You can pass along a stomach bug even if you or your child hasn’t thrown up or had diarrhea for a week or two.

The good news is that the large majority of people who do contract E.coli tend to get better. Still, my heart goes out to the families of those 22 people who died. It’s so sad that they died doing something that should carry no risk.