Monday, April 20, 2009

Simple Things That Make Me Happy

As many of you know, I have been in a little bit of a funk lately. I'm out of it now thankfully, but it got me thinking about the simple things I do almost every day that make me smile. Here is the most recent.

When I first moved into my house, I immediately tore out all of the iceplant on the hillside in front of my house, and replanted it in a Tuscan/ Califonia themed, water conscious garden. I chose every plant myself for its shape, color, smell etc. It occupied me for months. I spent special attention choosing the rosebushes that line my stairs. The one that is on the landing was the hardest. It took me forever to find it, but when I finally did, it was chosen for not only the color of the flowers, but the smell of the roses. (Yep, I can get obsessed that way.) As I walk down those stairs everyday, before my first cup of coffee, I stop and smell the roses and I smile. It is a simple act, but it connects me. It grounds me in a fundamental way.

The best smelling roses ever.



The other roses along the stairwell.


Wednesday, April 15, 2009

How Safe is Your Home Birth?

Last night I read my friend Jessica's post on a home birth turned tragedy, and immediately replied that I'd weigh in on it today.    The tragedy, the death of a baby born in an unassisted, unmonitored home birth.  So, here I am.

As a neonatologist, my profession, my passion is taking care of critically ill babies, most of whom would not survive without medical assistance.  I live in the world of the <1% of births that go really wrong. Approximately 10% of babies require some assistance at birth, included in that number is the ever increasing percentage of preterm births. And yet still many argue that we are "medicalizing" a process that is natural and  has occurred without medical assistance for thousands of years.  True, but for those same thousands of years there was generally a midwife or some trained person who assisted the the delivery.  Further, for those same thousands of years childbirth was the number one cause of death for women and babies.  Like I said, I live in the world of 1%.  I have seen crazy things.  There is one case that is burned into my mind of a home birth where the mom refused to listen to the midwife and her husband and go to the hospital when things started to go wrong.  After the woman passed out, the midwife drove her to the hospital, the baby was delivered, saved, but left neurologically devastated because of waiting too long.  A few hours earlier, they might have had a healthy baby.  The list is long and bad things happen even under the best of care, but wouldn't you want a chance to intervene if things start to go wrong, a chance for the baby and the mom.

 Reading the article about this woman in Australia it is clear that her labor was not going as planned, that she had to have an emergency c-section for her first child makes it even less safe for her to be completely unmonitored and unassisted. That she labored for 5 days, something no physician or midwife would allow, especially with the risk of uterine rupture after a prior c-section.  That the baby is dead is a tragedy.  Could medical intervention definitely have changed the outcome, no.  However, it would have given this baby a chance.  

Saturday, April 4, 2009

Just like riding a bike

I'm one week into having committed to this triathalon thing and the training has begun.  As I said before, I'm confident I can handle the swim.  The run will be rough because it is last, and 4 miles is pretty much the longest I've run.  So I definitely have to work up my running tolerance...  However, I haven't been on a bike in years.

So, phase 1 of triathalon training is to get comfortable riding a rode bike.  A friend from work lent me a Bianchi rode bike.  I had to get new pedals for it last weekend because I'm not quite ready to have my shoes clipped into the bike pedals.  Maybe that will come.  Then I had to start riding the bike.  People always use the phrase "just like riding  a bike" to describe something that should be rote muscle memory.  Something you haven't done in years, but that comes back to you immediately when you try again.  I am here to tell you IT ISN'T QUITE THAT EASY.  It is going to take some work for me to get really comfortable on this bike.  So, that is phase 1 of triathalon training.  Oh yeah, and to continue to build up my cardio toleranace.  On that note off to the gym I go. 

Thursday, April 2, 2009

Are Hospitals promoting Health?

I put this post up on facebook from work the other night when I discovered that the food that I had brought to be my evening snack was bad.  It was simple-  "I'm in trouble, I'm at work, I'm hungry and my hummus is bad.  What will I eat?".  This was after spending 2 hours at the gym earlier in the day which always leaves me somewhat hyperphagic and after recommitting to my healthy eating habits.  So, there I sat HUNGRY with just plain celery to eat.   As I munched away on my celery I pondered my possibilities to get something solid to eat and got some hilarious comments from my friends.  The sad reality is that at 8 pmon a weeknight while stuck in the hospital, my options are limited. There is a  McDonalds in the hospital open 24 hours, but I won't eat there. The cafeteria has almost nothing by processed overly salted food I wont' eat and if it were a weekend it wouldn't even be open at all.  I found an old banana in my desk drawer and some trail mix.  

So there you have it my options were McDonalds v. processed cafeteria food v. old food leftovers in my desk drawer.  Fortunately, the food in my drawer wasn't bad so I ate that. However, it really is a sad commentary that at an institution that is supposed to be promoting health there is nothing healthy to eat.  In an era when childhood obesity is an evergrowing problem, The only place to buy food from at on certain hours and on the weekends at a large freestanding Childrens Hospital is McDonalds.  Is the hospital really promoting health?  And it is not unique to this hospital. I have worked at several children's hospitals in the country and most of them have a McDonalds because of the link to Ronald McDonald houses, and most of them primarily serve unhealthy, fried food in the cafeteria.  As leaders in pediatric healthcare shouldn't we be promoting healthy lifestyles? I don't get it.  As I lay in my bed hungry that night this thought plagued me.  

Tonight when I came to work I packed plenty of healthy food and made sure it was all still good.