Wednesday, February 23, 2011

"C" is for Certified Nurse Midwife

Well, it's official--I changed my obstetric care over to a Certified Nurse Midwife (CNM).  On Monday, Kim, the CNM, completely put me at ease and provided answers to questions that I hadn't even asked yet.  She was very personable, and I felt like I could trust her with my care and Tully's delivery.  One neat thing we discussed is how Tully is positioned in my belly.  He kicks/punches/pushes in the same general areas, which I pointed out to Kim.  She confirmed his head is down and pointed out where his shoulders, back, butt, and legs are located.  There's not a lot of room to roll around, so he'll probably stay in his current position, which is similar to the picture to the right.  I could go on and on about how great Kim is and how she relieved all of my anxiety, but I'll spare you the details.

After deciding to use the CNM, we needed to choose a new hospital for Tully's delivery, either St. Francis South (SFS) or SouthCrest (SC).  Kim called both hospitals to see how busy they were.  Since SFS wasn't too busy, we toured the labor and delivery area.

For moms-to-be and future moms-to-be, here are a few questions you might want to ask when touring the labor and delivery area at your local hospital.
  • Is there a nursery?
  • If there is a nursery,
    • how soon is the baby taken to the nursery after delivery?
    • do babies room in with mom, or do they stay in the nursery until mom calls?
  • How long does mom stay in the labor and delivery room before being transferred to the postpartum recovery room?
  • Is there a NICU?
  • If there is no NICU,
    • where will baby be transferred, if needed?
    • will mom be transferred with the baby?  (There are cases where baby will be admitted to a different hospital for NICU care, and mom will not be discharged from the hospital where the delivery took place.)
Other questions to ask that are related specifically to natural childbirth are:
  • How do you feel about patients who request a natural childbirth?
  • How do you feel about intermittent vs. continuous fetal monitoring?
  • How do you feel about patients who wish to only have a hep-lock (i.e. IV hookup only) vs having the actual IV fluids connected?
SFS definitely had a different vibe than St. John (SJ), which we toured last weekend, and I felt much better when I walked out of SFS.  No tears.  No frantic phone calls.  I know the information we get and experiences we have are highly dependent on the nurse(s) we talk to, but since all of the nurses work together in a particular hospital, I would think the mentality and culture for care is somewhat the same.  SFS did not have a nursery like SJ, and SFS's policy was that the baby rooms in with mom.  (Rooming in was important to us!)  The only downside at SFS was that they do not have a Neonatal Intensive Care Unit (NICU).  In the event NICU care was needed, all of the nurses at SFS are NICU certified to care for the baby until it can be transferred to the main St. Francis Hospital, which is a few miles away.   A small percentage of babies require NICU care, and we haven't had any complications so far, so I don't have any big concerns with SFS not having a NICU.  Hopefully this weekend we can tour SC Labor and Delivery to compare it to SFS to make a final decision on the hospital where Tully will be born.

For those who are curious and may be considering a midwife instead of an obstetrician, I found the following info online.  I would also note that CNMs can also provide basic gynecological care, so I am considering Kim for this as well.

A Certified Nurse Midwife is an Advanced Practice Nurse who has specialized education and training in both Nursing and Midwifery.  CNMs function as primary healthcare providers for women and most often provide medical care for relatively healthy women, whose birth is considered uncomplicated and not "high risk," as well as their neonate.  CNMs in most states are required to possess a minimum of a graduate degree such as the Master of Science in Nursing or Post-Master's Certificate.  CNMs must also hold an active Registered Nurse license in the state in which they practice. They practice in hospitals and medical clinics and may also deliver in birthing centers or attend at-home births. They are able to prescribe some medications, treatments, medical devices, and therapeutic and diagnostic measures in all 50 states.  While their specific scope of practice will vary from state to state, in most states they provide medical care to women from puberty through menopause.

Monday, February 21, 2011

"C" is for Candles

My in-laws came to visit this past weekend.  I made dinner for everyone Thursday night and managed to burn my thumb with a flaming bag of shredded cheese.  My biggest fear while being pregnant is that I'm going to fall, cut off a finger, or injure myself in some way that requires a visit to the ER and major pain medication, which would be less than ideal for the baby.  The bag of cheese was accidentally set on top of the lit candle, and for some reason my instinct was to grab it.  Bad choice.  The plastic melted to my thumb, which was pretty gross, but it all eventually came off.  I kept it bandaged with Neosporin at night, so I just have a couple blisters now.

Thankfully there weren't any candles involved on Saturday when several of the ladies in my hometown and one of my dear friends from high school hosted a shower for baby Tully.  Below are a few of the photos.  I was overwhelmed by everyone's generosity.   Thank you to those who stopped by!

Several of the hosts.  Thanks, ladies!
My friend, Stevie, who also hosted.  Thanks, Stevie!
My mom and me
My MIL and one of the ladies from my hometown
Some of Tully's prezzies!
FOOD and a cute diaper cake!

Thursday, February 17, 2011

"C" is for Cupid

Valentine's Day was fabulous and productive at the Cockerham household.  My day started off with breakfast in bed, which included oatmeal, oranges, and heart-shaped pancakes.  Yum!  I got full pretty quickly, so a couple of the pancakes got stashed in the orange bowl until lunch.  I also got a very sweet card, a new plant (lilies!), and more of my favorite Godiva dark chocolate mix.

I gave John a new Canon 50 mm f/1.8 lens for the DSLR camera, so hopefully we'll be able to post even better photos in the future.  This lens is seriously awesome and totally affordable in comparison to other lenses.  It mimics the field of the human eye and can make people feel like they're "in" the moment.  It's great for portraits, candids and low-light situations.  I originally took my 8-month pregnancy update photo with the 50 mm lens, but since it has a fixed focal length, I couldn't stand in the right place, which made the shot look too different (i.e. made me look too LARGE) when compared to the other baby bump pics I had taken.  I was actually standing several feet back from where I usually do, but the 50 mm photo still appears much closer.  The bokeh a.k.a. blur for the 50 mm lens is amazing, but I had to switch back to the 18-55 mm lens to keep my baby bump series consistent.  Here's a comparison of similar shots taken with the two different lenses.

The detail is great in both photos, but see how blurry the bed and rug are in the 50 mm photo?!  I love photos that look like this--super crisp subject, blurry background.  I have to admit though that the comparison isn't totally fair here.  The 18-55 mm photo was taken at night, and the 50 mm photo was during the day, which is why the colors are off even though I'm wearing the same thing and standing in the same area.  I attempted to cover up my lack of ability to adjust the colors by going black and white, but sadly my Photoshop skills are about as good as my photography skills.  Both still need work.

So anyway, back to Valentine's Day.  My mom was in Tulsa running errands, so my dad drove over for dinner, and we all met at my house.  We ordered takeout from John's favorite Chinese place, Kit's Takee-Outee, and then I put both of my parents to work ;)  Dad helped John troubleshoot the dryer (See "C" is for Clogged Vent), and mom and I worked on the nursery.  Not exactly a romantic way to spend Valentine's Day, but I do enjoy spending time with family, and I really appreciated the help with our household projects.  Thanks, mom and dad!

Wednesday, February 16, 2011

"C" is for Clogged Vent

I knew we wouldn't make it out of Snowpocolypse without some sort of house issue or appliance malfunction.  First it was the frozen water pipe scare.  Next? The dryer.

I did several loads of laundry over the weekend, but I noticed the sheets took to dry.  Then I washed Tully's first load of outfits one evening and woke up the next morning to a bunch of damp blue onesies in my dryer.  Grrrr.  I can't imagine the price someone would charge to come out to fix a dryer, so I was on a mission to fix it myself.

Step 1.  Make sure lint screen is clean.


Step 2.  Pull dryer away from wall to make sure vent, gas line, and power are all correctly connected.  I hooked the washer and dryer up when we moved into the house several years ago, so I actually knew what I was looking at.  (Go me!)  Lines looked good.

Step 3.  Call dad before taking anything apart.
Step 4.  Brainstorm possible problems.
Step 5.  Conclude that vent line may be blocked somewhere, since the dryer is still getting some heat, just not enough to dry anything.
Step 6.  Go outside to check vent outlet.
Step 7.  Find vent outlet COMPLETELY covered in 3+ feet of snow.  (Technically I had already dug out the area on the right where the vent was located when I took the photo, but you get the idea.  This whole area was solid snow when I started.)

Step 8.  Clear snow from area around vent.

See the little off-white vent under all those black and gray lines?  The individuals who designed and constructed our house need to have their heads examined.  I had to dig this area out by hand.

Step 9.  Play with dog in snow.  (Okay, so this step isn't really necessary, but my little helper was just dying to have some fun.)

Step 10.  Go back inside, restart dryer and check for high heat and lots of air flow.

Mission accomplished!  The dryer worked once and then quit again.  Boo.  I had this post typed-up and ready to publish, but unfortunately my dryer has decided it has bigger problems--something about the gas not staying lit.  I dunno.  John and my dad spent several hours reading manuals and testing out every possible problem.  The result?  I'll be hang drying clothes for a while...

Tuesday, February 15, 2011

"C" is for Convex (cont.)

I've successfully completed eight months of incubating baby Tully in my belly, so it's time for another update.  The little Lilypie ticker on the side of my blog has vegetable-sized representations of the baby, and I think the watermelon is accurate.  Last week the ticker said Tully is doing more sleeping.  Lies.  Sleep is not on Tully's agenda: kicking, punching, rolling, and giving momma major heartburn are.  He also proved he was pretty tough when we both survived a nasty virus the week Snowpocolypse hit Oklahoma.  I was barely able to keep anything down for about seven days, but Tully still managed to pack on the pounds.  Good boy!

In other baby news, I put Tully's crib together on Superbowl Sunday.  Normally, I'd be glued to the TV, mainly for the commercials, but I wasn't interested this year.  Putting together a 200 lb iron crib sounded like a much better idea.  We're also working on some gutter bookshelves, which is an idea I got from another blog I follow.  Once the lighting and decorations are complete, I'll do a post on the nursery.  Until then, here's a sneak peek.

The biggest change this past month doesn't have much to do with my growing belly or the nursery, and it hasn't actually happened yet.  Remember when I said I was thinking about changing physicians? (See "C' is for Child, Week 11)  Well, it looks like it's going to happen.  Strike three with the current doctor's office occurred when we took the childbirth class at St. John's Hospital over the weekend.  Long story short: two qualified and well-meaning nurses led the class; there was a heavy emphasis on epidurals; they gave a great demonstration of all of the monitors that will be hooked up 24/7 during labor, even though my physician has assured me that I can have all of them unhooked or off during most of the labor process; they clearly described the snowball effect of interventions that follow a request for an epidural (additional meds for blood pressure, additional pitocin, catherization, etc.) and, most importantly, the nurses clearly stated that they may come into my room to intervene in any way they see fit and can tell me about it after the fact.  Ummm, hold up.  Run that last one by me again...where's the informed consent?  To top it all off, the video they showed at the end of the class was of a natural childbirth that didn't show any IV's, fetal monitoring, epidurals, or C-sections.  John specifically asked what the "take away" was from the video, since it didn't match what they had spent the past three hours preaching (epidurals and interventions), and they let the class know that the video was filmed in Colorado where things are more "granola" and "liberal."  I think their next statement was something along the lines of, "We don't do things that way here at state-of-the-art St. John's Medical Center..."  Then they mentioned something about the Bible Belt and being more conservative.  I don't consider myself a hippie, and I definitely don't line up on the left as far as politics go, so I don't see how choosing an unmedicated birth makes you granola or liberal.  I've said from the very beginning of the pregnancy that my goal was education.  I've read enough to know I'd really like to give natural childbirth a shot because it's best for me and my baby.  I'm also a realist and have stated to more than one of my family members that I may walk away from Tully's birth with an epidural, a C-section, and anything else they can legally give me in a hospital.  If that's the case, so be it.  But I will do so on my own volition and with consent.

I left the childbirth class Saturday in tears, mainly tears of frustration.  I felt like I only had two options: the medicated birth at St. John's or going totally natural at home with a midwife.  I didn't want either of those.  My solution?  1) Talk to John 2) Call my sister-in-law and 3) Call my Bradley (aka natural childbirth) instructor.  Thank goodness for all three of these people.  John told me simply that he supported whatever decision I made.  My sister-in-law has been a great resource during this whole process, so it was comforting to talk to her, even if I wasn't making the same decision she did to have the baby naturally at home.  The biggest relief came when my Bradley instructor told me about a certified nurse midwife who delivers babies in a hospital and has a physician backup.   YAHTZEE!!  So I called my insurance Monday to make sure there's no issue changing everything this late in the game, and they gave the green light.  My next call will be to the midwife to see if she'll take me as a patient.  If everything goes as planned, I'll deliver Tully naturally at SouthCrest hospital fully covered by insurance with a certified nurse midwife.  To make things even better, the pediatricians we are planning to use do rounds at SouthCrest (they did not go to St. John's), AND SouthCrest is less than 3 miles from my house (St. John's is about a 25-30 minute drive).  I'm hoping my anxiety over all of this will disappear in the next couple weeks and that everything will work out for the best before sweet baby Tully gets here!

Friday, February 11, 2011

"C" is for Conversation

I learned a new word today.

Pronunciation:  sŏm-nĭl'ə-kwē
Function: n
the act of talking in one's sleep

I always go to bed after John, and if I time it just right, he'll be awake enough to talk to me but asleep enough to have no idea what he's saying.  Usually he just mumbles incoherently, but last night we dialogued!  When I crawled into bed I really needed to ask him about the car situation for today.  One car has a clear pathway out of the garage, and the other car is completely blocked by a huge pile of shoveled snow.  I knew we would need to share the one car today, so I woke John up to ask him what time he was getting up the morning.  My plan was to take him to work and to keep the car.  He told me he was getting up at 6am.  I thought that was odd, so I asked why he was getting up at 6am, and he told me he had a duet...or a duel.  He wasn't sure.  When I inquired further, he "confirmed" it was a duet...with his piano 6am.  John doesn't have a piano teacher, and no one at our house gets up at 6am, especially on a Friday, so this totally cracked me up!  I hope to get more fun stories out of him in the future.

PS. I didn't hear anyone playing our piano at 6am this morning, so I guess he slept through his lesson. 
PPS.  Don't kill me for posting this, John!

Thursday, February 10, 2011

"C" is for Cheesy Potato Soup

Cold weather = warm soup in my kitchen!

Cheesy Potato Soup

Makes 6 servings.
Prep time: 5 minutes.
Cook time: ~30 minutes.

  • 6 medium potatoes
  • 1 stick butter
  • ½ cup chopped onion
  • ½ cup flour
  • 16 oz (1 small box) Velveeta
  • ½ cup shredded colby jack cheese
  • Salt
  • Pepper
  1. Cube potatoes with or without skins, boil in a pot until tender (do not overcook), drain
  2. While potatoes are boiling, sauté onions in butter in another large pot
  3. Add flour to onions and butter and stir to thicken
  4. Add enough milk to make the base for the soup and heat until warm
  5. Add cooked potatoes
  6. Add cubed Velveeta and shredded cheese and heat until melted
  7. Salt and pepper to taste
If soup is too thick, add more milk.  If soup is not thick enough, mash some of the potatoes.  If all potatoes are gone and soup base is left, cook more potatoes and use for another meal.

Monday, February 7, 2011

"C" is for Cold

Soooo, have you heard about Snowpocolypse in Oklahoma?  We received 14" of snow here in Tulsa last Tuesday, plus another four inches or so on Friday.  John had cabin fever, but I was happy and warm at the house, especially since the temp was in the single digits outside!  We had a little scare with some frozen pipes upstairs, but the water is running again, and it's not all over our ceilings and walls, so I think we got lucky this time.

The snow isn't going anywhere anytime soon, but our pup, Zachry, doesn't seem to mind.

John got Zach to sit in the snow for a couple photos. We usually make little noises, so he'll look at us and perk his ears up, but he was intentionally ignoring John in this pic.

I'm ignoring you, dad

Then out of nowhere he pounces.  Too funny.
Surprise ATTACK!

And here's Zach bouncing around in the snow like a bunny.

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