Wednesday, October 12, 2011

Fire safety

It's national fire prevention week.  I had originally planned to do a week long series on it, but then my husband talked me into picking up some overtime, so I am working 54 hours this week.  So no week long series.

Instead, we'll hit the highlights.

According to FEMA, 3,500 people die a year in house fires, and over 18,000 are injured.  Surviving is not a matter of luck; it's a matter of planning.

To start with, the most important factor in surviving a house fire are working smoke detectors.  You can buy them pretty cheaply at most stores, or if you truly can't afford one, contact your local fire department. They often have programs to get working smoke detectors into homes.  After that, check the batteries twice a year.  In order to remember, do it on the days we change the clocks.  A good rule of thumb is to have one smoke detector in each bedroom, and at least one more on each floor.  Also, have you considered checking with family members and friends that your children spend the night with?  Yes, this may be paranoid, and yes, your children's friend's parents might think you're a little weird, but consider this: a few years ago, there was a house fire in our district.  It burned down the entire house.  The pre-teen girl that lived there was having a slumber party, and they lit a candle on the kitchen table before falling asleep.  Something fell on the candle, it tipped over and ignited the papers on the table.
There was only one smoke detector in the house. It did not have  a working battery.  The occupants were alerted by a passerbyer on his way to an early morning job, and everyone got out with only a little smoke inhalation.  The house burned to the ground.  Had they had working smoke detectors, they would have gone off as soon as the candle ignited the papers.  I thought about the girls staying over--how would their parents have felt if they had all been injured or died while at a friend's house, because no one thought to make sure the smoke detectors were working?

Speaking of candles, firefighters in general are not big fans.  For starters, they cause an awful lot of house fires--around 15,600 a year.  The majority are lit too close to combustible material, and are not properly encased.  If you must light a candle, be sure it is not anywhere near something that can burn, such as paper, wood, or plastic.  Carefully supervise children around it, and only use candles that are in sturdy metal, ceramic or glass containers, and cannot be easily knocked over.

Do you have an exit plan?  Do you know how you're going to get out of the house, and have you set a designated location outside where your family is to meet?  Do your children know to stay low to the floor, where the air is the best, and to never, ever open a hot door?  Plan escape routes from every room in your home, and practice them with your children.
Exit plans are not just for the kids, either.  If you have more than one small child, have you and your spouse discussed who is getting whom?  You don't want to be deciding at 2 a.m. when your house is on fire, talk about it now.  For instance, I only have one child now, so it isn't an issue.  But when there are two, and my husband is home, we know that I will get the new baby and he will go get Joshua.  Plan now who is getting which child, so there is no confusion and someone gets left inside.

Do you keep a cell phone by your bed?  We do, because in the case of a fire, I can grab the cell phone on my way out.  Don't ever go back inside or veer out of your escape route for something, but it is wise to keep things next to your bed in case of an emergency.  For us, that is my contacts, since I'm legally blind without them, and our cell phone.  We also have a spare set of car keys hidden outside.  If your house burns down with your car keys in it, what are you going to do?

Teach your children that fire is a tool, not a toy.  Develop and enforce whatever guidelines are appropriate for your family.  For ours, it is that our children are never, ever to play with the stove or fire.  They are not to touch it, ever, until they are teenagers, and then we can discuss it again.  These may be stricter guidelines than what your family wants or needs, so decide for yourselves what rules you are going to have concerning fire, and make sure your children know them.

Fires are not always preventable.  But they are survivable, with some planning and discussion with your children.  Talk to your kids, practice with your kids, and be safe this winter season.

Sunday, October 9, 2011

Birth and marriage

My best friend had a baby this week. She had to be induced, as even at 42 weeks her body wasn't showing any signs of preparing for labor.  After a grueling fifteen hours of disorganized contractions but no other response to the drugs, heart decelerations during contractions, and the baby still not engaging, she finally had a c-section.  The baby was 9 lbs 3 oz, with fat chubby cheeks and fingernails so long they had to be trimmed shortly after birth.  He was, you could say, overcooked.

But it wasn't the birth she had planned or hoped for.

Admittedly, I was also disappointed.  Not in the baby's birth, but she delivered at the hospital I will have this next child at.  I was disappointed looking at the maternity rooms, which are nothing more than a plain hospital room, converted for one patient.  A lone picture on the wall with a mother and a baby are the one suggestion that this is more than a plain old med-surg hospital room.  There's a chair that pulls into a bed for Dad, a card table, and a tiny 12 inch TV stuck on an arm that the patient can pull in front of her to watch.  I've been an inpatient at this hospital before, and I can vouch that this room is indistinguishable from the medical patient rooms.  Not only that, but this hospital discourages the dad from staying more than one night, has a nursery--something most hospitals no longer have, except for very sick infants--that they encourage you to send your baby to, and isn't very welcoming to anything but flat-on-your-back-deliveries.  The baby is stuck in a normal isolette with no cover.

In contrast, the hospital where I had Joshua had large, airy rooms.  If I had delivered naturally, I would have checked into my room, delivered there(unless I chose the large birthing tub down the hall), and stayed there throughout my whole stay.  There was a large recliner that pulled down into a comfy bed for my husband, a wooden, round dining room table by the window, a large plush rocking chair, and a cradle for the baby.  There was a flat screen television on the wall and the whole room was tastefully decorated.  It was far more like a hotel room than a hospital bedroom.  Dads are encouraged to stay with mom and baby the entire time, and not only does the hospital encourage rooming-in, they actually no longer have a nursery.  There is a room with special equipment set aside if your baby needs extra care, but other than that, they don't put the babies in there.  If Mom is exhausted and there are no support people, the nurses were glad to take care of the baby while she slept, but the babies usually never left mom's side.  While the room wasn't huge, it was large enough to easily accomodate several visitors.

Of course, that hospital is an hour and ten minutes away, and we made the decision long ago that it was too much of a drive.  We talked, briefly, today about my absolute dislike of these maternity rooms at the hospital I'll be delivering at, but decided that anyplace else is really too far of a drive to be considered.

And, honestly, it doesn't matter. 
Here me out on this.

There are a lot of women I have known who think the birth is the be-all-and-end-all.  They want their babies born their way, with minimal interventions(or maybe a lot of interventions), a certain way with certain things going on.  I know labor and delivery nurses that laugh at birth plans, because so many of them are so detailed that it's impossible to follow.  You might get the birth you want. You might not.
If you have a healthy baby, who cares?

Births, I think, are an awful lot like weddings.  A lot of preparation and thought is put into a wedding.  The dresses have to be just right, the lighting, the music.  There is nothing wrong with planning for a birth or a wedding, but so often that planning takes our attention off of what is really important--that it really isn't the event.  It's the marriage. It's the baby.  Those are the important things.  How they happen? Not so much.  You can have the most beautiful, romantic, fairy tale wedding in the world, but if you don't follow your marriage vows--not just fidelity, but love, honor, and respect--your wedding was nothing more than a joke.  You can have the most natural, calm, peaceful birth in the world where nothing went wrong, but if you're a failure as a parent, the birth was meaningless.  (And, honestly, the baby doesn't care how or where it was born. Really. They don't.)

Now I'm not saying that there is anything wrong with a fairytale wedding or a romanticized birth.  There isn't.  But placing all your focus on an event, instead of on the marriage or the baby, is wrong.  It's a recipe for disaster.  This was the main reason my husband and I chose to have a small, simple wedding--because it wasn't about the wedding.  It was all about the promises we were making to each 0ther before God and witnesses; audacious promises that we have vowed to keep.  We didn't spend a lot of time planning our wedding; we did spend a lot of time planning our marriage.  Our wedding itself was not the main event.  The vows we were making to love, cherish, honor and respect each othere were.

So in the end, I'm not that concerned with where or how I give birth.  Yeah, this hospital is definately not my ideal--but if I have a healthy baby, who cares if I'm in a cramped hospital room for three days?  What does it matter?
It doesn't.

The baby matters.
Our marriage matters.
Nothing else really does.

Monday, October 3, 2011


Sunday, October 2, 2011

Vaccinations again

There is some essential biology you have to understand before really delving deep into vaccines.  Our immune system is complex, but I'll try to make it easy to understand.

The body's immune system works by first identifying something as a pathogen--a disease causing agent.  Every pathogen is covered with tiny molecules called antigens, and it is those antigens that trigger a specific immune response.  Our bodies don't recognize something just generally as a pathogen; those specific antigens are identified as their own unique pathogens, and the appropriate antibodies are released from the lymph nodes.  We have specific antibodies to fight off specific antigens.   To develop those specific antibodies, though, our bodies have to first be exposed to that disease's antigens.  Some pathogens, specifically viruses, are constantly mutating and having different antigens--this is why when you get a cold, then someone else in your family catches the cold, they don't pass it back to you.  You've been exposed to that specific antigen and have the proper antibodies to fight it off when it gets back in your system.  However, if you are exposed to another cold virus, one that has mutated and has antigens that your body doesn't have the antibodies for yet, you will probably catch it and have symptoms until those antibodies are made and can fight it off.  

This is the science behind vaccinations.  Vaccinations contain dead or greatly weakened pathogens.  Even though they can't cause a child to get sick because they cannot reproduce due to their dead or weakened state, the body still recognizes them as a pathogen.  The body then studies their specific antigens and creates the antibodies specific to those diseases.  If that child is ever exposed to those antigens again, the antibodies will activate and fight off that disease before it gets a chance to reproduce in the body.

(For a much more detailed, yet still easy to understand explanation, check out

Okay, you say.  But I know a lot of people who have been vaccinated who still got the disease, particularly pertussis, or whooping cough.  So how does that work?

This I understand. My parents are both firm believers in vaccinations, and myself and all of my younger sisters have been fully vaccinated.  Yet, several years ago, many of my sisters caught a case of whooping cough.

Whooping cough is, if you want to get technical, caused by B. Pertussis,  fastidious gram-negative coccobacillus.  In real life terms, it is a pathogen that produces toxins that damage the epithelial cells of respiratory tract and causes severe coughing.  This doesn't sound that bad, but, especially in infants and children under 2, that coughing causes a lack of oxygen to the brain, which in turn causes the brain cells to die, causing brain damage.   In classic pertussis, the coughing lasts longer than three weeks, and residual coughing can last for months.   In 2000-2004, there were 6,114 children under twelve months old hospitalized with clinically confirmed pertussis.  Out of that number, 5, 454 had apnea--periods where they stopped breathing.  1,063 had pneumonia, 146 had seizures, and 92 babies died of whooping cough.
             The greatest complications in adults, who usually don't see brain damage, is 5% suffer pneumonia and 4% have rib fractures from the coughing. (   The biggest issue with adults having pertussis, though, is that it can be passed on to infants. 

There are two reasons for the pertussis comeback: number one, researchers have found that the efficacy of the pertussis vaccine begins to wear off after around 10 years.  Basically, the body begins to forget those antigens.  This is why you may see commercials on the adult pertussis booster--it isn't a real issue for adults, other than an inconvenience, but it can be deadly when transmitted to an infant.  This is why I got my pertussis booster last year; it isn't something I am overly concerned about dealing with myself, but I would be horrified if I passed it onto my son. 

The other reason there are more pertussis cases is simply because there are fewer people getting vaccinated, something that we'll look at later this week. 
Now why did my family get whooping cough?  Especially when some of my sisters had vaccines that shouldn't have started to wear off yet?
Most likely, they didn't have actual pertussis.  At least not B. Pertussis.  There are other diseases that are in the pertussis family, but that the vaccine does not cover.  These are usually less severe and do not lead to the major complications that the actual B. Pertussis does.  Especially one pathogen called B. Parapertussis presents clinically similar to the deadly pertussis pathogen, but the symptoms are less severe.

Later on this week we'll look at the beginnings of the anti-vaccine movement, which actually began with the pertussis vaccine.