Wednesday, March 30, 2016

When All Bets Are Off

These past couple of months, as viruses are all'ultima moda in the city, we've been regular patrons at the pediatrician's office. Due to the quite unsavoury experiences my son has had at the office, from shots to caths (the main culprit being the latter), he immediately becomes sullen as we enter and gives me by now a perfected look that would strike guilt even in a non sentient piece of wood, its first conscious thoughts profoundly apologetic.

There are far few things worse than when your child is sick, shivering and moaning with a fever and you feel helpless to protect them. Only when Luca has been sick have we collectively cried, hugging each other, wishing we could take away his pain and bring him forth to full health again. When our son is sick, my husband and I become putty in his hands and he certainly milks it to the fullest. While we do not let him watch television, flights and illness are the exception to the rule and when he wails "Elmo" shivering with a fever, we deliver (Elmo, I may have mentioned before, from the toddlers I have perceived around me, is crack for kids- I wonder if he were designed after a thorough child psychology analysis). Albeit we've taken a hard line since sleep training him (which policy was necessary for us all), our collective front crumbles and either my husband or I sleep cuddling him during the night. He is acutely aware of our vulnerability and has finessed his tactics - and we have succumbed even when he's not sick. If he doesn't want to go to bed, he asks for "um" or purses his lips and licks them which in Luca language means I want food/I want water. When we rush to make food for him and give him water, he refuses. All he wanted to do was delay bedtime and he succeeded. It's difficult to admit, but there have been times when we've been outsmarted by our 17 month old.

In the pediatrician's office however, I would like to think that we have certain resolve. As our son has VUR, it's the same curse every time he gets sick - is it a UTI or not? (notwithstanding the fact that he has had only 3 of them in his life so far). Do we cath or do we not? When do we cath?

While both my husband and I suspected that last time he had a virus, this time, due to his high fevers and lack of other symptoms, we were inclined to believe that he did get another UTI. The problem with testing babies and toddlers, particularly pre or proto-toilet trained ones (as we are currently starting the process by acclimatizing him so that he pees in the toilet every night before bath time and has asked to pee on and off again during the day), is to obtain an uncontaminated urine sample. You can't simply direct them to wipe and then pee into a cup on demand. All of the available options contain their own list of issues. A bag sample can be contaminated by bacteria on the skin. Even if you bathe your kid, sterilize your hands and sterilize the groin area, a bag is only good for about an hour. A cup sample may likewise be contaminated by bacteria from the skin (albeit this must be negligible considering that they don't cath older children and adults but tell them to pee in a cup - after using a sterilization wipe). The only true test is a properly sterilized cath. Apart from the fact that this tortures the kid, it's also not reliable. After two dry caths, which we previously assumed were due to the fact that he has no liquid in his bladder, we've become wary of it.

 We bagged him, forced our poor little guy to drink and in the end, knowing that he hadn't peed for a few hours and had sufficient liquid, we opted for the cath (I had to excuse myself from the room, crying outside in tune to his wails). It was dry, a fact that speared our hearts. Not only did we put him through torture for nothing, but now we were prevented from cathing him in a short period to avoid irritation and worried we would treat based on a contaminated sample. Serendipitously, my son was so enraged by the torture, that he stood up and immediately peed and my husband caught it. He filled a whole cup and then peed all over the doctor's bed. How was it possible that they got a dry cath when his bladder held the Great Lakes? Apparently the cath was too short or they didn't go far enough.... Well, shouldn't they have stopped to think and reworked their method after the previous failed attempts? Meanwhile, worried whether he had drunk enough and/or absorbed enough liquid in his bladder in order to cath him, we were torturing the kid by imposing more liquid on him when he obviously had a bursting bladder.

Back at home, he downed his antibiotic but then refused to take any more medicine (such as his fever reducers). That's the other problem with babies and toddlers. You can't reason with them to take their medicine. You can't give them a pill to swallow. You have to be precise in delivery, because if they fight you and spit a portion out, you won't know how much they've missed - and giving too little can be as much of an issue as giving too much. Since physical force was not going to work - our son is as stubborn as we are and resisted all our machinations in trying to force medicine down his throat after cajoling him did not work - so we decided on trickery. We masqueraded the medicine with his milk. This is of course not without risk. We have to give him a small amount of milk (or water) that we know he will fully drink and have to ensure that he drinks it fast. There is always the risk that he may not drink all of what we give him, which means he would not have taken the full dose of medicine and we're back to the same problem of not knowing how much we gave. We're luckier than most - we have a routine with his nightly prophylaxis so we can simply follow the routine (kids love routine it seems, it provides them security) but when he have to provide more than is routine and when he's in a particular mood - such as he was yesterday - we're forced to work with what we can. I cannot wait until I can reason with him to take his medicine and have him understand that he is taking it for his own good so that he does not fight us...Hopefully that day will come soon.

By the way, on a completely unrelated note and since I've been watching a bunch of Sesame Street of late (which I adored when I was a kid and what helped me learn English), I'm glad they have more female muppets, but whatever happened to the oldies? Where's Oscar? (I suppose being a grouch may not be such a good role model). Where are Bert and Ernie? Big Bird? He only makes cameos now it seems. More importantly, they seem to have completely snuffed out poor old Snuffy. Now that's a pity.

Wednesday, March 23, 2016

Gone With the Wind - Reproductive Rights Today

One can hardly write a blog on the beautiful madness of pregnancy and motherhood without touching on the increasing vitriol against women's reproductive rights in this country and attendant regulatory restrictions. For being a mother is such an important role and one that overwhelmingly changes your life that it should always be a choice. The ability of a woman to control when she becomes pregnant - the ability to choose to have children and to space her children - provides a woman with the strongest step in providing an equal footing with men, allows a woman to develop herself until she feels ready to become a mother or decide she does not want to be a mother and allows a woman to set herself up economically so she may provide for her children. If a child is imposed upon a woman before she is ready, she may not only be stunted in her career and education prospects, but she may be entrenched in a cycle of poverty. One may even argue that behind this religious veneer of protecting women from themselves, there is merely misogyny at work, to keep women in their proper societal place (quintessentially as "mothers") and/or the interest in perpetuating a cheap labour force.

I find it hard to swallow that in a supposedly secular society in which government and religion must be separate, there is such accommodation of religious views and further that religious liberty is viewed as not only the right to practice one's religion but that this practice necessarily entails restricting the rights of others. I suppose I should not be so surprised since the first pilgrims, seeking so-called religious liberty, were in fact seen as pretty kooky back in the Old World as their practices were more fanatical than the majority view at that time.

I admit I am partial to John Stuart Mill. I believe everyone should pursue their own good unless it interfere with someone else's. I suppose in essence hardly a soul would have an issue with this judgement and it is more in the adjudication of this intersection of liberties wherein minds would differ. Reproductive rights are not insular, they too, are part of an interplay of rights that we must adjudicate. In my view, the courts have failed to properly account for women's reproductive rights. While Roe v Wade is culturally viewed as the seminal decision providing a fundamental right to an abortion, even this case focused on the right of privacy and the due process clause of the Fourteenth Amendment and was not decided on an equal protections clause. Unfortunately, even the greatest impact of Roe v Wade was quickly combatted by the Hyde Amendment to Medicaid appropriations which denied any coverage for abortion, even though all other medical care for a pregnancy was fully covered. In effect, paraphrasing Brennan J's dissent in Harris v McRae, in which the constitutionality of this provision was litigated and unfortunately upheld, the government was trying to achieve by its dispersion of largesse what it could not do with regulations for by denying payment for abortions for indigent women as opposed to full payment for prenatal care, the government was interfering with their constitutionally protected choice. As an example, Brennan J compared this to the government providing free transport to Democrats on election day, but not Republicans. As the amendment denied Medicaid services and as only the indigent are eligible for Medicaid, it was a fallacy for the majority to be able to state that the government was not unduly interfering with a woman's decision since it was patently obvious that the women in question could not afford themselves to pay for an abortion. Worse, by establishing a system in which the right to an abortion was viewed in a primarily negative fashion, the effect of the decision to was to establish a two-tiered system in which rich women could exercise their constitutionally protected rights, but poor women could not. How is this, as Marshall J opined, not a denial of the equal protections clause?  This amendment continues in effect today, denying indigent women, who may wish to have an abortion for health reasons (not an accepted exception unlike life, incest or rape) or because they could not afford a child or another child, an abortion. What is worse, many states have family welfare caps, which further deny benefits for the newborn which the state imposed on the mother to have. If there were ever an argument that the restriction of abortion is used to perpetuate poverty and provide cheap labour, it can be founded in this double denial of these benefits.

Women of higher means are no longer immune, either. Personhood is an entity that is lobbying intensely to impose personhood to embryos from conception, trying twice in Colorado, for instance, to impose such a law. Not only would this deny abortion in all instances but it would impose increased surveillance upon all pregnant women - are they taking enough prenatal vitamins, did they exercise too rigorously or have one too many coffees? Can they be penalized if anything should happen to their foetuses while in their care? If they fell down the stairs, would this be investigated to see if it were intentional or reckless? While no personhood amendment has passed, many states have enacted TRAPS or targeted regulation of abortion providers to severely restrict women's ability to have abortions.

The Supreme Court recently heard oral argument respecting Texan TRAPS in Whole Women's Health v Hellerstedt. Thankfully, the justices gave Scott Keller (the Texan SG) a run for his money. Sotomayor asked what whether the same restrictions applied to D & Cs after miscarriage when Keller admitted they did not, she asked what evidence he had that abortions- which are medically the same procedure - have increased risks. Keller had no such evidence. Sotomayor then asked why liposuctions and colonoscopies that have 28 to 30 times the amount of risk as abortions do not have the same restrictions imposed, again to evasive answers. When Sotmoyor asked why women had to take both pills over two days at a clinic, which would increase the expense and time women will have to expend in order to obtain an early stage abortion, asking whether any other oral medicinal treatment, such as for cancer patients had like regulations, Keller again had nothing. In looking at the undue burden standard and how many Texan women had to drive 200 miles (750,000) in order to get an abortion, Keller pointed out that women in the El Paso area could simply go to New Mexico. Ginsburg J quickly jumped on this fact as New Mexico does not have the same regulations imposed on its clinics. If Texas was of the opinion that it were OK for El Paso women to get abortions in New Mexico, why was it not OK for all Texan women? The masquerade was clearly exposed. While Texas claimed that admitting privileges were necessary so that women were not denied access to hospitals in an emergency, Keller did not submit into evidence one instance of a woman in an emergency from an abortion clinic that was not admitted because of her doctor's lack of admitting privileges (indubitably because there was no such instance requiring this regulation). Hopefully, the Supreme Court will find that the Texan regulations - so similar to those in effect in numerous states- unconstitutional.

While Texas has the spotlight, Indiana is about to pass an even more egregious law in House Bill 1337. It includes all the standard TRAPs - ultrasound requirement, waiting period, admitting privileges etc but it also provides that abortions will be prohibited if performed due to the discovery of a foetal abnormality and requiring that women pay for the cremation and/or burial of the foetus. This is also the state in which Purvi Patel is serving a 20 year sentence for allegedly self inducing her own abortion and neglecting a live born baby (of which the evidence for life was a floating lung test reminiscent of historical witch trials and junk science). Leaving aside the facts of the particular case, Indiana has only prosecuted two women for self inducing an abortion - neither of them white. As abortion becomes more difficult to obtain, women will indubitably turn to self induced abortions. This is the criminalization of a constitutionally protected right.

The laws restricting minors' right to abortions may be even more egregious, for the younger the woman, the more unprepared for motherhood. 21 states require parental consent, 13 have parental notification laws, 5 require both and 6 additional states have these laws enjoined (including California). If a minor finds themselves in distress, a parent may be the first person they contact. If they do not, there may be good reason to do so. In Casey v Planned Parenthood - the case that limited Roe v Wade- the court had to decide whether spousal notification was an undue burden and whether parental notification was an undue burden. The court found that spousal notification may lead to abuse and was an undue burden. However, the court conversely found that parental notification imposed no such burden. Unfortunately not all parent child relationships are to be emulated and minors may fear telling their parents because they may be severely reprimanded, denied consent where needed and/or kicked out of their homes. Minors in all these states can bypass the parental restrictions by going to court. This may seem easy, but it puts the already distressed child in a humiliating, frightening and near torturous position of having to admit in public court that she needs an abortion in front of a possible audience, which may include people from the neighbourhood that may know her or her parents.

There are even more insidious weapons. Pregnancy Crisis Centers, which are centers that deceive women as to the medical risks of abortion and the gestational age of their feotus in order to dissuade women from having abortions, often deceptively named to appear like an abortion clinic and spaced physically close to one, are active throughout the country. Very few states and cities- for instance New York and San Francisco have laws and ordinances which expressly aim to redress this mischief. Even despite these specific laws, these centers are indubitably violating false advertising and deceptive business practices laws and should be shut down everywhere.

Aside from restrictions to abortion, women are facing a fight over their right to contraception. The right to use contraception was decided by the Supreme Court in 1965 in Griswold v Connecticut. However, many women are denied affordable contraception in this country and in 2014 the Supreme Court in Hotel Lobby issued a 5-4 decision deciding that closely held private corporations which have owners whom hold religious beliefs against contraception can deny insurance coverage to their employees for contraception. This is a terrible decision. Ginsburg J in her dissent opined that it led to a slippery slope of accommodating other religious beliefs and denying further coverage - for instance Jehovah's Witnesses do not support blood transfusions. Further, people do not have unimpeded religious liberty in this country. People that believe in human or even animal sacrifice are not allowed to practice this despite their beliefs. Many people are of a religious belief - or even a moral belief against war and yet this does not excuse us from paying taxes that support numerous wars. Employers have hitherto fought and lost the right to deny employment and service to people of a different race or sexual preference due to their professed religious beliefs. The argument is that the government has a compelling interest in equal employment and that no religious belief for owners of closely held private companies and nonprofits (excluding religious organizations) can trump that. Does not the government have a compelling interest in providing affordable contraception and preventing unwanted pregnancy? Does not the government have a compelling interest in providing women proper reproductive care and health insurance no more costly than that of their male counterparts? The majority in that instance believed the government could find less "restrictive" methods to achieve this. After the federal government enacted new regulations in 2015 which provided that the insurance company would have to cover the cost if a closely held employer objects, several suits were filed that such accommodation- which requires the nonprofit or closely held private entity to certify to the HHS, insurer or third party that they hold a religious objection so that the insurer pays for the coverage is an infringement of the employer owners’  religious freedom. The Supreme Court will soon have to decide in Zubik v Burwell et al whether this accommodation imposes a substantial burden on the religious freedom of the individual employers at issue. Now the employers are not paying for the contraception, but have to submit a form. If paperwork is deemed too much of a burden over providing women contraception and prevention against unwanted pregnancy, I fail to see any rationality in such a decision. For too long has this country accommodated religious liberty so that its exercise directly impedes the exercise of others' constitutionally protected rights - including equal protection under the law.

I would also argue the same with respect to free speech. Free speech is fundamental to a free society and at times this requires that we allow those we do not agree with to espouse their views. It is also a fundamental constitutional right. However speech has always been regulated  - the government may regulate the content in very limited circumstances and the government may impose time, manner and place restrictions, provided the government uses the least restrictive means possible. In 2014 in an unfortunate 9-0 decision in McCullen v Coakley, SCOTUS struck down a Massachusetts law requiring a buffer zone against protest of 35 feet around abortion clinics as being insufficiently narrow for its purpose - which was to protect against harassment of women getting an abortion and abortion providers in a state that has historically faced assault, even murder of doctors and bombings of clinics. The main issue was that the plaintiff in question did not merely want to protest, did not merely want to speak, she wanted to speak and counsel the women entering the clinic in order to dissuade them from continuing with their abortion. Her speech right thus was framed not as a right to speak but as a right to converse. The court accepted that by denying her the right to have eye contact and the ability to dispense her literature and converse with the women entering the clinic, she was effectively silenced, because her strategy was silenced. I respectfully disagree. As much as I disagree with people's views, whether religious or not, being able to dictate how others make decisions about their bodies, I agree they have a constitutionally protected right to shout this out from the streets, to post it up on billboards, to write it in the sky. The right to speak, however, should not be equated with the right to converse- particularly in all instances. The women entering the clinic, already distressed, have the right to be left alone. They have the right to be away from prying eyes, duplicitous smiles that only care for their babies as long as they are not born, from the imposition of other's views when they are most vulnerable. This is particularly so in a climate of increased vitriol and violence - a climate of terrorism - against women and their right to control their own bodies. This should have been accepted as a proper time, manner and place restriction.

Some countries are even more restrictive and deny abortion in all instances, including where the feotus has a lethal abnormality that will result in a still birth or its death shortly after, in cases of rape and in cases of incest. The UN Special Rapporteur on Torture has recently opined that this denial of abortion is tantamount to torture. I would agree - forcing a woman to have a stillbirth or the child of her rapist is horrific. South America has some of the strictest abortion laws on the books. Ecuador, for instance, completely prohibits abortion in all instances. As the plague of zika pervades over the continent and women are told to delay all pregnancy until 2018, this unfortunate virus may yet lead to a public discussion in those states respecting the strictness of their abortion laws and lead to legislative change.

Thursday, March 17, 2016

To Cath or Not to Cath

That is the question that has pervaded our lives since our son was born. He was born with vesicoureteral reflux and unfortunately has been prodded, pricked, and poked since he was born in order to determine whether his kidneys are healthy and functioning well (so far so good!), whether there is any obstruction (nope!) and whether he had reflux and what grade (and herein lies our tragedy). As my son's condition means that his urine flows back into the kidneys, he is both susceptible to UTIs and his UTIs are really kidney infections. Thus, every time our little guy gets a fever and presents no other symptoms (what I would do at times for a persistent cough or a snotty nose! and yes, I never thought I would wish my kid to have this, but life's vicissitudes take you on surprising paths and reveal surprising reactions), we worry about his kidneys. Kidney infections can lead to kidney scarring if they persist and are consistent and kidney scarring can lead to the loss of a kidney. Therefore, every time our son presents a fever and no other symptoms and unfortunately even when he has had viruses he has presented no other symptoms,  we are faced with the situation that if we do not investigate, we are risking a kidney infection worsening and causing kidney scarring the longer we wait.

I would say that my husband and I are pretty intelligent, competent people capable of making good decisions. However, neither of us are pediatric urologists nor even general practitioners, nor any kind of medical professional. We read medical articles on our son's condition and can understand the issues but never to the extent that a person who has studied this for years can. When speaking with a doctor, we are meant to hold the ultimate control, be the final bastion of medical decision affecting our son's treatment or lack thereof and yet, we are on an unequal footing. Maybe as a lawyer I'm trained to accept specialization and accreditation to the obviation at times of my intuition. I am consistently plagued by lack of confidence in my medical assessment, knowing that I am not a doctor. Yet I know my son better than any doctor. I know that every time he's had a UTI, he's been lethargic, had a very high fever that does not subside and presented with no other symptoms. For this reason and our caution, we've caught each one early and hope his few infections have not led to any scarring. However, what medical basis do I have to support my view that every kidney infection in my son presents with the same symptoms? Am I to rely on my intuition and common sense when in truth I am not a doctor? Surely they have more information to base their views on?  Now of course, doctors, in fact any professionals, being but mere people, are not infallible and make mistakes. It is unfortunate that we tend to forgive doctors less for theirs as their mistakes directly impact our bodies and our lives - and more so when it affects our sons and daughters and other loved ones.

Today I write this, eschewing work for a bit, to vent my frustration and my disappointment, as a sort of confessional catharsis, at not being able to protect my son and make the best decision for him. In barely a month, the decisions I made on his behalf have led to to two dry caths and I cannot forgive myself for this. A few weeks ago, on the eve of a family trip to Maui, my son's limpid eyes revealed in their sunken state that something was off. He had no fever but the next day it rose. We knew he was teething. We knew you that toddlers get fevers when they teeth (it makes sense, they're more prone to infection as the teeth shoot out of the gums, or at least that's what my common sense tells me), but when I noted his steady decline, his lethargy and the fact that his fever kept rising, I was at the doctor's that day. He presented no other symptoms and the doctor assured me that no teething toddler gets a fever of 105.8. That made sense. So as his father's ghost plagued Hamlet, the catheter darkened that sunkissed afternoon and I was again placed in our continual stygian loop - to cath or not to cath.

I read somewhere that humans make mistakes of judgement because we are too hopeful. I am not sure if I agree with this as a general statement. After all, I'm part Russian. More importantly, if infallible optimism is a human trait, it seems to be a very keen trait for survival. Whatever you can say about our species - and when you present us in a parade alongside other predators we may be the only demons that prey for profit and pleasure - we are survivors. Our fragile little bodies have taken over the world, for good or ill, but we achieved this conquest together and through hope (so that now the main predator we fear is our ourselves). For with no hope, we lose. It is a necessary if not sufficient element for survival. But I digress...

When it comes to our children, we cannot but hope. They are our hearts that spurted forth and grew limbs. They are more than ourselves. And so, back to my bag sample. The best scenario would be a negative bag sample. You can't argue with that one and it would avoid a catheter. Seems like a win win, right? Why not hope for the best? So we waited and waited until my son peed. It was positive. As a positive bag sample cannot be trusted for it can be contaminated by the skin etc and as the culture that grows may not show the actual bacterial menace, I was faced with another decision. Medicate on a fallible test (and possibly give him antibiotics which he doesn't need) or wait and cath? Wanting to avoid giving him the wrong antibiotics or antibiotics for no reason, I gave him water and we waited. When the doctor assured us that his bladder would have juice for the plucking, my husband and I decided to cath. Dry cath. That evening, we decided to simply cath next time.

Next time came a lot quicker than we thought. Right after our rescheduled trip to Maui, my son and I both got sick. I had congestion, a scalding throat and a piercing headache - but no fever. He was miserable, irritable, appeared to point to his head as if he had a headache and presented with a low grade fever that would come out in the evenings. Common sense and patient history told me it wasn't a UTI. We both had colds. However, after some days, I panicked that it could be a UTI. After all, I'm not a doctor. Even if the scales weighed in favour of a cold, the risk of not checking, of letting an infection continue and possibly scar, no matter how negligible the probability, was too great. Probability and risk are not evenly matched. In my opinion, the risk was too great. So went to the doctor. My son has developed a fear of the doctor's office and for good reason. He's been cathed several times there. This time, I came prepared with the decision to cath immediately if they suspected a UTI. Unfortunately, they could see no other symptoms and assured me that UTIs can appear with a consistent low grade fever. They wanted to cath. I told them my concerns, my assessment - he hasn't presented that way with a UTI, we both got sick at the same time etc and yet, the risk was there.

I asked the doctor that stayed - a doctor I had not seen before - whether there was  chance of a dry cath. I told her the one risk I didn't want to take (as any catheter insertion has the risk of infection and complications, albeit small and causes him great anghst) was of a dry cath. I didn't want to put my son through torture if we weren't going to get anything out of it. She assured me that he had not peed in the diaper and that there was no risk - not even a negligible risk- that if I had put on the diaper 3 hours before and he had some water - which he had - that it would be a dry cath. So I explained to my son my decision and three nurses came to cath him. As we held him down and I continued to explained why we were doing this to him, that it was for his good, to protect his kidneys, he looked at me desperately all the while, screaming, looking for protection. Dry cath.

I failed him once more. Wore, as soon as it was over, he forgave me. He crawled into my arms and looked at me with such love that I didn't deserve after failing him once more. Children are so innocent, so fragile, so forgiving. I was ashamed.

I was livid. How could the doctor tell me there was no risk of a dry cath? I completely believed her. He must have peed in his diaper and she didn't know (he was wearing conventional Pampers diapers, diapers that we don't normally use- we used cotton then compostable- and that I am in truth not competent in assessing). Maybe it was my training again. I never tell my client there is no risk. If my client were to ask me if they would suddenly start floating into the air, I would say, possibly, if the laws of physics were to change and they should check with a physicist and that it wasn't my area. No way in hell would I utter the words "no risk" - I like to use "negligible"  or "no appreciable risk" for life has taught me that nothing can be taken for granted. So when the doctor told me there was NO risk, I was baited hook, line and sinker.

There is nothing more stressful than when your kid is sick. My husband and I are lucky - many people have far greater medical problems to deal with. My heart goes out to those parents that face these hard decisions, that are put in such a pernicious predicament, that see the pain sear over their children's faces and feel helpless. It is a caustic cage of misery.

This morning both my son and I feel a tonne better and he has become his crazy monkey self again, which again leads me to believe that it was a mere cold. However, if he has a fever later in the day, the question may present itself..... to cath or not to cath.... the recursive curse of our pernicious predicament.

Monday, March 14, 2016

Boy No 2!

I was so sure we were having a girl but we recently found out that we are having another boy. My husband admonished me at the ultrasound when I accidentally uttered "damn" and asked for the sonographer to double-check (in fact three times by two different doctors we were told "oh, that's definitely a boy!"). Perhaps I was disappointed for a second, having already named a girl and always imagining I would have a girl (probably stemming from the fact that my family is comprised of virtually all girls) but I am excited to have another boy. After all, I'm  not a girl's girl, most of my friends have always been boys and I like the fact that my son will have a brother (and one that is very close to him in age at that). Perhaps if we have number three, we may get a girl, but everyone tells me that if you try for a third to get the sex you didn't get, you will invariably end up with three of the same (albeit even in my small pool of friends I know of two couples which had the coveted switch with number three). Considering how insane it is having just one even after developing a rhythm wherein we split the work (for instance our bedtime routine is that I prepare the room, PJs, medicine and bottle while hubby gives our son a bath), we may find two overwhelming and never get to three. Certainly neither of us ever started with the aim of having football teams and if we do get to three, that would most definitely be a stop for us.

The patriarchal current in our society remains strong (for instance in the continued misogynist myths that women carrying girls lose their beauty and other such blatant crap), particularly among the older generations. When the great grandmothers for instance found out I was having another boy (both of which had a boy and then a girl), they awarded me with a knowing smile as if I has somehow achieved a fine result. The more sons, the better their ebullient smiles shouted out. Wink, wink.

Since we had such Homeric arguments respecting names with our son, whose name, Luca, we both adore, we decided the subject of names was best approached after we found out the sex. Now that we have and it's another boy, the name game becomes a more treacherous path to tread. We already have the name we most preferred after a major scout (and many a shout) and we don't want to rummage through unsuccessful runners up to beat out a name that's merely second best. So we have to expand our search...

I already feel I have let down boy 2. Throughout my first pregnancy, albeit there was a lot happening (my practice, including a multi-plaintiff federal litigation, my novel, house hunting etc) my main focus was on my son and my pregnancy. This time round, my main focus continues to be my first son. Even when I try to connect with my the son I'm currently carrying, for instance during prenatal yoga when the mother instinct is turned up full blast, I can't help but think of Luca. It helps now that I feel No 2's fluttering and I can't wait for the kicks to roll out. Hopefully I'll feel more connected then.

I worry that this may be a sign of favouritism and that Luca will always be my prime focus, but knowing how much more I loved Luca when he was born from when I was merely carrying him, I suppose it all evens out when Baby No2 graces us with his presence in July.

One of the first things that everyone has said when they've found out we're having another boy is that at least we won't have to go out and buy another full wardrobe and that it would be easier for them to share a room. The economics make sense. However, even if it were a girl, I wanted to dress her up mostly in Luca's clothes, albeit I was already eyeing some offensively hot pink numbers that I couldn't wait to bundle my supposed girl in. I can satisfy this urge by spoiling the hell out of my goddaughter, albeit her parents may be none too impressed...I've sauntered off topic again... as an only child, I'm not sure what it's like to have siblings, nor what it's like for parents to have divided attention. Does the second kid feel left out? Does the second kid resent hand-me-downs? I suppose when they are so small they can't comprehend it anyway and cannot care, but I remain suspicious of the subconscious effect...and I worry that I love my son so much that I could not possibly love someone as much as him. The wise words of mothers with more than one kid tell me to calm down and I suppose it does all come naturally.

Saturday, March 12, 2016

Travelling with the tyke

We were on the fence whether we should take our so called second babymoon with our son, but considering that we had never both left him even for one whole night (albeit we both have had to take business trips alone away from him), we weren't going to start with a week trip to to Maui. The worst thing would being in such an enchanted place and wishing we were back home with our son. So we brought the little tyke along and he seemed to have more fun that even we did!

Gone are the days of priding ourselves on our efficient packing when we could go on holidays with nothing but our carry-on (ha!). Even a stroll to the park now requires a diaper bag full of necessities, not the least being diapers and wipes (sippy cup with filtered water, an apple, an orange, his puffs, a change of clothes et al). One bag was for us, two were for our son.

Even though our son is not yet two and can fly for free, after our horrendous last trip from the east coast a few months ago, we decided to cave in and dish out for a third seat. The seat did wonders. He loved having his own space and for a while was pondering the mechanics of his belt, attempting to emancipate himself from it. Next came jumping up and down on his seat with me and hubby half sitting out of our seats to provide a ready net for him to fall into. After this episode, he had had enough and needed to run around. We walked him down the aisle a few times, then read some books and gave him legos, anxiously looking at the time we had left. As expected, the deluge came and the only thing that would calm him was the ipad, carefully prepared with Pixar treats. We've read much literature on the negative aspects of providing toddlers under two with television and films. However, at times, it becomes a necessity for the parents' and other passengers' sanity. Even at home, I must admit I put on Elmo (for instance when I need to take a shower) as I know that my son will sit calmly and watch. Elmo is crack for kids. Admittedly, one of our son's first words was Elmo and we were stupefied because to our knowledge, he had never been allowed to watch any television (after some light detective work our nanny explained that she too needed to look after her bodily functions and the screen nanny ensured that my son and my friend's son would not decide that the moment they would conquer all the sockets and the stairs had come). Hubby and I both wonder whether Elmo is providing subliminal messages to our kids watch more episodes! buy my merchandise! pay your taxes! and is a supremely effective method of mind control.

This is another area where we held steadfast opinions as to what we would never do before we were parents and looked down on parents that caved in to the ipad - and now realize how easy it is to judge someone's choices when you have never dealt with their situation. I find that the most judgemental people respecting parental choices are people that are not parents (just like we were) and have never been at the precipice of their sanity.

Flights will never be easy, but films, legos, books and their own seat ameliorate the horror.

We knew we would be in the car for a while and decided that our son, who had well reached the weight and height limits if not the age, for a front facing carseat, should switch from his back-facing seat for the first time. The switch did the trick. Luca was amazed at the scenery and calmly sat in his seat watching the beautiful scenery go by. He played with legos, he slept longer and generally felt more part of the family in the car. We can never go back.

Luca loved Maui. In fact, as much fun as we had (we swam with sea turtles and saw whales!), it appeared that he had even more fun. He was amazed at the sand and the waves and didn't want to leave the beach. I wonder what engrams were etched into his mind during his trip and am certain that even if he cannot remember the trip later in his life, it will have a substantive impact on his development. The more a child sees as their connections fire in these young years, the more impact they have - stored in their subconscious and feulling opinions, desires and reactions they may never realize the reasons for. We are adamant that we will bring our boys on our trips and widen their worldview as much as we can.

Hiking presented a tad wee of a problem, however. I'm already carrying a baby, so hubby had to carry our son when he couldn't walk (and when our son is spent, he simply flops on his butt and refuses to move) and pointed out the difference in baby weight that we were respectively carrying. I pointed out the difference in our weight and we should only look at the weight of each of our babies as a proportion of our weight and as we tried to measure this, we continued on our hike with the prego on one end and the pack mule, daddy, on the other. Luca had the best seat in the house - on top of daddy's shoulders, munching an apple, watching semi-dried waterfalls and banyan trees go by. Enjoy it while you can, buddy.

Back in rainy SF, we're all a little depressed that we're not still on Maui...