Unilateral idiopathic clubfoot

So we went to a pediatric orthopedist, about our pending baby’s pending clubfoot (I mean, the thing is, the diagnosis of unilateral idiopathic clubfoot was made at 20 weeks, with a sonogram technician who almost but then mostly caught it, and the attending on call, and even then it seemed a little squirrelly to me, but also, right, they were almost surely correct, unless they’re not, but we’re going on the assumption that the diagnosis is correct. Which is most certainly is. Unless it’s not. But I’m 95% sure it’s right. Mostly. Better to err on the side of preparation and caution). There’s some exhausting news, but almost all good news.

The good news is that in almost all cases, the problem is correctable. What they do is, when the baby is newborn (as in, in the first week or so of its life), they manipulate the foot, then cast it. The whole thigh. Then, after a week, you go in, they manipulate it a bit more, then cast it again. Repeat for 3-6 casts, depending on severity. At the last cast, they make an locally-anesthetized incision in the baby’s Achilles’ tendon, then cast it again. This cast stays on for 7 weeks. Then you are done with casting.

Then the fun begins. From there, you have to put the baby’s foot in a brace (you can see what the brace looks like). At first, for 23 hours a day. For a month or so. Then 18 hours a day for another month, reducing it gradually so that by 5 months, when the baby starts crawling, you are doing it only at night.

Herein lies the kind of exhausting news. The kid will have to wear the brace every night, at night, for a long time. Years. The problem is that there is a relatively high rate of recurrence if you don’t wear the brace, which would mean that the kid would need surgery to walk or not have arthritis, etc.. So either you wear the brace at night for 5 years, or you cross your fingers and hope you don’t need surgery, or that the kid doesn’t get arthritis in his/her 20s, etc. The brace is a much better choice.

Certainly not tragic. It’ll be part of the bedtime routine, that you brush your teeth, you put on pajamas, you wear the brace. Apparently, if you tell the kid it’s optional, they will not want to wear it. But when it’s just the routine they know, they’re more likely to just do it (right, I say this now, but I also get that it’s not nearly this straightforwardly simple).

The doctor says that after 7 yrs old, the bones of the foot are pretty much set as they will ever be. His ideal is that the kid would wear it until then, but realistically, more like 4-5 years. Depending on progress, severity, etc.

If there’s a humorous codicil to the experience at this point, it’s in baby mama’s and my varied reactions to the news. She had spoken to one pediatric orthopedist already, and he was all like ‘well, we’ll see what it looks like, and there’ll be a cast, or maybe a brace or whatevs. No big whup.’ And that made me feel like it was going to be a hassle but not really, and made baby mama feel like, WTF!?

The second pediatric orthopedist was all, ‘I strive for 100% correction, and this is likely a 3 month process, with a process that then lasts for 5 years, and if parents can’t commit to the 5 years, I don’t like to work with them. And here’s the probability of recurrence after 1 year’s use of the brace, it drops to 30% if you wear it for 2 years, 7% after 6 years. Here’s the brace, and what it looks like. I see 25 or so per year of these cases. Here’s the science. Here are my stats.’

And we walked out of the hospital, and I look at my wife and say, ‘damn, I guess I never realized this is going to take so much time and effort in our life. That guy was pretty hard-core.’ And she looked at me with the fanatical eyes of a woman in love and said, ‘That guy was AWESOME! I feel 100% more at ease about this!’

Apparently we have found a dude whose medical stylings perfectly match my wife’s MBA, detailed, project-management outlook. Go figure.

This will change everything

This is a post about something kind of reflective and a little bit more serious than what I often write about. If you are hoping for a funny post about my mother-in-law or how my wife topples over on the subway, you should feel free to look at those. Otherwise, press on. There’s no poop.

Part of the late-pregnancy experience is the imminent feeling that we’re about to hit a life inflection point. I think we don’t appreciate these inflection points as much as we should, because they don’t come around often in our lives.

What do I mean by inflection point, and their (potential) life effects? Inflection points are moments of natural break, where it’s much more possible to re-assess than while you’re mid-lifestream. In sociology, we sometimes call these ‘hot schema’, as opposed to cold schema, where you are in a state of reflective cognition. This is fancy-talk for saying that most of the time we run on autopilot. Our routines, culture, day-to-day lives are filled with autopilot. Then something happens, which pushes us to be more reflective, make more deliberative choices, to question routines.

If you think about your early life, these inflection points came hard and fast: pre-school to schooling, then school years themselves, elementary to middle school, high school, high school to college, post graduate. They get less frequent then, and less universally-shared: first real job, graduate school, marriage, kids, death of loved ones maybe. There are less inflection-ish inflection points, like promotions, but these are not exactly the same.

This is, I think, why post-collegiate relationships, and sometimes jobs, are such a bear. In absence of a natural break (graduation), you have to bring yourself to make a decision about what you want your life to be like. I would also argue it’s why people go to business school after working for a while – it is an opportunity to learn new stuff and formalize knowledge, yes, but it’s also a way to plant yourself and re-orient your career. Like the HS/college relationship, most MBA students don’t go back to their previous job.

The baby is providing us with another one of these moments – in the form of ‘OMG everything will change!’ rhetoric, but also things like when we say it’s not clear I (or baby mama) would want to back to our jobs after the baby comes. ‘You just might feel different,’ is what people tell us. What my partner tells me. What I tell myself. This is sometimes cringe-worthy, since the biggest effect of children on our friends is that they suddenly stop doing fun stuff with us. But it’s also enticing. An inflection point! Let’s not waste it!

I look out with eager anticipation at the ability to be deliberative about my life. I know, I know, deliberative with a newborn means no sleep and lots of routine baby-monitoring. That’s not so much ‘deliberative’ as it is a potential cause of death. At least in rats. In a matter of weeks. Even with this caveat, we don’t want to waste a good inflection point. We’re looking at houses, and figuring out our careers, all at the same time. If we do come out the other side of this inflection point without having changed anything, I have to admit I may feel a little disappointed.

More awesome

You know what would be more awesome than career uncertainty plus a first baby? Trying to buy a house at the same time. Let’s see if we can add that to our list of stuff to do. What could possibly go wrong?

Mother-in-law adorableness

But first, a brief conversation we had about banking cord blood:

MiL: So, a friend on my trip is a public health professional, and he was talking about cord blood, and I think you guys should look into it. It’s your baby’s own blood, just in case you need it. It seems like it’s worth it. It’s stem cells, that are an exact match for your baby!

Me: (laughing) Yeah, we’re not saving the cord blood.

MiL: Hey, don’t laugh, this is something you should look into, you should ask your doctor the next time you’re there.

Me: (no longer laughing) Yeah, no. The whole thing is kind of a scam, and any company whose marketing is basically “if you love your baby, use our product. If you are a selfish monster, don’t” doesn’t get any consideration from me. We’re not doing cord blood.

MiL: Ok, tell me how you really feel, you dick.

Ok, she didn’t say that last bit. If she did, it would be pretty awesome though, in the complete-360-from-my-normal-character kind of way. And even after I was kind of a dick, after looking into the research later on, she emailed me to say that publicly banking cord blood would be a good idea, but that for ourselves not so much.

So yeah, I’m getting a rep for shutting down on my mother-in-law. Which is a shame. Cause she is kind of awesome. In fact, I think I’ve won a gold medal in the mother-in-law Olympics. She’s attentive, darling, very active, interesting, sends us cute gifts, and lives 5000 miles away. All of her comments come from enthusiasm, and none of them in passive aggressive twisting the knife kinds of ways. Seriously man, can you even come close to topping this? I mean, the truth is that I don’t write enough about the times when my mother-in-law says stuff that makes us smile.

Case in point, she recently emailed baby mama to ask her if she could recommend some parenting books. She is thinking about taking a baby care, since it’s been a while, and she wants to come into town and actually help us out for a month or two after baby is born. But she wants to know what we’re reading, because she wants to be on the same page, philosophically, with how we want to raise our kid. Rock on, mother-in-law! If this keeps us, I’m going to have no one left to make fun of. I mean, sure, there’ll be my wife, but still…

Diverse City

My 6:15am, early morning commute is almost all Black people and Latinos, on the subway from Brooklyn. Many working men (from conversations, and from dress, and from tool boxes and such that I often see). Many nurses (from the shoes, always the shoes give away nurses). Of course, many people who could be rich as sin, but about whom I know nothing. Almost no Wall Street types, who I am guessing take cars into work. The demographics shift as we move from Brooklyn, through lower Manhattan, to the 110th street stop where I like to get off and walk up the rest of the way to work.

Today, I had a seat, which happens often but not always at such an early time, so far out from Manhattan. A White woman, red hair, seated across the aisle, proceeded to transform herself from an obvious sleep-over, or out-all-nighter, to a more conventional presentation. 20 public minutes of foundation, cream, mascara, blush, lipstick, earrings, a fuss of a hair brushing and grooming. The Black woman next to me was spread out and full-on fake sleeping, so as to prevent another person from squeezing into the space between us. Tinny rap music from the guy on my other side, headphones in and turned up. Older Black man, distinguished graying beard, tapping his fingers to the tune in my neighbor’s ear. By the doors, a Sikh man, wearing turban, studying from a textbook, stood next to an observant Jew, wearing Kippah, studying something in Hebrew on flash cards.

By the time I get to work in Morningside Heights, I’ve heard at least three different languages. My commute is utterly banal (as a commuter), and utterly fascinating (as an observer of the world).

Sometimes we talk about leaving New York, heading for some place more livable, less expensive, easier to raise the kid that’s coming down the pike (or more specifically, coming down the canal, or else out the abdominal cavity). Things here are often a pain, there’s never enough of anything, so you are constantly fighting for space, attention, the last copy of the Onion.

But I find such pleasure in the diversity of this city. I am awash in it. And having grown up in a suburb where diverse means some Jews, some Asians, and a couple of Black people, I don’t know how we are going to be able to leave New York. I want my kid to know about this. I want this to be the normal.

Oh shit

This post is going to gross you out. And so, if you don’t want to be grossed out, move along. Move. Along.

A bit of exhaustion

So strange to write this, after meeting the 20 people who actually read this blog. With my other blog, which is on work stuff, I’ve gotten used to the juxtaposition of having conversations where you can’t tell how much people are caught up on you, your life, work, and what you’re up to. But with this one, it was many of our in-life friends. In other words, I’m feeling a bit self-conscious.

That said, we had a baby shower this past Saturday, alongside having my mother-in-law in town, and friends in from Boston (and their two kids). And then today Aunt and Uncle from W. Mass came into town, to meet us for brunch. The people we need to thank, for coming and for helping and for hosting and for organizing and for their general good cheer and astounding well wishes, is large. We’ll be doing this individually, and for the rest of our lives. But for now, as they say on the internets, *group hug*

I made strata (recipe from Epicurious, modified to double it, added mushrooms which I sauteed in a big round-robin mess with the onions and spinach – it’s forgiving, put whatever cheese, vegetables you like in), mandel bread (recipe from ye olde Levin Family, NB: a bit tricky to execute), cinnamon rolls (recipe from the Pioneer Woman), and Bloody Mary’s (recipe from Jeffrey Morgenthaler). Add a cake, lox and bagels, fruit salad, and it was a feasty, feasty party.

There was fun and funny and touching. But I’m just tired and content. A little over-stuffed. And baby mama and I are truly thankful.

I feel sad when you’re sad, but don’t feel glad when you’re glad

Another news flash from Science™ – Darby Saxbe and Rena Repetti have done the work so you don’t have to. In their paper, “For Better or Worse? Coregulation of Couples’ Cortisol Levels and Mood States,” they measure the cortisol levels in couples on multiple occasions, on 3 days at work and at home. What is cortisol, you ask? Let’s go the tape (careful there pardner, that’s a p-d-f yer linkin’ at):

The hypothalamic–pituitary–adrenal (HPA) axis is one of the body’s key stress-responding systems, and its end product, cortisol, has been established across a wide body of studies as a marker of both perceived and objective stress, challenge, and threat. The HPA axis has been linked with allostatic load, or the cumulative “price of adaptation” to chronic stressors, and may affect health and mortality through pathways including immune functioning, metabolism, blood pressure, and cognition [Saxbe and Repetti, p. 93]

In other words, it’s a measure of how stressed out you are. STRESSS!!! What they wanted to know is, how much do the moods of one partner affect the moods of the other? Couples, I believe, cohabiting (assuming we’re talking about married peoples only, but not 100% clear). How much does my sweetie’s stress stress me out?

Well, it turns out that for both spouses, partner cortisol is significantly and positively associated with own cortisol, even controlling for time of day, sampling conditions, etc. In other words, when your partner’s stress level goes up, so does yours. Oof.

This relationship is moderated by martial satisfaction. Whaaa? It means, if you are satisfied with your marriage, your partner’s stress does not stress you out as much. If you are dissatisfied, your partner’s stress sends you looking for a handgun.

In addition, if the husband is satisfied in the marriage, their high stress level doesn’t freak out their wives as much. If wives are satisfied in the marriage, it doesn’t make a difference. Their husbands still get the full shot of stress. Great.

We also learn that if one or the other spouse is in a shitty mood, so is the other.

But my favorite finding is that husbands’ and wives’ positive mood levels were not significantly associated with each other, whether or not marital satisfaction was included in the model.

So what does this all mean? It means that when my wife is stressed out, it stresses me out regardless of whether or not I’m happy in my relationship. When she’s in a shitty mood, so the hell am I. But when one of us is happy, it does not increase the likelihood of the other being happy.

Obviously, this is all in the interests of saying that Science™ tells me I can blame my stress on the baby mama. If you need me, I’ll be over here searching the annals of science to find out what else I can blame on her.

Scary data points

1. Thirty-two weeks.

Man alive, that means some time in the next 6-8 weeks we’re going to have a baby.

We went to a childcare class on Tuesday night, 2 hours and 15 minutes from swaddle to toddle. Actually, the class was not nearly as anxiety-reducing as our first one. I think it’s quite possible that the preparation for having this baby (not having the baby, but you know, once the baby is had) are simply not in line with our current lifestyle. Sure, you’re saying to yourself, you guys are asshole DINKs, and your current lifestyle is selfishly playing video games and, you know, seeing movies and friends and stuff. But that’s not exactly what I mean.

For example: Baby teacher tells us that for the first weeks (and maybe months?) we should expect to be so completely frazzled. You see, says she, we really weren’t meant to have babies in apartment buildings and in places that are remote from our families. And in most of the world, and during most of history, we didn’t. So we’re not really totally equipped for asking for (and receiving) help.

Oh. Well, fuck you then lady. It’s like the fertility specialist who took every opportunity to casually remind me that women are really biologically meant to have kids when they are teenagers. I mean, maybe true. But how in the world does that information possibly help me in the slightest?

She goes on to say that we could organize a food schedule, for our friends, family, and neighbors to bring us food while the baby is a newborn. And better, they should drop off the food but not really visit (which would be a pain in the ass for new parents as well). Don’t be afraid to ask for help!

Now, generally, this is a great idea, and I did this for friends when I lived in Chicago. But seriously, what fucking city is this woman living in? I’d feel like such a jerk to have friends from Queens or CT actually make food, come into the city, drop it off, then not stick around. As I say, our current lifestyle is not conducive to this kind of baby-having.

2. Episiotomy.

Somehow, perineal tearing has emerged as one of my partner’s biggest physical concerns of the pregnancy (Yes, somehow. Like if there was a chance of tearing of my urinary meatus, I somehow might be a little concerned. That’s right. Urinary meatus). The OB’s response was, unbelievably, ‘if it makes you feel less anxious, almost all women have perineal tearing or episiotomies during their first pregnancy.’

This sure made me less anxious. But it didn’t do much for my wife. Apparently having an epidural decreases your chances of tearing, since the birth can be more easily controlled. Or else you have to have naturally flexible tissue. Or else you have to be able to be going through delivery without drugs, and then somehow ease up on the pushing at the moment that the baby’s head is coming through your vagina. I mean, come on. They call it the ring of fire, for god’s sake!

So yeah, less anxious in the sense that there is less uncertainty. But not less fearful.

3. Baby shower.

Actually, there is a scary vortex of activity this weekend. Friends coming from out of town. Mother-in-law in town. People coming over to our apartment for a baby shower. Dear colleague/friend in town for a job talk. College roommate’s big birthday celebration. All between Friday and Sunday. Plus the house needs cleaning, and the mondel bread ain’t going to cook itself.

On the upside, I made a big-ass tray of cinnamon rolls today. These. One tin was cooked as a test case, the others are now in the freezer, awaiting their moment in the sun. The frosting didn’t totally come out, but I think I can fix that. Tomorrow, mondel bread and cleaning, Friday strata. And big fat pitcher(s) of Bloody Mary’s.

Am I forgetting anything? Yes. Our lives are currently spinning around change and uncertainty, with careers and family and baby, the gravity of it all is making us freaked out and jubilant and concerned and strong and willful and on the verge of tears. Cut us a little slack, and we’ll try to cut ourselves some too.

Eat your vegetables!

I wonder if these would actually work, if I had a recalcitrant youngster. I recall having pea-throwing fights with my brothers as a child, so I don’t know if construction would have cut it. The product certaintly seems like the kind of thing a single child would work well with, though, very entertaining. But would that actually get food into youngster’s mouth? This calls for science!

Otherwise, when someone comes up with a pea-catapult, then I’ll consider that a solution to a real motion/physics/gastronomy problem.