Monday, September 16, 2013

The We in the I

The other night I was laying in bed reading when I stopped and asked Michael how many people he thought I was right then. This may be a question that would send some hubbies running for their emergency mental health hotline numbers but mine, used to questions that sound crazy and non sequiturs coming from me looked at me and said, "one." Really, I asked, but what about the baby? I mean he is not me really, but kind of is. This got him thinking a little more, but like me he didn't really have a clear answer.  I am 34 weeks pregnant. So maybe I am like 1.75 people? Being pregnant is a funny state of existence, and it changes as the whole thing goes along. I mean at first I would have said one as well. But now I guess, I feel, somehow more plural, while, at the same time, very much just me. There is this other being inside who has some behaviors I can't control. Like the rib kicking and the bladder smashing. But I can't really access him in any of the traditional ways you connect with other people. I have no way of knowing what his mind is up to, or what his personality is like, even though lots of my time is spent imagining these things.

Recently I have also been dealing with some pain in various joints of my pelvis, from my SI joint and all the tendons that attach my right leg to my hip. I have been on a crazy adventure of alternative therapies trying to find something that will help me feel balanced. I don't think I would be so fixated on solving the problem if it weren't for the fact that  the pelvis is pretty critical in the whole getting the baby out process. My pain and frustration with my body has played an interesting accompaniment to my questions about pregnancy plurality. It has highlighted a plurality that has been part of my "I" for a long time. I stood in front of the mirror a few mornings ago, and, trying to take my physical therapists advice to be kind to myself and stop trying to force a fix to things, I said out loud, "we are going to have this baby, and we are going to do it together, and it is going to be ok." I wasn't talking to the baby. I was talking to my body. Somehow, somewhere along the way, and I don't think I am unique in this at all, I separated out my mind and my body. Making each its own separate identity and parceling up and doling out my approval for each in frequently contradictory and often unkind ways. My body has always been the ugly step child in this two part self. It is the self that gets berated for not being good enough, poked and prodded with disapproving stares, and told over and over again that everyone would be better off if it were somehow different. I've done a lot of work around this unkind treatment of what is ultimately, myself, and have gotten a lot kinder and a better friend and mother to my body. My first pregnancy really helped me realize how truly awesome my body actually is. How perfectly it does exactly what it is supposed to do.  But I have yet to take that last unifying step where I stop seeing myself as these two (sometimes three if you count the spiritual self-which is generally much better integrated with the mind self) somehow separate individuals. This dual identity seems to be very much a part of American (western? modern?) female culture (maybe male too?) it is reinforced in the media, and passed down from generation to generation. I am working on focusing in more on the one-ness of my body and mind, the connections between my physical and emotional self and the links between my body and my mind.

Many of the healers I have visited believe strongly that the body holds and reflects not only physical but emotional traumas and that healing is done most completely when we open the doors of communication between the physical and emotional reactions of our bodies. I tend to believe this too. And as research about how our mind and body interact gets more sophisticated we are finding out more about the pathways that link our ultimately unified self and create a complex dance between our thoughts and feelings and our physical realities. But I also struggle with this idea in some ways. My grandmother truly believes that you can heal the body through the mind. Her conviction is so strong that she spent a lot of years meditating on healing her genetic and age related macular degeneration, often in place of learning to adapt and move and participate in her world with her increasing blindness. At 92 she is still mostly blind, and has very few activities she enjoys any more. There always seems to be this risk in the mind/body connection theory of healing of slipping into blame. My grandmother can't see because she didn't work hard enough to heal herself, she didn't access or let out the true underlying cause of her physical maladies. My pelvis is hurt because I am not grieving correctly or letting go of past trauma fully. It is this slippery slope from understanding and finding the very real connections between our mental and emotional lives and our physiological realities that I think may underly the seductiveness of so much of western allopathic medicine's take on illness and disease. Depression is a chemical imbalance, we can fix it with a drug. Your spine is out of alignment, we will fix it with surgery. If physical problems are just that, physical and only physical, then we can fix them like a mechanic fixes a car. It is not your fault. And, certainly there are some things we can fix this way and I am grateful for that. In the end though, as much as we may want to divide the self up into many separate selves, the reality is we are one. The short comings of western medicine are due to a reluctance to acknowledge this highly complex reality. Some alternative healing philosophies error to the other extreme, believing that just treating the mind is the key to the whole body. Both are divisive and over simplifying things. Neither truly reflects the complex interconnected nature of the human self.

Pregnancy has offered me the opportunity to explore more fully my own pluralities. If you have been pregnant, did you feel this "plural-ness?" If you also tend to see your self in a split sense, with the body and the mind as two separate selves, what is the relationship you see between the two? If you have done work on unifying your own theory of your self, what helped you embrace your oneness? If you are a trained healer of any kind, what links do you see between the body and the mind?

Each evening we sing my son to sleep with the prayer central the the Jewish faith, the shema, "Hear o Israel the Lord is God the Lord is one." I have always seen this as a reflection of how intimately connected we all are, the same energy running through all of us, and across time. The prayer leaves me feeling connected and less alone. It may be time to move towards this meditation as a reflection of myself as well.

Sunday, August 11, 2013

My Tribe

I remember being about 8 months pregnant with my first and clutching my husbands arm as we crossed a street one weekend during a community fair. There were cars and throngs of people. I felt vulnerable and slow and obvious. I remember thinking to myself, "if a Tiger attacked me right now, I'd be toast, I have zero get up and go, I'd be two treats in one and it'd be over before I knew it."

The feeling got me thinking about how the human race survived with all these slow pregnant women waddling around attracting saber tooth tigers and tyrannosaurs rexes from down below in the valley. Now, I imagine that part of it is that our naturally living ancestors did not suffer from some of the maladies that we do caused by your sedentary life styles, poor posture, and lack of good role models around child bearing and birth. But even if the average early pregnant lady could probably kick my non-pregnant and highly fit butt in a foot race, I imagine that she was slower than her non-pregnant compatriots and if I have learned anything from all the Discovery Channel and Planet Earth I have watched it is that hunters like to pick of the slowest wildebeest in the tribe.

So why are we all still here? There are probably lots of good answers to this founded in a solid understanding of human evolutionary science, archeology, and history. This is not one of those answers. I imagine that our fore-mothers did what I have found myself doing. She relied on her tribe. Or on her village as we moved out of the caves and settled down. I would bet early husbands held the hands of pregnant mothers as they crossed the stream and were a little extra vigilant as they climbed aboard the wooly mammoth mini van to drive down to the local Target. When she went to fetch water I image her non-pregnant friends kept their eye on her and carried an extra spear in case the man who met them at the well was more of the rape and pillage type than Eliezer was when he arrived to lure a maiden away with riches as a wife for Isaac.

I felt the power of my own tribe on our recent trip hiking in Sequoia. We saw four bears! Thanks largely to the unnaturally keen vision our official bear spotter, Maura. My husband went on to see five more over the course of the trip.  Normally I am pretty excited about wildlife. On a trip to florida before we were married I stopped paddling our canoe right by a huge alligator so I could get some close up photos. Alarmed, my then boyfriend, now husband, paddled furiously and chastised me for trying to get us eaten (I still don't think they would have gotten into the boat, but I suppose he has been keeping my ass alive, pregnant or not for a while now). But in my hobbled pregnant state these bears made me a bit squirrly. I am the slow wildebeest. But I didn't have to do anything, some of my friends got behind me and others in front and made sure I was never the end of the line. We were not in any likely danger, but my feeling safe mattered, and they didn't think twice about becoming the end of the line themselves. This also kept me safer from the more real risk that I would just be so much slower than everyone else that I would be left behind or twist my ankle thanks to my extra lax joints and no one would notice until they got to the car a few hours later, short 1.5 people.

My tribe has stepped up again this last week when I was told by my PT, that thanks to my abdominal wall tearing apart like a cheap old zipper on an overstuffed duffle bag, I was to rest for a week and not pick up anything over 15 pounds for the rest of my pregnancy. (Did I mention I have a 2 year old? He weighs, 25 pounds...). My sister showed up to play on my day off. My mom took him multiple afternoons. And to my amazement, my two year old, who usually refuses to walk five feet on his own listened thoughtfully as I explained that Mommy had an ouchie and it was hard for her to pick him up and that he needed to walk, did so, without complaint and repeatedly. Even my toddler is part of my tribe.

These days pregnant women and new mommas are not as likely to get eaten by a wild animal or attacked by a neighboring village. But we still need our tribe. We are vulnerable to feeling isolated and alone and stranded. We have a sort of weird hands off rule with new families, etiquette some how telling us to keep our distance rather than come on in and make sure everyone is hanging in there. Isolation seems to be a huge factor in postpartum depression, which impacts at least 10% of new families. Our tribe may do less fending off of wildlife with spears than it once did but its role as support and nurturing for pregnant women and new families are as critical as ever, if not even more important since many women live far away from their family that might have been their natural tribe even a few generations before. As I look around me, I know that I am one slow wildebeest thankful for my tribe.

Thursday, August 8, 2013

All Done Milkos

I have been holding off on writing this post because I wasn't sure if it was real or not. But after last night, I think I finally believe it has happened. My baby is weaned.

David and I had a rough start to nursing (I should say David, Michael, and I had a rough start because on those sleepless nights and tear-filled feedings Michael was right there adjusting pillows and wishing he could help as badly as I wanted there to be something I knew how to do to make things go better). David was born with a tongue tie, a sneaky posterior tie, that while my lactation consultant found it after two sessions together, I ignored her and was in denial about until he was about 5 weeks old. I feel lucky that I had a huge milk supply so unlike a lot of TT babies David grew like a weed despite our nursing woes. However, he tore me apart. I had a fissure across my entire left nipple that was so painful I ended up needing to stop nursing on it for four days to let it heal. During that time I nursed only on the right, which, doing as bodies do best, kicked into high gear and made all the milk David needed all by its self. To this day my right side is "my big gun." I had two thrush (yeast) infections, a bought of mastitis, numerous plugged ducts, nipples that were oddly shaped like lipstick with a beveled edge after each excruciating feeding.

David was 5 weeks old and Nina, my super hero lactation consultant I had just resent me information on posterior tongue ties. I was finally convinced that was what was going on but the local ENT who could perform the simple surgery he needed couldn't see me for two weeks, an eternity in the world of infant feeding. I sat on the couch at 5pm and David latched onto my newly healed left side. It was painful, as usual, and when he finished I looked down and saw to my horror he had resplit the fissure. I picked up the phone and called Nina who gave me the number to a doctor she knew in phoenix. Because I apparently had a small cache of good Karma, the office picked up at 5:11pm and because there apparently is a G-d got me an appointment THE NEXT DAY. Off I went to Phoenix with my tiny 5 week old in the back of the car (one of his least favorite places on earth at the time) and Nina in the front seat with me.

We arrived at the Dr. Agerwal's in time and I then experienced one of the most compassionate physician's visits I have ever had. He listened to my 5 week long saga with empathy, looked at my son's tongue and confirmed Nina's diagnosis. I was sent briefly out of the room while he strapped my precious baby to a board for the second time in his life (circumcision is a whole other blog post, I'll save it for another day, or maybe after our second bris). A quick cry and about 3 minutes later I was called back in and David was handed back to me to nurse. It was better instantly. Not perfect. But better enough that I believed that I wasn't going to have to pump and bottle feed for the rest of the year.

The next three weeks were full of somewhat improved but not perfect feedings that landed me eventually in the office of Amy Wheeler, a magical Traditional Chinese Medicine practitioner and cranio-sacral therapist who finally pushed us over the edge to the blissful nursing I had imagined when I was pregnant.

From there the story is less dramatic, and as it rightly should, takes up less space in my memory. When David was hungry I fed him. We got good enough at it together, and I got confident enough in what I was doing, that I was able to shed the nursing shield and nurse in public without my boobs flapping in the wind (too much at least). He got bigger and started eating foods too. We went on a backpacking trip when he was six month old and I felt the freedom that breast feeding allows, as long as I was with him, he had everything he needed.

His first birthday came and went. Some of my friends kids started slowing down, some with more encouragement than others but all in their own unique and gentle ways. By their 14 or 18 month marks some only nursed at night. Not David. He didn't seem anywhere near being done with Milkos, a coin he termed himself sometime after his first birthday. Sometimes, like first thing in the morning we nursed because he was hungry. Sometimes, like when I got home from work we nursed to reconnect. Sometimes we nursed to help him calm down, and at night we nursed to help him relax and drift off to sleep.

As his first birthday drifted away I felt the social approval for nursing fading too. It is hard to put my finger on what this is like, questions like "he is still nursing?" take on new meaning. The best metaphor I have come up with is when someone says something like, "you look great, and I know you will feel awesome when you finally loose those last ten pounds, but don't worry! You look great now too!" That sort of bestowal of temporary approval for something that everyone knows you should have gotten done already and as long as you plan on getting it done soon, you are still okay. But you are on notice.

As he approached two I started gently stopping nursing in public and he understood more about waiting and he needs weren't so pressing so it wasn't so hard. The exception of course being when it was convenient for me, such as while waiting for the food at a restaurant during a dinner planned at an inadvisable late hour for a toddler. I got to stay at the table and talk to friends or family rather than run around a restaurant entertaining an over tired toddler while avoiding crashes with tray laden waitresses.

Then I got pregnant. Faster than I imagined I would. At first things went on as normal. I didn't have any of the pain that some women experience when nursing while pregnant. Then about three months in Thursh reared its ugly little fungal head again and I had a hard time knocking it. Nursing got more uncomfortable. But I wanted so much for weaning to be a partnership and for him to be ready as well, so I persisted but knew I needed at least the number of nursings to decrease. So I just started pushing slowly, saying no, or telling him we needed to wait until before nap. I feel grateful he was ready and said ok. There were a number of feedings he stopped on his own, as my milk supply dwindled he popped out of bed each morning and demanded breakfast, milkos no longer enough to break his fast. Every once in a while he would let me know that he really still needed it and I would say okay to him in return. It felt flexible. No one felt stressed. But before long we were down to the elusive just before bed nursing that when pressed most people will condone when thinking about older nurslings.

There we were when we headed off on our family vacation to California. I think the change in scenery and routine let us both let go. Without the familiar routine cues to nurse he stopped asking before nap and bed time. Instead my husband and I sang him the Shema every night before we kissed him and left the room. I nursed him a few times on the trip. Once in the middle of the night on our first night away when he woke up disoriented. The last real nursing we had was sitting on the side of a windy mountain road in Sequoia National Park. He had gotten car sick and was miserable so we pulled over and I offered my fix-it-all solution, and, as the trusty parenting tool it had been for the last 27 months, it worked like a charm. After that he asked once or twice but would get distracted before I could say yes or no. Once he asked and I told him he could but that there might not be a lot of milkos left. "yes there are! they are BIG, I drink them up!" he insisted, in that way that two year olds have of being direct and honest about their observations and desires. I conceded, not really knowing how to explain the breast enlargement due to pregnancy to a two year old. He put his mouth briefly to me, without even a suckle, pulled away, and stated emphatically "no more milkos! I don't like that," off he went to play.

And that was it. We returned home and my mom had removed the rocking chair from his room at my request, although I don't think we needed to do that. Last night he asked again, and we had a similar discussion. He ended up curling up on the couch with me and as he was insistent, I offered. He took one look at the nipple and said, "I don't want that." so I asked, did you need to just cuddle? "Yes" he stated, popped his thumb in his mouth and began twirling his hair curled up next to me on the couch. He still needs the closeness that nursing provided and is now learning new words and new ways to get it. I am learning too. A few nights ago he woke up in the night and I comforted him, sleepy and in the dark, for the first time without my go to never fail trick-nursing. A skill my husband excels at by now, but was new for me, and I was proud. Of both of us.

The feeling is a bitter sweet. I was ready to be done, my body is giving itself over to his baby brother, and he has so many skills now, he doesn't need it. Not me, he still needs me, lots, but doesn't need my milk any more, the world sustains him in new ways. I am apprehensive and curious and excited to find out what my next nursing adventure will bring. I hope that what ever our start, our ending feels this good.

Saturday, July 27, 2013

The More You Port Them...

We just arrived home from a 2+ week vacation in the bay area. The final trip home is always my least favorite leg of a trip, all the fun is done and I just want to be home or still on vacation. But this was a pretty nice trip home all in all.  Dee napped quietly in his car seat strapped next to the window as we "blasted off" on the second leg of our flight home and I watched him, lovingly, and proud of what a great traveler he was.

I reflected on how flexible he had become in the last two weeks. The first few days were kind of rough, he woke up crying the first night and I nursed him back to sleep something I haven't had to do in over six months. He kept asking when we were going home. Demanded to go swim in the pool at mommy's house. He was crankier than usual, and clearly thrown off by all the changes in his routine and environment. I had to remind him a few times at a restaurant one day that we don't eat paper. Travel is kind of stressful for anyone, vacation travel hopefully in the "good stress" kind of way, but especially for two year olds. We did what we could to keep a regular nap and bedtime routine, sleep being key to a happy toddler in this house. We brought along his lamby (a lambskin rug he has slept on since birth) and some of his favorite books and a few toys from home.

As the trip wore on he seemed to relax into the new rhythm, enjoying meeting new people and exploring new places. We started "rehearsing" our day each morning, and at his request, throughout the day if he needed it. Rehearsing is a strategy I recommend to my clients all the time when children are having a hard time with transition and it is sad that it took me four days into the trip to really realize that it was what Dee needed. Each morning I would say "lets talk about our day" and then I would go over the plans, the when and where and who of what we had in mind for the day. Dee would listen attentively, often asking me to repeat the story over and over. In car rides to new places he would say "Mommy wanna talk about my day?" If it was early in the day we would go over what was coming up. If it was later in the day I would ask "do you want to talk about what we did today or what we are going to do tomorrow" his answer would vary but he often liked to relive his day over and review what we had already done and seen and where we had been. It is actually something we do at home too, usually over breakfast and then again at dinner each night.

 Two year olds don't have a lot of control in the world and a pretty limited concept of the scope and breadth of the possibilities out there. Their world is growing fast and it can be pretty disorienting. When I talk about rehearsing with families  I remind them that as the grown ups in control THEY KNOW what is happening next, but little ones don't have that privilege. If you or I were doing something engaging and someone came into the room and grabbed us by the arm and demanded we stop and move on to something new we might be peeved as well. Giving toddlers a little warning, "5 minutes and we are going to stop toys and get ready to go to the store" followed by a 2 min warning and maybe even a little clean up the toys song can prevent more toddler melt downs than you can imagine.

With some of the kids I work with verbal rehearsal isn't enough and we start using pictures to illustrate their day, or hand them a photo or object when it is time to move from one activity to another. In the end I think it is about respecting our little ones need to know, need to have a little control, and giving them some of the same courtesy we expect as adults.

As I sat on our plane I was reminding of an encounter I had on my husband and my's three month odyssey in Mexico after graduate school. We were staying at a spanish language school in Gunajuato and an American family was there as well with two children probably ages 7 and 9 or so. I said to the mother that I was glad to see them traveling abroad with kids. Sometime I felt that I had to do all my traveling before we had children, but really, they are portable too. She smiled and said yes, they are, and added "and, the more you port them, the more portable they become." We had such a great family vacation and it was a joy to watch my little one become a little more portable.

Thursday, May 23, 2013

Pink Shoes

My husband and I were at Summit Hut one day when our son was about 10 or 11 months old. We were looking at the baby sunglasses, contraptions that are designed to strap on to a baby's head and babies are supposed to keep on. I have yet to meet a child not photographed in the advertisements for these products (photoshop??) who actually keep them on, but that is another story. My son reached for the pink glasses. I laughed and told my husband he had made his choice and my husband said, no, we weren't going to buy him the pink, he reached randomly. Ok, I consented, besides, he won't allow me to put the sunglasses over his eyes anyway, and they were a really expensive chew toy. At that point I turned to my husband and asked, "If he were older, like three or four, and could express a preference, and he chose the pink, would that be okay with you? "Yeah, that'd be fine, I wouldn't care," he responded, without hesitation.

Flash forward, and my son is now two years old. It turns out kids can express pretty clear opinions by the age of two. We were in a baby/toy store a couple of weeks ago and my little guy skipped all the toys and went straight for the shoes. He loves shoes. My shoes, his dad's shoes, his Auntie Zaza's shoes (he once came out with a pair of my heels and announced they were Zaza's shoes, which lets you know how my young fashionable sister dresses compared to his frumpy Mom). On this occasion he went straight for the girls' shoes and demanded to try them all on. Let's face it, the girls' shoes are way more exciting. They were PINK and SPARKLY and had FLOWERS and BOWS. While the boys' shoes were all brown, navy, gray, and an occasional exciting burst of maroon. So we tried on girls' shoes. He was particularly fond of a pair of white patent leather which no mom in their right mind would buy for a toddler of any gender because they would be black and scuffy and gross in five minutes. Luckily we were just playing and he didn't need shoes that day so I wasn't faced with the dilemma of deciding whether or not to buy the pink ones he clearly preferred or a more gender conforming pair of my choosing. I think you could rightly argue two is too young to be making choices about which shoes to buy anyway, but I give him choices between acceptable options all the time. So would I have let pink shoes be acceptable? Would I have spent the ridiculously high toddler shoe prices on shoes I knew made him stand out and would confuse people?

I shared the story with a friend later that day and the next time I was at her house she handed me a pair of pink Mary Jane-style shoes in a quality toddler brand that were just my son's size and said, here, I got these in a bunch of hand-me-downs, I thought your little guy would like them. He does. He loves them. He quickly abandoned his sandals which he had been demanding to sleep in two weeks before (also a pass on from the same friend--we are enjoying the windfall from her hard to fit and picky little boy the same age) in favor of his pink shoes. When we are getting ready for school or an outing I say, let's find your shoes, and he pipes in "Pink Shoes!" If they are MIA (a common occurrence with a toddler and two not-that-organized parents) he will wear another pair, but not without a fuss. And I think he looks pretty darn cute in them.

He has a short boy hair cut and his clothes look like little boy clothes and then he has pink shoes. He looks like a boy wearing girls' shoes. He is deliciously and, as I am sadly aware, fleetingly, unaware of how his non-conformity looks to others and he has no idea that colors have gender in our culture. One woman stopped me in Target so say how much she loved his shoes, and that her son had also loved pink until another child had told him they were girls' shoes and he had stopped wearing them. She expressed anger at that long ago child and his parents. But I thought, the whole world tells them this, it is definitely not the child's fault. Others have commented that I must have a very open-minded husband. I do, and I am grateful for it. His sense of his own maleness is not caught up in how his child dresses, and he truly didn't care if people commented on "how pretty she is" when our son was a baby.

I ache to think about a moment when my oblivious little man becomes aware enough of others and himself to notice or care that his shoes don't match his genitalia. But I am also curious. What kind of a kid will he be? Will he just slowly notice the divide between boys' and girls' clothes, and toys, and shoes, and lunch boxes, and sippy cups, and tooth brushes, and drift away from his interest in pink to join the other boys around the trucks? Will he notice but continue to like the pink? If he still likes pink will he be the kind of kid who stops wearing it when other kids comment or tease? Will he be the kind of kid who looks at them and asks "says who?" when they say those are "girls shoes?" with that horrid tone of voice that suggests there is nothing worse than girl-ness? Or even better, "so what" and runs off to rejoin the soccer game?

He may look back at pictures of him in pink shoes and say "Mom, how could you have!" and I will say "I loved you no matter what you loved then, and I will love you no matter who or what you love now or in the future." And I will kiss him on the head and know that like his toddler years, his adolescence will pass. This seems to me a far better outcome than him sitting on a therapist's couch at 35 and digging up the oppressed feelings he shoved down inside when his parents shamed him for developmentally typical interest in "girly" things.

In the end, I guess I don't believe that what I say or how much I control what he wears now, while I still have some say over it, will really make a difference on the bigger questions that the color of his shoes are standing in for here. If my son is gay, he will be gay, whether I let him wear pink shoes or not. If my son is transgendered, that will be true even if I only buy him only blue sippy cups. Right now it is just a matter of my comfort, and my own issues. I admit that I find it reassuring that he still is wearing boys' clothes and looks like a boy. Generally, I dress him like a boy. I know it won't be as easy if one day he wants to really dress like a girl, or act like one, or become one. But, that is all to come or not to come and right now, he is pretty damn cute, no matter what color he wears.

Thursday, May 9, 2013

What I Do

At my sister's suggestion I thought I would do a post about my work.  I am an occupational therapist. To those who are unfamiliar with the profession (like I was until well after my graduation from undergrad) this brings up the idea that perhaps I counsel people on the type of job they should get. Maybe I'm trained to administer those personality and aptitude tests with results like "congratulations you should be either a brick layer or an acrobat."

In reality, occupational therapy is a pretty diverse profession in the rehabilitation field. Every occupational therapist you meet may work in vastly different settings. We work with preterm babies in NICU's and with people creating their last memories in hospice. We work with young men and women returning from war without limbs or with traumatic brain injury and we work with individuals with schizophrenia working on reintegrating into their community. We work with children in schools who struggle with handwriting and with workers trying to avoid carpal tunnel syndrome. We help your grandma relearn to put on her socks after a stroke and help children learn to put on their shoes for the first time.

The thing that links us all together is Occupation. We use the word a bit differently than the rest of the world to mean, broadly, any activity that is viewed as having a unique meaning and purpose in a person's life. Sometimes we work to fix whats not working well with a person, so they can get back to what matters to them. Sometimes we work to change the environment so it works better for the person, just how they are. Sometimes we help the person find meaning in a new occupation and that helps them heal. Always we try to use meaningful activity not just a our end goal, but as the means to achieve it as well.

I work with children who are learning to eat. Some are new babies trying to get started despite a heart defect or being born with Downs Syndrome. Others are struggling with the transition to solids. Others are starting to learn to eat with their mouths after spending months or years being fed mainly through a tube in their tummy. Eating and feeding others are central occupations for children, and really, for everyone. I am also called a feeding therapist, or feeding specialist. I was lucky enough to fall into this area of OT thanks to my mentor and boss, Marsha Dunn Klein. She called me back after I made a phone call inquiring more about her practice while I was starting my job search after graduate school. She casually mentioned that I might have used her book in my feeding class. I said, I'm not sure, and moved on, thinking nothing of it. When I later looked her up I felt pretty sheepish to realize I was talking to the author of the book referred to in the field as "the feeding bible". I ended up taking the job with Marsha despite the lack of benefits and pay rate half of what I could have been making at a hospital or in the schools, because in therapy, mentorship matters. Marsha has inspired me to constantly strive to be the best therapist I can and to never stop asking question or learning.

The never ending supply of questions, of unknowns  of challenges, is part of why I love my work. I can's ever imagine getting bored. It also means I always feel a little inadequate and wishing I knew just a little more, but I'd rather feel like I have to keep swimming to keep my head above water than to drown of boredom sitting in the shallow end.

Feeding and eating is fascinating because of how complex it is. Just the physical act of chewing and swallowing takes a ridiculous number of muscles, joints, nerve connections acting in concert. And that can only happen after to you manage to coordinate you hands and eyes to successfully get food from the table to your mouth. Then you layer on top of that the complicated relationship between food and culture,  between mothers and fathers and their children, between the medical community and families. When you are thinking about a child and their eating you have to take into consideration their motor system, gastrointestinal system, respiratory system, sensory processing abilities, cardiac function, their family and cultural context, their individual history with food, and their unique personality (I know I forgot some, but its a start).

I could go on for probably longer than the attention span of any of my four or five readers, so I will pause here. In the future I will probably write more about my work. If you know me, you know I talk about work a lot, probably much to your chagrin. So this is just a quick orientation before I launch into my latest story about my cutest new client or the crazy doctor am working with now.

Let's end with the most important part: I love my job. When I was in college I wrote a list of ten life goals on a post it note on my computer desk top. It included "have a job I love waking up for" check. It also included "fall in love" check, and, "have children" check. So I am not doing too shabby.

Monday, April 29, 2013

Group Check

As I imagine and know is the case with many of you I have been captivated and horrified by the recent events in Boston. The tragedy leaves so many questions and shakes, yet again, our sense of safety and security. One of the common themes I have been noticing in the hopeful and prayerful posts of other bloggers and on facebook is the intentional noticing of the good that such horrors bring into such sharp relief. No one could help but comment on how many people ran towards those who were injured and how people collectively and without designated leadership did what needed to be done. Spontaneously organized group of bystanders pulled down barriers, transported the wounded and helped in what ever way they knew how. This kindness, this disregard for self in the name of caring for another in need, is rightly pointed out as a counter balance to the horror and the evil that called the need into existence in the first place. So this got me thinking. Maybe life here on earth and our moral worthiness is really a Group Check.

I mentioned in my first post that I am a player of dungeons and dragons. And before I launch into my Group Check discussion a pause to orient those of you less nerdy than myself as to what this "D&D" is all about. If you have heard of it you likely have an image of dorky young men, potentially trench coat wearing, carrying around homemade swords and demanding to be called Trulingard, Destroyer of Evil, Slayer of Orcs. At least that is what I thought it was all about and was kind of dismayed when my sister suggested we start a game. My hubby was quickly on board and I kind of got dragged along. D&D is a role playing game. It is kind of a highly complicated board game where you get to control what the characters do within a set of contraints set up by the game creators. For a full description of it straight from them, check this out.

One person in the group plays what is called the Dungeon Master (DM for short). This person controls all the bad guys and help guides the story and the players. If you want to do something in the game the DM also determines what kind of check you need to make first. For example, you say, I am going to walk up to that bar tender and hit on him, the DM says, okay, make a diplomacy check. You have a predetermined number for diplomacy that is based on all sorts of factors that don't matter for our purposes here, and you role your 20 sided die (D20) and add your number to it. The DM then tells you if, for example the bar tender flirts right back and hands you a free drink, or laughs in your face and starts flirting with the elf wizard at the other end of the bar.

Certain tasks are more challenging than others and take a better check, kind of like real life, it isn't enough to say, "I want to be the president" if you want that to be true you better have a pretty damn good charisma modifier, as well as a booty load of gold pieces. So a lot of what you might want to do in the game is an individual challenge just like in life. But sometimes you work together with your group. For example, you are approaching a band of goblins around a camp fire and you don't want to them to hear you approach, the DM may say, okay, make a group stealth check. Everyone one in the group then goes ahead and rolls the D20 plus their own stealth modifier. Collectively the group has to hit a certain number to pass the check. So if one of you rolls a 4, the equivalent of knocking over a coat rack as you try and sneak into a party, it may not matter, because your buddy might roll a 17 and be right there to catch the coat rack before anyone is the wiser.

So, this brings me back to Boston. After the bomb went off the great Dungeon Master said, roll a group caring check. And each player on the board rolled. I'd like to think we passed our check, that we successfully responded to the encounter with the devastating opponent. It certainly seems like we have done well this round at least. The suspects were either dead or apprehended within a week and a huge proportion of those injured were saved.

Like in dungeons and dragons though, life is not just one encounter,  but a series of encounters that make up a big campaign or adventure. As a consequence of this encounter we will have many more. The individuals injured will be asked to roll strength and courage checks, the doctors treating them will be asked to roll healing checks. Thankfully we can assist one another, if someone rolls poorly on an individual check we can say, I want to help, and roll to see if we have the strength not only to take care of ourself but to help carry another as well. There will be more group checks too. Americans have a very high caring modifier but tolerance isn't always our strongest skill. As we continue to navigate our collective relationship with those of the Muslim faith will we pass or tolerance check?  As the medical bills for the injured roll in and the cost of prosthetic limbs go uncovered by insurance plans will we pass the endurance check? Or will time have washed away how pressing this all felt two weeks ago and sympathy fatigue will set in, and we will fail as a group, leaving people alone with the devastating consequences of these kinds of health challenges? We haven't rolled so well on this front with our 9-11 responders.

Obviously, this metaphor gets pretty complicated as you move through time and away from the initial encounter with the bad guy. And the metaphor of the DM as God brings up all the usual questions. In D&D the DM controls the bad guys, literally creating the opportunities for the heros in the game to prove their mettle. Maybe that is how this all works, God throws out the challenges and we respond, collectively, and see how we will fair. Or maybe the group check started before the bombs went off, and the two young men who, for whatever reason did this, rolled 1's, known in the D&D world as critical fails. So it took a whole lot of high rolls to counter those two terrible rolls. Because, while it may be tempting to cast these two young men as others, as evil, as clearly and concisely, "not us", much of the evidence so far suggests otherwise. Young immigrant men, going to school, learning here, making friends, and ostensibly building their lives here. But somehow they still managed this one huge critical fail. Why were they not trained in the requisite skills they needed not to fail so disastrously?  Were there group kindness checks or group tolerance checks or group paying attention checks that failed on their path to this critical fail?  Did we miss opportunities to help them on individual checks they were asked to roll and failed to succeed in that we could have assisted with?   Many religions focus on individual acts as the arbiters of ones fate in the world to come. But what about this world? The calculus gets so complex that only an all knowing, all powerful and hopefully loving and merciful DM could keep track of it all. But here, now, in the world we share, our group acts do so much more to create a more holy or more fearful space, and that in the end may be the point.

Sunday, April 21, 2013

The Other Day...I was thinking I should start a blog

So, I have been meaning to get around to starting my very own blog for a while now.  Of course now that I have done it I have writer's block and all of my very well thought out thoughts that the rest of the world just must be enlightened with have drifted off. I will blame the baby, you can pick which one: the two year old or the fetus, both take a lot of energy and have been sucking my brain and body's power to do basic things, like stay awake during all of the daylight hours or remember to bring my wallet to the grocery store. So part of this blog will probably be a "mommy blog" because, as it turns out, I am in fact, a mommy, a tired pregnant mommy at the moment. But I am also an occupational therapist that works with children with feeding challenges, so at moments, it may also be a therapy or feeding blog, I am also a feminist, a Tucsonan, a liberal,  a fan of musicals, and a player of dungeons and dragons. I have some opinions about other stuff too, so I reserve the right to blog about whatever topic drifts into my mind. I cant promise to ever by as culturally astute or well spoken a my amazing friend Laura or as hilarious as the sassy curmudgeon but I will try.

I suppose in a first blog post it is worth talking about your blog title. I have always said, if I ever start a blog it will be called "The Other Day." My friends all laugh. This is because there is an ongoing joke, or accusation, that I use this phrase incorrectly. Apparently, the rest of the world has a fairly firm sense of what "the other day" means. I am told that most people think it means a day, in the recent past, probably within a week or two. The free dictionary even suggests a specific number (3) of days in the past. Somehow, while going through the incredibly complex process of teaching and learning that takes place as a child grows, in which the nuances of language, and culture, and the many idiosyncratic meanings of idiomatic language are passed on to the next generation, I missed this.

I have been stubborn about altering my understanding of the phrase as an adult. I tend to use it much more loosely to mean, say, sometime in the past. I think that I have a fairly nuanced use of it and that my use usually makes sense to me. But tragically... NO ONE UNDERSTANDS ME. It is a phrase I would use to talk about certain past events in certain moments but not other events in the same moment or the same event in other moments. I usually use "the other day" as a way to signal that I feel that there is a bridge between the moment I am in now and the day, or moment, I am referring to. Hmmm, writing this out I can see how my friends pat me on the head and nod kindly while I try and explain this.

Maybe an example will help. So, let's say I am at a party and a delicious pizza is delivered, by a very good looking pizza delivery boy. And let's say a friend of mine flirts with said boy, gets his phone number and is all giggly about the interaction for a bit. I might, in making conversation a few minutes after pizza man has left, say to a friend "the other day, we were making pizza at my house..." and continue with a fascinating culinary adventure story. Or, "the other day, the UPS guys stopped by my house and he had the craziest facial hair I ever saw..." How long ago those "other" days were is not as critical to my mind as the thematic relationship to the moment. In the former, the connection between the food being consumed and delivered and the food in my story, and in the latter, the physical attributes of delivery men. I probably would not, in conversation in the aftermath of the pizza/phone number exchanges say "the other day I went to the dentist..." even if, three days prior I had done so.

Does this make sense to anyone else? It is just me who feels this phrase is so much more than a temporal marker? Be the first to agree with me on my blog by posting your comment about how you have always felt that the common understanding of "the other day" was far to banal. That you, too, feel that "the other day" has the transformative power to draw connection between past and present and help to cue listeners that the texture, feelings, and themes of the moment they are experiencing with the speaker NOW are similar to a moment when they weren't present or reminds them of the commonalities of an experience they shared in the PAST. Thus, allowing the listener a richer understanding of the person's lived experience. It is a phrase that the speaker uses to draw in their audience and by using it signals that she wants them to truly be a part of and understand more than just the narrative of what happened "the other day."