Anchorage Vacation

It is hard to believe we have already been home in Kodiak 3weeks. We had an amazing time in Anchorage waiting on Caitlyn to make an appearance. Scott followed us up about a week after the girls and I had been there, so we were able to get a feel for the area before he arrived and get some of the shopping out of the way that he wasn't thrilled about going to. After he arrived our weeks were filled with adventures our favorites included hiking and enjoying warmer weather and sunshine.

While exploring we found this wonderful waterfall that rain under the road and the opportunity for some hiking and cooling off in the water, which was VERY cold!!

We also discovered how much fun it was to pan for gold. This mine was a blast to explore and supposedly had quite a bit of gold in the river, although we didn't find any we once again enjoyed playing in the water.

These were the original building for the gold panning. The area was beautiful.

This wasn't at the same area, it was more of a tourist trap but the girls had a blast playing in the water and it sparked our interest in panning.

Panning provided ample opportunities to play in water. Generally it is too cold on Kodiak to enjoy playing with water. In Anchorage however we had several very sunny days in the 70's and at least one day almost hit 80. I think that was the day we were here at the river. Alisha and I got home with a little more sun than I had intended.

Brianna has an odd attraction to the water. Everytime she gets near it she ends up falling in which is generally a little traumatic for her. I don't think I had even finished putting our things down when Scott walked up with a very distraught and wet little girl. She spent the rest of the day on Jaime's back bundled up.

Aside from playing in water we also say a ton of wild life as can be expected in Alaska. This eagle was practicing being the flag pole topper for the Alaska zoo, I'm pretty sure he sat like that for over an hour.

I was very impressed with how active the animals were at the zoo. This polar bear paced infront of us for several minutes then would go to the gate and roll his head. There was also a badger that was running laps in his cage for a good 20mins. The bear cubs played in the pools and threw balls at the fence and wolf pack chased each other in their cage wrestling and howling. It was the best visit I think I've had to a zoo.

Aside from caged animals we also saw a wide range of wild animals. AFter arriving in Homer at midnight Jaime offered to drive to Anchorage for me, she wasn't driving 5mins before I hear this quite, "Oh my goodness, That's a moose!!", I opened my eyes to see a moose's very large rearend pass by my window. At one park we didn't even get out of sight of the car before running in to another moose resting on the path. I also learned that Moose are more dangerous than bears as more people are killed by moose each year than bears, although that is most caused by people hitting them with their cars. Moose with calves however are very dangerous and generally avoided by all.

Other than hiking and animal viewing we also went glacier viewing, hiking and jumping.

While I couldn't do much glacier hiking I enjoyed the view will Scott and Jaime explored. They also taught Alisha how to properly jump over cracks and water.

She had a blast coping Jaime

We also got to experience fresh from the glacier water, which was slightly warm by the time they brought it back to the car to me. I was told it was amazing though.

Yes the black "dirt" is actually ice and very slippery. Scott and Jaime also had a blast jumping.

To end our vacation we treated Jaime to her first King crab dinner. She was then attacked by her crab. However she beat it and from my understanding loved it.

We had too much fun and too many adventures to put into one post but at least these were the hightlights. The best adventure of the trip however came from the little bundle that we got to bring home.

Bri''s Birthday difficulties

So blogger apparently does not like my update on Bri's birthday. I have posted it at least twice and it shows up for a day then dissappears. I finally find it again in my edited posts and all my pictures are messed up.
We had a small party with close friends the weekend after her birthday. THe kids had a blast dressing up like princesses. B was especially cute in her pink ruffles dress. We had a grill out followed by homemade cupcakes. I thought the cupcakes turned out very well however I did need to work on my decorating. The birthday girl also got several wonderful gifts that she has been throughly enjoying ever since. The biggest gift was really a family surprise as the humane society had called earlier that day and asked if we would be interested in taking a puppy that had been returned. So after all the excitement we spent the night enjoying the newest addition to our family, a white mutt that A named Lucy a couple of weeks later.

VBAC vs. Elective Cesearen: Pros and Cons

There is apparently quite a bit of concern regarding mine and Scott's decision to pursue a Vaginal Birth After Cesarean (VBAC). So I would like to shed some light on some of the facts that we have discovered concerning VBAC and Elective C-sections.

The 1995 American College of Obstetricians and Gynecologist (ACOG), which is the leading governing and research body for OB-GYNs recommended "limiting repeat cesarean births to those that were medically necessary. Obstetricians should counsel and encourage women to try to give birth vaginally." It continued to say that vaginal births (after cesarean) "would lead to shorter hospital stays, fewer transfusion, fewer post-partum fevers and a savings of more than four-thousand dollars per birth." It also stated that "not only would this course of action (VBAC) be better for women it would also not cause any greater risk for their babies." They concluded by recommending that "women with 2 or more previous cesareans with no contraindication who want VBAC should not be discouraged from trying for a vaginal birth, that women with large babies should not be automatically exempted from trying a VBAC and that VBACs should not be limited to the largest hospitals."
Between '95 and '98 VBACs were encouraged and done at most hospitals, even the Dr's at our clinic on Kodiak fondly remember doing VBAC on the island. So what changed? Several things, the 2 changes that I find most compelling are the induction rate and societal changes. Prior to '98 little was known about the risk of using induction medication on VBAC patients therefore more VBAC patients were being induced as the use of induction medication also increased. We now know that using induction medication on a VBAC patient increases their risk of uterine rupture. Therefore, dr's willing to attend VBACs today do not consider induction an option until after 6cm dilation and most not even then. Another theory for the change in recommendations is that societal changes in the '90s led to increases in malpractice lawsuits which caused a shift in the recommendations.

The '99 ACOG bulletin withdrawals the recommendation that repeat cesarean section only be done when medically necessary and strongly urges that physicians capable of performing an emergency C-section be "immediately available". Since most hospitals do not have the capability to have round the clock staff they have developed policies that do not allow women to have VBAC's at their hospital. Some smaller hospitals however interpret this recommendation to allow VBAC by having staff on call so that the decision to incision time is 30mins just as they would in the case of a 1st time pregnancy in need of an emergency section. It is my feeling that any hospital that cannot offer emergency surgery to laboring VBAC patients is therefore unable to provide any other form of emergency surgery, as the decision to incision time would also be approximately 30min. The ACOG bulletin also does not provide research supporting their change in policy and since it is my understanding that the uterine rupture rate has not significantly changed it is understandable how people jump to the conclusion that the changes were made not for the benefit of the patient but for the benefit of the Drs. due to increases in malpractice suits. A few of the Drs I have talked to have stated that they feel another shift is coming and they are hopeful that ACOG will once again add in recommendations for allowing multiply cesarean VBACs. For the most recent ACOG recommendation you can visit consensus.nih.gov/2010/vbac.htm

Here is a pros and cons list concerning VBACs:
PROS:
-VBAC is safe (the consent form that must be signed for the Dr and Hospital clearly states that the patient must be made aware that VBAC is safer than elective C-section, no consent form or information form is given stating the risk of elective C-section).
-Elective repeat cesarean poses greater risks to the mother's life and health than does vaginal birth. It poses hazards to the baby as well, especially with succeeding pregnancies and more than one cesarean.
- Most women, including women whose prior cesarean was for lack of progress or who are believed to be carrying a big baby, will birth vaginally if allowed to labor.
CONS:
- While the healed uterine scar is tough it is widely excepted that a form of uterine rupture (symptomatic scar separation) will occur in 1% of VBAC patient that have had 1 prior c-section, it is my understanding that this type of separation occurs most commonly in the first couple hours of labor. Another form of uterine rupture (spontaneous scar separation) is the most common type of rupture and occurs most likely between 36 and 39 weeks, I am not sure at what percent this form of rupture occurs while I have asked several Drs they have not been able to give me an answer other than the 1% mentioned above. Also, while they quote the same percentage of risk they do not ask the patient to take any special precautions such as limiting activities or bed rest, since it is unknown what causes it. Uterine rupture means that the scar will open up enough for the umbilical cord or the baby to pass through the opening or for bleeding to occur (if left unattended or not caught fast enough this may lead to the death of the mother or baby) However, when a c-section is done promptly few babies and even fewer moms will be injured.
-The perinatal mortality rate (deaths around the time of birth) in 29 studies have found that 3 out of 10,000 deaths occur for both VBAC labors and planned cesareans.

Pros and Cons for Elective Cesarean
Pros:
Since there is no labor, there is no chance of symptomatic scar separation, at least not during labor, prelabor cesareans have lower infection and other complication rates than cesareans done in labor.
Cons:
Compared with vaginal birth, c-section substantially increases the risk of infection, injury to other organs, hemorrhage, and anesthesia complications. The complications, in turn, increase the risk of prolonged hospitalization, hysterectomy and maternal death. Repeat c-sections are more technically difficult to perform because of scar tissue. For this reason, injury to other organs is more common, Scar tissue formation can cause chronic pain and bowel problems. Elective cesarean also increases the baby's risk for poor condition at birth, breathing difficulties and jaundice. Each successive cesarean greatly increases the risk of developing placenta previa and/or placenta accreta in subsequent pregnancies. Both of these complications pose life-threatening risks to mother and baby. Cesareans also increase the odds of infertility and ectopic pregnancy, another life-threatening danger, in subsequent pregnancies. Women with multiple prior cesareans have a slightly increased risk of symptomatic scar separation during VBAC.

Closing note: I am not anti-Cesarean. Despite how it sounds I am completely open to allowing the Drs to perform a c-section if it becomes medically necessary. Since I am considered a higher risk I will be under greater supervision and monitoring so that should a c-section need to be done it will be done at the 1st signs of possible danger. However, as I have stated many times in this post all the research agrees that a VBAC is safer than a repeat elective cesarean.

Most of my information has come from the several Drs we have spoken with, Guide to Childbirth by Ina May and The Thinking Woman's Guide to a Better Birth by Henci Goer as well as the NIH website and ACOG VBAC statements.

Been a while . . .Update

It's so hard to believe how time can be so slow and yet so fast all at the same time. The past few weeks have crawled by and yet I can't believe it has been two months since my last post. So a quick few updates. Next week I will catch everyone up on B's birthday and our crazy Easter weekend. I had plans on doing it this past week however S took off with the camera that still has my pictures on it. While it is still a month away we are very rapidly approaching my due date, June 4th. A friend will be flying in the beginning of next week and then all the girls will be heading to Anchorage for a few weeks of relaxing and shopping while we wait for the baby to decide to get here.
For those wandering why the extra trip, we have decided to attempt a natural birth rather than planning another C-section. The hospital on Kodiak does not allow attempted VBAC due to policies on emergency C-sections so I have to deliver in Anchorage where the facilities are better equipped in the event of an emergency.
S will be following us a week later as the Coast Guard does not allow additional time off, which is why our friend was gracious enough to come stay with me. I can't be in medical housing without a chaperon and yet my husband isn't allowed off. I know lots of things don't make sense about the whole process.
So we are rapidly discovering we are running out of time to get all of our projects completed prior to leaving. We have been working on getting the yard ready for flowers and hopefully some grass. S has been working on getting lines and nets set up for fishing season which starts shortly after we leave. And today we have finally gotten the baby's room set up, somewhat. Not knowing if it will be a boy or girls makes it a little difficult to really decorate however we do have the crib set up with a set of white sheets that I had. We will finish decorating when we get back. Next on the list of things to finish is the garage and I'm having serious doubts as to whether or not we will finish it. So I guess I need to get back to work.

Getting Big!!

This week we celebrated A's 3rd Birthday!! I can't believe it has been three years already, where has the time gone? Just this past year has flown by it's hard to believe how fast the time goes. Originally I had planned to do a small birthday dinner as we don't know very many people here however as it turns out one of our friends little boy's birthday was just a few days ahead of A's and he was also turning 3. So we thought it would be fun to combine their parties since neither of us knew very many people.

They had a blast. A has a blast every time we sing "Happy Birthday" to anyone so she thought it was hilarious when we all sang it for her. I think that has become her favorite song lately. S and I made hamburgers while our friend did birthday cupcakes for everyone. For the birthday kids she combined 3 and decorated them to look like Mickey and Minnie Mouse. They were adorable and delicious!

Gifts were then opened much to the birthday kids delight! A had been eyeballing the princess bag all day. She mostly go board games as she fell in love with the ones that she got at Christmas.

Along with a backpack that she can carry her things around in. I think it reminded her of Dora's backpack.

Then the final present was a surprise from Grandma which had arrived earlier that day much to everyones surprise. It was a life size dollhouse that she and her sister will get to color in the weeks to come. She has been after me all week to let her color it.

Earlier in the day there was some concern that S was going to miss the party due to scheduling mix-ups at work and lots of confusion over the holiday weekend. He ended up getting called into work and put on an 8hr flight. However, thankfully C-130's are somewhat unreliable and the plane broke so they had to come back. Then due to not having another plane that could fly they all got sent home. While the day started a little crazy it ended perfectly with everyone being able to make the party.

Rabbit Stew

So I finally got brave enough the other week to cook the rabbit S caught the other day and made my first ever rabbit stew. It's not just my first rabbit stew it is the first time I've ever cooked anything wild or hunted, other than fish which doesn't really count. I have known for a week now that we had rabbit in the freezer and I was going to cook it in a stew. I was even a little excited about this new experiment. However as I stood in our kitchen that morning getting everything together I became very aware of the fact that I was going to have to actually touch a dead rabbit. I'm not really sure why the thought of touching a dead rabbit caused so much apprehension it was so strange it was actually kinda funny. It didn't matter how good the stew smelled all day I couldn't even bring myself to taste it, although I knew I was going to have to eat at least a bowl for dinner. It was a very strange day. However at the end of the day I did overcome my issues and try the stew. It was actually pretty decent to have been my first time. The meat turned out very tender although we really needed more meat. I used the same recipe that I use for my beef stew only substituted the beef for rabbit. So for a first time experiment it turned out very well and I'm actually looking forward to trying other types of meat. S came home with 2 more rabbits the other day that I have to try new recipes on so if anyone has any good rabbit recipes please pass them on.

Bri Update

As most of you probably saw on facebook our little B had an accident Friday night involving a bookshelf. She was eating a quick dinner before band practice when she decided to play in her chair instead of sit in it. With daddy across the room getting more pizza and me in the office talking with the pastor's wife and everyone else occupied with their food she stood up turned around and flipped the chair with her top two front teeth making contact with the bookshelf behind her. As with most injuries involving the mouth there was immediately a lot of blood. Not having any ice handy I grabbed a cup full of snow to help stop the bleeding to get a better look at the damage. At first glance she had a pretty good busted top lip, but not something that would need stitches. Upon further inspection we notice that the gum just above her teeth was also cut pretty good and there was also white showing through the gum as we could see her teeth we weren't sure what the white was so we aired on the side of caution and ran across the street to the hospital. The ER had no patiences and they were ready to see us before I was done checking her in. The Dr. was also in the room ready to examine her before the nurses were done asking questions and getting her vitals. It was by far the best ER visit I have ever had! It was determined that she cut the tissue that connects her upper lip to the gum and that she possible jammed her teeth. None of the cuts seemed severe enough to need stitches and she seemed okay as long as you didn't mess with her lip so nothing was given to numb her lip either. There was also nothing to be done about the teeth except to follow up with the Dentist and have them access the damage, which we did today.
The dentist confirmed that the white was partly bone and partly root, the gum is fairly thin in that area so it wouldn't have taken much for either one to show through. She didn't think that the teeth were jammed due to being able to see the roots and the teeth still appeared to be positioned correctly they also didn't feel loose. Also, with B's age she felt everything would heal quickly and correctly without having any problems. We do have to keep an eye out for any possible infection as there isn't a good way to clean it, since we can't brush up there due to disturbing the clot and causing more pain and discomfort for B. We were also warned that the teeth may change color as the bruising continues to heal but they should change back as the bruising clears up. The only concern would be if they didn't change back and she began to act like she was having pain in that area, in which case we would need to go back to check of infection or an abscess. The extent of some of the damage may also be unknown until her permanent teeth begin to come in, in which case she may have some spacing or other issues that would be addressed at that time.
So that about sums it up. Overall, she is acting like herself and eating just fine. The dentist was impressed with how well B took to her messing with the area and thankfully nothing else needs to be done at this time except keeping an eye on it.