Saturday, December 31, 2011

Ski Trip To Sunriver/Mount Bachelor

One of my good friend, a former x-country teammate in college, invited us to go on a ski trip in Sunriver, Oregon.  Lisa lives in Texas now, and had been living in Germany for a couple years, so I don't get to see her too often.  I've always thought it would be fun if our family's went on vacation together, but when she mentioned this trip I was hesitant.  It involved an 8+ hour car ride, and skiing, which neither of us have done in over 15 years.  But I wanted to see Lisa and her family (our kids are the same ages), and skiing could be fun, so I told Floyd I really wanted to go, so we did.

We borrowed my parents Suburu Outback for the trip and headed down.  It took us about eight hours to get there.  We stayed in a nice vacation rental in Sunriver, with Lisa's family and three other families (relatives and friends of relatives of Lisa).  There were seven kids running around, plus all the adults, but it was a good size house and didn't get overwhelming.  Sunriver is a funny town.  It is primarily a resort town, and the roads there seemed to be designed to be as confusing as possible.  There are no straight roads, and there are 10+ roundabouts.  But, it is really nice, with lots of trees, trails, pools, shops, etc.

Unfortunately the weather wasn't cooperating too much.  While it was nice to not have to deal with driving in the snow, when we headed up to Mount Bachelor for our first day of skiing it was pouring rain.  The good thing  was that no one was there, so it wasn't crowded at all.  The bad thing was that it was miserably cold and wet.  Selena was super excited about skiing and maintained her enthusiasm.  Allie was excited, but tended to get cold when she was actually outside.  We only got one pair of skis for the two of them to share.  Their foot sizes are only one size different, we figured Allie wouldn't want to ski that much, and I wasn't very confident in my ability to ski with either of the girls.

Selena had a blast, didn't seem to get cold, and didn't want to stop.  She caught on fairly quickly and was able to ski while holding onto a ski pole.  Lisa was amazing in helping Selena learn and showing us how to ski with her.  I did end up taking Selena once myself.  I was just happy that we didn't fall getting off the lift.  Selena claims responsibility for that feat.  She says she helped me keep my balance.  Selena did graduate and go down the Marshmallow run once with Floyd after she found out her friend, Lisa's daughter, did as well.

Allie liked skiing, but apparently did not like taxing up to the lift.  There was a slight uphill, and she did not like Floyd squeezing her between his legs and nudging her up.  But while she was actually skiing she liked it and she told everyone that she went on the lifter.

We based ourselves at the Sunrise lodge.  There is a free lift called Carousel that goes up a beginner hill.  Kids 5 and under ski free.  There was a web special a few weeks before we went that we got 3 day passes for $99/person (regularly lift tickets are $75/day).  In retrospect I wouldn't have bought the passes and just bought a half day ticket for me one day, and for Floyd the other day.  In having to take turns taking the girls out and taking turns watching the girls neither Floyd or I got to ski a whole bunch.  Lisa, her husband, her sister, and her parents were awesome and helped us out watching the girls so we got to ski more than we would have if they weren't there and willing, but still we didn't get that many runs.  We were both impressed, that even though it had been so long, and neither of us were that great to begin with, we still remembered how to ski, and it all came back fairly easily.

The second day of skiing, the conditions started out better with snow, but by the time we left it was switching between rain and snow.  We decided to go to the Mavericks recreation center and go swimming on the last day, instead of hitting the mountain again.  We were tired, and didn't really feel like getting all wet, and then driving straight home.  There was also reports that conditions wouldn't be good over Mount Hood pass and we figured leaving earlier rather than later would be better.  We ended up driving north to Yakima and going over Snoqualmie instead.  But we got unlucky it snowed some on our way to Yakima, and it started snowing right before we got to Snoqualmie pass, so it was a bit hairy going over.  But we made it safely thanks to Floyd's excellent driving and being able to take advantage of all-wheel-drive.

For the drive we packed lots of snacks, and had the iTouch and Nook Color for entertainment.  Books on "tape" are a big hit with Selena.  I had downloaded a Magic School Bus story from the library that Selena really liked plus our standard Robert Munsch and library mp3 downloads.  I was just bummed that most of the library downloads are in WMA format and I couldn't get them transferred to any device.  They are supposed to work on the iTouch, but I was trying to do it at the last minute and kept on getting errors.





Wednesday, December 21, 2011

Brachiosaurus aka Long Neck Dinosaur Costume

Yes, this is belated Halloween post, but that is how I work around here. :)  The girls wanted to be long-neck dinosaurs, specifically Little Foot from The Land Before Time.  I had already made monster/dinosaur costumes twice before, but adding in a long neck would be a bit of a challenge, but I was happy with the way they turned out.


While this won't really be a tutorial per se I will explain how I made it in case you want to tackle something similar yourself.

Fabric
I used fleece fabric, since I needed quite a bit and it is relatively cheap.  In the past costumes I used a more furry fabric.  I used a cotton/polyester interlock from Joanns for the lining of the sweatshirt, and to make some of the bumps on the back.

Pants
I used the Willow Wayfarer Hipster for Slimster pattern.  I LOVE this pattern.  I think this is my number one most used pattern.  They fit great, seem to be comfortable and I can sew up a pair of these in less than an hour.

Sweatshirt
I used the Heidi and Finn Urban Unisex Hoodie pattern for this.  I LOVE this pattern.  This is my number two most used pattern.  The fit is great, it is fully lined, and the style is uber cute.  I made the sweatshirts with the hoodies, but after I finished I realized I shouldn't have.  The hoodies hung over the bumps on the back so we ended up just tucking them in.  The bumps were simply circles cut out and sewn on the back piece before assembly.  I stuffed them with the fuzz you use for stuffed animals or pillows.  I can't remember exactly what its called at the moment.   The tail was made by cutting out two big triangles, sewing some bumps on, sewing them together, turn inside out, and stuffing with fuzz.  I basted the tail between the band and the back piece of the shirt and then sewed the band on.

Head
I made a pattern for the head that roughly looks like the above.  I cut two of the head pieces out and then sewed the rectangle around the edges.  Then I got a rectangle of 1/2" thick craft foam and looped it into a circle and stuffed it up the head to give shape and support.  I stuffed fuzz behind the foam into the nose.  I sewed a small "pillow" filled with fuzz and just stuffed it into the top of the head.  I didn't secure it at all but it seemed to stay propped up by the foam.  I folded the bottom of the fabric over the foam and sewed around the whole thing, not at all neatly.  I should have done that a little nicer. ;)  Selena drew mouths with a permanent marker, and we sewed buttons on for the eyes and the nostrils.   I did make Allie's hat slightly shorter as she had a harder time keeping the hat balanced on her head.


If that isn't clear, please feel free to ask me questions.

Saturday, December 17, 2011

You're the best mom ever!

Allie tells me every night when we snuggle up for bed, "You're the best mom ever."  It makes me smile and feel good.

Right now Allie is into coloring, drawing and painting.  We are rapidly going through printer paper printing out coloring sheets from the internet.  When we go to the Y, she proudly brings me between three and eight papers she colored while we were working out.  Markers are her preferred medium, but she forgets to put the caps back on and they dry out.  She enjoys watercolors as well.  I have some artist grade water colors I bought when I decided I wanted to learn how to paint.  That was short-lived, but the girls love using them, mixing their own colors, and they are easy to get out and clean up (as long as I keep the tubes away from them).   She has also started drawing recognizable shapes and people.  I like watching her discuss all the details of the picture while she is creating it.  She's started writing some letters too.  One day she had a paper and she says, "A for Allie", and then proceeds to write an A, but the tops didn't quite get connected, and she looked kind of confused then says, "that's an H."

She is still into computer games as well-on the Nook, the iTouch, and the computer.  She can't use the mouse on the computer so she has to convince me, Selena or Floyd to do them for her, but she is a master at the touch devices.

Her and Selena seem to be getting along better.  I think Allie is grasping Selena's imaginative play better and is more willing to play the roles Selena assigns, or offer up alternatives.  A few months ago she just seemed to cry if Selena told her to do something she didn't want to, or she'd ignore Selena and somehow "ruin" Selena's game, which made Selena cry.   There is still plenty of fighting and peskiness between the two, but there also seems to be longer periods of playing happily.  :)

Allie is a great eater.  She cheers when I make soup and begs to eat more eggs in the morning.

The sun came out today (amazing!)  and she says, "It's so beautiful."  I laughed and she says, "Don't laugh.  I just said it's beautiful."  I told her I agreed with her and I was laughing because what she said made me happy.

I had a first recently.  It was the first time I had to deal with a child who cut their own hair.  Allie decided to feather her bangs.  Fortunately she left enough that it did sort of blend in.  Her hair is kind of all over the place anyway.  Oh well.

 Allie drew this picture of me.  Then she asked Selena to help, so Selena drew the small head and smiley face. But I think Allie's original intent, based on what she described to me while she was drawing, was that the big circle is my head and the line across it is my mouth.

Thursday, December 8, 2011

Reindeer Are Not Filled With Hot Air

Fall has come and winter is almost here, and thus it is cold, windy and dark much of the time.  We're getting outside less than I'd like, but we've got a good routine of all of us going to the Y.  Both girls enjoy going in the child watch and so it works out for all of us.

Selena is always planning and plotting and implementing projects.  She writes songs, stories, and letters.  Paints pictures and coloring pages.  She designs new fashions and has me implement--lots of dinosaur applique.  But she has been doing a bit of sewing herself.  She has a good handle on the pedal while I help guide the fabric.  She is even able to stop sewing right when the needle is up.  I can't do that.

Christmas is coming up and we're working on delayed gratification by having her create her Christmas list.  A few months ago she was grilling me on the realities of Santa and his reindeer.  "How do they fly?  They don't have wings."  "Hot air baloons don't have wings," I reply.  "They are not filled with hot air."  Hmmm.  The last I heard she decided Santa was a real man who gave presents, but he didn't really arrive on reindeer.  But now that the magic of the season is here, she is very involved in the story and hasn't asked any questions, reindeer or otherwise.  She is ready to leave the reindeer two carrots on Christmas Eve, just as Santa requested when she talked to him at the Santa Brunch.

Selena's been more into games.  She invents her own games, making the game pieces out of paper.  But we've also played some checkers, chess and poker as well.  It is fun to see her start to develop some strategy.  She made up a game of colors the other day.  It is like rock-paper-scissors, but you use colors instead.  She had all the rules worked out so each color beat another color.  She didn't quite understand the simultaneous of rock-paper-scissors however.  In her game each person stated a color, of course whoever was last won.

.
It's fun to read good stories to her.  When she hears a joke or story she likes.  Her eyes light up and she gets all giggly. Per the recommendation of a friend we checked out a bunch of Chris Van Allsburg books. Her eyes really lit up at the end of The Sweetest Fig.

We experimented with dairy free for a week to try to resolve some issues that are a little too-much-information.  But she really missed her macaroni and cheese and there was no immediate noticeable difference so the experiment was abandoned after only a week and a half.  I did try a vegan macaroni and cheese that was very tasty, though not really like mac and cheese, and very authentic looking.  Selena was so excited about the thought of it, but when it was served she refused to take even one bite.  She said she could taste it through her sense of smell and it did not taste good. :S

Monday, November 28, 2011

Is Home Birth Safe?

This is another entry in my series on Pregnancy and Birth Outcomes based on the Washington state birth certificate data.

The Business of Being Born Again has just been released.  Which of course sparks the never ending discussion on whether home birth is safe or not.  I have not seen the new documentary, but the original Business of Being Born makes the premise that hospital birth is more dangerous than home birth because of the overuse of interventions, specifically induction, augmentation and an epidural.  The movie states that even women who want to avoid these interventions are pressured into them by the care providers in a hospital for a variety of reasons, including that it is more convenient for the staff, and they make more money.

I have been working on this analysis for a long time.  I kept waffling on whether it would be better to post analysis of each type of intervention, and then home birth, or vice verse.  I struggled getting the most fair, accurate, and mathematically correct analysis, and of course making all the data presentable and understandable.  I am also a bit scared because this is a topic that can get heated and I would prefer not to be the target of a barrage, but I think this information is important enough that I am willing to put myself out there.

Once again I'll start with the conclusion and work backward for the googlers who need answers at the top of the page ;)

CONCLUSION
In Washington state midwives are licensed, regulated, and are able to carry life saving medications that include anti-hemorrhagic, anti-seizure medication, intravenous fluids, epinephrine, oxygen and antibiotics for the treatment of group B strep infection.  Home birth is legal and is required to be covered by insurance (if the insurance covers maternity care).  Under these conditions from 2002 - 2007 for babies born between 37 - 42 weeks gestation home birth had overall better outcomes for both babies and mothers than low risk births that took place in a hospital.  Even when compared to births at a hospital that were not induced, augmented or made use of an epidural, births that took place at home had overall better outcomes for babies and mothers.   


RESULTS


Results highlighted in yellow are considered statistically significant, while those that are not highlighted are not considered so.  Click on the small thumbnail to see the table that includes the confidence intervals.

Home Birth With Attendant:  Births that happened at home or were planned on happening at home with the supervision of a care provider.  The care providers were mostly licensed midwives, but also included certified nurse midwives, osteopaths and doctors.  The births were between 37 - 42 weeks gestation.  I did not restrict the results to low risk, so the data includes VBAC's and other complications that the attendant apparently felt comfortable enough to attend the birth at home.

Low Risk Hospital: These are all the births that happened at a hospital and were planned to happen there. The births were between 37 and 42 weeks gestation.  Only low-risk patients were included in the data set so women that had  diabetes, hypertension, previous preterm births, other previous poor pregnancy outcomes, vaginal bleeding during this pregnancy prior to the onset of labor, pregnancy resulted from infertility treatment, had previous cesareans, Group B strep, were carrying multiple babies, had an incompetent cervix, had preterm labor, had a external cephalic version, received steroids (glucocorticoids) prior to labor, or the baby was breech or transverse were excluded from the data.

Click to enlarge


Click here to view all data including confidence intervals.



  • The rate of adverse outcomes for the baby were approximately 6.5 percentage points higher for hospital births than home births.  (6.4 percent vs 12.9 percent).  This reflects complications occurred almost twice as often.
  • There was a statistically significant better rate of outcomes in home birth for NICU admittance, assisted ventilation required for more than 6 hours, intolerance of labor and meconium staining amniotic fluid.  For all other outcomes there was not a statistically significant difference between the two. 
  • The rate of adverse outcomes for the mother were approximately 8 percentage points higher for hospital births than home births (2 percent vs 9.9 percent).  This reflects complications occurred more than 5 times as often.
  • There was a statistically significant better rate of outcomes for home birth among 3rd and 4th degree perineal lacerations and initial cesareans.  The differences between all other categories were not considered statistically significant.  
  • The rate of home births that transferred to a hospital was about 5.7 percent.  This includes mother's or baby's being transferred after the baby was born.  I initially published this with a lower number (3.6 percent), but that only counted transfers that occurred before the baby was born.  Thank you Annie for suggesting this number was too low.

Natural childbirth advocates claim that interventions cause many of the complications in hospital births.  I compared home birth to hospital birth where the labor was not induced, augmented, or made use of an epidural.  The data otherwise is the same as above.

Click to enlarge


Click here to view all data including confidence intervals

  • The rate of adverse outcomes for the baby were approximately 1.3 percentage points higher for hospital births than home births.  (6.4 percent vs 7.7 percent).  
  • More babies received assisted ventilation immediately after being born at home than at the hospital (1.4 percent vs 2.8 percent).  This reflects that this happened almost twice as often at home than at the hospital.  
  • More babies did not tolerate labor so that in-utero resuscitation measures, further fetal assessment or operative delivery at home than at the hospital.  (.29 vs 1.3).  This reflects that this happened about 5 times as often at the hospital than at home.
  • There was less staining of amniotic fluid with meconium among babies birthed at home than at a hospital. (1.7 percent vs 3.4 percent).
  • The rate of adverse outcomes for mother were approximately 1.7 percentage points higher for hospital births than home births. (5.5 percent vs 1.9 percent).  This reflects that complications occurred almost twice as often at the hospital than at home.
  • The rates were better for home birth for 3rd and 4th degree perineal tears.
  • The rate of initial cesarean was approximately 3 percentage points higher for intervention free hospital birth than home birth. (1.3 percent vs 4.3 percent).  This reflects that cesareans occurred almost three times more often among hospital births than home births.

Sometimes people will allow that home births are safer in the less serious outcomes, but when something bad happens your baby is more likely to die if you are at home.  Unfortunately the statistics regarding deaths are somewhat unreliable.

There are two fields used to describe mortality.  One is a link with infant death records.  This records that a baby died sometime in the first year, however the cause of death could be completely unrelated to its birth.  Another field that is used is whether the baby was alive when the birth certificate data was recorded.  There was a note about data quality saying that before 2005 there were records that said the baby was not alive, but there was no death certificate that matched the record.  It said this number was corrected after 2004, however there were many records after 2004 that said the baby was not alive, but it did not also have the field that linked the death certificates marked.  The majority of these records that had the discrepancy did not have any corresponding birth complications associated with them (ie resuscitation, NICU stay, etc) so I am assuming these records were probably marked incorrectly and thus this field isn't meaningful.

The second measurement of mortality are baby's who are not born alive otherwise known as still born.  These records are stored in a different database because the babies do not have a birth certificate.

In an effort to be unbiased I provided a few different rates for comparison.

Click to enlarge




  • The differences in mortality rates between home birth and hospital birth were not significant.
  • Using the most accurate data in the defined parameters (full term birth, born at home, on purpose, with a trained attendant vs low risk hospital birth) the actual outcomes were more favorable for home birth.
  • I included rates for home births of unknown planning with unknown attendants for curiosities sake and allowed babies from 36 wks gestation as well.  Even these were either only slightly worse, or better than the hospital births rates.
  • The "Not Alive When Reported" rate was poorer for home birth, by quite a bit, but as I mentioned earlier, this field is extremely questionable in its accuracy.  

DISCUSSION

Is birth safe?
Yes, but not really.  The best rates above have around a 5 percent chance of something wrong happening.  That doesn't sound like a lot, but when you phrase it as a 1 in 20 chance.  It would mean that 5 out of your 100 female/mommy Facebook friends would have had some less-than-ideal birth experience (unfortunately I was one of those five)--not rare and unheard of.  Also those optimum rates were for low risk pregnancies.  There is a high percentage of pregnancies that aren't low risk, so overall the rates might be (really I have no clue) more like 10 percent (1 in 10) to 15 percent (1 in 6ish).  Thankfully, with modern medicine, the vast majority of the time the less-than-ideal outcome doesn't last more than a few weeks (perhaps which is why there doesn't seem to be much effort in trying to improve it?).


Is home birth safe?
Yes, in Washington state, it has been safer than hospital birth for low risk pregnancies.

Does this mean home birth is always safer?
Probably not.  It is illegal for midwives to deliver babies at home in many states, or it is illegal for them to carry medications or administer antibiotics.  If proper backup is not available it is likely the results would not be so favorable.  This analysis is also for women who have low risk pregnancies, the outcomes could be different for higher risk pregnancies.

Should all women have access to home birth?
Yes! and no.  I think this data shows that it is safe, under prudent conditions.  All women in the U.S. who are deemed low risk should have high quality home birth care available (ie it shouldn't be illegal).

Do excessive interventions make hospital birth less safe?
Probably.  This particular analysis starts to make a case.  I may analyze this in future posts (I do have a post on epidurals almost completed already), but unfortunately there is not a whole lot of description on why an induction, augmentation or epidural was used so it makes it difficult to definitively say what came first--the intervention or the complication.  The fact that intervention free hospital birth has better outcomes than overall hospital birth alone isn't really indicative, but when combined with the information that a self-chosen group of women, who choose an intervention free birth beforehand (ie a home birth), have similar results provides stronger evidence toward the claim.

What's up with the assisted ventilation immediately after birth?
That was the one adverse event in which happened more often at home (albeit still only 3 percent of the time), than at a hospital.

Information lacking in the data
A neonatal mortality number (baby dies in the first couple months of life) is missing from this data.  This is a number that opponents of home birth commonly use to reflect that home birth is not safe and the fact that it is missing is unfortunate.  The inaccurate Not Alive When Reported number or the too broad infant mortality numbers are the closest we get.  Mother mortality is another number that is missing from the data.

Me/my wife/my baby would have died if I wasn't at a hospital
Yeah, me too.  The distinction that many people do not realize is that having a home birth does not mean the hospital isn't available.  The fact that it is available is what makes home birth safe.   Also, as shown above, the life threatening event is less likely (but not completely unlikely) to occur when you are at home.  Was the emergency caused by bad luck, or due to a bad drug interaction?

For some people the small chance that something really bad will happen, and being in the place it can get treated the quickest, is a more important a factor in deciding where to birth.  For others reducing the more common, though less serious, adverse outcomes is more important.  I believe that the important thing is that every women has the opportunity to receive quality care that aligns with her own risk comfort level.

Freestanding birth centers
I didn't include birth center births because some hospital's attached birth centers got labeled as free standing birth centers.  I didn't feel like picking through them and figure out which were truly free-standing and which were not so I chose to not include them.

What I would like to see
Home birth be legal, regulated, and covered by insurance in all fifty states.  I also think it would be great if CNM's and doctors delivered at home.  There are other things too, but I think they are out of the scope of this post.


Bias
I tried to be unbiased and get a true look at the safety of home birth.  I attempted to address concerns regarding perinatal mortality versus infant mortality.  I tried to include prudent parameters for home birth (ie full-term gestation and with a midwife attending) and only comparing similar demographics in the hospital.  Thus comparing home birth to only very low-risk pregnancies and intervention free births.  I hope that neither side can look at this and say I purposely skewed the data one way or the other.

Soap Box
If a woman decides to have a home birth or a natural birth she is not putting the "experience" ahead of her or her child's safety.  She should not be made fun of (cliche joke on TV), or told that she won't get a medal for doing it natural.  I know birth is tough.  I know home birth and unmedicated birth are not for everyone, nor am I saying that they should be, but women who look at this data and think it is worth it, should not be told they are crazy or that they are putting their child's life in danger, or every other awful  thing people and providers may say.

METHOD

This data comes from the Washington State birth certificate database for the years 2002 - 2007.  Here is a bit more information about me and the data.
  • Confidence Intervals were calculated using this document.  I used Poisson distributions when the number of events was less than 20 (I may have neglected this step, due to laziness, in cases where it was obviously not going to be significant).  It said to use 3 events if 0 events occurred, but this gave me weird results where the CI was statistically significantly higher than the comparative CI when in actuality there were no events recorded.  I switched to using 1 for the high, and zero for the low, and got more meaningful results.  I used the simplistic method in comparing confidence intervals, where statistical significance is only true when the intervals do not overlap.
  • Results were extracted using SQL.  They were copied into Excel where standard errors and confidence intervals were calculated and compared.
  • Each birth was only counted once, if multiple adverse reactions occurred the most severe event was the one recorded (ie if a baby had seizures, NICU stay and then died :(. The seizure and NICU fields would not reflect those events).
  • The adverse reactions recorded for the baby were:
    • adverse - a sum of all the events below
    • death - This does not include still births, but includes any baby that died within the first year of its life.  Whether the death was related to the birth or not is not specified.
    • assist_vent - Assisted Ventilation Required Immediately Following Delivery
    • assist_vent_cont - Assisted Ventilation Required for More Than 6 Hours
    • NICU - NICU Admission
    • surfactant - Newborn Given Surfactant  Replacement Therapy
    • sepsis - Antibiotics received by the Newborn for Suspected Neonatal Sepsis
    • seizure - Seizure or Serious Neurologic Dysfunction
    • birth_injury - Significant Birth Injury
    • intolerance_of_labor - Fetal Intolerance of Labor such that One or More of the Following Actions was Taken:  In-utero Resuscitation Measures, Further Fetal Assessment, or Operative Delivery 
    • meconium - Moderate/Heavy Meconium Staining of the Amniotic Fluid
  • The adverse reactions recorded for the mother were:
    • maternal_adverse - a sum of all the events below
    • transfusion - Maternal Transfusion
    • tear - Third or Fourth Degree Perineal Laceration
    • rupture_uterus - Ruptured Uterus
    • hysterectomy - Unplanned Hysterectomy
    • ICU - Admission to Intensive Care Unit
    • operation - Unplanned Operating Room Procedure Following Delivery
    • initial_cesarean - the birth was via cesarean and the mother had not had a previous cesarean
    • transfer_to_hospital - the mother did not give birth at home, though she intended to.\
  • I could not compare the number of still born babies between home births and intervention free hospital births because the fetal death records do not specify what interventions occurred.
Please let me know if you find any errors, mathematical or otherwise.  I hope this information is helpful and meaningful.  I spent an excessive amount of time producing this so pats on the back are appreciated. :)  Joining Kachingle is a great idea too!

Recommended reading and resources on natural childbirth:

Saturday, November 19, 2011

Why Pay For Something When It Is Free?

I started using a new service recently called Kachingle.  You pay $5 a month and it keeps track of websites you visits, and how many times you visit them, and then divides your $5 up the sites and gives the money to the author as a tip.

Why would I pay people for services they are offering for free?  The reciprocity on the internet is amazing and I love to participate in the free exchange of knowledge, but at the same time, money is what provides food on the table and a house to live in.   If people could earn a bit of money, maybe they would have more time to share even more?

I consume the content, so shouldn't I pay for it?  Allowing who-knows-who advertisers to pay for the content I'm consuming introduces conflicts of interest, and creates a convoluted economic system that doesn't sit well with me.  I'm a sucker, like most everyone, for a good deal, but at the same time people work really hard to write software, write articles, etc.  Shouldn't they get compensated for it, and shouldn't the beneficiaries of their work be the ones to compensate them?

I'm also against over-consumption and have been working hard to limit what I buy.  One way I do this is by avoiding advertising.  While advertising does have its usefulness, it also drives our entire buy more, over-consumptive economy.  Some bloggers are able to be very discretionary on what advertising goes on their site, but not everyone has the necessary traffic that allows them that privilege.

Micro-payments probably won't ever take hold, but it is an idea I like so I'm going to support it.


Wednesday, October 26, 2011

Weaning Off Epiliepsy Medications

It has been a year since I got the flu and had a few seizures.  The last year had been pretty crappy as far as how I was feeling.  My last update I had started taking Lyrica and Klonopin and was feeling better.  But better is all relative.  I still had waves of anxiety, was very moody, had lots of self-deprecating feelings, would sleep a ton if allowed, and had a headache about 75 percent of the time.  I tried switching to Lamictal but the headaches just got worse, so I stayed on Lyrica but took a teeny bit of Lamictal because it seemed to help curb the anxiety.  My dosages were so low though that the neurologist said he doubted they were doing anything and we should try going off the medications.  I tried weaning very very slowly, droping a dose every other day, but after a week the lower dosage cause me anxiety and made me twitchy, which freaked me out.  I went back to what I was taking.

Floyd wanted me to go off the meds, but I was very scared to, and when he said so, it would make me mad.  Like he wasn't validating my fears.  He said the meds were messing with me.  I agreed with him logically, but there was a huge disconnect between my emotions and my thoughts.  Finally after a huge emotional meltdown on my part, we talked, and he managed to convince me that all my problems were caused by the medications and if I would get off them I wouldn't be so crazy.

So I tried weaning again.  This time I decided I wouldn't try to go slowly, but I would do it relatively quickly and get it over with.  You can't wean completely cold turkey because weaning can cause rebound seizures.  I know you are supposed to consult with your doctor for a plan, but I didn't, because I wasn't in my right mind, and I didn't want him to sway me.  So I first stopped taking Lamictal.  I cut the pill in half for 5 days, and then stopped taking it all together.  A week later I decided to drop the Klonopin, because hypothetically I didn't need it, because supposedly my initial anxiety was caused by Keppra and now I shouldn't have any.  Though obviously this wasn't true because I still had some--which supposedly meant I developed an anxiety order from the seizure incident.  Anyways I took a quarter of the pill for five days and then stopped it.

I added tons of fish oil supplements as well as 750mg of magnesium supplements and B-complex vitamins to try to help with the anxiety that ensued.  I also was running a ton.  Thirty minutes into a run my head would start to clear and I kind of felt normal.  I also started taking a L-tryptophan supplement at night.  I have sleep walking/hallucination episodes that could possibly be partial seizures, or may just be a sleep disorder.  I'm not really sure, but they do seem to trigger the panic attacks I was having.  I took some tryptophan and that squelched the sleep walking.  I still had some insomnia due to stopping the Klonopin, but the tryptophan definitely helped.

Three days after stopping the Klonopin I dropped my morning dosage of Lyrica.  That first day I felt really, really, good. I was very happy and my mind was clear and it was amazing.  I felt totally vindicated that the medicines were making me crazy.  However the next day I was out with friends for dinner and my body got all tingly and my heart started racing and I didn't feel good at all.  I don't know if it was a panic attack, or what.  But it was definitely some weird withdrawal reaction.  I came home and took .25mg of Klonopin again (no tryptophan), but I kept with the weaning process of Lyrica and took only the evening dose for 3 days and then  stopped all Lyrica.  The next day I took .125mg of Klonopin and the next day no Klonopin, no nothing.  The next three days sucked.  I felt faint and jittery.  I had problems focusing.  I felt like I was going to jump out of my skin.  I was very twitchy.  I had muscle cramps, and my fingers would fall asleep and get weird cramps.  Running helped.  One night I couldn't handle it and I just went out and did sprints around the neighborhood and it definitely helped me calm down.

But every day my emotional health improved.   After the one day where I had felt so good I had started to doubt myself again.  I thought I imagined feeling good, and that it was just a coincidence, and that I really was crazy and it wouldn't matter if I got off the medications or not.  But then I started getting my mind back. And the disconnect between my emotions and my thinking disappeared.  I was crazy, but it wasn't my fault. It was the medicine, and I wasn't crazy anymore.

I also realized how much I was being affected.  For a year I often felt resentful towards Floyd and the girls.  I snapped and yelled at the kids almost daily.  It was hard for me because I felt like an awful mom and a bad wife, but that didn't fit my self-image.  But the way I acted and the way I felt didn't fit with my self-image either.  I WAS resentful and angry so therefore I must be a bad mom.  It was a vicious cycle.

It took about one week being med free to feel pretty normal, and two weeks to feel great.  A cold and a painful stye didn't help the process.  The twitching and muscle cramps have pretty much stopped.  I think they were mostly withdrawal symptoms.   I have had way more patience with the girls.  My feelings of resentment, anger, self-pity, and low self-esteem that have haunted me for the last year are gone. :)   I stopped taking the L-tryptophan at night about three weeks after and I have had two sleep-walking episodes since with one causing me a bit of anxiety/panic.  I'm hoping that it is still just a bit of withdrawal.  Eating right before I go to bed seems to help.  It's been 6 weeks and so far no seizures.  :)  I am praying that the incident a year ago was a fluke due to the flu, because there is no way I can handle being on medications for the rest of my life.

The one real bummer is that my headache has not gone away.  I've been trying to work out some possible causes including, my contact lens prescription was way too strong (I think pregnancy and nursing made my eyes wonky because my prescription went back to what it was before I had kids) and I started eating sugar again.  I had initially stopped because I was mistaking the anxiety as low blood-sugar, and then I kept on not eating it because ironically I thought it was making my headaches worse.   But I really do think sugar is detrimental to ones health, so I'd rather not eat it--but ice cream is so good, and I haven't had as much of a headache this last week.  I don't know.  I'm still experimenting.

Monday, October 24, 2011

Sweetie Pie

Allie is almost 2.5 and is as sweet as always.

- Her dad has taught her to tease me :( and she has mastered a mocking voice complete with eye rolling and will say things like, "Mom loves crows so much she just wants to marry them."
- Whenever she sees a bug, or an animal, or a character in a story that she thinks is sad she says, "Where's its mommy?"
- She enjoys running while I time her on my stopwatch.
- She is good at math.  Her and Selena were playing Curious George games on pbskids.com and they had four dog biscuits and were supposed to give each dog the same amount.  Selena had given one dog three and the other one, so I asked, "Hundley has 3 biscuits and the gray dog has 1, how many biscuits do you need to give each dog?"  and Allie immediately pipes up, "Two!"
- She always eats better when she sits in my lap and shares my plate.  We both enjoy eating stinky sandwiches together (canned salmon with mayo and Mrs. Dash).   Dad and Selena do not like them.
- She enjoys painting and coloring coloring sheets.  She always says, "I want to paint, and I won't make a mess."  Which unfortunately is usually not true.
- She keeps telling me she is going to be taller than Auntie when she grows up.
- She loves family hugs.
- She likes chasing her sister with a banana.  Selena can't stand the smell so of course she torments her.
- She's a bit literal and can get upset if you don't say something right.  She is always correcting me that shorts aren't pants.
- We were at the pumpkin patch and she had to go poop, but was having problems going, partially because it was a port-a-potty.  We tried two times but she couldn't go, and she says, "I squeezed my butt as hard as I could and nothing came out."  Then 10 minutes later in the car on our way home she says she has to go, and Floyd says, "You already went three times."  She pouts and yells, "It was only two."
- When she goes potty sometimes she'll drag you in to "watch" her, but then she doesn't like being watched so she takes the shower curtain and hides behind it.
- She always says, "Pre-ee peas." (Pretty please)

Tuesday, October 11, 2011

Selena as Galileo

Lots has been going on since the last time I posted.  Preschool has started.  She is going in the afternoons three days a week.  Going in the afternoons has been much better.  She likes it and seems to be more involved and aware of what is going on.  She is coaching Allie about manners and things.  She'll tell Allie, "At school we do it like this, so we should do it like that at home."  She doesn't remember many of the kids names, but hopefully that will come.

We also did a session of outdoor soccer through the Y.  Her Papa kept wanting her to sign up, but I told him I wouldn't sign her up till she was begging.  Well she started begging.  The team was co-ed 3 and 4 year-olds with a 45 minute practice and a 36 minute game for 6 weeks.  She was definitely into it, but did get pushed around some by the boys.  One practice she said, "Soccer sure is fun, except for the boys."  There were three girls on her team and they would frequently run off the field and sit and watch.  Selena seemed to want to play, but wanted to be with her friends more.  The first few practices and games she got pretty tired.  She said soccer was harder than it looked, but she would tell herself that she was tough and to keep going.  By the end of the season she didn't get tired and it was hard for her to come off the field, she was always on the verge of tears.  She scored a goal in the last game of the season.  She also had one game at goalie that I was very impressed with.  She knew where the goal box was and would come out of the box to block a kick, and use her hands inside the box.  There were other times when all the girls decided to sit in the goal, then they got distracted and didn't really stop anything. She was torn between signing up for indoor soccer or swimming, but she decided to do swimming lessons next.

We went to the Puyallup fair, as is our tradition, and she got to do Mutton Bustin after two years of waiting.  When she was two, she was too young.  Last year they said she was too small and pulled her off the sheep before it ran out the gate.  This year she got to do it.  She didn't stay on long, but she popped right up and ran out of the arena.  Her face was covered in dirt.  She said it wasn't what she expected because she expected to hold on longer.

She is still very much into dinosaurs and has seen almost every single Land Before Time movie and TV show.

Being a DIY'er has been backfiring on me.  Selena thinks that I should be able to make every single thing.  For instance she wanted to fly somewhere, and I said it was expensive, so she said we should build our own plane. Cute, until she starts throwing a tantrum because I won't.  So then she decides we should make a boat instead, a real one, that really floats.  And another tantrum.  She has grand plans for me to make her a long-neck costume for Halloween.  I don't know how that is going to work.

She definitely has a creative spirit.  She is constantly drawing, and making books, and cutting out cardboard to make things.  Often she recruits me to help her.  For instance I should color her picture because it is getting a bit boring for her.

Other anecdotes:
- I took her out kayaking to assuage her boat building desires.  She said it wasn't as exciting as it looked.  She also was very scared of the seaweed.
- One day we were driving to visit my brother and family and Selena tells Allie, "Allie did you know that the sun doesn't go around the Earth, the Earth goes around the sun."  Allie says, "No way."  Selena says, "Yes it does.  It really, really does."  Allie says, "You're kooky."  I have no idea where Allie came up with the word kooky, but I felt like they were recreating the debate between Galileo and the Church.





Wednesday, October 5, 2011

For-Sale-By-Owner Paperwork

This post is the fourth and final post in a four part series on how to sell your home without a real estate agent.

Once our house was listed we got our first call just a couple hours later.  Our lock box hadn’t arrived so we had to let the agent and their clients in and we walked to the park while he was showing the house.  Each time our house was shown the agent showing the house left their card.  I called each agent afterwards to find out what their clients thought and their overall impression.  It was during one of these phone calls that I found out that an offer was being made.  The agent simply faxed the offer to the mls4owners.com fax number that was listed.  The fax was supposed to be automatically forwarded via email to us, but mls4owners never received it (fax’s not going through was a frequent problem).  I had not yet purchased our fax machine so I had to go to Staples and have him fax it there while I was on the phone with him.



Once the offer was made we had to review it and decide to accept, counter-offer, or decline.  I forget the exact details, but the initial offer was about 5k less, they wanted us to pay closing costs (3 percent), and give them a $1500 carpet allowance.  We had already felt like we had priced our house low and didn’t really like the offer.  I forget if we officially countered or not, but eventually they offered our asking price and us to pay closing costs, they explained that there bank would give them no more.  We had listed our house two weeks before the federal tax credits for buying homes were just going to expire.  We said that we wanted to wait and see if we could get any other offers the next weekend.  



We went looking ourselves that weekend and found a house we liked so we accepted the offer.  The paperwork involved is called a purchase agreement.  The purchase agreement was what was faxed to us.  When we countered we simply crossed stuff out, and added our amendments and then initialed it and dated it and sent it back.  The entire timeline for closing is based on the dates you signed so dating the initials is important.   If we had received a buyer who did not have an agent mls4owners.com provided a copy of a purchase agreement and we would have provided it to the buyers, or possibly have sat down with them and negotiated the price in person and signed the agreement together.



Our agent we were using to buy a house was very concerned about us not having an agent.  She insisted that we get a copy of the letter that said the buyers of our house had pre-qualified for the loan.  Their agent gave us the copy but insisted that really the paper was meaningless.



Once a purchase agreement has been signed by both parties then there is a whole host of things that need to happen.  The buyer’s agent should be in charge of it all and tell you what they need from you.  The main item is a Seller’s Disclosure.  The agent representing our buyers never requested one and pretty much told us the paper was pointless and we didn’t need to fill it out (I wasn’t impressed with this guy), but if we didn’t give them one it would give them a potential way to back out of the agreement without forfeiting escrow money.  I ended up faxing it to their agent anyway.  When we bought our house the Seller’s Disclosure was returned with the signed purchase agreement.  Once again mls4owners provided this form.



The inspection (assuming this was part of your purchase agreement) is one of the first things that will be completed after the purchase agreement is signed.  I think it is customary for the agent to let the inspector in, and sometimes the buyer will come to the inspection as well (at least this is what happened on the house we were purchasing).  I ended up having to let the inspector into our house because once again the agent we were dealing with was kind of lame.  After the inspection is complete negotiation happens again depending on what the inspection found..  The only things our buyers asked was that our furnace be serviced, which is very common.  For the house we were buying we asked that the sellers clean the gutters, adjust the garage door opener safety settings, and fix a support beam in the attic that was not bolted together properly.  



Other things that have to be completed are: the buyers agent contacts a title and escrow company and starts things going including collecting the buyer’s earnest money, the buyer’s need to turn in all necessary paperwork for their loan, an appraisal will be ordered by the buyers, you need to provide the information about where the money for the sale is to go.  There is a lot of hurry up and waiting.  People demanding paperwork that they could have requested a week ago to be sent to them right away, etc.  It is prudent to get everything done as soon as possible, since most of the responsibilities are the buyers, calling the agent to check up on them is a good idea.  I had a hard time with this because I felt like I was telling him how to do his job, but unfortunately he was slow having his client turn in their loan paperwork and due to some freak FHA problem we ended up closing a day late so maybe if I had harassed him more we could have avoided that.  All of the things that need to be done and how many days you have to do them are described in the purchase agreement, so read it carefully.



Due to discrepancies about when we were actually closing we ended up agreeing on a different possession date than closing date.  When we signed the papers for closing we also paid the buyers for 3 days “rent” so we could stay in the house till we actually had some place to move our stuff.  The rent amount was simply their monthly mortgage amount divided by 30 times the three days we were renting.

Finally the last thing to do is to sign the closing papers.  The title company called and set up an appointment and we signed stacks and stacks of paper and then the house was no longer ours.

If you find these posts useful and wish to offer monetary reciprocation I would gladly accept paypal donations or amazon.com gift certificates.  Even just a dollar would be nice. ;)

Monday, October 3, 2011

How to Use a Self Service Realty Service

This is the third post in a four part series on how to sell your home without a real estate agent.


We decided to go with a flat-fee self-service real estate agency called mls4owners.com. The benefits of this were: we would be listed in the MLS where the vast majority of home buyers are looking for houses. Real estate agents would not be hesitant to show our house because we have clearly stated what their commission is in the MLS listing. And finally, by foregoing an agent we would save about $6000.


There were a few other companies with similar services, but I decided on this one because I liked their selling statistics section on their website and I could find their listings on all the other real-estate search engines I used.   Mls4owners provided us with a lockbox for our door, a professional sign for our house, listing in the Northwest MLS, and the legal forms we needed.   The lockbox came one day after the house was listed, our sign was installed (and uninstalled) for us very quickly.  



Filling out the forms was pretty easy.  Some forms were filled out online while others needed to be faxed.  I highly recommend purchasing a fax.  I went to a used computer store and got one for $20.  At first I kept on going to Staples, but they charge a $1 a page and some things are 10 – 20 pages and sometimes faxes don’t go through.  It was much easier having one at home.  



We were allowed to post 12 pictures.  I highly recommend posting the maximum number of pictures as I personally did not feel inclined to visit houses that did not have many pictures. For my camera I bought a fairly inexpensive wide-angle lens to take the pictures and then used Photoshop to touch them up a bit.  The key in taking pictures with the wide angle lens is to include as much of the room as possible in the picture, but not to distort the picture so much that the room looks a lot larger than it is.  Distorted pictures may upset potential buyers if they feel lied to by the advertisement.  There are different techniques you can use in Photoshop to make the pictures pop. Many agents use these techniques to emphasize and call attention to the listing, but I chose to forego that technique, and go for the most natural look, as I found it a bit distracting as a buyer looking at the unnatural pictures.



I also made a simple color flyer to put in the display box on the sign.  While the flyers were probably mostly taken by nosy neighbors I do think having a nice color flyer aids in the overall positive impression of the house.  


We had two young children and a dog at the time so it was hard for me to have the house in a presentable state at all times so I emailed mls4owners and explained that I wanted a note in the MLS listing that agents should call at least 2 hours ahead of time on weekdays before showing up.  On the weekends we stayed at my parents.  We only ended up having 2 people viewing on Friday so it worked out quite well.



The other item of note in the MLS listing is the agent fee.  You are allowed to list at a flat fee of $500 or more, or as a percentage.  The traditional percentage for a buyer’s agent is 3% so we went with that.  We did not want to risk having an agent try to talk their buyers into not buying our house because that agent wanted to collect a larger fee.  



I also listed our house on craigslist in the for-sale-by-owner section.  We were hoping that we could attract a buyer without an agent and split the savings of the agent fee with the buyer.  Unfortunately the only interest we got from craigslist were some “investment” people who initially posed as a family looking to buy but in the end revealed that they were looking to buy houses that were on the verge of foreclosure.  That whole situation was pretty annoying.  

If you find these posts useful and wish to offer monetary reciprocation I would gladly accept paypal donations or amazon.com gift certificates.  Even just a dollar would be nice. ;)

Sunday, October 2, 2011

How to Price Your House to Sell

This post is the second post in a four part series on how to sell your home without a real estate agent.


After making your house presentable enough to be shown, you need to price it appropriately.  The main complaint real estate agents seem to have about For-Sale By Owner is that the people who are selling their home do not have a realistic expectation of what their house can sell for.  It is important to pick the correct price because if you price too high then people might be reluctant to make an offer because what they are willing to pay is so far below what you are asking that they might feel like it is a waste of time. If you price too low, then obviously you might miss out on making the most money, and also possibly make people assume that the price is too good to be true and that there must be something wrong.

The first thing to do is research what homes have been selling for, and what homes are currently being listed at, and what direction the market is headed.  A few resources available are:

  • Zillow is a great source of information.  The site contains estimates of what current houses are worth, and shows you what homes have sold for recently.  While the information isn’t guaranteed to be 100% accurate, I found it to be accurate enough.  I found their z-estimate functionality to be the most helpful.
  • CMA (Current Market Activity) – This is a report that real estate agents have to aid their customers in pricing and purchasing.  The self-service real estate broker we used also provided us with this report.  While it was interesting, it seemed that the comparable houses that had sold near us were sold a few months prior, and the market was rapidly going down. It seemed that a price based solely on this analysis would be too high.  
  • Pretend you are a buyer.  The site that I found the most user friendly to look at houses was John L Scott.com.  They have a neighborhood function where you can select a neighborhood and it will show you all the houses for sale nearby.  Once our house was ready, and I had photographed it, I pretended I was a buyer and searched for houses in different price ranges in our neighborhood and I then compared the photographs in those listings with ours to see how I felt we compared.  

When we were picking a price it was difficult because there was lots of new construction in our area.  Those houses were bigger, but had no yards.  Our house had a yard, but was smaller.  The houses with more property were priced higher, but you could get a much larger house for significantly less.  We found a price range where our house looked very comparable to the other houses, and at 5k less ours looked noticeably better.  We decided to go with the 5k less because the market was poor, and we knew we were saving money by not having an agent thus we could afford to pass on that savings to the buyer.  

The drawback of the low price was that the people who did buy our house were looking above their price range and because the market was poor no one is going to offer full price. Thus the offer we received was well below what we were asking.  That is the one problem when researching prices is there is no information on what concessions the seller made to the buyer.  I have heard rumors that this information may become more available, but at then (and maybe now?) it was not, so it is hard to say what is fair, or not.  

As a side note when we were buying, the agent we were working with was not happy with the fact we were not using an agent to sell.  Her number one concern was that our house was not priced appropriately.  She briefly ran a CMA and from the results it seemed that we had priced our home too high, BUT she did not know the neighborhood or area we lived in.  The houses she was comparing ours to were not in our specific neighborhood, which was known to be nicer, and some were in a neighborhood that were right next to a garbage dump (which was not noted on the report).  Which demonstrates the fact that if you do work with an agent, it is important to find one who knows the specific area very well.


If you find these posts useful and wish to offer monetary reciprocation I would gladly accept paypal donations or amazon.com gift certificates.  Even just a dollar would be nice. ;)