Rest for the Weary and Hurray for Summer

The last 6 weeks have been pretty exhausting.  Not the sleep deprived kind of exhausting, but the kind where you're experiencing too many stressful things, and eventually your body starts to feel the exhaustion spilling over from your mind.  I put most of this on Facebook, but just as a recap, here were the things that happened this last month:

• Joshua's kindergarten transition meeting 
• Several check up appts, including pulmonology and craniofacial team.
• A weight check (following a weight check 3 months ago where he had lost weight and re-inserting the feeding tube was discussed if we couldn't get him to gain some weight)
• Inguinal hernia surgery
• 20 week ultrasound / anatomy check for new baby

The great news is that every single thing went as well as it possibly could have.  The school district agreed to give us all the supportive services that we feel Joshua needs.  We made it through 6 check up appointments without needing a single new test, surgery, med, or therapy (especially when seeing the craniofacial team, this is rare, but hopefully will be the new norm!).  At his weight check, he gained 3 pounds in 3 months and got back on track with his growth chart, despite still eating a very limited range of food - the doctor was very pleased and a little dumbfounded to see this kind of gain (me too, honestly, but I think he had just taken a dip and now his growth will level back to normal).  Surgery is always a hard day, but an outpatient surgery with no complications or infections and a quick and fairly painless recovery is as good as it gets.  And the anatomy scan showed all good news with new baby, including when they took a close look at the heart, jaw, and palate.  Lots and lots to be grateful for this month.

Thank you all for your support through these things.  I'm sure you get as tired of "liking" my incessant Facebook posts as I do of writing them over and over, but the encouragement that people offer (through Facebook, emails, and texts) really goes a long way towards getting me through hard days and weeks.

This month has provided several good chances to apply the memory verse I'm learning with my small group -- "This is my command - be strong and courageous.  Do not be afraid or discouraged, for the Lord your God is with you wherever you go."  (Joshua 1:9)  But now I am in need of a different kind of verse - “Come to me, all you who are weary and burdened, and I will give you rest. Take my yoke upon you and learn from me, for I am gentle and humble in heart, and you will find rest for your souls.  For my yoke is easy and my burden is light.”  (Matthew 11:28-30)

Luckily, it's looking good that the next stretch of weeks will be restful.  We don't have any appointments (other than OT) on the calendar for the next few months.  The warm months are the preferred season of our whole family, and I'm looking forward to having more time to go to parks, wade in the Truckee River, spend beach mornings at Lake Tahoe, and take our hyper puppy for walks.  The kids and I will visit Nebraska for the first couple weeks of July and spend time with my family, which is always a fun and restorative time.  Reno has lots of fun festivals in the summer, so hopefully we'll be able to hit a few of those events.

The other really exciting thing is that Kenny's book is released on July 20th.  I will blog more about this sometime soon, but if you would like to pre-order a copy, here's the link.

Happy first day of summer!

Two Kids or Three?

This post is about our decision to have a third child.  I wrote this because I know that many of you are around the same age as me (shout out to my fellow '81 babies!) and might be thinking about adding a child.  Also because people are really excited to urge you to have your first and second child, and much more ambivalent about a family size of 3 or more children - and whether it's good or bad, we generally think harder before making decisions that go (somewhat) against our cultural norm.

I hesitated to write this blog because I know this kind of topic can be loaded for many:  people who have struggled to have kids, people who have lost kids, people who aren't in the life circumstances to have more kids; and for people who have faced this same decision and decided differently, for whatever reason.  If this post is hurtful to you, I'm sorry.

So, with those caveats in place, here are the things we thought about in expanding our family by one more child:

First, what made us pause in thinking about adding a third:

• Special needs - thinking about whether we can handle Joshua's needs while also handling the needs of two siblings; and what if we have another kid with the same needs or other special needs (can I do a good job taking care of both?).  
• We love our family the way it is now--  
• We already have 2 kids - our kids each have a sibling, it doesn't feel like anything is "missing" from our family.
• Zoey and Josh are best friends and you never know how adding another family member will shake up the entire dynamic of the family.  
• Life is just starting to get easier.  Do we really want to go through the baby phase again?
• Many say that the transition from 2 kids to 3 kids is when things really get crazy.  
• Fewer kids = better ability to financially provide for each individual child, both now and in the future. 
• Getting back to my career -- I've enjoyed being a stay at home mom for this stretch of time, but I also love being a lawyer and would eventually like to get back to that.  

What made us ultimately decide to go for it:

• Our 2 kids bring us great joy - so it seems like one more kid would bring even more joy.  (This was our single biggest consideration.)
• As they get older, they get more fun.  I'm not really a baby person (though I do find my own and other people's babies extremely cute), but as they get into the toddler and the kid phase, it's more and more fun to interact with them and watch their personalities emerge (and also, it's really fun to get back to sleeping through the night).
• I'm under no illusion that things don't get exponentially busier with each added child, but there are many ways in which we're already set up for family life - we already have the family car and family house, already eat most meals at home, already keep a schedule and choose activities and vacations that work for the kids, already have a house overtaken by toys - so in those ways, another child will be joining the lifestyle that we already have.   
• I grew up in a family with four kids and absolutely dug it - for the kids, I think it's usually the case that the more siblings you have, the merrier.  And while there must have been some very challenging stages for my parents, they are also happy (i think? haha) with their decision to have a big family.  
• You're making the decision for the rest of your life - 20 years down the line, when it's way past time to decide to (biologically) add to the family, how many people do we want coming home for Christmas?  How much of a support network do we want the siblings to have with each other?  How many people do we want to be part of our family for the rest of our life?  I've never met an older adult who wishes they had less kids, but you do sometimes meet older adults who would appreciate having more kids.

First picture of Baby #3!

The considerations in the "pause" list are real (and for years, made us think that we were likely done having kids), but there is an answer to each of them, and the answers look like:  we'll figure out our new normal and if necessary get the help we need; we can re-arrange the budget as needed; and there are trade-offs with every life decision you make so you need to decide what your top priorities are.  The considerations in the "go for it" list seemed like the things that in the long-term are what will matter to us the most.  And in the end, it comes down to a feeling more than a pros and cons list.

I'm looking forward to meeting Baby #3, and in the meantime, I'm enjoying my sleep!

High Risk Prenatal Care

This post talks about our odds of having another baby with a chromosome disorder and the process of high risk prenatal care.

So what are the odds that we will have another baby with 4Q deletion syndrome?  Our risk of having another baby with Joshua's same deletion is unknown (kind of) - Kenny and I have not been genetically tested, so we don't know if Joshua's disorder was inherited.  If one of us carries the same deletion, then our likelihood of passing it on with every child is 50%.  If the disorder was new with Joshua, then the chances of new baby having the deletion are the same as anyone else - so 1 in 100,000 of having a deletion on the 4th chromosome (and to get Joshua's exact deletion, probably more like 1 in 100,000,000+).  But we also have good reason to believe that the deletion was a new genetic variant in Joshua and not inherited - this is true for 86% of people with his deletion, and we have no family history on either side of the type of medical or developmental issues you typically see with a 4Q deletion.  So it's much more likely than not that the deletion was new in Joshua rather than inherited from us, and if that's true, then our other children are not at an elevated risk to have this extremely rare chromosome condition.

Now, the prenatal care -- because I am "advanced maternal age" (but still occasionally get carded when buying alcohol, so don't cry for me Argentina) and have a history of baby with chromosome disorder, my pregnancy is considered high risk.  (Thankfully, my health through pregnancy and L&D has historically been low risk and healthy, and all signs point to this pregnancy going the same way.)  When you have risk factors, you see a doctor called a maternal fetal specialist in addition to your regular OB-Gyn.  In the first trimester, the specialist talks to you about your odds of various disorders (and gives lots and lots of details about what those disorders entail) and then they offer a wide range of testing.  It's amazing where genetic testing is at these days.  If we chose to do an amniocentesis, they could do a full micro-array on a 12 week old fetus.  Even with non-invasive blood testing of the mother, they can gather a lot of information about the fetus's DNA based on the how it's interacting with the mother's DNA.

Putting aside the technology-is-amazing aspect, the testing conversation is a difficult one for me because I understand the doctor's urge for early testing is partly because they want to give you time to "exercise options" if you do have a baby with a chromosome disorder (not that all, or even most, people are thinking that way when they choose to do testing - I know planning ahead can be extremely useful).  (Also, I don't want to start an abortion debate in the comments section - I'm just expressing my feelings about my personal situation.)  When you've already got a living, breathing child with a chromosome disorder, it's hard not to then take the implication a step further and wonder what they would have advised if they saw in my first pregnancy that I was carrying a child with a fairly large deletion and a series of birth defects.  And how this focus on the defects ignores everything else that the child will turn out to be, and the joy that he will bring to his family and the world.  And it makes me feel angry and sad at the devaluing of what I know, from firsthand experience, is a beautiful, wonderful life.  So that's the first trimester.

In the second and third trimesters, they do several ultrasounds with their high tech machines (i believe the ultrasounds are 4D?) and watch for specific problems where the baby has the highest risk.  For 4Q deletion syndrome, they will be watching mainly for heart problems and craniofacial problems.  This is helpful - exactly the kind of information that I want to have from the experts who are in the best position to gather it.  But this is also terrifying - instead of enjoying the moment where you get first glimpses at your new baby, you're holding your breath, hoping they're not about to announce a defect in an organ system that will mean major surgery or incompatibility with life.

Also, what we found in my pregnancy with Zoey is that, if you're looking for a problem, you're much more likely to spot one.  With that pregnancy, the doctors were looking for a recessed jaw, and they went back and forth in 6 different ultrasounds on whether she had a recessed jaw or not (with some dabbling in low birth weight and low amniotic fluid - nothing major, but while we're looking for problems....).  It turned out that she was born perfectly healthy, but we were nervous wrecks for the last half of the pregnancy and the best that the doctor could tell us was "maybe there's a problem, maybe not".  Nevertheless, it was good to know that doctor was watching and ready, should a problem arise.

That's the process for prenatal care if there is a possibility that the baby is high risk, but otherwise the pregnancy is low risk.  I would be interested to hear other's experiences with maternal fetal specialists, especially in the case where the main thing they're watching is the health of the baby.  We are hitting the 20 week mark and the first set of ultrasounds this month, so would appreciate prayers for 1) a healthy baby and 2) peace throughout the process.

The Education Post

Josh starts kindergarten next year!  And I am a basketcase!  It's funny, because in some ways it will be much less of a transition for him than for most kids entering kindergarten - he's already had 3 full years of preschool on a half day kindergarten schedule in a public elementary school, so it will feel like more of the same as he walks into his school building next fall.  I also don't think I'll have the feelings of "how can it already be time?" because I got to work through those feelings back when he was 3.  (And let me tell you how scary it is to have your 3 year old, dwarfed by his backpack, can't verbalize what's going on in the classroom, amble down the hall for his first day of school as 11 year old 5th graders race by in the same building.)

But nevertheless this is a huge transition for him, because this is the year he moves from a special ed classroom to a mainstream classroom.  In the special ed classroom, the teachers have special ed training, activities are usually designed with accomodations for developmental delay already built in, help for "life skills" things like feeding and bathroom breaks is readily available, the student teacher ratio is in the single digits, and there are therapists and one-on-ones and nurses frequently in and out of the classroom as well.  In the mainstream classroom, all these "extras" will not be provided except as we negotiate with the school.

There are potentially lots of positives about moving Josh into mainstream: he will see the role modeling and hopefully form friendships with developmentally typical peers, and he will be asked to do more challenging activities and more independent acting during the school day.  These things can really cause growth.  It will also help us to see if there are areas where we have been underestimating what he is capable of, and if so, let him show his stuff.

At the same time, we want to provide him with enough support as he makes this transition that we are setting him up for success.  The number one thing I'm worried about with this change is the huge leap in student teacher ratio.  His current class has one adult for every 6 kids, and next year's class will have one teacher for 30+ students.  He still needs a little extra help with almost everything and it would be tremendously helpful to have another adult or two in the classroom.   The school will "wrap around" with supportive services - speech therapy (40 min/wk), occupational therapy (90 min/wk), resource (individual academic help)(90 min/wk), and accomodations for feeding and bathroom - but these things still leave most hours of most days where he will be going it alone.  The school's solution to this issue is to place him in the same class with another student who has a one-on-one aide, and  this aide can also informally keep an eye on Joshua as he needs help throughout the day.  This might work great, or it might not work well at all, but hopefully we will know within the first few weeks whether this is a sustainable set-up.

We will have his annual IEP meeting a few weeks into the school year, and that will be my chance to hear how things are going, request additional accomodations if needed (and pull out the lawyer card if the school isn't cooperating), think about a different classroom if really needed, etc.  There's another class in the district that does have many of the special ed supports listed above, and Josh would be eligible for it, but we would rather keep him at his current school, where he is thriving, and let him get to know the classmates he will spend elementary school with, rather than sending him out of zone for one year and thing bring him back a year later as a stranger to the other kids.

(I have to say, as we wade through all these options of classrooms and accomodations and services, that I am SO grateful that we are living in the United States in 2016.  I know that kids with special needs in other parts of the world do not have these kinds of options to make their education work well, and I know that parents of kids with special needs of previous generations had to fight tooth and nail for things that are now just a laundry list of options for my child.  I'm very thankful that we have so many resources in our public education system.)

We would really appreciate prayers for this whole transition:

• That between the teacher and special ed case manager and me, that we figure out the right level of accomodations so that Josh is appropriately supported, and that we can work well as a team as the school year goes on.  
• That his class has nice kids, and that he makes good friends. 
• That this informally shared one-on-one aide situation works great rather than being a total disaster.  
• That his adjustment is smooth and the new classroom is a really positive thing for Josh.  
• And finally, for the IEP meeting on Friday, where we put all these details on paper!

---------------------

Zoey turns 4 this summer, so we have also started thinking about school for her.  She will likely start kindergarten in the fall of 2017 (though with an August birthday, we have some flexibility to hold her back a year if we need to, but at this point there would be no reason to do that), so this coming year is the natural year to think about preschool.

In some ways, it's been a lot lower pressure thinking about her early childhood education, because it feels like she will probably be fine no matter what route we choose.  On the other hand, it can feel a little overwhelming choosing from the wide range of preschools out there. (Waldorf?  Montessori?  Play based or academic focused?  Christian or secular?  Homeschool?  Unschool?  etc. etc. etc.)

We toured a few preschools and did a little research, and in the end our decision was to keep her home with me for one more year.  The reasons are:  #1) she loves and prefers being at home and #2) I think the early years should mostly be about building up feelings of emotional security / love, working on moral character / manners, lots of time for free play / exploration / hands on experiences, and lots of time outside.  There are preschools that do an excellent job of all this, but they have huge wait lists and huge price tags, and meanwhile, i'm going to be stay at home next year anyway.  This means I'm really going to need to step up my arts and crafts game!  We also got some workbooks and I'm hoping to teach her the basics of writing letters, using scissors, reading readiness, etc.

It's a little funny to send our first child to three years of max schedule preschool and keep our second child at home until kindergarten, but I think it suits each of their needs and personalities best.  If anybody has tips on either of these situations, please let me know!

36 Hours in New York

This weekend, Kenny and I took a trip to New York City to celebrate our upcoming 10 year wedding anniversary.  It was a whirlwind:  we flew out of Reno at midnight on Friday, had about 36 hours in the city, and then flew back and landed in Reno around midnight on Sunday.  Thanks to Kenny's mom for watching the kids all weekend, and thanks to Jet Blue for providing a travel schedule and rates that made it possible to do this trip in the span of 2 days!

This was our first weekend away together since the kids have been born, so it was really great to get time together as a couple.  And, I love my kids as much as I love anything in this world, but it was ah-MAZ-ing to fly, sightsee, have conversations (and/or enjoy silence) with just the two of us.  Very refreshing and rejuvenating.  (But also lovely to be back with my kiddos come Monday morning.)

The Northeast has a special place in my heart because I went to college in Rhode Island - so while I'm not from there and I don't expect to live there ever again, some of my very favorite years and best memories were spent in the Northeast, including a few weekend trips with college friends riding the Peter Pan bus from downtown Providence into Port Authority.  It was fun to get to make the trip again with my hubs.

Without further ado, here's a mostly-pictures-but-also-a-few-words summary of what we did:

Lots of sightseeing!

We stayed at a hotel in Midtown Manhattan, near the Empire State building, and this turned out to be a great place to wander around on foot and see LOTS of iconic New York buildings (many of these pictures are taken from the Internet and not by me):

St. Patrick's Cathedral

New York Public Library (who you gonna call?  Ghostbusters!)

Rockefeller Center, home of NBC studios and the famous huge Christmas tree

Grand Central Station

Empire State building at night (this one taken by me, that's why the picture quality dropped off!)

We also saw the Chrysler Building, Madison Square Garden, Radio City Music Hall, Saks 5th Avenue, and ate pizza in the Village.  It was really cool to see so many famous sights just by wandering around, exploring.

Tasting menu at Grammercy Tavern

We planned one really fancy meal for our time in the city, and that was the tasting menu at Gramercy Tavern.  Here's the menu, for any foodies who are interested (we did the seasonal tasting menu).  The highlight was the dessert, which was a strawberries and cream whipped cheesecake that was unforgettable.

Going to a show on Broadway / Times Square after dark

We saw a play called The Humans on Broadway, and this was both of our favorite part of the whole trip.  The writing, acting, and atmosphere was all excellent.  It was also fun just to walk around the theater district before and after the play and take in that atmosphere.  

Right next to the Broadway shows is Times Square, which is something to see once, but once is enough.  It is crowded and over-stimulating and not as lovely as everything else we saw in Manhattan.  But we did get Josh a framed picture of the Brooklyn Bridge for $5 from a street vendor that has so far made his entire day, so there's that.

Touring the Metropolitan Museum of Art

"Autumn Landscape" by Agnes Northrop

This museum is HUGE.  We probably should have gone in with more of a game plan.  We saw a smattering of European rennaissance art, a bit of the fashion and technology exhibit, and some American sculptures.  There was way, way too much to see and appreciate in one day, but we got a good taste of the exhibits that were most interesting to us.

Strolling through Central Park

We were lucky to have lovely weather on Sunday, so we walked several blocks through Central Park on our way from the Met to the subway that took us to the Village.  By this point on Sunday afternoon, this out of shape and expecting mama's legs were pretty worn out, so we also enjoyed several of Central Park's benches.

It's impossible to see everything that New York has to offer in 2 days, but we had a really fun time and flew home with tired feet and good memories, so I call that a successful weekend.  I'm so grateful to Kenny's mom for watching the kids and so grateful we had the opportunity to make a special trip to celebrate our 10 year milestone!

Blog-a-versary

This week I'm celebrating the 3 year anniversary of my blog!  My hope in the beginning was to make it through a full year without running out of ideas and quitting early, or without dying of embarrassment (due to no readers / mortification over the content I produced / unpleasant exchanges with readers).  I'm happy to say that I'm still alive and kicking!

Since starting this blog, I've talked to several people who have thought about starting their own blog, and almost always they are great writers and would be a welcome addition to the blogosphere - if you are one of those people who thinks about starting a blog, this post goes out to you. I'm going to discuss some of the things I've enjoyed about writing a blog, some of the things I was worried about (and whether they came to pass), and tips for those who are thinking about starting their own blog.  I'm also going to do a brief Erin's Blog in review, because it wouldn't be a blogaversary without some celebration of old posts!

What I get out of writing a blog and why you should do it too:

• Creative outlet - Most of my time these days is spent meeting the needs of my kids (martyr alert!).  So it's been really restorative for me to work on a project that is my own thing, done solely because I want to.  Also, it's been really helpful to have this space dedicated to working on my thinking and writing.  Not that this blog is some deep, literary endeavor, but you'd be surprised how much even the light and silly posts cause you to think creatively and try to craft your prose well.
• Risk is good for us - I will discuss what I perceived the risks to be below, but suffice it to say
  
  that I initially perceived blogging as terrifying.  Eleanor Roosevelt said that you should do one thing each day that scares you.  So every time I write out my thoughts and feelings, and then publish them, and then advertise that I published them by putting a link on social media -- I'm building up my capacity to be brave. 
• Chance to discuss things more in depth - I think there used to be (and maybe still is?) the perception that you have to be pretty narcissistic to write a blog.  Why would the world care to read as you spout your thoughts about every random thing?  I think the fact that we're living in the age of reality TV and social media turns the role of blogs upside down.  Maybe it used to be the case that blogs were the lightest, most navel gazing form of communication.  But now I think they're a chance to delve deeper into a topic than the ways we primarily communicate (text, email, status update).  I can write a one sentence Facebook update about Joshua's health or I can type out several paragraphs in my blog.  I can post a meme about a current event, or I can write in a much more nuanced way in a blog post.  Blogs are a chance to expand, and if things go really well, to elevate, the conversation.  

Things I worried about when I first started the blog and how they turned out:

• No one will read it:  Mostly this doesn't happen, but every once in awhile it (pretty much) does - and it's okay.  You just move on to the next post, and usually it turns out the readers will come back.  After you've done a bunch of posts, you start to get a sense of what is really going to bring out the readers (Joshua health updates are my most popular) and what is likely going to bomb (book reviews), and you can mentally prepare accordingly.  
• I have nothing to say / it will be dumb:  You can handle having nothing to say two ways - 1) only write when you feel the inspiration (the big problem with this is if you go through a long dry spell, your blog dies), or 2)  prepare for the times when you feel less inspired by frequently thinking about ideas for blog posts and writing down ideas for the future.  After a few months of getting out everything you always wanted to say, coming up with ideas is the hardest part of regular blogging, so having a list of ideas helps you in the weeks when your inspiration well is coming up dry.  As far as the content being dumb, some of your blog posts will be stronger than others, but if you are the type of person to do a blog, your writing is probably on point and your posts won't be dumb.  
• Readers will be mean and trample upon my sensitive feelings:  This has literally never happened, and I do indeed have sensitive feelings about my writing.  I've had readers disagree with me many times, sometimes strongly, but they have always been kind and respectful.  It helps when your blog readership stays within your circle of friends and aquaintances, so even though people are commenting over the Internet, they also know you in real life and don't get the same mob mentality that it's okay to say mean things and make personal attacks.
• I don't want people to read my writing:  Now I like it!  I've gone from being prideful one way (afraid of having people read my writing and tell me it's no good when I think it is good) to prideful another way (feeling much more confident in my writing and wanting a bunch of people to read it).  
• I don't want to unintentionally hurt / offend my friends and family: -- This is the hardest part of blogging for me.  I don't worry about this so much with opinion posts, but more in personal / family posts.  You never know who exactly is reading your blog, and I like to try to be sensitive to my audience.  When discussing parenting, for example, I would prefer to tailor my topic and tone differently for people who are childless (maybe by choice, maybe not), another for fellow parents, another for fellow special needs parents, maybe yet another for parents who have lost a child.  You can't do this with a blog, so you do your best to be sensitive to whoever might come along, and you plow ahead.  I don't usually write about tremendously controversial or hurtful things, but you never know where people's tender spots are.  

Tips for getting started:

• Post at least once per week for the first several months.  This will get you in the habit of 1) making time to blog, 2) looking for ideas all the time.  It will also eventually lead you to write some posts that are winners and some that are losers, and you will be able to get past both of those experiences and write without primarily thinking about how your blog is going to be received.  After you've gotten in the habit of regularly thinking of ideas and writing, you can shift to a pace that works best for you.  I wrote once a week for the first 6 months, and I now try to write at least once a month, which feels much more sustainable - but if I wrote less than this, it would be easy to just forget to blog altogether.  
• Consider limiting your universe of topics.  I don't formally do this, but I have a limited range of things I like to write about (parenting / special needs parenting, faith, book reviews, opinion pieces, and very occasionally other stuff).  Sometimes having an unlimited choice of things to write about feels so overwhelming that you can't narrow it down to any one thing.  If you decide to dedicated your blog to a specific topic, like trying Pinterest projects, or analyzing current events, or updates on your child's first couple years - you can cut way down on time spent thinking of ideas and get right down to writing.  
• Post a link to your blog on Facebook / Twitter.  Blogs are a lot more fun when they are interactive, and people are much more likely to read your blog if you post it on Facebook.  Some people will stumble upon it other ways - RSS feed, cruising the blogosphere, regularly checking for updates - but you will get more readers, and more comments to respond to, if you put a link on social media.  

Erin's Blog:  3 Years in Review
Top 5 most read blogs:
1.  New diagnosis:  4q deletion syndrome
2.   Joshua age 5 Health Update
3.  Moving Back to the Biggest Little City and Virginia Beach Love
4.  G-Button Out!
5.  On Having a Special Needs Kid v. Medically Typical Kid

Top 5 blogs that generated the most back and forth with readers:
1.  My Thoughts on "Daring Greatly"
2.  Political Rant on Why We Shouldn't put type-of-food limits on Food Stamps  (this was a blog post that made me re-think the issue -- my heart still agrees with the argument I made, but my head knows I'm probably wrong, as I had many thoughtful friends on both sides of the political spectrum unanimously disagree with me)
3.  Ban Bossy?
4.  Raising Boys v. Girls:  The Toddler Edition
5.  Top 10 Reasons I love (but also sometimes hate) Facebook

My 5 personal favorites:
1.  An Advent Reflection
2.  On Being a Stay at Home mom with a Law Degree
3.  My Second Annual Thankfulness Post
4.  On Having a Special Needs Kid v. Medically Typical Kid
5.  On Half Marathoning:  to run or not to run

Thanks for reading!  Looking forward to writing many more posts, and hoping that a few of you will read this and decide to join the blogger train!

Books Worth Reading -- Dreamland: the true tale of America's opiate epidemic

In the three years I've been writing my blog, I've written a dozen book review blog posts, and they are always by far the least popular and least read posts of the year (unless I name drop Brene Brown in the Facebook tagline).  Nevertheless, I'm going to continue to write them for 2 reasons: 1)  Writing a book review is a fun way for me to think more carefully about a good book I just read (yes I did say "fun" - I'm awesome at parties), and 2)  I think good books deserve to be shouted from the rooftops, and no matter how tiny my contribution might be to that cause, I'm hoping that occasionally people will stumble across these blog posts and decide to read the books.  Today's book is "Dreamland:  The True Tale of America's Opiate Epidemic".

Summary of the book: 
This book, written by an investigative journalist, explores why heroin has made such a big comeback and hit new communities (especially predominantly white, mid-sized) so hard in the last 20 years.  The author explains that it was the convergence of these 3 factors:

1. A new kind of heroin dealer network: 
    - Dealers sold a newly developed type of heroin from Mexico that was much cheaper and more potent than heroin had ever been before.
    - Instead of operating out of a centralized house or neighborhood and threatening violence to people who opposed their territory, these dealers operated a non-violent, customer service based model - they would drive the drugs to you, pizza delivery style, and they wouldn't carry weapons.  This made the actual purchasing of drugs seem more accessible to a wider range of people.
    - They knew how to beat the police system (only carry a small amount of drugs, have a decentralized franchise system where no one has too much power anywhere up or down the chain, don't carry weapons - then busts aren't worth police time and energy).
    - They sought out communities where Oxycontin use was already big.

2. The "pain revolution" in the medical community -
            -In the last few decades, a new belief gained popularity in the medical community that doctors should be aggressively treating pain with narcotics,
            - This combined with the erroneous belief that Oxycontin is non-addictive for the vast majority of people, so doctors prescribed it freely.
            - The discovery that there was a huge profit to be made on Oxy, both in a "legal" way (pill mills where doctors would accept cash only and write prescriptions for hundreds of patients a day) and on the black market.

3. The close relationship between Oxy and heroin, which are both morphine-based.  Many people first started using morphine-based drugs through a pain pill prescription.  Through this, they developed an addiction.  When they could no longer get a prescription, and if Oxy got too expensive or too difficult to find, heroin was a good alternative for prescription pill addicts.  (They both satisfy the same addiction.)

These factors combined to bring heroin to mid-sized communities that had never had serious trouble with heroin abuse before, and it made black tar heroin overdoses a public health epidemic in these communities.

The most important thing I got from this book:

• I am still blown away by how much difference marketing and context can make.  I had no idea that heroin was so closely related to Oxycontin, a drug which Joshua has taken at least half a dozen times (as a baby!) while in the hospital for surgery.  I would make the same decisions for him because you need heavy duty pain relief after major surgery, but it's just interesting how something can seem so clearly good in one context (doctor prescribed in a medical facility for pain relief) and so clearly bad in another (bought illegally by a dealer in the street for an addiction), even though it's essentially the same drug.  
• I'm sure medical associations are way ahead of me on this observation, but certainly doctors are now thinking about the major risks before writing a script for narcotics that might eventually lead to a heroin addiction.  (And we as patients should also be weighing that risk before filling a script that might become addictive.)
• I've written before about mass incarceration and drug laws - it will be interesting to see the political implications as heroin and pain pill addicts are increasingly white, middle and upper class, and suburban / rural.  I think it would be great to see drug laws shift towards a more treatment focused approach for non-violent addicts, regardless of the racial composition of users.  
• It's interesting to think about what new strategies law enforcement can use as dealers are figuring out ways to decentralize their operation so nobody can get big-time busted.  

Two things I didn't like about this book:

• Repetitive:  this book was originally a series of articles, which the author eventually strung together as chapters and turned into a book.  Consequently, there were pieces of background information that must have been repeated at least 20-30 times - a more stringent edit could have cut down on the length substantially, but it's also easy enough to skim past repeat information.  
• Demonization of certain programs - this book criticizes Walmart and Medicaid for enabling users by providing broke addicts the financial means to score drugs.  And while each of these beheamoths certainly has its share of legit problems, I think it's really unfair to criticize an institution when it's actually individuals using the system illegally who are the problem.  In the case of Walmart, it was people stealing goods and then returning them easily, thanks to Walmart's liberal return policy, then using that money to buy drugs.  In the case of Medicaid, it was doctors helping people get qualified as disabled so that they could be Medicaid recipients, then prescribing drugs that Medicaid would pay for, and sometimes those drugs were then illegally dealt to others.  If doctors are wrongly helping people qualify for disability, or wrongly writing scripts, or if individuals are fradulently seeking these things out, or illegally selling their meds - none of these things are the fault of the insurance company.  

Other than those two things, I would recommend this book.  It's educational, it's got a true crime vibe (you get to see the inner workings of a drug ring!), and it's relevant to some of our major domestic issues (mass incarceration reform, the pain pill epidemic, the "war on drugs").