Summer Swimming Schedule

With the scholastic school year ending and daylight hours being longer I look forward to a change in routine. Even though we are homeschooling, we get a break from some paced and attendance-based activities. I was going to enroll William in a FLVS course though summer, but the pace of his lessons kept me from my own exam studying. Hebrew school is a 2-3 week attendance. Most parents love dropping their kids off for a few hours, but I tend to find everything has a little give and take. The Hebrew School for the first time this summer has parents co-ordinating some summer youth group activities. I am so relieved to be able to have a break from mandoatory attendance. No Hebrew School, no FLVS, what do I do?

I love being in the pool. We have a big pool in the neighborhood. I head out to the pool early (like at 8) to beat the sun and crowd at least 4 days a week (W, TH, S, S). I am not a very good swimmer, but for an hour I have been treading, doggy paddling it, or just walking back a forth (Scott calls it "walking with the elders"). Generally I like evening swimming, but with all the rain in the afternoon, I would miss my chance. I've made it out cycling on a few good evenings. I've been consistent and for the past 2 months, I feel like I have gotten the proper amount of exercise! It's the first time I can say that in a long time (like before William was born). Since the boys can go with me, it's something I can do with them rather than it be something that takes me away from them.

Lucky for them, I do take them to karate an extra third night during the summer and William continues with his drum lessons. Outside of office hours and, I am studying a lot and put my other projects on hold until I get past the exam.

Who's Eating the Produce?

I've been wanting to keep tabs on what I do with all my produce from our co-op. I also want to be more aware if my kids are eating significant amounts and how long it lasts us. This is a list of what I got in my share today and I am going to update this post as I use up things.

broccoli - some raw in salad for me and J on Sun. Rest being used in cream of broccoli soup.
red cabbage - 1/2 head went into the juicer. Me, J, & S tried it. Tasted like raw cabbage, (big
surprise!). The other 1/2 is marinating in vinegar and oil to become a sugar-free cole slaw. My house reeks of cabbage. I wonder if I'll be able to eat it after smelling it. (William took a sip of juice and vomitted bile. If I was 11, I probably would have vomitted too.)
carrots used 2 in the slaw. Sunday salad
celery - Sunday- boys and john put some Peanut butter on celery. D liked the PB off, the rest ate at least one 3 inch stick. I put raw almond butter on my celery.
cucumber - salad on Friday and Monday, all used
garlic - I have 4 whole bulbs of garlic( 2 from last share). I wrote to Jane today and told her once amonth on the garlic would be more than enough.
spinach - one bunch lightly suteed in coconut oil for me and John. sauteed on Monday in avacoado oil, a few leaves were put into a smoothie, all used up.
rosemary - I have rosemary growing in my garden. I never knew what to do with it. I looked it up in World's Healthiest food for ideas. Historically, the ancient greeks wore it behind their ear to help their memory. I am going to wear mine since I am studying for this test. I won't run out because my plant is big. John is sleeping and I stuck a twig behind his ear. (Don't push any buttons and wake him.)
green leaf lettuce -salad sunday
cremini mushrooms - Saturday all went into the beef (turkey substitute) strogonoff that everyone eats but me
yukon gold potatoes - a few potato fries on Sat.
flame seedless grapes - David ate most on the way home. I am going to freeze the rest and add a few to smoothies and fresh juice to as a sweetener.
yellow peaches Peaches and pluots gone by Saturday night by me and w & S.
rosa pluots
bananas - 2 used in a banana, canned pineapple (had), and orange smoothie at Scott's request. S & W had a glassful. Saving the rest for tomorrow.

raspberries - some snacked on by me, W, S, rest frozen, all used on Monday in smoothie
gold kiwis - snacking on by me and boys, all used by Sunday
honeydew melon -1/2 eaten Friday morning, finished last one on Monday
17 oranges - we still have a few left, all the boys love these. gone by Saturday. John ate a few.

Sunday- some broth with rosemary, carrots, onions, garlic, parsley, celery. It didn't taste good. It was bitter like rosemary. I won't be putting rosemary in broth anymore.
I still have plenty of veggies, but I like this list it's helping me keep up what I have. I might have to do this each share!

Wednesday- I made No-fuss potato soup and sunflower sour cream. Tomorrow I am making broccoli soup. That will take care of all my vegetables and fruit except for the garlic. I gave a bulb of garlic away today and I still have 2 1/2 bulbs. I am using the garlic nearly everday.

I went to Nelson's today and stocked up on more berries and veggies. Next week I want to do the same thing with the organic produce share and list out what we get and what I do with it and who eats it.

Organic Buying Club for more info.

Explain to me about Husbands

Two things (right now) I am trying to understand:

1. Dear husband does not bring his cups and dishes to the sink (he thinks the angel is coming to get them). He is eating more nuts now, so I told him TO LEAVE HIS DISH with the shell and I would collect & dumps the shells into the compost.

--Next thing I know the shells are in the garbage and the dish is in the sink. I am trying to figure out what made him clean up after himself. Because I wanted the shells??


2. The other thing. His beeper goes off constantly at night, especially with hospital calls. When you here a noise that much, the noise disappears in the background and it doesn't wake you up as much. Clarification--it doesn't wake him up. I am awake. He also falls asleep to the TV on.

So... the beeper is ringing and ringing... the TV is on... its 3am... he is snoring away. I get up and quietly turn the TV off by pressing the little button. He startles out of his recliner because the little sound of the "button" woke him. You would have thought their was an earthquake. Go figure.

Tongue-tie in the Newborn

I wrote an article about my background experiences with tongue-tie, a minor condition which can be an impediment to successful breastfeeding. I've also included a version of this article as a chapter in Permission to Mother.

As the community is becoming more educated on tongue-tie and the impact on breastfeeding, I get calls from furthur away with seemingly more complex issues.

"Before, I drive 3 hours to see you with the baby are you sure you can treat the tongue-tie in your office? The ENT (or Pediatrician) said my the procedure could only be done under general anesthesia in the OR. He said he could not do a posterior tongue-tie in the office."

Usually with a motivated mother, in the abscence of co-existing conditions, a simple release of a tight frenulum in the office makes all the difference in the world as far as breastfeeding goes.

Satisfaction rate is high, but a loyal reader can imagine that I can't guarantee 100%satisfaction when I haven't seen the problem. The biggest problem is not the "condition," but is the societal belief system that these problems can't be treated easily.

In addition, I don't classify tongue-tie as anterior or posterior. I don't use the other common classification of third degree or fourth degree.

I am not sure who uses that terminology--ENT's and PEDS or ACEDEMICS? Just to make the breastfeeding issues sound more complex and confusing and discouraging? I have also seen these terms accepted and discussed on the Academy of Breastfeeding Medicine's physicians professional group and on holistic mothering community boards, but clinically in real life, classification of severity is not important is not relevant. At least not to me.

The way I look at it is, if it interferes with breastfeeding, I cut it. Pretty simple. I decide the severity on how damaged the mothers nipples look or babies difficulty in gaining weight, labeling and classification on physical characteristics of the tongue-tie doesn't mean much (except to build more maternal fear). It's a simple office procedure. After I snip the frenulum a complete assessment of breastfeeding can be done by me to optimize latch and I can also treat the mother's saw nipples and follow through through resolved. Period.

Inspired by Katie

Inspired by Katie.

Not Joining the AMA

Four months ago ACOG came out with a statement condoning homebirths and I posted my response to it. All this was thought to do with the amazing public response to Rikki Lake's documentrary on homebirth.

Now the AMA (American Medical Association tries to outlaw homebirth and back-up the ACOG statement and outlaw homebirth! Kathy has taken time to search and post the complete original document. Here is an excerpt:

"That our American Medical Association support the recent American College of Obstetricians and Gynecologists (ACOG) statement that “the safest setting for labor, delivery, and the immediate post-partum(sic) period is in the hospital, or a birthing center within a hospital complex, that meets standards jointly outlined by the American Academy of Pediatrics (AAP) and ACOG, or in a freestanding birthing center that meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers” # (New HOD Policy);

and be it further RESOLVED, That our AMA develop model legislation in support of the concept that the safest setting for labor, delivery, and the immediate post-partum(sic) period is in the hospital, or a birthing center within a hospital complex, that meets standards jointly outlined by the AAP and ACOG, or in a freestanding birthing center that meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers.”

EXCUSE ME.... Outlaw homebirth?

One important thing I must say here:

My husband and I ARE not members of the AMA . I have never felt the AMA had my best interest in mind. Not personally, not professionally in their lobbying efforts. Being a member of the AMA is not a requirement for us to practice medicine, be licensed, be certified, see patients, have hospital privileges, etc... Our continuing education needs to be "AMA" approved, but doesn't not have to be sponsored/arranged by the AMA. I do not know how many physicians decline membership to the AMA. I never thought to ask. It doesn't look like they will ever win my membership. I don't need the AMA.

In response to this statement on homebirth:

My blog and my website are filled with details about my homebirth and how I feel about homebirth. I am glad to have a way to express myself against the politics. Women don't need more barriers to homebirth.

When ACOG came out with their statement Permission to Mother was not published yet, but now I can say I have a book that describes in a stepwise, logical progression from medically managed birth to my breech homebirth (where no doubt I was in the safest place for my circumstances).

Permission to Mother is my response to this financially & selfishly motivated statement which does not look out for the best interest of women and their families. I would love to one day know how ACOG and the AMA responds to my book. :) In the meantime I hope it helps you see beyond these political statements and achieve the birth and mothering experience you want.

Do YOU go to a physician that pays AMA dues? Perhaps its time to look for another.

PS- I would spell postpartum without the dash! Why? Go here.

Day Planner/Organizer Systems

I'd like your input about organization and calendars.

Years ago, BC (before computers), I started using the Franklin Day Planner. It's time for me to get new binders and inserts for the rest of the year. Before I do that, I'd like to consider online organizational systems. I noticed hotmail, google, myspace all have calenders. I have used hotmail's, I like that it allows me to print and send e-mail reminders to myself. I like that my son could even access pertinent shared features. The problem is sometimes it doesn't let me log in.

With as much time as I spend on a computer, I feel like I should consider having my calender/organizer on the screen.

Does anyone use the electronic version of Franklin? I'd like to know your experiences with other online planners. How does it help you make shopping lists and organize family/children's activities? Does anyone know how to overcome the sign in problem at hotmail's calendar?

I look forward to your response. If you want to post in detail on your blog about this important topic that we can all benefit from, please leave a note in my comments so I know where to look!

Catching up with my Comments

I got caught up writing some indepth comments I wanted to leave on other blogs. The first four are related to sugar-free recipes and ideas. If you are following my sugar-free experience it is worth checking out the discussions.

The Cooking Lady's Triple Grain Pancake Recipe (and my experiment making it!)
http://itsallaboutmesometimes.blogspot.com/2008/06/pancake-heaven.html

Here is The Cooking Lady's Black Bean Soup Recipe (and what happen when I made it!)
http://itsallaboutmesometimes.blogspot.com/2008/06/black-bean-soup.html

My Sister's Mineral Broth (and I tried this too!)
http://fitncrafty.blogspot.com/2008/06/is-it-stone-soup.html

My sister wants a juicer and I beat her to it!
http://fitncrafty.blogspot.com/2008/06/adventures-in-juicing.html

Responding to comment in a previous post by me about sugar...
http://permissiontomother.blogspot.com/2008/06/sugar-is-hidden-in-everything.html

Not food related... responding to some comments about my EXAM.
http://permissiontomother.blogspot.com/2008/06/board-exam-coming-up-soon.html

Welcome to Our Practice

This is a letter I sent out to my mailing list 2 weeks before opening our practice four years ago.

Dear Friends and all, June 15, 2004

I can’t believe John and I are so close to opening our Family Medicine Office. It was about two years ago, and in some ways seems like yesterday, that John and I announced that we were leaving the Treasure Coast area. As everyone knows, that decision to leave secure employment with Martin Memorial, our house, and our community we call home was a tough one. We left with a sense of adventure to overcome our sadness [of leaving] and hopes that in the future we would find the opportunity to come back to the area doing our own thing.

We have gained on our “sabbatical.” I have enjoyed the freedom of staying at home with the boys without having to report to a boss. I have enjoyed the mountains, new friendships and reunions with friends from college, and new perspective. We bring a third son back to Florida with us. John watched David Stuart crawling around and destroying all our piles of papers yesterday. John says, “Why did YOU have to have an infant just as we were starting a business?” I was amused, “John, that infant, with those feet always one step ahead made you a name around here. He and our three boys are our reputation.” I don’t know if men get it. As a mother I certainly feel my identity through my children. They are a part of us, our plans, and our life. The boys are a reason to pursue our goals.

Our practice is an independent practice. We have started it from scratch. Early November [2003] we planned a trip down to the Treasure Coast [driving from Rome, Georgia] to meet with the CEO’s at the hospitals in Saint Lucie County and a few other physicians. The night before our drive which was two days before our meeting at Lawnwood I injured my left ankle resulting in a painful, non-weight bearing injury. Nothing could stop my determination to get down to Florida. I was supposed to be packing the evening of the injury. After I got a splint and crutches at the “medicenter,” I directed my oldest son William to get the suitcases and pack while I sat with my leg elevated. I belonged in therapy. (And actually thought about going to Treasure Coast Orthopedics and Rehab while down here, but I didn’t have much time.) I went to all our meetings with area hospital CEOs on crutches or a wheel chair [requesting handicap accommodations] and a nursing seven-week-old. It was very humbling to need so much help, while trying to leave a positive impact. [I must have been quite a sight.]

We chose our office location in regard to demonstrated community need. It is hard to imagine really that there are locations on the Treasure Coast not in need of primary care, but Lawnwood thought our 25th Street location in Ft. Pierce would be most successful and pointed us to that location. We drove back and forth several times from North Georgia to firm up details, buy another house, and get things going. From our computer and phone in Georgia we worked daily on other details of the office. No consulting firms. Sometimes we call it grass roots. We now know what family-owned and operated means. I give a lot of credit to John who has dealt with all the lawyers, accountants, and insurance representatives while I felt overwhelmed. We have a terrific office staff; for the most part hired long distance., They office staff has also aided us with paper work and encouragement.

Our homeschooled boys are good boys and learning as we go about all our activities. Our first weekend back in Florida, Scott got a sunburn on his shoulders. The next day he complained how much it hurt and wanted to know when it will go away. I explained that probably by the morning it will be gone and I put some cool moisturizer on it. When he woke up, his shoulders still burned. He complained, “Mom you’re a doctor, you should’ve known I would still hurt!”
Ready or not, here we come…

Denise

Pregnancy Photos of Rockstar's Wife

I've been watching Rockstar's wife's belly grow through the photos on her blog and I told her I was going to swing by her place one day to take some photos. (I've been dying to get my camera out.) I saw Lulu on my schedule and there was no one after her, so I happily took advantage of this time to get some photos. She said she didn't come prepared! I am so much better at taking impromptu photos when the opportunity is right. Lulu and mom are natural beauties and no preparation is needed. And how could you resist that polka dotted dress? Dino, my office manager, got a few shots with me in it. (Watch out for the droopy eye-lid. I forgot to glue it up this morning. :) ) You can see more photos of today on Rockstar's blog and you can see Dino's photography talents here. I love being able to celebrate pregnancy through photography!




I still want to go by her house and get some photos with the other children. Watch out for more photos soon!

New Digital Drum Board

I am writing tonight with banging in the background. William got his new digital drum board today. The boys were too eager to pound it and fight over who uses it first. I warned all the boys what the repercussions would be if they broke the drums. I specifically told David, "If you break William's Drums, I am going to take your drumsticks away."

He didn't miss a beat and he totally ignored me.

Being persistent (in my nagging tone of voice), "What's going to happen if you break the drums?" I asked David.

As indifferent to my words and straight-faced as he could be: "Oooh, you'll just throw them out."

Now I am going to study while listening to music. :)

Board Exam Coming UP Soon

It's getting close to my upcoming board exam on August 1st. Studying for this test can kill a summer of weekends.


This is the schedule:

7:45-8:30 check in
8:30-8:50 Review of rules, enter validation code and other business
8:55-Section 1, 120 multiple choice questions
10:55-15 minute break
11:10-Rentry, validation code
11:15-Section 2, 45 question
12:00-section 3, 45 questions
12:50-75 minute break
2:05-Rentry, validation code
2:10-Section 4, 190 questions Total of 400 questions
5:20-Brief survey
5:30-can go home.

Sections 1 and 4 include all of Family Medicine
Section 2 and 3-- I choose two categories from these choices: Geriatrics, Emergency/Urgent Care, Ambulatory Family Medicine, Child and Adolescent Care, Women's Health, Maternity Care, Hospital Medicine, or Sports Medicine

I need to make hotel arrangements. Child care has been arranged. Not sure when we get results.

Sugar is hidden in Everything!

It's been 34 days since I got my food sensitivity results back. I have been (cane) sugar-free, dairy (cow's milk protein), and (Bakers' )yeast bread free. Almost....

Sugar is hidden in EVERYTHING! I've been looking closely for it because almost everything else I was sensitive to cleared and I want to know why sugar didn't.

This is where I found it:

• I didn't realize cane is molasses. I ate enough of it to throw off a detox. Infact, I shared a recipe with molasses in a previous sugar-free post. And no one caught it! And If they did, didn't tell me.
• Dried Cranberries have cane sugar in them. A rare restaurant treat at Gator Trace, I ordered a cranberry, feta , chicken, salad (thinking it was sugar-free). More recently, I purchased a bag of cranberries. I am munching along and finally look at the label ---> 6 month detox starts all over for cane sugar. You can't even get a filling resaurant salad without sugar. If you know of one, let me know.
• Caramel Coloring. I have stayed away from it not knowing what it is. By now you have figured out it is cane sugar, caramelized cane. So there goes the possibility of soy crumbles from my diet. Caramel col0ring is in a ton of stuff including many things we think are sugar-free like balsamic vinager and boca burgers.
• The large bottle of vitamin water has fructose (ok), the small bottle of the SAME flavor has cane sugar and fructose.

I plan to carry on with the sugar-free and read every label and if a label is not available I am not eating it.

I am not sure how long I will do the bread (baker's yeast) and cow's milk protein for. Sounds depriving, doesn't it. I look at it like this-- I have never deprived myself of food. I have always ate what I want, when I want, restaurants, brands not on sale and I didn't feel good. Now I want to feel good.

I do have a list of 200 whole foods I can eat. Its actually quite a positive challenge bringing the variety of all those foods into my diet and you can see I haven't disappeared yet from not having enough to eat. :)

This kind of nutriton plan has lead me to look at green smoothies, juicing, and raw food preparation to fill me up. Soon I'll blog more about that.

FitnCrafty

My sister has been e-mailing me all sorts of interesting recipes, nutritional info, crafts and family pictures. For the past few months I have told her, "Your stuff is good! Put it on a blog and share it with everyone, not just me!" I told her that many of my blog readers would find her contribution to blog world very informative. So finally, she started a blog last week. By the time I went to check it out just a few hours later, she already had two comments and they weren't referred by me. Some of you have found her blog already in my side bar.

My sister is a mother of 3 and a navy wife. She lives too far to visit. Between my practice and my 3 and her commitments and her 3, we don't see each other much. She has recently lost over 100 pounds through nutrition and exercises. (No surgery, no pills). Next week she is beginning the Master's program in Holistic Nutrition. She is going to have a popular blog. She is FitnCrafty.

Our mom felt left out, I suppose. She started her blog this weekend, too. My mother's interest is small paws rescue, tasty cooking and gardening, and photography (she took the current family portrait on my blog). She loves decorating her home. She'd loved to decorate yours (and mine). She is Orlando Realtor.

Enjoy their writing. I hope they don't tell too many family secrets. :)

Going Green? Me?

It seems hypocritical to have "tree huggin' " as one of my labels and have 4 gas guzzlers in my driveway, a boat, a jet ski, and 2 Fore Runners to pull the watercraft. One Fore Runner would enough! Those are what makes my husband happy and we all have our own way to contribute.

Even if we haven't been so fuel efficient in our cars, there are many ways to save our petroleum resources. Some of them I started years ago, for example the exclusive breastfeeding and cloth diapering and using natural menstrual products. For our babies we have used cloth reusable swim diapers designed to hold it in. The plastic shopping bags get returned to a bin at the grocery store.

Within the past two years I started eating Organic produce. More recently than that I have used reusable bags when shopping. I have stocked up on several types including canvas bags; however, the Publix green bags are my favorite (It is so much easier carrying these bags in over your shoulder and not having all the plastic all around the house.). We've upped the recycling in the house (foam, cardboard,glass, and containers) and the office. I set up a compost bin in both locations also. We've been shredding more paper and adding it to the bins. Anything I can do electronically, I do, include on-line bill pay.

Way back when, my husband started buying fluorescent bulbs (see he HAS contributed). He is probably the first one ever to buy those light bulbs, making up for his vehicle addiction. He has been better at turning lights off than I am. Yes, now he is talking about getting a small car (Any opportunity to buy a new vehicle works for him.)!


There are lots of ways to break old habits. Here is some recent blog links I've read by women considering the same:

Gradually Going Green
How Green Is Your Life? I only scored 56%, Lot's of suggestions for change.
Living Green
A Tree Huggin' Teen
Conserving Energy

Daughterless

I've been looking at the photo in the previous post a lot. And this new one. I've spent the past two evenings with Katie. Katie is so precious and when I watch her with her mom, she is like her moms "little best friend." My friend is an animal rescuer for the humane society. As we were cycling, Katie wanted to stop and see every rabbit, snake, kitty, puppy. She is waving and talking to them, just like her mother does. Katie likes sharing the bike ride. When we were done with the bikes, it was just so cute how she got the exercises ball for her mom and "helped" her do sit-ups by some pseudo-spotting. Katie got out the dress-up clothes and wanted us to help her look pretty. She sat in between us on the couch all cuddly looking at photos, web pages, and showing me photos of her in my book, "That's me!" (pages 18, 235.)

As you know, I am the mother of three boys. Boys love video games and guns. I don't have a girl to pass on my passions. I may influence many woman and they may influence me. Indeed, my sons are more than familiar with with what's important to me. But, I won't have a daughter to tell her (OK-nag, as the boys say I would do) how to birth and take care of her family and to share the more simpler day-to-day activities of being a mother/female/friend. I'll be OK.

Photo provided by Katie.

I Love a Happy Breastfeeding Story

I grieved with my friend nine months ago, when her daughter suddenly refused to nurse; she was close to two years old. She said it tasted yucky and said she was a big girl now.

My friend's goals were to breastfeed until 3-4 years old, especially after hearing all my stories and being around me and my boys who latched on at 3-4 years without any issues, so she was sad about the weaning, the loss of intimacy between mother and child, and immunologic protection .

We discussed possible causes of her abrupt weaning... being in daycare and separation, someone telling her she was a big girl, mother's IUD, or the rough start (I posted about it here.) . This mother and baby are attached and very loving, it didn't make sense to me. It didn't make sense to be knit-picking for reasons.

Nine months later, Dad is deployed, My friend and her almost 3-year old are spending lots of time together. They are alone at night and share a bed, every night, all night.

Last night, My friend announces to me, "She asked to suck booby!" And she did latch on. My friend had milk. Her daughter didn't nurse for long. Her eyes rolled to the back of her head like when she was a baby and she went to sleep. She's nursed a couple of times to sleep now and my friend is drinking mother's tea and noticed her breasts looking a little more full.

I am so happy for them... I said, "You know I am going to post this on my blog!"

Photo submitted by K.

Tribute to Twins

Twins can be breastfed, worn in slings, and cloth diapered. At least one set of twins was born at home (two, if you count the puppies).

One's in this sling!

Two is in this sling!





Two hanging on!

Adopted twins in cloth diapers .

(clicking on their photos willtake you to their blog.)

"It can be done!"

Who's Lurking?

Time to come out of hiding! I'd love to meet some of my lurkers. Please introduce yourself!

Thanks,

Denise

The Best Way to Do a Newborn Screening Test

PKU (newborn screening or the heel stick) is a test usually done in the hospital on all newborns required by law. The nurses usually do this. From previous employment and training, I remember this always being done in the nursery away from the mother and it looks like a real bother to the baby and another reason used to separate the pair. Some home health nurses do a PKU. I do not know if Pediatricians and other FP's do this. They may not have any reason to?

I am providing this service in my office for established families who choose to birth at home or otherwise need a heel stick done. With an assistant to help me, I am able to do this with the mother nursing the baby. I get mom and baby comfy in a rocking chair and I can pull up to the side on my stool. Mom can stay in constant contact with her baby. The stick is made with a lancet specially made for a baby's heal. This baby didn't cry. After I make the stick, the blood drips on a card and is not painful.

In Florida the heel stick test checks for PKU, galalctosemia, other and metabolic diseases. Cystic fibrosis, Hemoglobin diseases (sickle cell and thalassemia's) and some others.

Some families have declined it. Despite it being required by law, no one has come after me or them. I am not sure you can decline this in the hospital. Some families have delayed it 2-3 weeks. The metabolic diseases can be prevented by modifying infants diet from expressing themselves if identified very early. The other diseases it screens for are things that are nice to know, but don't have to be known the minute the baby is born. All the results are a screening and positives need to be confirmed.

My first two sons had theirs done in the hospital and by homehealth. There is (or at least was) a silly rule if the baby wasn't 72 hours old when discharged it had to be done again. The hospital did it anyway just incase you didn't come back for follow-up. My third son's midwife did the heel stick in my bed in my presence. It only had to be done once.

It took me a while to find the best lancet and the best position to do this in. Now that I have found the best way, I am happy to share to share my example.

I apppreciate Dino taking the photo and for the mother to allow me to share this.