Happy Birthday Motherwoman

Just a little electronic love for my pal Mother-Woman, who is celebrating the anniversary of her birth today. I may not have it together enough to send her a real card, but it is the thought that counts, right?

Happy birthday Mo! I am so glad to know you.

Random Quote and Unrelated Photo of the Week

He and the interviewer realized they shared the most happy bond: a prejudice.

David Mamet

Birth Story, Finally

I wrote this pretty much right after the delivery, but I needed to put it away for a bit. Now Mira and Ian are 5 months old...

Monday, May 18 started with a non-stress test during which I had a contraction that caused "Baby B" (Ian) to have a heart rate deceleration. This led to a trip to Labor and Delivery for extended fetal monitoring, during which all went well and I was sent home.

That Thursday started with work and another non-stress test. Both fetuses had heart rate decelerations during some long (6-7 minute) contractions. This activity caused the OB (in consultation with the perinatologist) to suggest I go back to the hospital for a trial of induction, to see if (a) the babies continued to show “decels” or other signs of stress or (b) these long contractions could be nudged into something productive (and labor-y).  This marked my first laboring moment of "thank goodness Karen is with me."

I want to stress the doc said this was a trial, because this became important once we got to the hospital. Actually, before that even. After a quick chat with Ellen (her day job is midwifery and she acted as translator and reasonableness-checker throughout my labor) I called the hospital to get a little clarity on the plan.  I got this clarity (and a few metaphors from the OB on call) and Chris, Karen and I headed in to L and D.

Evidence that my labor was not yet in full swing: I stopped to document this on the door of the first room we were given. We were quickly moved next door.

The first L and D nurse on duty made it clear that not everyone was clued to the "trial" part of the plan. She kept saying things like “you are here kind of late” or even “with inductions…” until Chris brought her up to speed on our sense of this as a trial, not an induction. From there things were smoother, as I was hooked up to fluids and fetal monitoring. Apparently the hospital’s wireless monitors won’t work with twins, or at least no one could figure out how to make them work for me.

As a side note: my first labor occurred mostly at home without much intervention and no invasive monitoring. (Chris and Ellen were there with me, but not invasive.) I went to the hospital fully dilated and resisting the urge to push while we drove. Neither Chris nor I remember any monitors during that hour between our arrival and Ada’s (though more than one nurse assured me that there must have been monitoring once we got to the hospital, because that's just what is done).  All this is to say that the drip and the monitors set a very different tone for the labor, and I felt a little nervous.

After some time (hours? I can't recall) waiting and watching the monitors, we talked to the OB and anesthesiologist on service. The OB served up more metaphors, including some incomprehensible sports analogies that I don't think the OB himself understood. The anesthesiologist threw me off by talking about the pain relief benefits of epidurals. I get that many people use epidurals for pain relief, but I wanted to talk about how an epidural could be used in the event that I needed a c-section (which after a few scary contraction/decel combinations was looking like an increasingly likely outcome). The docs were trying their best to help us get the information, but it wasn't until they left the room and Chris, Ellen and I talked that I felt fully comfortable with the idea of an epidural set at a low level. The idea was to have an epi in place so that it could be ramped up later when we started moving toward a cesarean.

By this time a new anesthesiologist was on, and she hooked me up and connected me to what she referred to as "water" (a little anesthesiologist's joke about a low-dose epi). After some chatting, the new anesthesiologist (reluctantly) agreed that I could stand up in the room, but not go out into the hall. As I was wearing only a hospital gown, I was fine with this limitation. It was weird to feel like I'd "won" something by being allowed to stand up, but I appreciated the doc's willingness to work with me.

About 5 hours after we arrived at the hospital, the nurse got her orders to start the pitocin. The drip was turned on, and after 10 minutes I had a long contraction (again in the 5-7 minute range) that caused Ian's heart rate to dip noticeably.  Suddenly the room was frighteningly full of people, the pitocin was shut off and everyone was in a flurry that ended once it was clear that Ian's heart recovered with the end of the contraction. So okay, no pitocin. The timing may have been coincidental, as the pitocin apparently doesn't take effect for about 15 minutes. 

Even without pitocin, I then progressed fairly rapidly from 2 - 5.5 centimeters. With the epidural, I did not feel any of the contractions, though I could see them on the monitor. There were a few more decels, but nothing as scary as that first one.

After a few hours the contractions faded. We went from thinking that labor would progress quickly and maybe lead to a cesarean that night, to realizing that not much was happening. Chris, Karen, Ellen and I all tried to get some sleep, and the next morning decided to try the pitocin again. As the pitocin was gradually increased, I started contracting more, but rather than having the mega-contractions that had caused problems earlier, I was having shorter ones that weren't creating decels. I was still really amazed that I was contracting and not feeling any pain. (So ok, I get why people might want this.) I could sort of feel that a contraction was happening, but without the pain I was still kind of in the boredom phase of labor, waiting for something dramatic.

Some time after nine am, I felt something dramatic. All of a sudden the contractions went from "hmm, I guess I feel something" to "wow, THAT'S a contraction." With the onset of intense contractions, the docs were back in the room to ask if I was ready to push the epidural to cesarean strength. (As it takes 15 minutes for the drugs to work, if these contractions led to fetal distress that led to needing a c-section, I would need to pump the drugs up immediately in order to use them should I need surgery at a moment's notice.) I agreed to this, and as I was 8 or 9 centimeters dilated and ready to push, after getting a kiss from my sister I was wheeled down the hall to the operating room. (for those playing along at home, twins are generally delivered in the OR, just in case a cesarean is needed quickly)

Once on the operating table, I started pushing. I have to say that while pain in general is not such a great thing, I was really glad to feel the desire to push. Following my body's natural urge really moved me along, and Mira was delivered at 10:20 am, after about 15 minutes of pushing. Pushing with Mira felt a lot easier than it had been with Ada. Maybe that was because I knew where we were going this time, or maybe it was just easier. Mostly I remember looking up at Chris standing above me as I pressed my palm into his.

I saw the doctor pull Mira into view. She cried and was taken by the nurses to the other side of the room. She was brought back to me for a moment (I am a bit fuzzy about this time - maybe this was while the doc was coaxing Ian into a head-down position, convincing him that his foot could not come out alongside his head, and insisting that his chin needed to be tucked before he came out. And again, THIS was certainly a good use of an epidural. I don't think I would have wanted to feel what the doctor was doing to make any of that Ian-wrangling happen.) Once Ian was properly aligned, it was time for me to push him out. It was at this point that the epidural was in full effect, and not only did I not feel any urge to push, I could not feel the contractions. I relied on the nurse to tell me when each contraction started, and on Chris to be with me as I tried to push with no feedback from my body.

Eventually Chris called Ellen over (she had been watching over Mira). He recognized that I needed some additional help. The emotional effort of pushing was more intense in this pain vacuum, and I had stopped looking at Chris and started staring at the overhead light. Making eye contact was too hard. 

Ellen turned up the heat by telling me that I needed to push more. She told me to push, take a little breath when I needed to and then quickly get back to pushing. Her drill sergeant "no rest" message was what I needed, and I started working harder. After pushing through some number of contractions (6? 12? 30? I can not recall at all) the doctor alerted me that this was to be my last chance, saying something like: "we're going to try this one more time, then we'll try something else." It was clear what this meant, but what I did not know at the time was that while Ian's heart rate had dipped during each contraction, it had bounced back once the contraction ended. Now it was not bouncing back and I only had one more chance to make this work. I pushed and pushed, and (with some help from a vacuum extractor) out came Ian. A little blue and floppy, but he pinked up pretty quickly.

It wasn't until both babies were out that I started to cry. In a rush I felt how hard and scary it had been, and how close we'd come to something bad happening to Ian. In a few dark postpartum moments I retrospectively worried about the birth. Did I take too many risks? Should I have just gotten a cesarean earlier, and not allowed Ian to go through multiple serious heart decelerations? What if his heart had stopped? What if he'd suffered brain damage? Before going too far down this path, I worked to remember that we were surrounded by doctors and nurses. They could have advised us to act differently if they'd thought it was necessary, and I assume they would have. The doctor who caught the babies is a serious guy and I trusted his judgment. I still do. When he poked his head into the exam room at my postpartum visit, he was quick to tell my doctor that my birth had been a scary one. His response surprised me a bit, because I assumed that if we'd needed to act earlier he would have advised us to do so. When he told us I had one more chance to push before he moved to cesarean, I knew this was based on his best medical judgment. (I recognize this paragraph has gone from "what if it had gone bad" to "I trusted my providers" but this is the kind of experience that does not easily fit into an "all is well" or "wow that was terrible" mold.)

Re-reading what I have written, I recognize how inadequate (yet long-winded) this is. What I have written fails to convey how scary the process was at times, especially at the end. I also can't quite explain how the knowledge that a c-section was coming (at points it seemed an absolute certainty) affected the process. With Mira on my lap as I edit, I am amazed how vigorous, beautiful and healthy both she and Ian are. Their arrival was a bit bumpy, but once they came out, they quickly became normal healthy babies. I would like to think that even if they had come via cesarean, I would feel as happy with the birth anyway. Or at least, I would not care so much about the birth, given the outcome was so overwhelmingly good.

A mere 5 months ago

Re-reading this again at 5 months, I still feel happy about how things turned out. I know it is crazy, but this birth story feels like a necessary response to the recent New York Times article on how IVF is increasing the number of twins and how this leads to all kinds of crazy and expensive pregnancies, births and babies.

A post, about US?

Random Quote and Unrelated Photo of the Week

A court can't tell the man, You've got to do more than carry out the garbage.

Justice Ruth Bader Ginsberg

Five at Five

When I was pregnant, I had this song stuck in my head. With a little tweak to the words (the original includes the words "a sister and two brothers") it describes my family pretty well. We are a family of five, though we are not yet muppets. And now the twins are five (months).

Ian and Mira are increasingly becoming more fun as they move out of the infant stage into babyhood. They are interested in one another and in the world around them. While they clearly know and like Chris and me, they reserve special status for Ada. She walks in the room and the babies light up. This evening I was holding Mira while Ada and I talked. Mira started laughing and within a minute was in hysterics, just watching Ada and taking great joy in her.

The babies have also gotten REALLY drooly. As evidence, check out the following photograph, in which Ian and Mira are linked by Ian's spit.

Nice, huh? We are still holding out on the bibs, by the way.

While both Ian and Mira have shown the ability to get from their backs to their bellies, neither kid is routinely rolling over. This is fine with me. It is so different to be doing this a second time. I remember getting really excited when Ada was close to a milestone (rolling over, sitting up, programming the VCR). With these two, I frankly don't really relish the idea of them becoming mobile. They are enough work as it is, but once we can't just lay them down and walk out of the room to grab a coffee or a burp rag, we are screwed. This will be especially problematic because Ada has gotten really into building with Legos. Thanks to my thrift store purchase of a giant tub of them, we find tiny pieces all over the playroom. living room and pretty much everywhere else. I am thrilled that Ada is so into building, but getting her to put away her carefully constructed houses, cars and airplanes is turning out to be fairly difficult. So, the longer the babies are unable to motor themselves over to the myriad choking hazards that surround them, the better.

The past week or so, both kids have stepped up their vocalizations. They have gotten loud, and they want to talk a lot. Ian was warbling the whole time I was taking 5 Month pictures, much to the amusement of the assembled adults. (Okay, it was only me and our helper Caitlin, but we were pretty darn amused.) The photo below shows the moment at which the singing and talking turned to unhappy complaint. Mira is giving me a nice "what the hell is wrong with him?" look. I think by age 2 she'll have perfected the faux angel shtick, especially at moments when her brother is acting a bit wild.

No officer, I have never seen this man before in my life.

 
Also, she's a ham. (Look at me! No, look at ME!)

Ian, for his part, is getting very directive. Here we see him piloting Chris around the neighborhood:

Turn Left. I said LEFT, Papa.

All in all, life is pretty good. We still don't get enough sleep, but the couple of times the babies have slept through the night* have us hopeful for the future. Plus, it helps to remember that at this point with Ada I was still getting up twice a night to nurse her.

*by "slept through the night" I certainly do not mean "did not wake up at all during the night." I meant "didn't eat during the night even though they woke up and cried enough to wake us up at least once"

And speaking of Ada, she continues to be interesting in dressing herself, to interesting effect. One day she wears tights on her head:

and another she puts together this outfit, much to her own amusement:

How come it never occurred to me to turn a turtleneck into a tube top?

November's big task is finding a nanny. Juniper (Ada's old nanny and our good friend) has promised to help us with this. She's even offered to write a Craigslist ad. After seeing the incredibly wide range of people who responded to our mother's helper ad in September (from an over-sharing welfare mother to a woman with a master's degree and 12 years experience) I wonder how this process will go. Juniper set a pretty high bar, so we'll see. 

Neighborhood Pigs

Spotted within a seven block area:

The Good, The Bad and the Sleeping*

Good morning. (I am typing this at 6 am.) You might ask: why are you up and conscious enough to be blogging at this early hour? Good question! I am up because Miss Congeniality (formerly and no doubt again soon the Snotmaster General) woke up for the day at 5:20. I nursed her in bed for a while, but (unlike her brother) Mira does not like to drift off to sleep after nursing. (When she agrees to nurse at all.) The girl is still a little testy about taking milk from the source sometimes, but this morning she was hungry and decided to cooperate. So she nursed. And after a half hour, she was ready to face the day, or at least go downstairs for a diaper change and some quality time with her giraffe rattle toy.

BUT. She woke up for the day at 5:20 for a reason. That reason is: she slept all night, from about 5:45 pm until 5:20 am without eating. This is not to say she did not wake up at all. (We are currently trying to train her not to wake up every time the pacifier slips out of her mouth, with at least some limited success.) But she did not wake up after 2 am, which is our current marker between "too early to feed you" and "okay fine we'll get up and deal with your pathetic cries." This is great, right? We are on our way to happy sleep-filled nights, right?

Oh, except for one thing. There is a brother. And Ian's sleep patterns are not exactly aligned with hers. Another fantastic element of our glamorous life with twins. Even when Ian sleeps until 7, which he seems likely to do, having woken at 4:30 for a bottle, at least one parent is up way too early with Mira. I'm not even sure which kid to praise, the one who did not wake us during the night, or the one who let (one of us) sleep in a bit. (Or would have, if Chris hadn't needed to get out of the house early today. And for the record, Ian slept until 7:45. Wow.)

This not-eating-all-night was first for Mira. Usually Ian wakes up to eat, and a short time later Mira rouses and is fed. Very often Ian is the first to wake in the morning, but as he allows me to take him into the bed for nursing (and then we both drift into sleep for a while), a 5:30 wake up can turn into a 7:00 get up. (Occasionally it is even later, but I won't dwell on this for fear of depressing Chris, who - due to his total lack of nursing ability - never gets to drowse in bed with Ian. He definitely gets the short end of the stick on this.)

Yesterday I complained on facebook that Ian was refusing to nap for longer than a half-hour. Whenever people ask me who is my favorite, I reply "whichever one is sleeping better." Needless to say, Ian was not winning any popularity contests yesterday. Today? Today he's going for the gold. It is now 2 pm and Mira and Ian have done a personality swap today, apparently. Really - this morning Mira had a half-hour nap, while Ian snoozed nicely.  Crazy.

I guess that shows me for thinking I know something about these two. Sure, Mira smiles easily and Ian makes funny noises when he's annoyed. But what do I really know about them yet? Once they are more able to express themselves, I am sure Chris and I will look back and see their personality traits in their baby selves. But while they are inhabiting those baby bodies, it is still a bit hard to know what is going on.  I need to remember not to label them as "the good sleeper" or "the funny one." It always comes back to bite me in the ass, and in the end it does not mean much anyway.

*I considered using the title The Sleeping and the Dead, but that seemed a little macabre.

Random Quote and Unrelated Photo of the Week

He's got that unmistakable graduate-student look of having just climbed out of a root cellar.

Andrea Lee
Altered State: Pennsylvania, blackness, and the art of being foreign

Two Birds

Chris and I recently decided that each week we would try to do something with one of us and Ada. Just Ada. Not "a baby and Ada" and not "take Ada on an errand." (Okay, so we still take her on errands, but an errand doesn't count as the "fun thing" of the week.)

Two weeks ago I took Ada to the Children's Museum. Last week she and Chris went to the waffle window. And for the past two weeks, I have picked up Ada from school and biked her over to a local photo booth.

Two Birds, 9/30/09

Taking Ada to the photo booth kills two birds with one stone; it is a special activity that only she and I get to do, and it allows me to indulge regularly in something I love. Even better, we've been biking on these little jaunts. Ada loves to be carted around in the trailer, and it is yet another thing she can do that the babies can not.

10/5/09

I am going to keep doing this with her as long as she wants to keep going with me.

An alternative to crabs

I was going to post a crabby post borne out of an annoying but completely ordinary day. Instead I am cutting you a break, and offering this instead:

Rachel sent us a tiger costume (along with a ton of other clothes). I immediately put the costume on Ada's Mira's head and took a picture.

She doesn't look entirely thrilled, but otherwise all is well.

I got up to grab something in the other room and when I returned 20 seconds later:

Don't call the cops, she was only like this for a moment.  
She hadn't even started to complain yet.

Walk the Walk

NB: Somehow this got resaved as a draft, then reposted here, even though I originally posted it in September. Oh well. Technology burp. 

Did anyone else read this article? It is about how many parents won't allow their children to walk to school (or other places), even when the walk is a block or two. Parents are too afraid that their children will be abducted. Included in the article is a bit about a mom who let her 10 year old son walk a mile to soccer practice. Not only did several people call 911 to report a child walking alone, but the officer who found the kid drove him to the park (before chewing out the mom). I'm knocked out that (a) multiple people found the sight of a kid walking alone worrisome enough to report it to police, and (b) they called 911, the emergency number. The kid was 10, not 4.

The article upset me for a couple of reasons. To begin with, it busts into the fantasy I have had since we moved to this house that my children will get to walk themselves to school. We live 5 blocks from our local elementary. Of course I will be walking Ada to kindergarten, but will I be expected to walk her to and from school until she graduates from 8th grade? When Ian and Mira are ready for kindergarten Ada will be entering 4th grade. At what point can she escort them without me along for the stroll? Why couldn't a 4th grader walk her younger siblings to school?

The other thing that really bugs me is that refusing to let kids walk to local schools is an environmental nightmare. The article may have picked out really extreme cases to make a point about modern, fear-based parenting, but wow. A mom let her kid walk the five houses to a friend's place, only to have the kid driven home at the end of the play-date. Really? Driven? The host mom was what - too busy? Too lazy? to walk the length of five houses?

Honestly now

Dad Who Writes tagged me for a meme. The rules are: post 10 honest things about yourself and tag 7 people to do the same. Annoyingly, DWW would definitely be one of the people I would ask to do this, if he hadn't just asked me.

And now for some honest things: 

1. I am simultaneously thrilled and horrified to get tagged for any meme, no matter how interesting or inane it is. I am thrilled because the inner pathetic teenager in me cares a lot about things like comments and hits and whether people like my blog enough to tag me for memes. I am horrified because I fear that I will tag people, only to have them ignore me or loudly refuse to participate. (Again, thanks inner teen!) The upshot is that I worry more about what people think of me than I would like to believe about myself.
2. I was pleasantly surprised when Ada told me I am lucky, and when I asked her why she thinks that, she said: "because you have three kids." I am glad she sees this as a good thing. 
3. One of the reasons I don't want to give up breastfeeding is that when I stop I may have to start real exercise again (beyond daily walks) and won't be able to eat as much. While it is true that I will be able to drink more, I don't drink so much that this seems like a good trade-off. Plus, alcohol is fattening, leading to the need for more exercise.
   
4. I often tell one of two close friends what is bothering me before I tell Chris. This is especially true when I am annoyed at Chris. This helps me a lot, because by the time I tell him what is going on I have thought about it more and am less likely to get irrationally angry. My many years with Chris have taught me that irrational expressions of emotion don't lead to meaningful dialog with him.
   
5. I was recently very embarrassed that a coworker I really respect knew what a slip-shod job I did keeping track of documents for a grant I worked on a couple of years ago. This coworker very kindly made it clear that it was no big deal, but I still felt horrified that she would see what a slacker I'd been.
6. I sometimes think I chose the wrong profession, not because I do not enjoy or care about what I do, but because I know I will never make much money. Especially with additional mouths to feed and bottoms to clothe, this worries me. 
7. I am an intellectual, but I am lazy about it. 
8. I get totally sucked into a game and then play it all the time for a few weeks before getting bored. Right now I am obsessed with the Boggle-like Scramble on Facebook. Both my sister and Chris are kicking my ass, high-score wise. I have beaten Chris in head-to-head games, however. 
9. I wish there was a way to explain to a four-year old that when she is crazily needy, I want to withdraw. I know there is no way for her to understand this, but it does not stop me from wishing. I feel like a shitty parent for wanting her to back off a little. I love her loving me, but sometimes it is so exhausting to be needed all the time. 
10. Ada is exploring the idea that she could be something or someone else. When she says she wishes she was Lila or Avery, it makes me wonder who I would like to be. For all my complaining, I am not sure I would really want to be someone else. I have barely figured out how to be me without having to learn someone new.
    

And now, a quick ridiculous picture of Mira:

What?

Tagging. Oy. Okay, here goes:

Magpie Musing, because she will certainly write something interesting
Mayberry Mom, who wrote very honestly about her (hopefully finished) hard year
Cartoon Goddess, because she comes up with great visuals for what is in her head
Mad.Momma, the kindest, most generous almost-stranger I know
Planet Nomad, whose posts from abroad are so interesting, even the mundane details
Lumpyhead's Mom, since she can post pictures of stuff on her son's head
Heathen Family Revival, because I love her blog title and her photography skills

The Unexpected Joy of Parenting

2:26 A.M.

Mira had been crying on and off for an hour. I got up and fed her, then rocked her and put her back to bed. On my way downstairs to pump, I stopped in Ada's room to make sure she was warm enough. She has taken to sleeping on top of her down comforter, covered only by her baby blankets. Sometimes she kicks off the covers early in the evening and spends the rest of the night without blankets. Tonight she was covered by two of her favorites, but her toes were sticking out. I laid a third blanket over her so that her feet were covered. She stirred, and as I was leaving, said, "I love you Mama."

I love you too, Ada.

Random Quote and Unrelated Photo of the Week

"If we weren't making decisions based on marketability, John Malkovich would be in every movie,"  a top studio marketer says.

Tad Friend
The Cobra

It bears repeating

Two years ago I wrote a post about a friend, and why you should do breast self-exams. Last year I linked to the post, and wrote about friends I'd made who were living with and living through cancer. This year I thought I might mention a resource, in case you take my advice to do self-exams and then end up needing insurance to deal with something you found. Oh, how I hope you will find nothing wrong and need no assistance. I also hope you have good health insurance. But if any of that is not true, there are resources available, including the U.S. Center for Disease Control and Prevention's National Breast and Cervical Cancer Early Detection Program. The NBCCEDP helps low-income, uninsured, and underinsured women gain access to breast and cervical cancer screening and diagnostic services. These services include:

• Clinical breast examinations.
• Mammograms.
• Pap tests.
• Pelvic examinations.
• Diagnostic testing if results are abnormal.
• Referrals to treatment.

In Oregon, you can contact the state's Breast and Cervical Cancer Program. For resources in other states, check out CDC's NBCCEDP web site.

In the mean time, here is my friend Stephanie's story.

When I moved to Rhode Island in 2000, I left a job I loved and a close group of friends, in a city I'd come to see as home. Chris is an academic, so he made friends at work, but I struggled to meet people in a place where most of the residents are natives. Almost everyone I met had lived in Rhode Island their entire lives, had the same friends they'd had since before kindergarten, and though they were kind, it was clear that they were not looking to make new friends. I really struggled to find friends, and in the end one of my favorite people in Rhode Island did not even live in the state.

Stephanie Williams was the girlfriend of Dan, one of Chris's colleagues. Every other weekend she would take the train from New York City to visit Dan. A journalist, Stephanie was interesting, funny and smart. Some of my favorite moments in Rhode Island were spent in the company of Stephanie and Dan. Chris and I liked them enough that we we saw them in New York too. We went to NYC regularly to see family, and we'd meet up for brunch or pizza.

Shortly before we met, Stephanie was diagnosed with breast cancer. She was 30. One of the things that impressed me about Stephanie was that despite dealing with cancer (surgeries, chemotherapy, radiation), she was always interested in other people. Maybe because she was a journalist, she tended to look out into the world rather than retreat into her own pain.

Stephanie fought her cancer for three years. She ultimately died, but not before fulfilling a dream to write a novel. Her book, Enter Sandman was published in 2004, the summer she died. Stephanie's story, including her struggle with cancer and her decision to use her limited time to write a book, was featured in a number of national and local publications. She herself wrote an article for Glamour that was published after her death. Her alma mater wrote a a very nice article about her.

It is terrible that Stephanie died so young, but you can do something to help ensure that you and your loved ones do not. Please do monthly self breast exams, and please get an annual exam every year. This is a great start for young women, especially those of us who are generally healthy and do not see ourselves at being at risk for cancer. If you do not know how to do a monthly exam, click here. Most insurance covers annual exams with either a very low or no copayment. It is more than worth the $10 doctor fee and an hour of your time. I know you are busy, but really, this seems like a good use of time. I hope the men in my readership will urge their loved ones to do these exams as well.

I thought to tell you this because October is National Breast Cancer Awareness Month, but you should do an exam every month. Even though I admit that I have not been so good about this in the past, I'll promise if you do too.