Notes to OB-GYNs from a Primagravida - First-Time Pregnancy - Betwain

I'm not sure what I thought when I first picked a medical provider after celebrating a positive pregnancy test.

Maybe I thought it would be like building a house. Make a detailed budget. Make a detailed blueprint. Make a detailed schedule. Meet weekly with your general contractor to get an update on where things are on track, where they're off track, and what decisions need to be made to move forward.

Maybe I thought it would be like a catering project or even making a simple dinner. Make a budget. Make a plan. Consider the time constraints. Check the recipe. Cook and serve.

I have no real way of knowing if my experience so far is typical, but I picked a teaching hospital with a great reputation and felt lucky to go through this pregnancy with them.

My first appointment went well. I left the hospital with an approximate due date, a starting weight and blood pressure as well as a helpful booklet that let me know what I should and shouldn't eat during pregnancy, what symptoms to expect, and more.

The next appointment or the third, the doctor asked me when my due date was because her "PA didn't take great notes." My husband had taken the day off work for the ultrasound, but we learned that we had to schedule the ultrasound separately with a different department, so we would have to do that at the next appointment.

What? Good to know.

At an appointment further down the road, we really needed the baby to wiggle, so they could get a better image. I learned that had I run a few miles that morning, had orange juice, taken the stairs, or even drank more water, the baby would've wiggled more. I guess I should've known they would need an active baby during the ultrasound?

At another appointment, I showed up and learned I would be taking a glucose drink to test my blood sugar and would need to wait at the office for an hour before they could test my blood sugar.

What? Ok.

Ladies, are you having a different experience?

I know there are guides online, and I have looked to see if I could find a "what to expect" at each appointment, but it's not completely consistent per provider. 

In my dreams, there would be an intake appointment where a clinic staff person would go over paperwork, insurance, and scheduling--maybe even for the duration. If the doctors, medical support staff, patients, and office support all had a checklist, there would rarely be a need to wonder---did anyone speak to this patient about birth plans yet? The record would show that having been completed during appointment 12.

I guess in reality, we have a revolving door of support staff, patients who don't always attend appointments on the recommended timeline, and even pregnancies that don't make it to full term, so it's tricky to create a protocol. However, it's crazy to me how professionals so studied in surgical procedures and pathology are even comfortable functioning in such a chaotic system. There are challenges that arise during surgery, too, but that doesn't mean there isn't an ideal procedure to follow.

So, the third trimester has begun with a helpful packet of information that includes specifics about policies that will impact the birth. We're headed to a birthing class, and we've connected with a doula. As much reading as there is concerning pregnancy, maybe there's no way to navigate it without feeling completely lost. I wish we had scheduled the class and the doula even earlier.

If I had known better when I started this, I would have made a chart like the below for myself and asked enough questions at the onset to fill it in for myself, regardless of the practice's practices. I would've tried to schedule out all of my appointments as early as possible as well.

Maybe there will be a "next time" to try it. This is completely based on my own limited experience and is not medical advice for anyone but myself.

FIRST and SECOND TRIMESTERS (monthly)
Appointment                               Date                  Doctor                What to Expect           Preparation    1-Four Weeks   
2- Eight Weeks
3- Twelve Weeks                                                                             Ultrasound/Genetic Test Talks
4- Sixteen Weeks
5- Twenty Weeks
6- Twenty-Four Weeks                                                                    Blood Glucose

THIRD TRIMESTER (twice per month)
Appointment                               Date                  Doctor                What to Expect           Preparation 
7- Twenty-Eight Weeks
8- Thirty Weeks
9- Thirty-Two Weeks
10- Thirty-Four Weeks
11- Thirty-Six Weeks

LAST MONTH (weekly)
Appointment                               Date                  Doctor                What to Expect           Preparation
12- 37 Weeks
13- 38 Weeks
14- 39 Weeks
15- 40 Weeks

BIRTH

Great Mexican Food in Atlanta | Sotolero

We used to frequent the local mom-and-pop "combination lunch" Mexican restaurant. Then one eve, a Groupon led us to Sotolero.

I had the tamales, and Jason had the carnitas. Y.U.M.

This place hits all the marks. The service is excellent. It's clean and creative. The salsa is the best I've had in a long time. The food is wonderful, and the drink menu has enough variety to keep it interesting.

We feel like we've found one of the best kept secrets in town because all of this and a side of queso for less than it would cost you to take a date to the Olive Garden.

C'mon??  If you're in the Atlanta area, you're going to try it, and you're going to put it on the rotation.

You're welcome.

Best Peanut Butter Cake Ever

I'm constantly on watch for peanut butter sweets because my husband loves them. This looks like a mess, and I had to make a different chocolate frosting because I didn't have heavy whipping cream on hand for ganache, but this cake was incredible. The cake was moist, the peanut butter frosting was not cloyingly sweet, and the chocolate frosting is perfect on top. I made this one totally spur of the moment, so we didn't have peanut butter cups on hand either. Again--not so pretty, but so, so good.

Thanks, Brown Eyed Baker! Here's the best peanut butter cake ever.

Mom's 60th Birthday in Hilton Head

When Mom's 60th birthday was approaching, I ran into some research about a Japanese tradition called kanreki. Many east Asian cultures embrace a version of kanreki, which is meant to be a celebration of achievements and a time of rebirth.

My dad, who turns 60 this year, celebrated his kanreki by finding a new love younger than his children and having a beautiful baby boy--truly leaving his wife and old family behind completely and starting over in an attempt to finally be happy. He seized his own "rebirth" for himself.

My mom, on the other hand, needed some celebrating. Of nine different choices, she chose a road trip to Hilton Head Island! The trip turned out to be quick and fun. One of our favorite parts was stopping at a pecan orchard outside of Macon on the way down. There's a huge commercial farm called Lane closer to the interstate, but we read some good reviews for Dickeys and headed to Musella. It was off season for peaches and pecans, but the shopkeepers were so nice, and we bought a few bags for the road. These pecans are nothing like the variety you generally find in stores. They're fatter and sweeter. They really taste like candy.

I like to have a plan on trips--even if we don't end up following most of it. :)

One of the best parts of the trip was the sunset tour of the Sound. It was gorgeous, and our tour guide was so knowledgeable and energetic.

Of course, if we could, we'd zoom to Tuscany for a month, but taking a pause to make a birthday memory was a good time.

FRIDAY

Stop in Macon

Arrive and check in

Dinner in Harbor Town OR sandwiches and cupcakes at Signes’

Walk to the beach for sunset

SATURDAY

Breakfast in the condo

Walk to the beach

Black Market Minerals & Coffee break at Caretta Coffee Company

5:15 PM to 7:15 PM: Sunset cruise tour of the Colibogue Sound

Dinner at the Salty Dog Cafe

SUNDAY

Palmetto Bay Sunrise Café

Drive Home

 

Dinner this Week:

We're having a 1960s, homestyle week. I have a can of pumpkin I've been hoarding in the pantry and an extra store bought pie crust from a quiche a while back, so I've decided to launch us on a one-dessert-per-week initiative. We'll take turns picking the dessert each week, and when we have kids, it'll be a tradition to take turns picking the dessert. Fun. Fun.


M- oven fried pork chops
YUM. I used thin-sliced, center-cut chops ($6.50 from Kroger. Thank you, Krog) I threw in some panko to the breadcrumb mix because I had it. These earned a spot on the permanent rotation.

T- honey glazed salmon with wasabi

Hm. I was attracted to this one because it's only 4 Weight Watchers points. Is wasabi always in a greenish mustard form? I don't know if I messed up something in the recipe, but the sauce was a very pungent combination of flavors. I'm a mustard lover, but the soy sauce, wasabi mustard, salmon, and honey combined into something I didn't love. I'd rather throw the salmon straight on the grill and serve with lemon or a Greek dill sauce.

W- salisbury steak 

Another trip to Mayberry. This was my first time making salisbury steak. I thought it would be a good alternative to burgers (lose the buns, Margaret). I used Ree Drummond's recipe (with onion powder in place of onions), and I loved it. The layers of flavors from the ketchup, Worcestershire, and beef broth make a really deep and flavorful gravy. When I make this again, I may try tomato paste in place of ketchup.

R-gnocchi with pomodoro sauce

This is the first time I've sauteed herbs in olive oil to start a sauce. I think it's going to be delicious!

F- breakfast

I'm winging it with a version of huevos rancheros this week. We'll see how it goes. 

dessert night (1 night)

pumpkin pie

I love cloves. I love cinnamon. I love pumpkin! I had some extra filling, so I baked it in custard cups. If I have an extra can of pumpkin in the future, I might just bake the custard without the crust or make some shortbread cookies to top the custard. Yum. Yum. Yum.

emergency desserts:

chocolate almond milk

Reflections on Standards-Based Grading (so far)

When you were in school, did your grades correspond with what your subject knowledge? For example, if you completed a lesson on arguing Cavalieri's theory in geometry, could you find a score in the gradebook like A or B?

A. 1-2 Homework
B. Argue Cavalieri's theory

I'm teaching summer school and trying out a version of standards-based grading. The experience promped me to do a little digging to see how far back this initiative goes.

 In 2008, the Association for Supervision and Curriculum Development proposed seven reasons schools should switch from assignment-based grades (math homework: 100%) to standards-based grading (arguing Cavalieri's Principle: 100%). Though standards-based grading has some benefits, there are also drawbacks that are important to consider.

1. Grades should have meaning.

In her ASCD article, Patricia L. Scriffiny writes that using "A", "B", "C" as grade symbols communicates little about the student's actual mastery level. Instead, teachers should use definitions like "An "A" means the student has completed proficient work on all course objectives and advanced work on some objectives."

***
That sounds reasonable. I'm curious how this plan would flesh out in the gradebook. Would the teacher input "advanced work" activities available only to students who reached that level? All others would receive zeroes for those scores--reflecting their zero-level mastery?

2. We need to challenge the status quo.

Scriffiny relates how her scoring practices evolved over her years as a teacher, citing her dissolution of homework in practice.

***
Yes. Homework has fallen out of pop culture. I worked with a former science professor for a few years who related Education to the practice of scientific researchers. Often, Education ebbs and flows along with the whims of pop culture without stopping to study whether the methods we have are effective or not. I don't like homework either, but as we challenge the status quo, perhaps we should be responsible as researchers in asking whether what we're doing (what math program we're using, what standards we're using, how we're evaluating teachers) is working and what grounds we have for thinking that the new method will be effective. Are there people in education using A/B testing?

3. We can control grading practices.

Scriffany offers a pep talk that teachers can lead change in their schools.

4. Standards-based grading reduces meaningless paperwork.

Scriffany vaguely implies that she provides formative feedback but grades nothing but assessments.

***

I wonder if we would lose something by focusing completely on product versus process + product. How can we maintain a sense of accountability and personal investment in the process for those students who need external accountability? Often, parents are the first to ask "Is this for a grade?"

5. It helps teachers adjust instruction.

***

This is so true. Being able to look in a gradebook and quickly track which students are "nearing proficiency" versus "expert" in a certain standard would make grouping and remediation a breeze. However, if grading systems move from a relatively consistent four-point scale to a helter-skelter proficiency scale, how will college applications and GPAs work?

6. It teaches what quality looks like.

Sciffany writes that standards-based grading pushes teachers to award scores for something other than extra credit and attendance thereby making grades more relevant.

***

This article is almost 10 years old. If we trust (and evaluate teachers) based on their standards-based programs, doesn't it follow that whether the gradebook lists the standard or "Expository Essay: Leadership," the work demonstrates practice or mastery of the standards? Are there teachers giving grades for attendance and behavior?

7. It's a launchpad to other reforms. 

***

As long as the oceans flow to the seas, education will be reforming. What and how we teach our children is a reflection of the evolving face and revolving door of politics, the media, and the experienced and inexperienced leaders of the public (and PRIVATE) educational sectors. Standards-based grading is not a launchpad any more than waking up and breathing is a launchpad. Education will change.

To read Sciffinay's article, visit the ACSD.

I see a few pros and cons of standards-based grading. In my situation, I give students a standards-tracker with a list of standards and corresponding choices of assignments. They spend half a day in a classroom working through the standards at a personal pace. For most standards, students have an option of a few different assignments to use to "prove" mastery of the standards.

Because our day (half a day in one classroom) is so long, I can conference with each student every second day. This gives me time to input scores (Unlike Sciffany, I'm using a traditional grading scale and percentages) and encourage students to retake/redo some work or 

 Standards-Based Grading Pros:

• Students seem more accountable and "in charge" of their progress. They hold the road map in their hands in the form of the standards tracker, and they can navigate the map as they like.
• It's easier to see patterns in proficiencies and deficiencies. At a gradebook glance, both the students and I can see all writing standards met or all language standards in the 70s. 

Standards-Based Grading Cons: 

• It's more efficient in English (and more reflective of actual life experiences) for one assignment to show mastery of multiple standards. If a student writes an expository essay and is scored using a rubric that includes each sub-standard of the writing standard (writing an introduction, using transitions, etc.), it may be that each substandard reflects a different mastery level. Though the score on the essay is an 84%, the student may have written an introduction at a 100% level."
• One of the advantages to face-to-face learning versus virtual school is the opportunity to collaborate and share a common "story" In a classroom, reading a novel together can build a strong sense of community in a classroom. It's hard to see  how this might work with a completely self-paced standards-based grading system like I'm testing.
• There are 50+ standards. In order to prove true mastery, a student should complete tasks over a few occasions. This means the gradebook is loaded with hundreds of scores. If better clarity is what instructional leaders are looking for with standards-based grading, they're not getting it.
• Parents don't understand standards-based grading.
• Students need training to avoid stress when looking at the pile of standards they're expected to master each semester.

A Compromise to Standards-Based Grading:

Missouri tried something years ago as a compromise between traditional and standards-based grading. Teachers created several key assignments that among them represented all standards for the course. Students were required to reach a certain level of mastery (75%, I think) on these assignments to pass the course and could re-do the assignments if necessary until they demonstrated mastery.

The other parts of the gradebook reflected a more traditional approach.

I like this idea because it's more manageable than inputting and tracking each standard individually. It connects students to the standards, but it also leaves room for courses that are Pre-AP and gear students for work that is even more rigorous than the standards. It is also more real-life. How often does a task represent a single skill, ability, or bit of knowledge? 

It will be interesting to see where this goes.

Digging my Favorite High School Poem

Hey There,

What do you remember from your high school lit classes? I remember in the late 90s, my Missouri high school still did not have air conditioning. What? I'm serious. Freshman year, I remember reading the part of Juliet one September afternoon while sweat poured down my face. A rose by any other name?

Not every experience in lit was so excruciating. I can't remember what year we read it, but one of my favorite poems was one of Seamus Heaney's most popular poems, "Digging." When Heaney won the Nobel Prize for Literature in 1995, the foundation granting it "for works of lyrical beauty and ethical depth, which exalt everyday miracles and the living past."

Lyrical beauty.
Ethical depth.
Exalted everyday miracles.
The living past.

Wow. What a legacy. What a beautiful way of seeing the world.

In "Digging," he captures heritage so poignantly. You can tell that the speaker has watched his father digging over the course of many years and that he's noticed the rhythm and care of his father at work. The pride of coming from fine North Irish digging stock reflects in the scatter of new potatoes and the spaded heave of new sod. Gorgeous.

The greatest literature speaks once and speaks a thousand times because you never land on the page the same person. Tonight, I'm struck by the peace and confidence the speaker has with his pen. He's not mad he and his father aren't spending time together planting in the garden. He's upstairs with a pen in hand, contributing to the world in a way he trusts he should. I imagine him in a house like the one off in the distance in the pic (by flight187 on flickr @public domain) above.

Here is Digging as printed by the Poetry Foundation.

Between my finger and my thumb
The squat pen rests; snug as a gun.

Under my window, a clean rasping sound
When the spade sinks into gravelly ground:
My father, digging. I look down

Till his straining rump among the flowerbeds  
Bends low, comes up twenty years away  
Stooping in rhythm through potato drills  
Where he was digging.

The coarse boot nestled on the lug, the shaft  
Against the inside knee was levered firmly.
He rooted out tall tops, buried the bright edge deep
To scatter new potatoes that we picked,
Loving their cool hardness in our hands.

By God, the old man could handle a spade.  
Just like his old man.

My grandfather cut more turf in a day
Than any other man on Toner’s bog.
Once I carried him milk in a bottle
Corked sloppily with paper. He straightened up
To drink it, then fell to right away
Nicking and slicing neatly, heaving sods
Over his shoulder, going down and down
For the good turf. Digging.

The cold smell of potato mould, the squelch and slap
Of soggy peat, the curt cuts of an edge
Through living roots awaken in my head.
But I’ve no spade to follow men like them.

Between my finger and my thumb
The squat pen rests.
I’ll dig with it.