Sunday, March 20, 2011


I've done it! I've successfully completed my first term in graduate school, and I didn't even end up in the mental asylum! (I did find a couple gray hairs, but we'll address that on another day... ;)

These last few days have been a complete blur with me scrambling to get things finished.  Today I spent several hours camped out in the bedroom churning out a 9 page paper for my History of Nurse-Midwifery class. At this point I don't even care if I get a bad great on it, I'm just so happy to be finished.

Now I get to enjoy 2 whole weeks before starting it up again.  The next term's classes are Decision Making in Health Assessment and Theories in Advanced Primary Care Nursing....and I just bought the required 5* books. Ugh.

* There are actually 6 required books, but the other one is an APA manual.  I'm not buying it because I already own 2 of them and have the PERRLA I really don't feel like cluttering up my bookcase with another book. I'd appreciate it if you didn't tell on me. 

Thursday, March 17, 2011

I'm finished with Pathophys!

It seems so surreal that I have (successfully) completed my first graduate-level pathophysiology no less! At this point I have taken 3 courses in this subject alone...and it is by far one of the most difficult ones for me.   Not only that, but I was 1 point away from an A too!  I refuse to be discouraged about my grade, because I am absolutely flabbergasted that I was able to get through it successfully without going completely insane!!!

Today alone I took 3 exams, listened to a 71 minute long lecture, wrote a paper and completed a homework assignment.  If only I was able to plow through like this all term I may have been able to finish it sooner!  Well, no not really because I still had to listen to her lectures as she put them up...oh well.

I AM SO RELIEVED TO BE DONE! (with pathophys...I still have to write 2 papers for my History of Nurse-Midwifery course...which shall be completed by this weekend)


Go, Go, Go!

I completed a homework assignment and an exam during Allie's nap today! (oh and took a was definitely a necessity)

Now I only have 1 exam and 3 homework assignments (1 large and 2 small papers) to go. I can do this!

Go, Go, Go!!

Friday, March 11, 2011

A couple of thoughts...

I have two reflections to post about:

1) I am utterly sick and tired of typing out the etiology, pathophysiology and clinical manifestations of various disorders. Seriously.

2) I just realized that I have 2 weeks to complete 4 exams, 2 homework assignments and 3 papers.  Will I be successful??  Time will tell! (insert *goingcrazy* emoticon here)

Wednesday, March 2, 2011

Exams, Exams and more Exams!

I had a minor nervous breakdown the other day for multiple reasons, but one being because of school.  I'm finding it more difficult to set aside homework time than I was hoping it would be, which really shouldn't be any surprise when you think that our household has 2 adults working full-time with both in school part-time and a little monkey who's main goal in life seems to be to completely destroy this house ;)    Oh, and let's not forget the minor fact that we are also trying to get said house ready to put on the market!  (which brings in an additional set of complications)

Anyway, I started this week off being 2 weeks behind in patho since I had taken some time off of that to devote all my time to a paper due in the history course.  Thankfully I was able to take one exam on Sunday and have gotten prepared to take another exam tonight (Wednesday) and that will bring me up to speed. Then I can start working on this week's homework ;)


I'll be so glad when I am finished with Pathophysiology.  It is by far the most difficult subject for me.  Next term I will be taking courses in Nursing Theory and Decision Making.  Not specifically midwifery related, but oh well.  Hopefully they won't be too difficult.  I think I get something like a week and a half off between these two terms, but I'll have to double-check.  Not much of a break....

Saturday, February 12, 2011

Emotional upset surrounding milk letdown...

Navelgazing Midwife has a blog I follow and she posted a topic today that I find simple fascinating.  Apparently, there is a condition known as Dysphoric Milk Ejection Reflex (D-mer) that causes some women to have intensely negative feelings when their milk is letdown and all throughout the feeding process. Can you imagine a new Mother with her first child, who is already struggling to adjust to her new life and little one, only to have this extra situation piled on?  These poor women, and I am curious to see if this is corelated with PPD and a more difficult bonding between Mother and Child.

Her direct link is below:
Terrible Emotional Feelings Surrounding Letdown

and this is what it says:

Terrible Feelings Surrounding Letdown?

You might have something called Dysphoric Milk Ejection Reflex -D-Mer for short.
I stumbled across an article a couple of days ago and while I’m still reading about the condition, I didn’t want to wait until I was more knowledgeable before sharing it here. 
Just-Identified Breastfeeding Disorder Gives New Meaning to ‘Letdown’,” written in Babble’s Strollerderby, speaks D-Mer, a negative visceral reaction surrounding the let-down reflex while nursing. It seems to have been begun being studied in 2008… that’s the earliest studies I can find. (A list of the available studies is found on the D-Mer.orgwebsite.) 
While the causes are still being explored and studied, it seems there’s a glitch in the dopamine receptor and its regulation. This is the more scientific area I’ll look at later. 
It’s the information that women aren’t nuts if they feel these feelings during nursing that I want to get out right now. 
Alia Macrina Heise writes in “Opening the Door to Breastfeeding’s Best Kept Secret”: 
“The birth was a fairytale and my babymoon was like a dream. Then the babymoon came to an abrupt end as I started to find that just before my milk released, each and every time, I had an overwhelming sensation of guilt, dread and horror. I didn't have any pain, no physical problems, just a surge of negative emotions that hit me in the gut out of nowhere, only to fade away a few moments after my milk released from my breast. I felt great otherwise.” 
Michelle writes in “A Feeling of Dread – Michelle’s Story”: 
“I asked myself if maybe it was postnatal depression, but that didn’t sit right. I was actually elated to have birthed at home and to have had such a great experience. Maybe I was coming down from that high? I wasn’t sure. At first the bad feelings were like an intuition, that something really bad was about to happen. There was nothing I could put my finger on, but I had been trying so hard to tune into my intuition over the final weeks of pregnancy and during labour, I thought I was somehow now psychic and that bad things were about to happen to me, the kids, my husband, the house. Once I even hobbled out of bed to check my older son, not really sure why, but so sure that something was wrong.” 
This is fascinating. And is a testament that even someone like me who reads nearly everything she can find on birth and nursing, there are still black holes of knowledge that need filling. I wrote in Facebook: 
“It's when topics like this come up... a very, very important link in the birth process... that I've never heard of before that keeps me humble as all get out. You all see only a part of what I read on a daily basis and... for goodness sake,... I was a La Leche League leader for 10 years! I just cannot believe I've never heard of this. 
And yes! When I take this new color to the breastfeeding spectrum and hold it up against the misunderstood or confusing situations I've seen over the last almost 3 decades, some of them make perfect sense. As Erin said, ‘I never understood why some women said they hated breastfeeding... now I get it.’ 
And, beside the humbling aspects, this also serves as a GLARING reminder of the massive amounts of information still yet to be ‘discovered’ and named and studied... experiences women right next to us... or even ourselves... have no explanation for that, if we had the future knowledge, might change the entire relationship with our bodies/our breasts/our babies/our partners/our minds. 
Just wow.”
I hope this information resonates with any of you that might not have heard of D-Mer either.

Friday, February 11, 2011

Passed Exam 2

I passed Exam 2 after stressing out about it for two weeks. I am so glad that is over with!  I've also already taken the open book exam covering chapters 44 and 45, which luckily I did well in. Now to move forward and prepare for Exams 3a and 3b...only 6 more exams and a few homeworks to go and I'll be finished with this class.

At some point I really need to work on my Midwifery paper or my partner is going to beat me.  Perhaps I'll do that tonight or tomorrow after Andrew comes home.

Ugh. Remind me why I thought going to grad school was a good idea :S

Disclaimer: After having my brain melt over school, I have apparently lost the ability to form proper sentences and follow grammatical rules.  You're stuck with this because I am too tired to change it ;)

I am an idiot.

So as I am sitting here getting ready to listen to my most recent Elluminate session (online class lecture), I realize that I had completely forgotten to listen to the one covering my last exam. No wonder I did so poorly on it!

...I guess the only positive thought I could take from this is that now I have more insight as to what happened with that last exam and what else I can do for my future ones. What a harsh lesson though. :(

Tuesday, February 8, 2011

An email from a friend

I just received a great email that I'm posting here so I can remember it whenever I'm feeling discouraged :)


Hey girl! I know you had been having a lot going on over the past couple of weeks. I hope that all is going better. It has been very overwhelming to work full time, school full time, and have a family....adding sickness for both yourself and your little doesn't help. Keep your head up and moving are so strong and your desire to succeed will help you get through it. I am keeping you in my prayers and just wanted you to know that I was thinking about you..
Love, J


Ugh, these last couple of weeks have been a complete blur.   I came down with the norovirus and a bad URI/influenza/plague that knocked me off of my feet for a couple days. Then of course Allie came down with it and had a fever for several days, which one time resulted in us taking her to the hospital because it was 105.1 rectally. Then she continued to have the coughing/sneezing/wheezing nonsense and was just overall not a happy camper. Pretty stressful time for the Bowers fam.

Of course I tried to continue to keep up with my homework and so I took an exam in Pathophysiology (Exam 1b).  Which I failed. Hard.   That resulted in a couple conversations with my instructor and advisor, and then I had to fill out a student learning plan basically outlining what the problem was and my plan to fix it.   Fun times all around.

So now I've been working on the study guide for Exam 2 for two weeks now and I'm scared to take the exam for fear that I will fail again.  My self-esteem is pretty much shot with this class, even though I got a 96 on the first exam. (Seriously, who follows up a 96 with a failure?)

So that's where I am now. Oh and my midwifery class?  Haven't thought about that in almost 2 weeks because of Pathophysiology! ;)

Tuesday, January 25, 2011

First Exam...and I got an...


I took my first secured exam in Pathophysiology on Saturday after spending several days working through the study guide.  I was pretty nervous, especially since I was delayed somewhat by coming down with the norovirus (thanks work!)

Luckily, I only missed one, which gave me a 96 on the exam. Phew!  There may be some hope with me passing this class after all! ;)

Thursday, January 13, 2011

Holy stress levels, Batman!

Well classes have officially begun as of January 10th. Of course the majority of our classmates on the Facebook group are nice and freaked out, but hopefully things will calm down once we all get into the swing of things. 

I took one of this week's exams in pathophysiology yesterday. It was in acid-base imbalances, and thankfully I aced it.  It did help that it was open book, but I'm pretty proud of myself anyway because I was able to pick the correct answers, Haha!

One thing I picked up on pretty quickly is the amount of reading we have to do each week. It is a TON.  I am so glad that I didn't try to register for 3 classes this term...I think the readings alone would have killed me!

As excited as I am about finally starting my courses again, I have a very much unwanted added stressor.  One benefit that my employer offers is tuition reimbursement, which is fantastic, however even though I had it all finalized...the HR rep sent me an email last week saying she needed a form for the school to fill out before they could remit payment.  Well that was accomplished quickly enough, but then fast forward a week of me calling and pretty much stalking the woman until I finally got ahold of her supervisor, and then she finally decided to return my phone call.  So now the payment won't be sent out for another week or so due to "processing."    Too bad the tuition is due the 15th and if my school doesn't receive payment by that time I will be suspended.  Reinstation isn't such a huge issue, but that means I can't turn in any assignments or complete any exams during that I get hit with a late fee.

Needless to say, I'm freaked out.  I've sent a few emails to my school's financial advisor trying to get an extension. We'll see what she has to say. :(

Tuesday, January 4, 2011

Posterior Tongue-Tie

This is a fascinating read for someone, such as myself, who after all her experience and education regarding breastfeeding, still couldn't get her daughter to properly breastfeed. Yes, I was able to still provide her with milk from pumping. But that was by far a second-best option for me.

Original article posted on: Stand and Deliver


Posterior tongue-tie

In last weeks' post A Proactive Approach to Breastfeeding, I briefly mentioned tongue tie as a possible culprit for breastfeeding problems. Cassandra of wrote in about her daughter's posterior tongue tie:
My 3 month old recently had a posterior tongue tie fixed after being told by three different IBCLC, my midwife and a pediatrician that nothing was wrong with her. She got clipped and like magic latched for the very first time. I'm doing what I can to spread the word about this rare but severely underdiagnosed problem since if I hadn't been extremely stubborn and kept at it, this problem would never have been taken care of. Here is a very in depth and fantastic resource for diagnosing tongue tie of every type:

I wanted so very badly to breastfed I seriously almost killed myself over not being able to (yay hormones) and it's incredibly frustrating that it was a problem that could have been fixed, but nobody caught what was actually a pretty obvious tongue tie. I don't want to see any other moms go through the same thing.
Yesterday, Shannon shared her story of posterior tongue tie at the Motherwear Breastfeeding Blog. Shannon was an IBCLC and still did not pick up on the tongue tie! It wasn't until she was in a room full of IBCLCs (most of whom misdiagnosed the problem as well) that she met one woman experienced with posterior tongue tie. Like Cassandra's story, as soon as Shannon took her baby in to have the tongue tie clipped, the baby latched on perfectly for the first time. Here are a few excerpts from her story:
After the birth of my first son Aidan, I was so excited to nurse. After spending so many years teaching breastfeeding, I was finally going to experience it myself. In the labor and delivery room when I nursed him for the first time, I was surprised at how painful it was. I knew I was latching him correctly; after all, I was the expert! When he came off, my nipple was misshaped, smashed into a slant, like a new tube of lipstick. I looked at his tongue and he could stick it out, so I thought it was not tongue tie. By the next day, my nipples were cracked and bleeding. The agony was too much, and I had to pump and bottle feed most of the time to give my nipples a break. I was devastated and thought I might have to change careers.

I was ashamed that as an IBCLC I couldn't get this right, and the only person I could be honest with was my husband. When friends and colleagues would ask how things were going, I was not fully honest about how terrible I was feeling. When Aidan nursed, it was more than just a pinching or biting feeling. It was irritating, like sand paper on my nipple. His sucking was choppy, and he was having a hard time maintaining latch. Feedings were 45-60 minutes long....

Then there was one IBCLC, Debra Page, who saw him stick out his tongue and said I think he is tongue tied. I asked her to explain because when I worked in the hospital, the babies I saw who were tongue tied could not stick out their tongue past their gums, and if they did, it was heart-shaped on the tip. She said there were different types of tongue tie, the obvious ones are type 1 or type 2, and it looked like Aidan had a type 3 posterior tongue tie. I had never heard of this. She explained that he couldn't elevate or lateralize his tongue, and when he did stick it out, it was duck bill shaped, not pointed.

The surgeon we went to, Dr. Elizabeth Coryllos, explained that she would do the frenotomy in the office and she would numb him under his tongue. I began to cry. She assured me it would not be painful to him and he would be able to nurse right away. I told her that was not why I was crying. I explained to her I was upset that I was not able to solve this on my own, that as a professional and as a mom I felt like a failure. Then she gave me the best advice I have ever heard as a mom. She said even if I was the best race car driver in the world and I had the best car ever built I could not win the race if a tree fell across the track. Someone would have to remove the barrier so my car and I could continue on our journey. It was not my fault that nursing was not going well. I had the best baby in the world and I was the best mom for him; we just needed to remove the barrier to continue on our journey.
In an AAP newsletter on breastfeeding, the article Congenital Tongue-Tie and its Impact on Breastfeeding (PDF) explains the four types of tongue tie and how they can affect breastfeeding.
Types 1 and 2, considered “classical” tongue-tie, are the most common and obvious tongue-ties, and probably account for 75% of incidence. Types 3 and 4 are less common, and since they are more difficult to visualize are the most likely to go untreated. Type 4 is most likely to cause difficulty with bolus handling and swallowing, resulting in more significant symptoms for mother and infant.

An infant can obtain milk from a bottle without the wide gape and consistent suction needed for a good breast latch. If the tongue-tied infant cannot maintain the tongue over the lower gum during sucking, the “phasic bite reflex” (chewing) is triggered. This chewing motion is ufficient to transfer milk from the bottle, but is clearly problematic at breast. Bottle feeding allows milk to drip into the mouth without effort, thus requiring less tongue muscle effort (such as tongue grooving, cupping and depression) than needed for breastfeeding. Breastfeeding requires well-defined peristalsis from the front to the back of the tongue as well as tongue–palate synchronization. Some tongue-tied infants cannot even manage a bottle.
Even more simple forms of tongue tie can be overlooked. In Totally Tongue-Tied, Sheila, an experienced breastfeeding mom, describes her difficulties nursing her third baby. She had expressed concern to her pediatrician about possible tongue-tie, and he told her that " there was nothing wrong with Kyle's tongue since he could extend it out past his lips." But it turns out her baby was tongue-tied. His latch improved somewhat after the frenotomy, but he still had to learn how to latch, to drink, and to extend his tongue properly. She writes:
I was frustrated that it was taking so much work to train him to suck, but the lactation consultant reminded me, "He hasn't been able to move his tongue out of his mouth for 9 months. It's going to take more than a few days to teach him to use it properly to nurse." The next day, I noticed Kyle was actually sucking and swallowing while at the breast, so I started massaging the breast while he was nursing to encourage the milk out and his swallowing per suck ratio increased dramatically. He was still requiring about an ounce of additional expressed human milk after nursing most of the time, but this was major progress. At three months, Kyle is now nursing totally independent of any supplements, and only occasionally requires adjustment of his sucking.

I never expected my third child to be the most difficult to breastfeed. I feel very fortunate to have an extensive network of support from friends and family. I am eternally grateful for a loving and supportive husband who feels as strongly about the importance of mother's milk as I do. I am also thankful for the support and encouragement I have received from my La Leche League friends. Without them, I feel I may not have been able to provide my son with the best nutrition available to him, his mommy's milk.

School is starting soon!

I feel like I just turned in my Final exam for in the world is the next term coming up so quickly!?!

At any rate, January 10th is quickly approaching whether I'm ready or not.  I told myself I wouldn't do any school work ahead of schedule, but I did go ahead and setup folders on my Google docs site so I can organize it.  I have OneNote at home, which I actually prefer (especially since I paid for it), but I need something that I can access at work. Unfortunately, I don't think they'd let me tote around my giant laptop....

I'll be taking a course covering the Role of Midwifery and Birthing Centers in America, as well as a course in Pathophysiology. Both, of course, are graduate level.   I'm so excited to finally be starting to work on my Masters, and yet I still can't believe I'm here. It seems so surreal and feels like just yesterday I was working on my first undergraduate degree in Biology. Where has the time gone!?!?!

I'm somewhat nervous about Pathophys...I find the subject fascinating, but so complicated! I hope my brain can handle all this information!