Friday, March 30, 2012

Routine "health" care for babies

There won't be any silly "look at the pregnant chick doing crazy CrossFit things" in this post.  Time to touch on something serious.  Because I babysat and nannied a ton throughout college and law school, I always figured I knew most everything there was to know about babies and how to take care of them.  But since becoming pregnant, I've realized how little I knew about all of the decisions Justin and I will have to make as parents, especially when it comes to medical decisions.

Like many crossfitters, I'm not one to blindly trust generally accepted health and medical "science" just because it's generally accepted.  You could show me thousands of medical articles and ridiculous infographics about how meat is killing me and whole grains / low fat dairy are the secret to a healthy life, and it would not change the fact that I know eating paleo is the most healthy diet for me and my family.  And if something is government recommended, I'm going to question it even more.  So when I started reading about routine medical procedures for newborns, I realized I was going to need to do my own research.

Early in my pregnancy, I bought a couple popular pregnancy books -- What to Expect when You're Expecting and Mayo Clinics Guide to a Healthy Pregnancy.  These books are fine for things like "how baby's developing" and "weird things that will happen to you and your body while pregnant," but when they briefly touch on routine newborn procedures, they aren't helpful or informative ... in fact, they are pretty misleading.  For instance, newborns are rountinely given eye ointment in hospitals.  What to Expect merely says this treatment is mandated in many states and that "antibotic ointment prevents infections that can cause blindness."  Without any discussion of risks or the parents' right to refuse the treatment, the message is simply "your baby will receive eye ointment so he/she doesn't become blind."  And the parent's reaction is supposed to be "I don't want my baby to be blind, so the eye ointment is a good thing.  Besides, it's mandated, so I have no choice."  Of course, it's not that simple. 


- Eye Ointment.  The infections that cause blindness are caused by bacteria when the mother has gonorrhea or chlamydia.  Many women with these STDs don't have any identifiable symptoms, so rather than test the mother, we just give the eye drops to every newborn.  The eye drops or ointment cause blurry vision and can irritate the baby's eyes.  So, if I don't have an STD, what's the point?  None, from what I can tell.  

- Vitamin K Injection.  Newborns routinely receive an injection of Vitamin K. The reasoning behind this is the belief that infants are deficient in Vitamin K (because Vitamin K doesn't pass through the placenta), and Vitamin K is needed for blood clotting.  5 out of 100,000 babies that don't receive the injection suffer from a bleeding disorder called hemmorhagic disease that can cause brain damage and death.  Breastfed babies are at higher risk of the disorder because formula is fortified with Vitamin K.  The injection essentially eliminates this small risk.  Some studies linked the Vitamin K injection with an increased risk of childhood leukemia; this association has been discredited, but there are other risks to the injection

- Hepatitis B Vaccine.  While still in the hospital, newborns typically receive their first of three doses of the Hepatitis B vaccine.  The CDC began recommending the HepB vaccine for all infants in 1991.  To prevent what?  Hepatitis B is spread through bodily fluids.  The only way my baby could have Hepatitis B at birth is if I have the disease (I don't).  After birth, my baby could get Hepatitis B by having sex with an infected person or IV drug use -- I see these as minimal risks.  And vaccines aren't effective forever.  10-15 years after vaccination, especially if vaccinated as a child, a person may not be immune from the disease.  If my child is having unprotected sex and doing drugs by age 10-15, then I'll consider myself a failure as a parent for many more reasons than his/her possible unimmunized exposure to Hepatitis B.  Besides being completely unnecessary in most infants, like all vaccines, this one is not without risks and adverse reactions


It was easy to conclude that the risks of the HepB vaccine far outweigh our child's risk of contracting the disease.  Check that one off the list.  (Don't worry, I'll be sure to tell other parents not to let their kids have sex with or share needles with mine).  What about other vaccines?  I never knew much about the whole vaccine debate, but Jenny McCarthy as the face of the connection between vaccine and autism did not exactly inspire credibility.  I mean, I received vaccines as a child and always assumed this was a good thing and prevented horrible diseases, so what's the problem?

When I was born (1984), there were 7 routine vaccinations given to children:  the polio vaccine, a combination vaccine for diphtheria, tetanus, and pertussis (DTP) in two doses, and a comination vaccine for measles, mumps, and rubella (MMR) in two doses.  So at that time, children received 5 shots, no more than one shot per doctor visit, and were vaccinated against 7 diseases.  Now, the CDC recommends routine vaccines against 14 diseases by age 6.  In addition to polio, DTP (now DTap), and MMR, we now also vaccinate for Hepatitis B (recommended since 1991), Rotavirus (2006), Haemophilus influenzae type b (1989), Pneumococcal (2000), influenza (2002), Varicella (chicken pox) (1996), Hepatitis A (2000), and sometimes Meningococcal.  Many of these are given in three doses at ages 2 months, 4 months, and 6 months, with the baby receiving as many as six shots in one visit.   By 18 months, babies on the recommended CDC vaccination schedule will receive 25 vaccine injections.  Is this a good thing?  Obviously the CDC, the general medical community, and drug companies think that it is. 

My instinct is that this seems excessive.  Why are so many more vaccines given now?  When I was growing up, everyone got chicken pox and it was no big deal.  You get it, then you are immune.  (In fact, the chicken pox vaccine may be contributing to rising rates of adults getting shingles, a virus related to chicken pox.  But don't worry, a shingles vaccine is on the way!)  Another disease we now vaccinate for that seems especially silly is rotavirus.  Rotavirus causes diarrhea, vomiting, fever, and other flu like symptoms for 3-8 days.  It's very contageous and common in babies and young children, but immunity builds after the first infection. By age 5, most healthy children have built natural antibodies and won't exhibit symptoms when exposed to rotavirus.  Rotavirus can lead to dehydration, which can be fatal (it caused about 20-40 infant deaths in 1999).  Nobody wants to see their kids get sick, but what's wrong with letting kids be exposed to some viruses, recover, and naturally build a strong immune system? 

And the vaccines themselves are not without risks.  All vaccines have potential side effects.  This debate is heated on both sides, but some people believe vaccines are contributing to rising rates of other childhood autoimmune illnesses such as autism, ADHD, and asthma.  Just this week, the CDC issued a report estimating that 1 in 88 children (11.3 per 1,000 children) has an autism spectrum disorder.  The CDC, and most other reports, dismiss some (or all) of this increase -- an increase of 78% since just 2007 -- on changes in the way these disorders are identified and diagnosed.  The prevalence of autism spectrum disorders in the 1980s was believed to be 5 in 10,000 (or 1 in 2,000) persons.  Although not implicating vaccines as a cause, some studies indicate that environment is contributing to the increase in autism rates.  Understandably, parents want to know what's causing so many more kids to have these disorders.

In 2008, The Doctors discussed the measles and the MMR vaccine, and I think it gives a good summary of the debate:

I'm not a doctor, but I am an attorney, and in order to convince me of something, your argument has to make sense.  Starting off by calling 130 cases of measles nationwide in a year an "outbreak" isn't a great start, and neither is dismissing the link between the MMR vaccine and autism because "most doctors and scientists agree that it probably isn't the major cause."  But let's talk about how aweful it is if your child gets the measles -- 1 out of 1,000 children who get the measles will die.  That's horrible!  (Usually it's mild -- you get a "terrible" rash, cough, and cold symptoms.)  But "the child is miserable," and don't forget, it can be fatal.  (Remember that 1 in 1,000 chance?)  [He forgot to mention that most healthy children recover from the measles without complications and then have lifelong immunity from the disease.]  Don't worry, former Bachelor Dr. Travis Stork will put your mind at ease about vaccines: "the life expectancy in this country is longer than it's even been, and it's because of things like vaccinations."  Well, that's just an illogical argument in this context.  How can we possibly know the life expectancy of children born today and receiving vaccinations in this manner when it's something we've only been doing at this magnitude for less than a generation?  And if vaccines do cause or contribute to other autoimmune problems, is that really a fair trade off for a longer life expectancy? 

I've barely scratched the surface of the amount of information out there, and I'm certainly in no position to say whether I believe vaccines are causing autism or other disorders in children.  But I do think it's possible that injecting babies with so much foreign material at a time when their brains and bodies are rapidly developing could affect their development and immune systems.  Saying there's no link between vaccines and other childhood disorders and dismissing the debate as settled doesn't sit well with me, especially where there is heavy influence from the government and drug companies.  And from what I've read, the studies that have concluded there is no causal link have looked at a single vaccine in isolation where, in reality, we are giving babies 5-6 injections at one visit.  

I think a lot of parents see their baby's 2 month appointment as the time where their baby's doctor will activate the baby's immune system and the baby will be magically protected from all these deadly diseases.  There's a pregnancy message board that I sometimes visit, and I recently read a thread about pertusis (whopping cough) and whether others will be requiring their family members to be up to date on their DTaP vaccine before being allowed around the baby.  Comment after comment talked about how whooping cough is "almost 100% fatal in infants."  Well, that just isn't true -- according to the CDC, over 50% of the infants who get whooping cough will be hospitalized, and of those hospitalized, 1 in 100 will die.  If my math is correct, that's just over 0.5% chance of fatality.  In 2010, there were 27,550 reported cases of whooping cough in the U.S. with 27 reported deaths and 25 of those deaths were infants under 1 year old.  Scary, yes, but certainly not a guaranteed death sentence.

I think it's best for people to, first, be aware that the safety and necessity of vaccines is a legitimate question to have and not just accept a simplistic argument like "our life expectancy is longer than ever because of vaccines, and if we don't vaccinate, we will have disease epidemics running rampant."  And second, educate themselves of the true risks of the diseases as well as the risks of the vaccines themselves.  Justin and my approach is to find a pediatrician that will support whatever educated decisions we decide to make and go though, disease by disease and vaccine by vaccine, and weigh the risks. 

57 days left! 

Monday, March 26, 2012

2012 CrossFit Games Open: Complete

The 2012 CrossFit Games Open is in the books, and I can officially check off my goal of competing in the Open while pregnant.  Even 7 months pregnant, I'm the 218th fittest woman in the North Central region.  Not bad. 

12.5 was last year's 11.6, so it was easy to compare how much the extra weight is holding me back.  Last year, I did 11.6 twice and got 89 reps the first time and 91 reps the second time.  This year, I got 70 reps.  My weight is around 150-153# now (about 25-28# heavier than I was last year at this time), so not surprisingly, the chest to bar pull ups were tough.  To put it in pre-pregnancy perspective, my max weighted chest to bar pull up on August 1, 2011 was 28.5# ... basically my current body weight, yikes!       

I'm proud to say, CrossFit 515 represented very well in the Open!  The team finished 6th in the North Central region and 46th worldwide.  Jaime Noyce (7th), Bobby Noyce (12th), and Bart Boyd (25th) qualified individually for regionals.  And Shelley Noyce, my mom and reigning Games champion in her age group, finished 3rd worldwide in the 55-59 year old master women division ... headed back to Cali!  Let's hope we have some more 515 athletes joining her.  I'm excited to watch everyone train and prepare to dominate in Chicago this year!!!

Now that the Open is over, I think I need a new crossfitting while pregnant goal to set my sights on because, I'll admit, I'm getting sick of being pregnant while working out.  Not that there's much I'm scaling or not doing -- I still do things like rope climbs, handstand walk, and got a new 3RM on overhead squats yesterday of 140# (prior 3RM was 135# and 1RM is 145#).  But, especially after watching everyone at CrossFit 515 crush the Open wods, I'm getting anxious to be able to train as hard as I want again and get back to being able to do everything I used to do.

61 days left!

Monday, March 19, 2012

30 Weeks & Open wod 12.4

30 Weeks

20 Weeks

Less than 10 weeks to go!  It's funny looking back on pictures where I first thought I was really looking pregnant (around 20 weeks) and comparing to now ... and thinking how HUGE I'm going to get over the next 10(ish) weeks.  It's crazy everything that happens and how much your body can change in such a short amount of time.

There are definitely some down sides to being pregnant, especially on days like St. Patrick's Day, but I still have no big complaints.  I have to pee a lot, but I've always had to pee a lot, and sometimes my back hurts.  But I'm (mostly) just enjoying the experience ... and Justin's and Bobby's fat jokes.  Enjoy them while you can, losers.    

I'm just one workout away from accomplishing my goal of competing in the Open.  And I'm not the only crazy pregnant lady doing this -- -- Shanyn has visited CrossFit515 a few times and is due about a week before I am.  (Notice from her video that she's also still doing box jumps).  And she got 93 reps on 12.2, 9th in her region on that workout -- WOW!

About 12.4 - I wasn't super excited when 12.4 was announced.  Wallballs have never been my thing, double unders have gotten a lot harder lately, and muscles ups stopped happening around 19 weeks.  Pre-pregnancy I was decent at muscles ups, and that's one thing I'm really looking forward to being able to do again.  Here's pre-pregnancy video of my second ever muscle up (Nov. 2010) and me doing Amanda (July 2011):  

 Anyway, my goal for 12.4 was obvious: get through the double unders.  With a 9' wallball target, I didn't think this would be too difficult to achieve.  But on my first attempt last Thursday, I only made it through 71 of the double unders.  My excuses:  it was my 3rd day in a row working out, I was still sore from my version of "J.T." (21-15-9, shoulder press 65#, dips with a band, push ups), and I had a stupid strategy (starting with a set of 25 wallballs).  Even though my score wasn't going to matter for the team, I wanted to get through the double unders.  So after a few days of hobbling around and wondering if my legs would ever feel normal again, I redid 12.4 on Sunday with a strategy of doing sets of 10 throughout for wallballs and double unders:   

Not much time to spare, but got my 240!  I only left myself a few seconds for a really solid muscle up attempt that wasn't captured on video.  Trust me, it was super close.  At least my legs aren't as sore after my second attempt at this wod as they were after my first.  I must have looked like a big, uncomfortable pregnant lady because while waddling around last Friday, I was asked "are you due any day?"  Nope ...

68 days left :)   

Thursday, March 15, 2012

Jumping while Pregnant will NOT cause Brain Damage

The moron that commented on my 12.3 video had some more insight.  Here's the comment and my response: 

I think a lot of people have this gut reaction that a pregnant woman shouldn't be jumping, so I'll address this.  There are legitimate things to be concerned about with jarring exercises like jumping and running while pregnant, but "bashing [the baby's] heat (or head)" and causing brain damage is not one of them.  The baby is well protected by amniotic fluid in the uterus, and I cannot find a single (reliable or unreliable) source that says brain damage or anything like shaken baby syndrome can occur while in the womb.  But since pioneerworx is concerned about my baby's safety, I'll address some legitimate concerns about jumping while pregnant:
  • The uterus becomes heavy during pregnancy (baby + amniotic fluid + placenta) and puts pressure on the cervix.  Jumping and running can cause impact between the uterus and cervix, and could cause preterm labor.  Women vary in their ability to handle these activities during pregnancy, so the main thing is to listen to your body and STOP if it feels uncomfortable, especially if you experience any contractions.  The only risk to the baby here is being born too early, not physical injury from the impact of mom jumping.  As I mentioned in my last post, running is no longer comfortable for me, so I no longer run.  I still feel good doing box jumps and double unders, so I still do them.  If/when they become uncomfortable, I will stop.
  • During pregnancy, the placenta produces the horomone relaxin which causes the joints to loosen.  It also "relaxes" ligaments, allowing the uterus and pelvis to expand.  Good things for carrying and delivering a baby, but all joints and ligaments become looser, so pregnant women should be extra careful to avoid injury.  This is why advises not to squat below parallel and to be careful on box jumps (or do step ups).  Most women that were crossfitting before pregnancy will have strong muscles that can handle the shifting/loosening joints.  I personally have not yet noticed any difference because of this.  The risk here is injury to the mom, not the baby.
  • When anyone, pregnant or not, does box jumps, there is a risk of missing the box and falling.  Your center of gravity shifts during prenancy, although I have yet to experience difficulty balancing, I'm told it will happen.  But jumping does become more difficult as you gain weight (duh).  The risk of falling is the main reason I scaled down from 24" to 20" box jumps as early as I did.  I did miss one box jump in 12.3 (Justin was not happy with me about this), but I've never missed a box jump and come anywhere close to hitting my stomach on the box or actually falling to the ground.  I've never witnessed anyone else do this either.  I suppose it's a risk, but I see it as a minimal one. 
My main point: any source that talks about avoiding jumping/jarring exercises and activities while pregnant are NOT concerned about the baby shaking and getting brain damage.  Yes, the baby's brain is still developing -- that is a reason to get plenty of omega 3's, not a reason to stop doing box jumps.  There are legitimate reasons for me to stop doing box jumps at this point, but bashing my baby's head is not one of them.  

I'm not sure what type of injuries my critic is concerned about with push press, but in my opinion light to moderate weight push press (which is what 75# is for me) is one of the safest exercises to do while pregnant. 

Some references: (particularly the forum Q&A)

Obviously I don't agree with everything these sources say to avoid doing while pregnant, but the point is none of them say "jumping is bad because you are shaking the baby and can cause brain damage." 

72 days to go! 

Monday, March 12, 2012

Open wod 12.3

Three weeks of the 2012 Open down, two weeks to go.  After two single modality workouts, I think we were all excited to see a good, classic CrossFit wod for 12.3.  Here's how 12.3 went for me (at 28 weeks pregnant).  

Box Jumps -- I've been following the recommendation to "continue doing box jumps until they become uncomfortable, then switch to step ups."  Jumping onto the box has not felt weird or uncomfortable yet, but jumping down and rebounding off the floor sometimes does, so lately I've mostly been doing box jumps with step downs.  When the workout was announced, I planned on doing 12.3 with step downs, but rebounding off the bottom felt good that morning so I went with that (other than the few reps to finish out round 3 after I missed the box on one jump ... I was more careful the rest of the workout).  Warning: bladder control may be an issue while jumping and 6 1/2 months pregnant. 

Push Press / Shoulders to Overhead -- Not really any different than doing these non-pregnant, but I do think I would have been able to do a lot more sets unbroken if I weren't concerned about keeping the intensity at a pregnancy-comfortable level.

Toes to Bar -- Anything that involves getting my feet close to my hands has gotten much more difficult in the last couple weeks.  Kipping these fell apart very quickly, then it was all about grip ... and I'm heavy!

The big question (asked in response to my 12.3 video on YouTube):  do [I] really think its a good idear for a pregnant woman ?

In addition to Bobby's sarcastic response, I'll answer pioneerworx seriously.  In no way do I think I'm crossing the line of what's safe and healthy to do while pregnant, especially with this workout.  If you watch the video, I took frequent breaks, including drinking water 6 times.  I felt good the whole time.  If something felt uncomfortable or wrong, I would have stopped.  I was doing a workout on Saturday that ended with running, and about 100 meters into the run, it wasn't feeling right.  So I stopped.  I understand my body has limits now that it didn't have before, and figuring out those limits is a learning process.  But what I think would be a bad idea is throwing exercise and a healthy diet out the window because I'm pregnant and going to get huge anyway -- that's a ridiculous attitude to have.  In short, yes, I do think it's a good idear. 

My prediction for 12.4:  8 minute amrap, double unders and overhead squats (95/65)

75 days left!

Tuesday, March 6, 2012

Open Standings After Week 2

After two weeks of the 2012 CrossFit Games Open, I am currently in 202nd place (out of 1,282) in the North Central region and 2,763rd place (out of over 18,000) worldwide.  Not bad considering the prego-style burpees I had to do week 1 and that the week 2 wod would have been a weakness for me pregnant or not.  

I love that, with the online format of the Open, I'm still able to compete and even help my team (CrossFit 515) despite being super pregnant.  I'm trying to focus on how my workouts now will make me a better, stronger crossfitter after my pregnancy, but it is a bit frustrating looking at the workouts and thinking about how much better I could perform if I weren't pregnant.  I'm typically all about the longer, bodyweight metcons, but this year with an extra 25(ish) pounds of bodyweight I think I'll stack up better on shorter, barbell biased workouts.  Unless they throw in ab-mat or GHD sit-ups, which I don't think they will, I don't see there being any movements I can't do.  Muscle ups went out the window a long time ago, but I don't see them programming muscle ups unless it's done like 11.4 was last year.  I can still do rope climbs (I did them yesterday with 115# C&J), chest to bar pull ups (I think), toes to bar, kipping handstand push ups (I've never been able to figure out strict ... on the post-pregnancy goal list), box jumps (jump up, step down), double unders, and all barbell / weight movements.

Here's what I predict workout 12.3 has in store for us -
12-15 min amrap, some combination of
pull ups or toes to bar
light barbell (95/65), maybe front squats, OHS, or thrusters
box jumps or double unders

I'm excited to see everyone on team CrossFit 515 (currently tied for 10th in the region) complete the rest of the Open wods at the new CrossFit 515 location!!!  Check it out -

81 days left!

Friday, March 2, 2012

3rd Trimester and Open wod 12.2

27 Weeks
I made it to third trimester!  Third trimester starts at 27 weeks (based on most things I've read), and I'll be 28 weeks this Saturday (tomorrow).  At this point, the baby is pretty much fully developed and just needs to continue to mature and pack on weight before delivery.  Babies born at 27 weeks have a greater than 90% chance of survival, but let's hope this baby decides to stay put for at least another 10 weeks!  The baby only weighs about 2 pounds now, so his/her weight will still almost quadruple by birth (the average weight of a full term newborn is 7.5 pounds).  Uncle Bobby -- Baby Vaught is calling you out!  Bobby vs. Baby V weight gain challenge from now until birth??

As my belly gets bigger, some CrossFit movements are becoming more difficult or modified, including this week's snatch-extravaganza Open wod 12.2.  One of the main cues I tell people with snatches is "keep the bar close to your body" -- this is not a great thing to focus on with a big, pregnant belly.  However, other than thinking "do not smack yourself in the stomach," I don't think pregnancy hindered my performance all that much on this workout.  My max snatch is 110#, which I got on 11/9/2011 (11 weeks pregnant), and on that same day I did Isabel in 6:15 (30 snatches at 95#).  My Isabel PR is 5:31.  So my goal for 12.2 was to get some of the 100# snatches, but I didn't expect to get too many.  Here's how it went.

The 30 reps at 45# were super light, but still enough to get my heart rate up and shoulders tired.  I should have moved faster through the 30 reps at 75#, but I started worrying about how tired I would be for the 100# reps.  I ended up getting 5 reps at 100#, for a total of 65 reps.  Not thrilled with it, but not disappointed either.  I foresee a lot of people re-doing this wod multiple times.  There's a lot of strategy with how to break up reps, it's not that fatiguing of a workout, and a few reps will make a big difference in standings.  If a better score will help team CrossFit515, I may re-do 12.2 this weekend because I'm confident I could get at least a few more reps if I move more quickly through the 75# reps.

Update: I re-did 12.2 over the weekend and got 69 reps (4 reps better).  I did the 45# snatches unbroken, then I started the 75# snatches with two sets of 5 then did singles.  I think I finished 75# with about 4:30 left, so the difference was just having more time with 100#. 

What do I think of 12.2?  Overall, I think it's a pretty good workout to follow the all-burpee wod.  12.2 should shut up the people whining about the lack of skill or strength needed for 12.1.  The snatch is a high skill movement, and I'm a little surprised they would throw it in this early in the Open.  I was expecting maybe deadlifts or ground to overhead, but the starting snatch weight (75/45) is so light that this workout shouldn't exclude anybody.  I don't get the reasoning for the variance in guys' weights versus girls' weights, although I am glad I didn't have to jump up to Isabel weight for reps 31-60.  If the last 3 Open workouts are more classic CrossFit wods, couplets or triplets with moderate weight, then I think HQ has done a good job of programming for the Open ... as long as they don't throw anything in there that I can't do :)

Two weeks down of successful pregnant CrossFit Games Open participation, three weeks to go! 

85 days left!