I'm Down on Carly's Knees

So, an update on the biological status of the project.

Carly has busted her knee. Again. I warned her, if she busted her knee again, I'd trade her in for a newer model. I have not done that just yet, but she is on notice!

About 15 years ago, Carly wrecked her knee in a skiing accident. Her doctor told her then that she should get surgery. She didn't. So every few years, she's knock her knee out one way or another, including at least one memorable moment, flying kites in a cemetery. The last time she blew it out, almost exactly 2 years ago, she was training for the FBI. True story.

MRI scans revealed that Carly had mangled all the ligaments around her left knee, and the ACL was totally ripped. Surgery was scheduled, small scars produced, crutches bought, and physical therapy ensued. After about 6 months, Carly was allowed to run again, and things were pretty good.

Then she went to North Carolina for a family vacation (I was wise to avoid it), and walked out into the surf when there was a riptide warning. Warning unheeded, she was knocked down by the water, and rrrRRRRIIIIIiiipppp! New ACL is torn.

She saw the orthopaedic doctor today, and he told her that she's going to need surgery again. This time, they're going to use corpse tendons, so she'll be part zombie (I warned her! I have a shotgun!). And this presents a dilemma.

Knee surgery, hell--any surgery--is a pretty intense, traumatic event. Should she get the surgery before she gets pregnant, or after? I mean, we are somewhat on a clock here. Our chances of getting pregnant naturally drop off every year after 30, and if we want to have a kid the old fashioned way, we need to think about timing. On top of that, would she be in danger of greater injury if she walks around, fatted and with calf, on a busted knee? It turns out, there have been a number of studies about this.*

Pregnancy hormones actually make a woman's body more pliable and flexible, and lots of pregnant ladies suffer knee injuries when they're With Parasite.* Carly would actually be in slightly increased danger if she were to get heavy with spawn on a bum knee. So yeah, she should have her surgery before.

But the drugs and therapy and bodily stress will push out our eventual pregnancy date for a bit. And, let's face it, sex with a busted knee is quite limited in the kinds of twisting and flipping that can be done. If you flop one way or the other during a roll in the hay, you could twist that corpse tendon right out of its graft. And then, zombies are running loose--it'll be anarchy!

For a final verdict, the doctor called human nature into the fray: "If you don't do it before you get pregnant, you'll never do it." And he's right. It took Carly 15 years to get the damned thing fixed in the first place, so better do it now.

* I am leaving these unattributed. I am too lazy, today, to find the links again, and I didn't save them. Anyway, google "ACL surgery pregnant before after" and see what comes up. There are a bunch of useless, un-scientific forum posts, but if you sort through it, you'll find the Canadian study I read.

A Good Death?

This is quite deadly accurate in terms of what we went through this year.

The only good abortion is my abortion « Boing Boing

An Example of the Crazy

Since Carly has been off the baby blockers, she's been experiencing the full range of female hormones and their fluctuations. She started taking birth control when she was reasonably young, so I'm pretty sure this is the first time her body has actually been allowed to do what it does. And what it does is break out.

Her skin develops ranges and archipelagoes of pimples without warning. No soaps or creams really work. These are hormonal acne and there's really no cure, just maintenance. So she went to see her dermatologist. In addition to being a bit of a spaz, he prescribed to her a hormonal-based cream for her zits, one that will knock her back to that semi-bound state that she was when her skin was clear. The nurse of course warned her that if she was going to get pregnant, she'd have to stop taking the stuff. The doctor said, like a spaz would say, "Yeah, um, yeah, you can't take it if you're pregnant, but they haven't really done any studies, and um, like, one in four pregnancies aborts anyway, so yeah."

Reading the materials that come with the goo, you get this disclaimer:

8    USE IN SPECIFIC POPULATIONS

8.1 Pregnancy

Pregnancy Category C. There are no well-controlled trials in pregnant women treated with [PRODUCT] Gel. Animal reproduction studies have not been conducted with the combination gel or benzoyl peroxide. Furthermore, such studies are not always predictive of human response; therefore [PRODUCT] Gel should be used during pregnancy only if the potential benefit justifies the risk to the fetus.

No teratogenic effects were observed in rats treated with oral dozes of 0.15 to 5.0 mg adapalene/kg/day, up to 25 times (mg/m2/day) the maximum recommended human dose (MRHD) of 2 grams of [PRODUCT] Gel. However, teratogenic changes were observed in rats and rabbits when treated with oral doses of greater than or equal to 25 mg adapalene/kg/day representing 123 and 246 times MRHD, respectively. Findings included cleft palate, microphthalmia, encephalocele and skeletal abnormalities in rats; and umbilical hernia, exophthalmos and kidney and skeletal abnormalities in rabbits.

Dermal teratology studies conducted in rats and rabbits at doses of 0.6-6.0 mg adapalene/kg/day [25-29 times (mg/m2) the MRHD] exhibited no fetotoxicity and only minimal increases in supernumerary ribs in both species and delayed ossification in rabbits.

Okay, so this says that the drug is a Pregnancy Category C substance, and rightly defines it as something that has risks in animal tests, but may be used if there's a good reason during pregnancy. Those reasons are not well-defined, but I'm betting, "I want to look good in my pregnancy boudoir photos," is good enough.

It then says that no teratogenic effects were observed in rodents given oral doses in excess of 25x the recommended maximum dose for humans. Remember, what Carly is using is smeared on the skin--the rats and bunnies were taking it orally. Teratogenic basically just means "birth defects." It ranges from weird birth marks to extra heads, and so on. The range of things that happened to the bunnies and rats was relatively minor... when exposed to 123 to 246 times the maximum human dose, the rodents had some cleft palates (Hares with hare lips? OH THE IRONY!), buggy eyes or small, lazy, blind eyeballs, and encephaloceles.

That last one is a bit of a scary one--encephaloceles are protrusions of the brain and spinal cord generally caused when the neural tube fails to close completely during the fetal stage of pregnancy. So your brain matter bulges out of your skull. It's really grody, but generally treatable... the matter that's hanging out is usually not functional and can be cut off or packed back in the skull. Some people live their whole lives with that condition, though it is the source of a lot of problems. Very Mutter Museum stuff.

That's not to minimize the deformity--lots of encephaloceles are fatal, non-operable, or end up causing permanent damage to the brain when removed. So it sucks. And lazy eyes and cleft palates are no laughing matter, either. But the point is, the baby websites freak the fuck out about things like this. They tell you to not even think about any kind of acne meds or whatever, even if they don't include any of the chemicals that work in this one, because WHAT IF your baby has a second head??? The problem is that the readers and the writers don't rely on what the science actually says...

It says, if you slather on 200 times more than we tell you you should EVER put on your skin, your baby has a small chance of having a deformity that is very likely operable or at least not fatal or particularly debilitating if caught early enough. If you're the sort of person who overdoes things, you probably should stay out of the drug store, except to buy condoms. Lots and lots of condoms.

Fathers Day

I had kind of been hoping that I'd be able to celebrate this Fathers Day as a prospective father, but alas, the biology hasn't worked out quite that way.

So, I thought I'd subject you all to a video of my parents being themselves, while really just looking at their pets the whole time. I hope you enjoy it.

I Hate My Baby

One of the things I have been researching is how good, upstanding, moral citizens deal with the big life change from being a person to being a parent. I have had the privilege of being in a room with Michael Ian Black, my famous clone, reading from his new book, You're Not Doing It Right.

Here's a thing, ganked from the Onion's A.V. Club:




It's a rumination on how much of an asshole a baby can be, in discussion with the A.V. Club populars.

Dream a Little Dream

I'm a little weirded out by this, but it happened: I had a dream about having a baby.

There are two reasons that this is weird, to me: The first is that I don't dream that often, and when I do dream, I almost never remember it. But this time, I don't just remember the dream, I remember it in kind of specific detail.

I was testing the problem of having a baby. I've never really held a tiny baby, a new one, less than at least 4 months old. All the babies I've held in real life have been kind of healthy, potato-shaped children. I haven't really held the pink, blotchy kind. So I was testing how to hold the thing, where to put the head in relation to my elbow, etc. It was a boy. Just stating that for posterity, not as any kind of prophecy. I know you all take stock in dreams. I don't, not really.

The dream was specifically set in a hospital, something you might see in a medical drama, but generally what I am used to for actual baby parts of hospitals.

The second reason it is unnerving is because when I do dream, I rarely dream about anything in a normal kind of context. It's usually couched in some kind of supernatural or action-oriented setting, like a zombie movie or a terrorist invasion or something. I don't ever dream about regular crap. So this is something, I think.

I figure that I'm coming to terms with the idea of having a kid. It's become something that I specifically want to do, and for a lot of reasons. So now, I am working on the kinds of things that I know I need to know, and hope that I'll have when the merry moment rolls around. Just musing there.

In other news, the procreation thing is on hold for at least a few days as Carly is in North Carolina with her family, on the annual family hootenanny. I failed to go for a lot of reasons, not least of which is work--I've been given a reasonably important special project that needs worked on and I don't want to let it slide right now. But anyway, hard to work on the baby stuff over the phone. Or the internet. But that gives me ideas....

An update on the injury.

So, I'm healing pretty well and I don't think it's broken. Just bruised. A small price for the great reward.

http://instagr.am/p/Lp77oQN5Vx/

Casual Sex

One of the things I love about this whole project is that my irreverence is in very good company. For your Friday entertainment, I offer you Andrea Savage's Casual Sex: Part 1.

The dangers of whoopie!

Just a short update:
While seducing my wife, tonight, I have broken my toe.
This is the third bone I have ever broken. The first was another toe, one that I dropped a piano on. The other was a finger, playing football. This one was a seduction.
The End.

A Shout Out, to My Homies

Now is a trendy time to have babies, I guess. While the rest of my procreating friends are not quite as self-absorbed and outgoing as I am about the whole business, many people are well along the path, even quite successful at it!

• Joel, a former colleague in the Philosophy Department at University of Akron, and his wife, Stephanie, are now expecting. They've got ultrasounds to prove it. It seems like they waited until Joel was about done with his PhD to start trying, as really, there was only slightly less of a chance of him supporting the family as a grad student rather than as a philosophy professor. He recently discovered that the median income for a first-year associate professor is only marginally above the poverty line.
• Josh and his wife, Kate, are well into their seventh month, I think. They had a doozy of a time getting there, as a few rounds of IVF didn't take, and just about when they were ready to give up, they got the good news. They've been off the radar a bit lately, as they're also going though career changes and recently moved, so it's been a bit nuts. When things die down, I want Josh to do a guest blog here.
• My cousin, Kate, whom I believe I mention here extensively, and her hubs, Adam, are doing quite well with their twins. They also had some medical intervention in getting their boys into the world, but everything is going great for them. We recently got to interact with the boys for the first real time last weekend, when we visited them in their neat little townhouse and ate a ton of barbeque. Like you do.
• Former law classmate, Kevin, and his wife, Jill, have recently welcomed their second child, nicknamed Loki, into the world, and from what I see on our weekly Google+ meetings, they're all doing great.
• Now, I hear that our friends Gabe and Anna are on the path, as well. We had a few funny conversations about the breeding program around Cinco de Mayo... the timing, the strange hormones, the half-crazy, half-fun way of thinking about the future. And all the gelato you can stand.
• Some other friends are adjusting to deciding to NOT have kids, as they have decided to go ahead and get snipped. While I'm certain they would have been great parents, I'm glad that they have decided to just cut off this possibility that they were otherwise somewhat fearful of. They're the sort of people who are quite fulfilled as they are. They travel extensively, have crazy awesome hobbies, and love each other and get along so well that adding another mouth to the equation might just fuck it up. That reminds me... there's a blog post coming up about how damned arrogant it is for people to just up and decide to have kids, plan it and so on. More on that, later.

In other news, Carly is still fluttering through various hormonal changes as her body resets, and she complains to me on a daily basis--after much internet research--that she requires different chemical ingredients. Lately, it has been acne meds, as she is "breaking out like a teenager." I say, this is a serendipitous event, as I also need to change the oil in the car. BA DUM, BUM!

And now for something completely different: