Queen’s Journey to Motherhood: Part 5
Part 5 of Queen’s journey to motherhood. Watch Queen as she shares her experiences of becoming a mother after a high-risk pregnancy.
Queen’s Journey to Motherhood: Part 4
Part 4 of Queen’s journey towards motherhood and how Cherokee Women’s Health helped her realize her dreams of being a mom.
Queen’s Journey to Motherhood: Part 2
Part 2 of a video series. Queen continues to share her journey towards motherhood.
Pelvic Organ Prolapse with Dr. Litrel
Dr. Michael Litrel discusses treatment for pelvic organ prolapse can help improve quality of life.
Miscarriage: A Father’s Grief
A father’s grief after a miscarriage is often overlooked. Miscarriage and subsequent pregnancies often center on the emotions of the mother only: the grieving and anxiety of losing a baby, and the nerve-racking experience of becoming pregnant again with a “Rainbow Baby”. A rainbow baby is a baby born after a miscarriage, thus becoming the “rainbow after the storm.” Sharing Grief With the Husband and Learning To Live With Grief and Joy Fathers often feel they have to be “strong for the mother,” so they may put their grief on the back burner, all while silently suffering alone. But solitary grieving can take a toll on a marriage, especially during stressful times, like losing a baby. “Rainbow Mom” Mariah Foster and her husband lost their unborn daughter, Raelynn, late in Mariah’s pregnancy, from a cord accident. She shares their experience and the words of advice from their doctor, who told her to pay attention to how the experience affected not only her, but also her husband and their relationship as a married couple. “After I lost my daughter, Dr. Litrel asked to see us so he could see how we were doing. His advice was not to try to cover up our grief with antidepressants. He told us to go ahead and scream, yell, even be mad at God – but especially to learn how each other grieves.” Mom Mariah shares how she coped with the devastation of miscarriage Miscarriage is Hard on Men Too Mariah said Dr. Litrel told them that the father’s grief is often overlooked, and that he had seen couples divorce after losing a baby because neither understood how the other grieves. “He told me to pay attention to my husband during this time of being sad. He said it’s hard for the man, too – and they grieve in a different way from the woman. “That conversation opened our eyes. And honestly, the grieving process built on our communication and compromise skills.” Mariah shares that Dr. Litrel also advised them to ‘talk about our daughter and use her name’, telling us to take time to enjoy each other, so we could accept the loss better and go on with the marriage. He didn’t want us to lose what we had. He also didn’t want us to try to have another, but just to ‘let it happen’, so he did not prescribe birth control for me. Smiling at the baby beside her in the stroller, Mariah says, “Eleven months later we ended up having our wonderful Rainbow Baby, Cayson Charles. Cayson means ‘Healer’ in Gaelic,” she explains. Getting Pregnant Again is Scary Mariah comments that becoming pregnant after a miscarriage is not the purely joyful experience everyone assumes it will be. “You know, everyone’s excited when you’re pregnant with a rainbow baby, but it’s a lot harder. I was nervous. When I hit nine months and said, “I need to be induced!” I finally ended up having a C-section — and the most beautiful rainbow baby. “During the pregnancy, Dr. Litrel had us on a strict schedule of seeing doctors and also the specialist. By 29-30 weeks, we were going to the doctor every week. “Pregnancy with a Rainbow Baby is nerve-racking. You want to feel him every second of the day. When he’s not moving, you’re panicking.” “The scariest time was at one point, when I slipped and fell at work. I thought at that point I was going to lose him. Dr. Litrel and really, all the medical staff, did everything for us. “They gave me a Doppler (a hand-held monitor) so I could check on Cayson, and seeing him on the screen helped me so much with my anxiety. “Pregnancy with a rainbow baby is nerve-racking. You want to feel him every second of the day. When he’s not moving, you’re panicking. You lay on your left side, you drink ice water, you try all the tricks the doctors tell you. There were times I went to Northside Hospital and just said, ‘Hey, I just need you to do an ultrasound. I can’t find my baby on the Doppler.’ They were great and really supportive during the entire pregnancy.” The Grieving Process “Losing Raelynn was hard for my husband, and sometimes it still is. He’ll take a picture of Cayson, which is his way of grieving. He’ll say, ‘I want to be with him so much, because sometimes he fills that void.’ When Cayson was crawling at six months, my husband was excited to see him, and he’d say, ‘Wow, Raelynn, look what your little brother is doing!’ Mariah wipes away a tear. “It’s hard to explain how it feels because the grieving never stops. “We actually planted a tree for my daughter, and we watch it grow, and talk about it all the time. We got a bird feeder and all the birds come so we can feed them. It’s really sweet. Getting Support “The grievance counselors at Northside are really great and so supportive. On Facebook, there’s a group called Rainbows of Atlanta. When you’re having a hard time — when that anniversary comes up and it’s the week you lost your baby — you can get on that group and post at 4 a.m., and you know someone is going to comment. Someone will be there. It’s so rewarding to see women back each other up. They give advice, and they’re just there.” Mariah smiles and gives her rainbow baby Cayson (aka the Healer), a kiss. Her eyes glisten, but there is happiness there, too. After Miscarriage – Stories of Hope Reading stories of hope from others who have experienced what you’re going through can help you feel not so alone. Here, we share stories from patients who suffered from miscarriage and how they got through it. Sheila suffered many miscarriages so we sat down with her to get her story and learn what she had to overcome to eventually have three Rainbow Babies. Jamie shares her story of
What is Pelvic Prolapse?
Pelvic organ prolapse (POP) refers to the sagging or drooping of any pelvic organs due to damage, trauma, childbirth or injury. The pelvic floor consists of a group of cradle-shaped muscles that hold pelvic organs in place. The pelvic organs include the uterus, bladder, cervix, vagina, rectum and intestines. Like any other part of the body, these muscles, with their surrounding tissues (fascia), can develop problems. If you fill a small plastic bag with grocery items, say for instance, a box of cereal, a few cans of vegetables, some jars and a package of rice —the bag should hold the items with no problem. But if you hang that full bag on a wall hook and leave it suspended, you’ll start to notice the items in it begin to bulge against the membrane of the bag as it takes on the shape of its contents. After a while, depending on how heavy the items are, the corner of the cereal box or rim of a can may start to bulge and even poke through as the bag stretches, weakens and eventually tears from the weight of the items in it. The groceries may even begin to protrude and dangle outside of the bag as the tears get larger. Pelvic prolapse happens much the same way. As the muscles and tissues holding the pelvic organs weaken, degrade or tear, the pelvic organs slip or drop through, sometimes forming a small hanging internal bulge. At other times, depending on the damage, they may actually dangle externally from the vagina or anus, causing problems and inhibiting their function. This is called prolapse. Who is at Risk for Pelvic Organ Prolapse? One in three women suffer from POP. Any activity that puts undue pressure on the abdomen can cause pelvic floor disorders. Typically, labor and childbirth are the leading causes of prolapse, especially when a woman has had several children, a long, difficult labor, or has given birth to a larger child.Pelvic organ prolapse becomes more common with age, usually around menopause when tissues damaged during a woman’s childbearing years begin to lose strength. Other causes are: What are the Symptoms of Pelvic Organ Prolapse? It is entirely possible not to have any symptoms at all. Sometimes pelvic organ prolapse is only discovered during a routine gynecological examination. Minor symptoms are a feeling of annoying pressure of the uterus or other pelvic organs against the vaginal wall, minimal malfunction of those organs, and mild discomfort. Other symptoms are: Symptoms may be aggravated by jumping, lifting or standing. Relief is usually found after lying down for a while. When Should You See Your Doctor? If you have increased sensations of pelvic pressure or pulling which is exacerbated by lifting or straining, but relieved when you lie down. Diagnosis At times, pelvic organ prolapse may be hard to diagnose, especially if a patient does not complain of any symptoms. Patients might be aware there’s a problem but cannot actually pinpoint its location. After asking questions regarding symptoms, medical history, past pregnancies, and other health problems, your doctor will perform a physical examination. Then, if organ prolapse is suspected or discovered, the following additional tests may be ordered: The doctor will then use a classification system to decide the organ prolapse level so he can best decide treatment options. Often, only simple non-invasive treatments and lifestyle changes are recommended for minor prolapse. If surgery is warranted, the following may be suggested: What Can You Do? Pelvic prolapse often sounds worse than it is. For many women, there are hardly any symptoms. For those who do suffer, there is help available, whether it is a simple lifestyle change, surgical repair, or reconstruction. If you have questions about your gynecological health or would like to consult with one of our pelvic reconstructive surgeons, please call 770.720.7733 or schedule an appointment online.
What is Overactive Bladder Syndrome?
Overactive bladder syndrome, also referred to as OAB, is an uncontrollable need to urinate, often at the worst possible times. For most of us, when the bladder fills to about half its capacity, the urge to void is triggered. Much like a snooze button on an alarm clock that lets us sleep awhile longer, we can hold off until we’re closer to a bathroom, or the timing is more convenient. Not so for OAB sufferers. Their urgency is more like the constant demand of a malfunctioning alarm clock without that button — intense, shrill and non-stop until it’s turned off. OAB sufferers feel more like their bladders are overflowing. They don’t have the luxury of waiting, needing relief immediately. If they’re unable to void right away, leakage may occur. OAB is unbiased. Whether you’re at work or play, it disrupts concentration, performance and pleasure, negatively impacting your life. In time, those afflicted with OAB may become depressed, withdrawing socially. What Causes Overactive Bladder? No one really knows, but it’s believed that involuntary contractions of the detrusor muscle in the bladder transmits false messages to the brain. Symptoms Contributing factors: Age may contribute to, but does not always cause Overactive Bladder Syndrome. Never assume you’re doomed to live with OAB based on the number of years you’ve roamed the earth. Speak to your gynecologist. Don’t be ashamed. They’ve heard it before—often. They can help. Diagnosis You will need to provide your doctor with your medical history, including all drugs, vitamins and supplements you are taking. A physical examination will also be necessary.Sometimes, a urine culture, ultrasound, and neurological tests may be needed to rule out any sensory or reflex problems. If necessary, you might need more extensive analysis such as: You may be asked to keep a journal that includes information like fluid intake, urinary outflow, any leakage, and a time chart of bathroom visits to assess your condition more accurately. Treatment Options Medications and Treatments Other treatments may include: For more resistant cases, surgery, bladder augmentation, or the use of catheters may be necessary. Overactive bladder does not have to isolate you. Help is available. Speaking to your OB/GYN is always the first step to overcoming the problems associated with this syndrome, restoring your confidence, happiness, and quality of life.
Leaky Bladder Symptoms and Remedies
One in five women endures the symptoms of leaky bladder, or urinary incontinence. Yet often, a suffering woman does not acknowledge it as an issue. She may be self-conscious about mentioning the condition to her doctor, or she may assume it’s a normal part of being a woman. Two of the most commonly accepted situations are incontinence after pregnancy and incontinence during exercise. The truth is, although urinary incontinence is common, it is not considered normal. Needing to urinate frequently, as well as urinary urgency, are signs that one may be dealing with a leaky bladder. Fortunately, for a woman experiencing these symptoms, she can find both surgical and non-surgical options in treatment to minimize or even eliminate these symptoms permanently. What is Urinary Incontinence? Weakening of the pelvic floor can affect bladder control and urethra function, causing issues with urination. Women suffering from urinary incontinence find themselves running to the bathroom frequently. Strong urges to use the restroom, even after urinating, is another sign that a woman may be dealing with urinary incontinence. It is important to not brush off the occasional leak experienced while exercising or shifting position, because there are treatments available for women dealing with urinary incontinence. Types of Urinary Incontinence One important step in the diagnosis process is identifying the type of urinary incontinence, in order to find the best treatment option. Stress Incontinence This type of incontinence occurs when urine leaks out of the bladder during certain strenuous activities. Jogging or other exercising can cause urine leakage. Coughing and laughing can also bring on an unexpected leak. More severe symptoms of stress incontinence may include urine leakage during low stress activities such as changing position or walking. Many pregnant women can experience stress incontinence as the growing uterus puts pressure on their relaxed pelvic floor and the organs shift to make room for baby. Sometimes the symptoms are dismissed as an annoying pregnancy symptom, but if they do not subside after delivery, they may need medical assistance to prevent symptoms from worsening. Urge Incontinence Commonly referred to as overactive bladder, or OAB, urge incontinence is a continued sensation of needing to urinate. This sensation is often an overwhelming, powerful urge which sends women dodging for the nearest restroom. Urge incontinence is different from stress incontinence in that it occurs suddenly, without pressure on the bladder from strenuous activity. In addition to strong urges to urinate, women with urge incontinence may find themselves waking up at night to use the restroom, interfering with a full night’s rest. Sometimes, there may be an underlying condition that is causing the undeniable urges to urinate. An honest discussion about symptoms with a doctor can help them determine any underlying conditions so they can better treat you. Preventing Urinary Incontinence Many situations can result in urinary incontinence. There are some factors that do make a woman more prone to the condition, including pregnancy and childbirth. Women who want to lessen the chance of experiencing urinary incontinence can follow the advice below: Leaky Bladder Remedies Don’t be ashamed or embarrassed to mention your symptoms to one of our double board-certified FPMRS specialists. Treatment options will be chosen based on the severity of the symptoms but can include:
April Fools
by Michael Litrel, MD, FACOG, FPMRS The year my sons were seven and ten, I asked for my wife Ann’s help playing an April Fools’ joke on them. Sunrise on the big day found me crawling like a Ninja across the floor of my eldest son Tyler’s bedroom. With barely a sound, I rolled on to my back and shifted my body directly beneath his bed. I took a deep breath, and then, using all my strength, began shaking the entire bed frame. Ann’s timing was perfect. She burst into the bedroom. “Tyler!” she shouted. “Get up! It’s an earthquake – it’s an earthquake! Go downstairs – HURRY!” Tyler hardly moved. “It’s okay, Mom,” he mumbled, still half asleep. “It’s just Dad under my bed.” I was demoralized, with only bruised knees and a scraped back from my efforts. But it was not going to be for nothing. Nursing my wounded pride, I hushed Ann and went to the next room. “Let’s try it on Joseph.” But by the time I had crawled under Joseph’s bed, Ann reported that Joseph was smiling, his eyes closed, pretending to sleep. Luckily, I had prepared a backup trick the night before. I’d slid a rubber band around the kitchen sink nozzle so it would spray as soon as the water came on. It pointed up to the exact spot for dousing whichever of my beloved offspring washed his hands first. Tyler came downstairs still half asleep. “Would you please wash your hands before you eat,” I reminded him. It was hard to hide the eagerness in my voice. I watched Tyler as he came to the sink and reached for the soap. He stopped, looked at the faucet, and yawned. “You know, Dad,” he said with a trace of patronization, “if you use scotch tape, it won’t show as much.” I wasn’t in the mood for advice. “Just be quiet, and let’s wait for Joseph,” I replied testily. “AAUGHH!” screeched Ann. Oops. While I was distracted, Annie had turned on the water. Her pajamas were soaked. I apologized profusely, but Ann was not amused. Well, at least I’d gotten someone. But my real quarry was Tyler. He was just too cocky for his own good. I spent the day mulling it over, playing a few jokes to pass the day. Pregnant patients made the easiest targets. “Gosh, I hope you have two girls’ names picked out.” Or, “Wow, we haven’t had triplets in the practice in four or five years.” Back at home that evening, Tyler wouldn’t fall for anything. I found myself growing amateurish in my desperation. “There’s a spider on your shoulder!” “Your teacher just called. You’re in trouble!” Tyler just rolled his eyes. April Fools was obviously beneath him. Indeed, he hadn’t played a single joke on me all day. I finally gave up and trudged upstairs to bed. Just as Ann and I climbed between the sheets, we were met with an impediment. Tyler had short-sheeted our bed. Ann was dead tired. She began to complain and laugh simultaneously as she stripped the bedcovers to remake the bed. I tried to shush her so Tyler wouldn’t have the satisfaction of knowing his trick had succeeded. But it was too late. I could hear him snickering outside our bedroom door. My mind was unsettled. Although I was tired, I lay awake in bed for a while, unable to sleep. Finally, after some honest introspection, I came to a resolution which allowed me to drift off at last. Just wait ‘til next year. Excerpted from Dr. Litrel and his wife Ann’s book of “he-said, she-said” stories about love and family. A MisMatch Made In Heaven: Surviving True Love, Children, and Other Blessings In Disguise is available in the office, and online at www.createspace.com/4229812
Do We Have Enough?
by Michael Litrel, MD, FACOG, FPMRS When my son Tyler was fifteen, I brought him with me on a church mission trip to Honduras. It seemed an inspired idea: I was seized with a vision of him forsaking his Xbox for a transformative week of caring for poor people in a third world country. Twenty of us boarded the plane headed for rural Central America. Our physical task was to repair homes. Our spiritual task was to learn and teach about God’s love. Tyler was shocked by the poverty. Forty people lived in the remote village in mud and stick huts. They had no running water or electricity. Wandering the village were dogs so emaciated you could count each rib. Over the days that followed, Tyler took me to the side several times to sort through his feelings. How could we have so much at home when others in the world have so little? I was proud of him, growing up, asking the right questions… But as it turned out, he was still an obtuse adolescent. On the last day, we faced a grueling three-mile hike through the steaming jungle to the work site. Tyler assured me he had filled all our water bottles. But when we arrived, I discovered only three of the eight bottles were full. Tyler had gotten lazy and just hadn’t bothered. I was livid. We had an entire afternoon of physical labor ahead. Don’t you realize we have four THOUSAND pounds of cement to mix? How can we work without water? Blah, blah, blah… I’m sorry, DAD!!! I GET it! Tyler threw up his hands in exasperation. I could tell Tyler was more angry than sorry. But I stopped and sulked away, muttering dark thoughts under my breath. I had been proud that Tyler had chosen to come – the youngest in the group by five years. Heaven knows it was gratifying to see his hands finally off the game controller and wielding a shovel full of dirt. But I didn’t want to hear any adolescent fibs about filling water bottles. Our project was a hut with a dirt floor, to be replaced with cement. Twenty bags of mix had already been carried to the site. The choice of tasks were these: carry buckets of water from the stream, mix the cement on the ground, carry the wet cement into the hut, or lay down the floor. There were eight of us. It was back-breaking work. Three hours later, we lay exhausted under the hot equatorial sun. A feeling of discouragement began to creep over us. The floor was only a third done, and we were running out of both cement and energy. I slumped on a stool. A small village girl named Amalia crept quietly next to me. Her dress was worn, her face dirty, but her smile was glowing. She was one of eight children who lived in this tiny hut. A cement floor would keep her young body off the ground at night. Tyler rested motionless, his back against a tree. His work efforts had been listless at best. But I kept my criticism to myself. At least he was here. Just when the job seemed hopeless, a few neighboring villagers arrived to help. Recharged, we resumed mixing cement, carrying bucket after bucket into the hut. Somehow, we now had so much that we could not only cover the entire dirt floor but even make a front porch. Remarkably, too, our water bottles never ran out. Tyler and I had enough to last all afternoon. It was a strange and wonderful day in Honduras. Tyler and I had partaken in a kind of miracle: plenty of cement, a floor for Amalia, and even enough water. For me, it was a spiritual reminder that we are always given enough – an ironic lesson to learn while helping a family whose belongings could fit in the trunk of my car. It was only later, as I was falling asleep, that I figured out – Tyler had left all the water for me. Excerpted from Dr. Litrel and his wife Ann’s book of “he-said, she-said” stories about love and family. A MisMatch Made In Heaven: Surviving True Love, Children, and Other Blessings In Disguise is available in the office, and online at www.createspace.com/4229812
The Marriage Thermostat
For ten years, without fail, Ann and I kept our razors side by side in the shower. Then I switched to the Mach 3 triple blade razor, and suddenly the ever-present disposable pink lady razor disappeared. I didn’t give it much thought at the time. I figured such a sissy razor was an embarrassment beside my macho marvel of modern technology. The truth was more horrific. One morning I walked into the bathroom while Ann was in the shower, and I discovered that my Mach 3 triple blade marvel was being used to shave her legs. It didn’t take much to surmise that it might be getting some time under her arms, too. I kept my mouth shut until our morning coffee. “Doesn’t it repulse you,” I said calmly, “to know that the razor you’re using under your arms is the same one that I’m using on my face?” Ann laughed, and then quickly reached for my hand. “Sometimes…” she replied with a serious voice. “But love is a strange and wonderful thing.” She gave me an angelic smile. All was forgiven. Disagreement between a husband and wife occurs in the best of marriages. Sometimes this manifests as open argument. Other times, marital conflict can be more subtle, an unspoken tension permeating the relationship for years, like an uncomfortable humidity. When I met Ann at that fraternity costume party, she was supposedly dressed as a Greek goddess, in a skimpy toga no father would have permitted his daughter to wear in public. I fell in love. After our three years apart, there was nothing I looked forward to more than marriage and spending my life with Ann. My attraction to her was more than just her physical beauty; I admired her talent, kindness, intelligence and discipline. I still admire her. But after twenty-five years of marriage, the intelligence and discipline thing sometimes gets on my nerves. Ann has tendencies towards frugality that do honor to her Scottish heritage. She also endeavors to be environmentally aware. These two qualities are evidenced in the temperature settings Ann prefers for the household thermostat. During the hot Georgia summer the air conditioning is set at 80. During the cold of winter the heat is set at 65. In January when I am cold, Ann tells me to put on a sweater. In July when I am hot, Ann tells me to take my sweater off. Last year it was another hot, humid summer. So one day when Ann wasn’t looking, I sneaked to the thermostat and deftly dropped the temperature five degrees. It didn’t take Ann long to notice. “Who turned the air conditioning so low, Michael?” “Those kids,” I responded, shaking my head disapprovingly. I was not lying. I was simply making a declarative statement designed to misdirect. “The boys say they didn’t touch the thermostat, Michael.” “Those kids,” I repeated, shaking my head disapprovingly. Ann laughed and moved the thermostat back to “where it belongs.” I didn’t argue. I could understand her perspective: why burn fossil fuels to lower the temperature of my house just so I could be a tad bit more comfortable? But sometimes it was annoying. It was like I was married to Al Gore, and every time I touched the temperature control I was sinking an axe into the trunk of the last giant redwood. Over the years, Ann had successfully colored our “thermostat decision” in spiritual terms. With artful language she conveyed to me sophisticated thoughts about the needs of the body versus the needs of the soul. Essentially, her argument boiled down to this: Jesus didn’t have air conditioning, so why don’t you spend more time praying for strength, and less time whining about the heat? One summer Ann left town to visit her sister for a week. It was like Dorothy’s house had plopped down in Oz, and ding dong, you-know-who was dead! I ran to the thermostat like an unsupervised teenager and lowered it not five degrees, but ten. I was going to get all the air conditioning that compressor could muster. That night my house was so cold I needed another blanket from the closet. Immobilized by comforters, I slept like it was the dead of winter. Condensation covered all my windows when I awoke. I shivered when I sat down to my morning coffee. Now this was what July in Georgia should feel like! I thought about getting out that dang sweater. Maybe I should light a fire too? But after an hour of reflection, I simply turned the air conditioning off. I missed Ann. Morning coffee was more fun with her. It’s far better to have a home that is too hot in the summer and too cold in the winter than to suffer again through the fires and chills of a long distance relationship. A prescription for tolerance is an occasional few days apart. In our human struggles, we can sometimes fixate on small problems. Absence gives God a chance to direct our focus on the big picture – Love. Excerpted from Dr. Litrel and his wife Ann’s book of “he-said, she-said” stories about love and family. A MisMatch Made In Heaven: Surviving True Love, Children, and Other Blessings In Disguise is available in the office, and online at www.createspace.com/4229812
A Ritz Cracker Kind of Guy
by Michael Litrel, MD, FACOG, FPMRS My doctor partners and I take turns being on call for the holidays. Two years ago, my turn fell on Thanksgiving, and as I looked across the table at my loved ones and listened to their loud and animated conversation, I remember noticing they all seemed to be in various states of inebriation. I began to wish the hospital would call me. Nothing is more annoying than being the only sober one at the dinner table. Especially when you paid for all the wine. I realized there were three ways to handle my unhappiness. One, I could make sure I wasn’t on call the following year so I could join in the frivolity. Two, I could cultivate new friends and family who were less inclined to intoxicate themselves at holiday meals. Or three, I could view this moment of unhappiness as a spiritual lesson and walk more strongly the path of Love. The decision was easy. I decided not to be on call again. Holidays are stressful, but particularly so for women. Women are more aware of the subtleties of celebration. They put effort into aesthetic touches that would never dawn on a man. The intention, I believe, is to manifest beauty. But sometimes the result is marital conflict. Every Thanksgiving, Ann makes six dozen homemade crackers called “Cheddar Crisps” that come in three flavors: cracked blacked pepper, caraway seed, and something called nigella seed. Ann carefully sequesters her crackers in a tin box to be doled out at the right moment. Every guest is given three crackers just after saying grace, one of each flavor – and a bowl of butternut squash soup. It’s such a big deal to Ann that you handle each cracker like Grandma’s antique tea cup. Unfortunately, I am more a Ritz cracker kind of guy, accustomed to shoveling large quantities into my mouth until I am full. So for me this homemade cracker stuff is holiday stress. How do I express genuine appreciation for the work my wife has put into this pre-Thanksgiving snack, without conveying my true thoughts? Stop wasting so much time already – they’re just crackers! Instead, I channel Effete Cracker Connoisseur, solemnly critiquing the subtleties of each flavor and commenting about how the steam from the soup opens up the palate so one can fully appreciate the differences. But truthfully, I just wanted Ann to stop making them. Last year I got my wish. I was not on call, and no homemade crackers were to be found! But I noticed a few things. Free to imbibe a glass of wine, I found I did not want any, but instead chose sparkling water. And the sodden idiots inclined to boorish conversation I remembered from the year before were actually beautiful people I am so very blessed to have in my life. But what surprised me most was that I actually missed Ann’s homemade crackers. It’s not always easy for a man to appreciate the attention to detail an effortful woman brings into her family’s life. Sometimes what she does seems frivolous – and God knows, sometimes it’s expensive. But there is a reason for a woman’s efforts, and this I understand – as a father, as a husband of twenty-eight years, and also as a physician who has listened to women carefully over the years. A woman gives life to her children, brings beauty to her home, and creates ties in her community. A woman makes life more beautiful for us men – Whether we want her to or not.
