Our Most Recent Doctor's Appointment

This past week we went in for a check-up. It was both a normal pregnancy check-up and a post-op check-up.

I left feeling great about the baby, but frustrated about the ever-nearing birth of our child.

First the wonderful part of our appointment...
The doctor tested the neuromuscular reaction of the baby, and boy is this baby a live one! (just like his sister) Using an handheld fetal heart rate monitor he monitored the baby's movement and heart rate pre- and post-honking something that resembled a clown horn. The baby's movements and heart rate both increased post horn honking. Our OB/GYN was very happy with the reaction, commenting on the baby'e excellent response to the stimuli. Hooray for healthy babies!

The part the frustrated me...
Arturo and I had discussed waiting for labor to begin naturally before going in for a c-section. Our doctor greatly discouraged this, commenting that if my water were to break or my labor were to progress quickly the c-section could easily turn in to a hurried or emergency process and that his recommendation was to pre-select the date.

I have an issue with this personally (not medically).

Babies cannot make many decisions for themselves until they are a bit older, but one decision I feel like they can make is when they come in to this world. I feel that with modern medicine and the increase in c-sections, we are taking away this important (and very natural) decision from them.

It frustrates me that I will never have a natural birth (I have mentioned before that this will be our last child). I know I can't compare a c-section to a vaginal delivery, but I cannot fathom that having your abdomen and uterus sliced completely open, having doctors stick their hands in and take out a 6+ pound human, followed by a minimum 6 week recovery period during which you have to be overly cautious about your wound to ensure that it doesn't become infected (which can be extremely disgusting and painful and including things like drainage tubes) could be better than pushing that same kid out of your vagina (which I would like to point out used to be pretty much the only option for having children).

The idea of having another giant incision that I have to take care of and let heal before I can sort of feel like myself again, plus taking care of two children and running my business while healing... daunting! Also, the fact that I have this second surgery impending, after having had one just a few weeks ago, is starting to get to me. I feel out of control. I am doubting my decisions, and worse yet, I feel like I don't have any decisions to make... I feel they are already made for me and I have no say.

At the moment I feel as though my life is being dictated by the fact that I already had a c-section, by my removed appendix (damn useless body parts), my unborn child, and my impending c-section. I feel like I can't educate myself on this topic to make the informed decision I want to make. So I have to trust my doctor's judgement completely. He is an excellent professional, but as someone who loves to be in control, letting go and having total and utter faith in someone else is difficult for me.

Also, being pregnant this time around has been harder for me. I am larger than I was with Kesha, the baby is sitting much lower causing all types of fun issues which I'll let you dream up on your own, I'm grumpier, have a hard time sleeping (as I write this at 4:00am), and feel pretty lazy in general (yes, I'm whining, get over it). I was even told at this past appointment that I need to cut back how much I'm walking, as 3-5 miles per day 3 weeks out of surgery is apparently too much.

We won't go back in to the doctor for another month and hopefully at that appointment we'll have a bit more clarity on when this baby will be delivered.

Since I've moped enough in this entry I thought we should end it with something more jovial. We will not be divulging the selected c-section date for a while, so even though we aren't guessing when I will deliver naturally, if you want to play along and guess our c-section date it would be fun! If you want to play here's the link to our ExpectNet online baby pool due date game. Good luck guessing!

Something From "Nothing" (recipe)

We grocery shop every week and a half to two weeks.

Working all morning (grocery stores open at 10am here and I am in the office by 9), combined with a long family lunch, followed by an immediate 2 hour nap post lunch, plus the rainy season (we have downpours most afternoons), and the fact that we have no car, makes grocery shopping quite the task; something that has to be well planned.

So, our fridge often looks like this...

We very fortunate that food here is very natural, however, this also means that it doesn't last as long. Meat spoils quickly, fruits and veggies rot within the week, and bread, don't even get me started on bread. The last loaf I bought had mold on it in two or three days (this led to quite the outburst of pregnancy hormones as I wailed over my two day old moldy bread).

So, since my fridge spends most of its days 80% empty I have to use my amazingly creative culinary skills (which have been lacking during this pregnancy) to create a meal that is appetizing, filling, and nutritious (can you hear the lazy pregnant lady sigh emanating all the way from Ecuador?)

A couple of weeks ago I created a meal that I was quite proud of, so I thought I should pat myself on the back by highlighting my crafty kitchen creation here, showing you all that you truly can make something from nothing!

My ingredients for the entire meal (not including spices)...
Fresh garlic (this is a staple and something we almost never go without in our home)
Baby red potatoes
Tomatoes
A lemon
Brussels sprouts
Smoked pork chops (I served 3 chops for 5 people)


Dish 1: Frying pan potatoes

Drizzle olive oil in your pan and fry up garlic clove halves. Let them cook for about a minute or so (until they start smelling fragrant, but not until they brown).

Dice up some baby red potatoes in to small-ish pieces (I actually used the papa chola here, we don't have "baby reds" per se, but they are very similar).

Dop them in to the pan with your garlic and olive oil (add more olive oil if needed). If you have an aluminum pan like we do then you will need to cook the potatoes on a lower heat and add more oil. If you have a nonstick pan, you probably won't have to worry as much.

Season to taste! I used a smoked sea salt, a French gray sea salt, rosemary, and freshly ground pepper (mixed pepper corns). As a side note I LOVE my infused sea salts and would be totally and completely lost without them. I stock pile every time I visit Seattle. Metropolitan Market is my favorite place to buy them. 

Mix up the potatoes with your herb and spice choices, put on a lid, and let them cook! Stir occasionally.

Dish 2: Oven roasted tomatoes

Get some delicious tomatoes and cut them in to thin slices (see picture below for example).

Grease up a a cookie sheet (or in my case in a roasting pan as I do not own a cookie sheet... yeah, I know, don't get me started) with olive oil and place your slices on the sheet (they can be close together).

Season! Again, I chose a sea salt (French gray) and freshly ground pepper (mixed peppercorns), and drizzled a Fig balsamic vinegar on the top.

See... doesn't that look amazing?! Bake in the oven until well cooked, but not burned (I almost burned mine!). I think I baked them at about 350 for about 45 minutes. (no I don't have a picture of them after they were baked, sorry!)

Dish 3: Blended lemonade

This is a local favorite and is easy and delicious!

Take a big lemon (see photo for example) and trim off the ends. If you have a blender like ours that is not extremely powerful cut the lemon in to fourths. If you have a super blender, like a Vitamix, just stick the lemon in whole.

One lemon will make a small pitcher of lemonade, so add several cups of water to the blender.

Add sugar to your liking (this will vary greatly and you can always add sugar later, so be careful not to put in too much right away).

Blend.

After the lemon is well blended strain out the chunks of rind and the pulp using a fairly fine strainer (you can see mine in the photo below).

You will be left with the juice as shown below. Adjust the sugar and water content to your liking. If it's a hot day you can re-blend the juice with ice to make it slightly slushy, or just add ice cubes to your pitcher.

Here is a picture of the pulp that you should strain out. If you deseed the lemon before blending it you can make marmalade out of this pulp (the seeds make it too bitter for a marmalade), but I will discuss this at another time...

Dish 4: Sautéed Brussels sprouts with honey

I LOVE Brussels sprouts and in our home they frequently show up on our dinner table.

I didn't photograph this recipe step by step as I did with the others, but it is quite simple.

First, stem, halve and clean your Brussels sprouts. If you're not sure how to do this Google it or look it up on YouTube (how do you think we learned how to cut a whole chicken apart?!). Double check them for little worms, as they are prone to attracting these lovely creatures.

Second, grease up your frying pan with olive oil (yes, I like the stuff, no I like it as much as Jamie Oliver does) and drop in your cleaned and cut sprouts. Season as you wish (I typically use Thyme, a plain sea salt, and freshly ground pepper).

Let them cook for a bit on medium high to high heat. When they have begun to change color (from a light "raw" green to a darker green) add in honey. I over honeyed the sprouts in the picture below, so I say for a small frying pan full of sprouts you should use 1 heaping teaspoon of honey.

Stir them well to ensure that they are all coated in honey and let them continue to cook on medium high until the other layer starts to become caramelized and crispy.

Then serve!

Dish 5: Pork chops

I realized with joy when opening my freezer that my mother-in-law had purchased smoked pork chops while I was down and out after my surgery! This was especially thrilling since I had invited guests over for dinner. So I was able to up the anti on this meal by throwing in 3 chops to split between 5 people. I simply pan seared them for a couple of minutes on each side and served. 

I feel like the key to success when creating a meal with very few ingredients is thinking of alternative ways to use every day ingredients. For example, oven roasting tomato slices instead of making a pasta sauce. Or stuffing tomatoes and roasting them instead of serving in simple slices as I did. 

I know I am personally guilty of getting stuck in a routine of how I use a certain food (my Brussels sprouts are a great example! I always cook them the same way), and breaking out of that routine can help freshen up a dish and bring a new life to the few ingredients you have.

What have you created from "nothing" lately? How did it turn out? What recommendations do you have for cooking with a limited number of ingredients?

Third Trimester!

Welcome to the third (and last) trimester!

28 weeks!

We definitely had a big hurdle to jump over in the last part of the second trimester, but are getting ready and excited for the arrival of Baby Garate #2.

He will be our last, completing our wonderful little family.

Prior to our appendicitis adventure last week we had been pursuing a VBAC (natural delivery post cesarian section). We had contacted a Doula, found doctors willing to work with us, and were ready to make an appointment to get things going.

However, with 6 weeks to full recovery from this recent abdominal surgery, and a birth coming another short 6 weeks after that, we have decided that a VBAC attempt is not the right path for us at this point in time. I'm sure there are many of you that would say it is still fully possible and will not understand our choice, and you may be right, but this decision is the right one for me, my body, our family, and this baby.

I am disappointed that I will never experience a natural birth. But I am truly at peace with our decision.

We are heading back to the OBGYN in a couple of weeks and hope to get a better sense of our actual due date (we have only had one ultrasound when we first found out we were pregnant at 15 weeks) and begin to discuss a scheduled c-section versus a c-section when we naturally go in to labor. My personal goal is to make it to week 39 (as research shows this is best for the baby), but we'll see if he has other plans in mind (as his sister did).

Thankfully I took advantage of my visit to Seattle in December and purchased the majority of the baby clothes we will need for the first 9 months. My parents gifted us an Ergo carrier so we don't have to worry about a double stroller for a while (the sidewalks here are not very conducive to the more economical double stroller models), and we have the crib ordered and are just waiting for it to be finished!

Now if only we could come up with a name for this kid! (see my last post for details on this subject)

I can't believe we're in the home stretch. It seems like just yesterday we found out that we were pregnant. Here's to 3 more months as a family of 3 and a new life as a family of 4!

Arturo, Kesh, and me (and baby in the belly at around 20 weeks)

And Then There Were 4...

Ppost transferred from my old Blog.com site. Originally posted on 12/25/2012)

Yes, the rumors are true, our family will be expanding by one small person. We are excited that we will have the privilege of adding a little boy to our mix toward the end of May 2013! (or at least the docs tell us, two conferred on this subject, that they are 99.9% sure it is a boy)

Here is his first portrait...

No, we don't have a name picked out yet, so stop asking! We are, however, taking suggestions and would love to hear your thoughts on both first and middle names (last names will be Garate Adams, in that order). We are also debating just throwing all of the suggestions in to a fish bowl and drawing the winning name at the moment of his birth (wouldn't that go over wonderfully later on in life when we have to tell him how he got the name The Hulkmeister Rudolpf Garate Adams, or something of a similar nature).

I spent from September to late November bemoaning how many illnesses were coming in to our home from K's daycare. And how was it that I was getting sick but my husband was the lucky one who stayed healthy (I suppose that is a relative statement considering that since he was the healthy one he spent his time taking care of the sick women in his life). Well, now we know why!

Oh, and yes, you read that correctly. We did not know that we were pregnant until week 15 (way to go mom and dad!). We were so far along when we found out that they were able to sex our child on his first ultrasound (HA!).

So, I am now 18 weeks pregnant and the little monster is growing like he's going to be a football player (of the U.S. variety, not the international one), although considering my husband and I are about the same size, the odds of this happening are truly against him .

This pregnancy has been a bit tougher than the first for a few reasons...

1. K is in daycare and I was literally sick with some sort of cold, stomach flu, or parasite every two weeks for the first 4 months of my pregnancy. When I was pregnant with K there were no additional toddler germs to be found, so I stayed relatively healthy.
2. My heartburn has carried on longer with him that it did with her and is wreaking havoc on my body, especially since I am craving, and giving in to the desire for, spicy foods. *TUM TUM TUM TUM TUUUUUMS* ( also really want ceviche, of the spicy Peruvian nature, of course... raw fish is fine during pregnancy, right?)
3. I'm experiencing more "growing pains" with him that I did with K. I am crampier and can feel my round ligaments growing more often than I did in my first pregnancy. Again, not sure why (I should check with my doc when I'm back in Ecuador), but am wondering if it has to do with the fact that I had a c-section with K so my uterus is holding a grudge...
4. I am getting bigger faster and carrying differently. Here's the proof...

17 weeks with baby #1

17 weeks pregnant with #2

My stomach is this strange egg shape this time. Not sure if it's because my body has done this before and is adjusting accordingly, because it's a boy, or because I just turned 30 (JUST KIDDING).

But overall, I have to say that if I could totally be oblivious to the fact that I was pregnant for my first 4 months that I've got it made (just like I did with K).

When I get back to Ecuador we will be exploring our birthing options. Speaking with doctors about VBAC versus repeat c-section options. We are satisfied with our decision to educate ourselves as fully as possible on our options and come to a decision that is best for our baby, our family, and me. I know many of you will be very opinionated on this topic, but our family will make the choice that is best for us utilizing the medical resources we have where we live.

I will keep updates coming as the little man grows and from our growing family to yours, happy holidays!

The Name Game

Boy names are hard.

Our baby is due in about 3 months and we still have no names on our list that both Arturo and I agree on. I've scoured naming websites, talked to friends, looked at maps, and found very few inspirations.

During my searches I came across a website called Nancy's Baby Names, and noticed that in the past she had done write-ups for people who had no idea where to start naming their children... who could turn that opportunity down?! I decided to contact her to see what she said, but on her contact page was this disclaimer "Please note that I rarely write baby name suggestion posts nowadays, due to time constraints. If you’d like to send me your information anyway, remember to include your blog’s URL."

I went for it anyway and sent her the following email:

We are a mixed family (North American/Ecuadorian). We live in Ecuador and have a 2.5yo daughter named Kesha Lee who has a traditional Ecuadorian combined last name (Garate Adams, the first part of our last name is pronounced Gah-ra-teh).

I am currently 25 weeks pregnant with a boy and we can’t come up with names that both my husband and I agree upon. We both have very typical names (I am Rebecca Lee, he is Christian Arturo but goes by Arturo), but we would like something original, yet not totally weird for our son. Something like Kesha. You can pronounce it in both English and Spanish. It’s not too long, and it’s not one of those names that teachers will have a pre-existing bias about her when she steps foot in the classroom! (Basically, she can create her own personality!)

The only name my husband and I can agree on is London, but I’m not convinced and don’t think that naming a boy London, considering the current feminine trend for this name, is a good choice.

We own an international immersion program company here in Ecuador (www.elnomad.com) and are avid travelers. So something related to that would ring true with our family. We don’t have family names that we like (I like my dad’s middle name for a middle name, Holmes, but my husband says it sounds like a real estate agency haha).

And guess what. She responded! (see the article here) It is fun to see what others come up with and I have enjoyed reading her suggestions as well as those of her readers! 

We are still completely undecided about what we are going to name our little man, but suggestions are always appreciated (and are fun to hear).

What would YOU name our baby?

Horno de Leña (recipe)

I love to cook. I love to bake. And because of its matron-like culture I am often presented with interesting culinary experiences, opportunities to learn from the expert females themselves! 
Sometimes, I become the teacher. And sometimes, it goes both ways.

An horno de leña is a traditional wood fired oven. 
It is an outdoor oven that is dome-shaped. Wood is burned to form coals, which are pushed to one side and heat the oven. The dome shape of the oven allows the heat to circulate and evenly cook whatever you put in the oven (you can cook everything from chicken to pork to bread).

When my husband's Godmother and her family requested cinnamon rolls, I had the opportunity to bake in this exact oven! 

I had the help of a handful of women, all who wanted to learn how to make the "pan" (bread) as they kept calling it. I had to laugh and explained that this is more of a dessert or sweet treat than bread, but we stuck with the "pan de canela" name in Spanish. We made a quadruple batch.

First we mixed our dough (the part of the recipe below that says FOR THE DOUGH). It took two women holding the bowl and one stirring with a wooden spoon to get it evenly mixed. We laughed a lot!

All combined dough ingredients in the mixing bowl

Mixing our dough with a wooden spoon

What our dough looked like when it was thoroughly mixed

Because we were having lunch first we set the dough in the fridge for several hours (exactly as pictured above, but covered with a clean towel).

In the mean time we took advantage of the time (and that fact that other people were watching our children) to prep the filling and the icing.

The filling (if you were to use pecans they would go in here)

The icing (we cooked it early and put a lid on it which worked just fine)

When we were ready to bake the rolls we pulled the dough out of the fridge, divided it in to 4 pieces, rolled each piece out, slathered melted butter on them, added the filling, rolled, and sliced! The recipe comments that you should be patient in the rolling process. This is true! Also, I find it helpful to lighly flour my knife before each roll you slice. 

Butter smearing....

Our rolls ready to go in the oven!

We baked them for about 25 minutes each sheet at an altitude of around 2,000 meters above sea level, in a traditional wood fired, outdoor oven.

Margarita making sure the coals in the oven are properly placed before putting in the rolls

My lovely husband manning the oven

The first tin as it came out of the oven

Getting ready to serve them up warm!

Frosted and being nibbled on (more like devoured!)

Maple Pecan Cinnamon Rolls

Sourcing...

The recipe I used came from Pinterest (of course), but here is the link to the direct site for the actual recipe: http://www.bakingdom.com/2011/11/maple-pecan-cinnamon-rolls.html. I have also copied the recipe directly from the Bakingdom site and pasted it below. It is word for word. The changes I personally made when preparing this recipe are listed two sections below this one.

Personal testimonial...

I have made this recipe a total of 3 times now (once at sea level, the other times at altitude). It has turned out marvelously each time! The recipe claims it makes 8 rolls. I found this to hold true (even when I quadrupled the recipe). 

Ch ch ch changes...

Pecans are very expensive here, so I omitted them. 

I also substituted brown sugar for the local "panela" (an unrefined cane sugar that still has vitamins and minerals in it) and it also worked wonderfully. 

Baking soda is hard to get here, so I omitted it as well, and the recipe still worked just fine. 

Buttermilk is not common here, so we squeezed one large lime in to each cup of milk and let it rest for a few minutes. This seemed to be an adequate substitute. 

Lastly, when baking at altitude you always need to add extra flour (no, I don't know why). I have no idea how much extra flour I added. You also have to bake things a bit longer, which for this recipe I cannot advise on since I've never made it at altitude in a conventional oven. 

And finally, the recipe...

Ingredients

FOR THE FILLING

3/4 cup (191 grams) brown sugar, packed

1/4 cup (50 grams) sugar

3/4 cup chopped pecans

2 teaspoons cinnamon

1/8 teaspoon salt

1 tablespoon (14 grams) unsalted butter, melted

FOR THE DOUGH

3 cups (381 grams) all-purpose flour

3 tablespoons (38 grams) sugar

1 teaspoons baking powder

1/2 teaspoon baking soda

1/2 teaspoon salt

1 cup (250 ml) buttermilk

6 tablespoons (85 grams) unsalted butter, melted

1/3 cup (83 ml) maple syrup

FOR THE ICING

2 tablespoons (28 grams) unsalted butter, softened

3 tablespoons (45 ml) maple syrup

1 to 2 teaspoons (5 to 10 ml) milk

1 cup (125 grams) confectioners' sugar

To make the filling: Combine all of the dry ingredients in a small bowl. Add the melted butter and stir with a fork until the mixture looks like wet sand. Set aside.

To make the dough: Preheat the oven to 425 degrees (220 C). Brush a 9-inch cake pan with 1 tablespoon of the melted butter.

In a medium bowl, combine the flour, sugar, baking powder, baking soda, and salt. Add the buttermilk, syrup, and 2 tablespoons of the melted butter, and stir until just combined. Transfer the dough to a floured work surface and knead until smooth (it will still be very soft and a little sticky, but will be smoother and less lumpy). Place in a lightly floured bowl, cover, and chill for 20 minutes.

Once chilled, flatten the dough into a rectangle about 12 X 8 inches. Pour 2 tablespoons of the melted butter on and spread around with your fingers. Pour the filling over the dough and spread it evenly over the top, leaving about a 1/2 inch or so border around the outside edge. Press the filling down to pack it on top of the dough.

Starting on the long side of the dough, roll the side up, pressing as you go, to create a tightly rolled log (be gentle, as this will likely stick to the counter a bit). Pinch the seam closed and lay the log seam side down. Cut into 8 even pieces, and transfer each roll to the prepared cake pan. Brush with the remaining 2 tablespoons of melted butter. Bake for 20 to 23minutes, until golden brown.

To make the icing: In a medium bowl, cream the butter and add the sugar. Mix until the sugar and butter start to come together a bit. Add the syrup and whisk well, until the mixture is smooth. If it is too thick, add a teaspoon or so of milk to loosen it up.

Allow the cinnamon rolls to cool in the pan for about 5 minutes. Pour the icing over the rolls. Serve warm.

These will keep in an airtight container for about 3 days.

Recipe by Darla (THANK YOU DARLA!)

Not Quite as Planned

This post should have been about baking cinnamon rolls in a wood-fired oven, however, sometimes our lives don't quite go as we plan. Why I am not writing about deliciously gooey rolls is no exception...

As of a couple of days ago I was heading to NC for a partnership building visit and to present at a NC study abroad conference.

Kesha had been sick, fever, tummy ache, cough... So when I presented with the same symptoms earlier this week I wrote them off as the same bug. However, by Tuesday night I was tossing and turning with a very uncomfortable pain in my abdomen and back. Wednesday morning I was nauseous, had no appetite, and a low grade fever (in addition to my previous symptoms ). I laid in bed all day resting (which is big for me). Worried about my abdominal pain with the pregnancy I made an appointment with my OBGYN for early evening.

Upon arrival I gave all my symptoms to my Doc, he pushed around on my abdomen, and then diagnosed me. Diagnosis? Appendicitis. My jaw could have hit the floor with shock. Since you cannot 100% confirm the diagnosis of appendicitis when pregnant (ultrasounds wont find the appendix because it is hidden by the enlarged uterus) my Doc called a surgeon for a consultation and second opinion. After a series of pushing on the most painful parts of my belly, and a couple of strange tests (such as jumping up and down on one foot), the surgeon came to the same conclusion.

Course of treatment? Surgery. Immediate surgery. And due to the pregnancy lycroscopic options were out.

Well, now that ruins quite a few plans, doesn't it?

I was prepped and in the operating room less than an hour later. Due to the pregnancy I could not be fully put under, so I received an epidural (the exact same one they give you for a c-section) and remained fully conscious during the procedure.

My OBGYN is a gynecological surgeon, so he assisted the primary surgeon. Both are well known for their skill and experience. The operation lasted about an hour.

I got to see my appendix after they removed it (remember, I'm awake for the entire operation), and half of it was completely black. They also showed it to Arturo and told him that if we had waited another hour or two we would have been dealing with a ruptured appendix. Thank goodness I opted for the 5:15 appointment, not the 6:15!

I stayed in the clinic on Wednesday night, all day Thursday, and Thursday night, finally being discharged Friday morning. The extra night's stay was to observe baby more than mommy.

It will be a tough recovery, as with any abdominal surgery, and it will be another couple of weeks before I am cleared to do anything physical activity-wise again (including travel). But the baby is doing well, there have been no signs of pre-term labor post surgery, and I am up and out of bed with help.

I am very disappointed about my NC trip, but am thankful that this all came to fruition here and not on an airplane or in the US! And am greatful for such good medical attention and care.

If you are in Cuenca looking for a Spanish-speaking OBGYN visit Dr. Xavier Molina at the Clinica Paucarbamba. Surgeon (again, Spanish-speaking) Dr. Vasquez also at the Clinica Paucarbamba.

Here are a few photos from our pregnancy appendicitis ordeal...