A is for Astigmatism

It was only a matter of time before the children of Harry Caray (aka Frank) needed glasses, granted my poor vision didn’t probably help either. In fact, researchers have found that if both parents are near-sighted, the child has a 33% chance of also being near-sighted. This is the case for Theo, Bella and Elliott. We learned at their latest eye exam that all are near-sighted and have astigmatism.

What’s Astigmatism?

Astigmatism is caused by an abnormal curve of the cornea, or the outer region of the eye. Technically, it’s a refractive error because the shape does not bend light correctly. Their optician stated that their eyes look more like footballs versus the normal baseballs. In order to see clearly, light needs to be bent by the cornea and the lens of the eye before it reaches the retina.

How did we know?


Since the V5 were premature, we have been seeing an eye doctor annually since birth. The early examinations were quite medieval and used an odd contraption to keep their eyes open during the exam. Now, the visits resemble an adult visit where they complete a variety of vision tests near to the eye and far from the eye. Then, the eyes are dilated (takes 30 minutes) and the back of the eye or retina is examined. The dilation is necessary to evaluate astigmatism.

In the end, you will receive a “score card” describing the prescription for the right eye (“OD”) and left eye (“OS”). It starts with the “spherical error,” or whether the child is nearsighted (can’t see faraway) or farsighted (can’t see close up). A positive sign indicates farsightedness whereas the negative sign indicates nearsightedness. The higher the prescription the worse the vision. The “Cyl,” or cylinder numbers describes the astigmatism and the “Axis” indicates which way the astigmatism is oriented. Finally, the “Add” section is used for bifocals.


Getting Gear

There are several companies that make child-proof glasses. Our insurance company covered Miraflex and after 2 weeks, they’ve proven their worth in not only correcting vision but withstanding some trauma. You can choose from a variety of shapes and colors. Of course, our 3 chose their favorite colors: blue. purple and pink; they’re true to their brands.

First Impressions

When trying on the glasses in the optical shop, we observed different reactions.


Theo was excited for his new gear, Bella appeared quite upset and slightly confused and Ellie was unsure. I believe its important to recognize these feelings as simply feelings and help children to understand that glasses are just like medicine and they can help to heal your eyes just like medicine does for the body.

The first few days required a lot of reinforcement.

image3For example, Theo thought it made sense to hide his glasses in a tree in the yard for almost a whole day. Many thanks to Nana for tracking them down. On the other side of the spectrum, Ellie’s words after putting them on were,”I can see you Mom!”


Bella has also grown to love her glasses and has come to recognize how much they are helping her.  While it first it was disheartening to learn of their vision problems, it warms my heart to see how much better they can see and thus experience life now.

V5 at their Dental Appt with Dr. Cece and her crew

Trick, Treat, or Teaching Opportunity

Halloween can be a scary time for more reasons than the goblins and spooky ghosts. Halloween seems to kick-off the season of treats beginning with the tempting sweets that line the grocery store aisles. Many parents dread Halloween due to the amount of candy that their child drags home after a long night of trick-or-treating.  However, I am looking forward to this teaching opportunity.


Many of you know that food, nutrition and overall wellness are near and dear to my heart. I love equipping and empowering people in their health pursuits… especially my children. Trick-or-treating is a great time to teach moderation. There is a growing body of research that encourages families to mark no food as forbidden. Ellyn Satter encourages parents to help their children to, “Learn to manage sweets and to keep sweets in proportion to the other food [they] eat.” Moderation can be a difficult concept to grasp, but it is a lesson worth learning. According to research, treat-deprived children often end up weighing more later in life due to hoarding forbidden foods. I appreciate these findings but also recognize that these lessons need to be age-appropriate.

At three years young, my kiddos still are led by their frontal lobes (aka Impulsivity) therefore, we have tailored the moderation conversation to one of “wants” versus “needs” and “wants” have a time and a place. Since candy and sweets are unnecessary “wants,” my children have never had any. We don’t have any in the home so, if they encountered a candy bar on the street they wouldn’t know what it is. This is intentional because I know the power of sugar and I also know the consequences. Sugar is a sweet and silent killer that is a great contributor of morbidity and mortality around the world. Because of this I often associate excess sugar with excess alcohol or even smoking. As parents, we are guides and guardians for our children. We are blessed with the opportunity to guard their hearts, minds, bodies and souls until they are able to “digest” the media and message and then tasked with helping to guide them through this muddy world.

This does not mean my children will never have the pleasure of candy; recall those that are deprived often become the secret hoarders. Instead, we will continue to be intentional about when, where, why and how we introduce these types of foods and experiences. I also feel led to set others up for success that is why we will continue to be the weirdo house on the street that does not handout candy, but rather an allergen free snack. There are also a host of other food and non-food alternatives including…

Non-Food Alternatives:

  • Stickers
  • Glow sticks
  • Play dough
  • Rings
  • Toothpaste/Floss/Toothbrush
  • Pencil/Erasers
  • Seasonal Post-it’s
  • Bubbles

Food Alternatives:

  • Gum
  • Granola Bars
  • Pretzels/Crackers
  • Popcorn or Puffed Corn

So, with moderation in mind may the force be with you as we forge into the season of sweets and continue to guard and guide our children in the days to come!

The Cost of Good Care


The healthcare industry is constantly evolving. Scientific research spurs on new discoveries, techniques, surgeries and cures. The economic environment dictates the distribution of healthcare. In the present day and age, there are many “what-if’s” about how and to whom healthcare is delivered. This post is not intended to be an epic dissertation on healthcare in America. The purpose, rather, is to explain to those inquiring why we are no longer pursuing medical care for our pregnancy in Madison, WI.

Upon learning that we were pregnant with quintuplets, the initial meetings with our fertility specialist and perinatologists were an emotional undertaking, to say the least. These medical specialists fought long and hard to convince us to pursue multi-fetal reduction. They wanted us to take the five and reduce to 2, maybe 3. This was never an option for us, and we made it very clear from day one. However, despite our stance, the perinatologists would not discuss a plan of care with us for over a month under their supervision.

Finally, nearly two months into our pregnancy we were able to sit down and discuss how we were going to make our pregnancy a success and give our unborn children the best chance at a happy and healthy life. We came prepared to this meeting, well read on terms and proactive treatments and even brought along a few research articles to discuss. The docs may have been a bit thrown off; one was not even prepared to discuss how to combat pre-term labor. Luckily, his colleague was.

We had a long conversation about what their practice was willing to provide and what they were not. They were willing to provide monitoring prior to 24 weeks of gestation, which simply meant monthly ultrasounds. They were willing to provide a nutrition consult with their dietitian and psychological care with their social worker. But, they were not willing to consider preventative measures, and what I would consider proactive care. Despite the research I held in my hand, they would not acknowledge the efficacy of a cerclage (stitching of the cervix), non-stress testing (contraction monitoring), intensive tocolysis (treatment of contractions to delay labor), or even bed-rest. Instead they encouraged me to continue to take my prenatal vitamin and told me it was fine to exercise up to 30 minutes a day.

This information did not sit well with me, so I reached out to other mothers of quints and they were appalled. They encouraged us to get a second opinion and quickly. I didn’t at that point. I decided that I needed to come to trust my current healthcare practitioners; I did not want to seek care elsewhere knowing: 1) This would mean leaving home and 2) Our insurance would not cover it.

Then, at 18 weeks we sat across the table from another perinatologist from the same practice and a clinical nurse specialist. They informed us that we would most likely lose this pregnancy in the next 3-4 weeks. I asked and begged for them to reconsider a cerclage, and they said it would not help but would actually put me in more danger of losing my pregnancy. They shared that cerclages are only provided to persons with incompetent cervixes, which is a diagnosis typically given to moms only after having a previous miscarriage prior to 24 weeks. He told us not to give up hope but that there was essentially nothing else we could do. He encouraged me to continue to eat right and said I could still exercise up to 30 minutes daily. I asked about bed rest, tocolytic drugs and contraction monitoring and was once again told these treatment options would be of no help. Then, came the moment I realized that care at this clinic was not our only choice. I sought a second opinion.

The second opinion came from a renowned high-risk perinatologist in Arizona, who many other quint mom’s highly recommended and adored. They loved him for a very important reason; he saved their pregnancies. After a 30-minute phone call with this doc, also known as the, “Quad God,” I learned that if I didn’t have a cerclage within the next 3 days, we would, in all likelihood, lose our babies. He had a recipe for success that was incomparable to other docs’ practices due to his extensive experience with high order multiples. He has delivered 101 sets of quadruplets, 15 sets of quintuplets and 2 sets of sextuplets. To put that in perspective, our previous docs had delivered just 1 set of quads, no quints, and no sextuplets. Additionally, the average gestational age of quints delivered under his care is 33 weeks and 1 day… Academic research indicates the total population gestational average is somewhere between 25 and 27 weeks. The “Quad God’s” success was quite simply unheard of.

The next few days flew by as we attempted to plead with our insurance company to cover this care. However, to this day, they continue to deny us because:

  1. The services requested are/were with a non-participating provider.
  2.  The services are/were not medically indicated because they are not appropriate to treat the condition and do not represent the standard of care to treat the condition.
  3.  The utility of prophylactic cerclage is unproven and there is evidence to suggest it may be detrimental and may be associated with an increase in preterm delivery and pregnancy loss.

However, here I sit to write this post at 24 weeks- 6 weeks later- with healthy babies developing within me.

So, many ask why am I still here? I have the cerclage, the pregnancy is stable and insurance continues to not be willing to pay a dime towards our care. Why would I not come back to Madison?

The answer to me is plain and simple:

1. There were no other participating providers in our insurance network besides our  initial maternal and fetal medicine specialists.

We were concerned with the care that was being provided by our previous providers for several reasons, including their unwillingness to consider preventative and proactive measures of care.  Even after the cerclage, they informed me that they would be unwilling to provide intense tocolysis, contraction monitoring and support strict bed rest. I have been receiving these treatments here in AZ since the moment I arrived.

2. Emergent care, via cerclage, strict bed rest, contraction monitoring and tocolysis, were/are all required and medically indicated, in order to, prevent pre-term labor.

There is a body of research, which supports these facets of care during multi-fetal gestation. Additionally, a cerclage is not an “experimental therapy” but again is considered a component of normal perinatal care in a high-order multiples pregnancy.

My current perinatologist has published over 25 peer-reviewed articles on the management of high-order multiples and has delivered 15 sets of quintuplets whom have exceeded the average gestational age by over 5 weeks. The previous specialists have never delivered, or managed, a quintuplet pregnancy and while they are revered clinicians in their areas of research, they have not published on the management of high-order multiple pregnancies.

The peace that I feel in pursuing treatment under this new doctor’s care is overwhelming. For the first time in this pregnancy, I am confident in the care that I am receiving.  I would fear for the well being of my babies if they were subject to the care of the practitioners in Madison. They have not demonstrated that they truly care about our five miracles, nor do they appear willing to proactively fight for a healthy pregnancy.

Unfortunately, these reasons are not convincing to our insurance provider. Therefore, we will continue to appeal and grieve this process with them, as we have since we initiated care outside of network. It is truly unfortunate that we cannot find comparable care within our insurance providers network. Our current doctor even offered to communicate his care plan to our previous docs, so that we could remain in-network, however they have denied all collaboration at this point.

Our biggest concern at this point, outside the healthy delivery of our 5 babies, is the financial livelihood of our family. The medical practitioners we are working with are very cognoscente of our financial situation and have been more than accommodating. But, we know that once I am admitted for closer monitoring and more intense treatment, the bills will begin to accumulate. Then, of course, will come the likely astronomical Neonatal Intensive Care Unit bill for 5 babies.

And so, we are witness to the cost of good healthcare in America. Still, we are simply unwilling to sacrifice our right to choose a qualified practitioner just because an insurance company is holding us financially hostage. We feel as parents-to-be that we now represent our children; we are now responsible for their well being until they are able to take on that responsibility themselves. We will fight, and continue to fight, for our children’s God given right to life, liberty, and the pursuit of happiness.