The Candida Expert

Archive for the ‘Family’ Category

Gut Microbes Benefit Pregnancy

More and more science points out how critical and essential the intestinal flora (microbiome) is for health in the body. We are “Super-organisms.” The current point of view is that we consist of host cells (human cells) and support cells (bacteria, parasites, viruses, yeasts, fungi, etc.). Over thousands of years, we have co-evolved into a cohesive and co-dependent unit, where the presence and health of all the parts (human and non-human alike) constitutes the health of the whole. This recent research article demonstrates how the intestinal flora, or gut microbiota, play a regulatory role in creating a healthy pregnancy.

The composition of microbes in the gut –http://candidaplan.com/blog/?p=336

 

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Candida, Fruit, and Dr. McCombs Candida Plan

When I developed the McCombs Plan about 20 years ago, I was fortunate enough NOT to be familiar with the anti-candida programs or books that were around. That meant that I could discover for myself what worked and what didn’t work for my patients. Three years later, I started getting questions from my patients about why this or why not that.

The Plan as it had been developed was very successful from the beginning and is still the original Plan as it is laid out today. One of the common questions that I received was why – http://candidaplan.com/blog/432/candida-fruit-and-dr-mccombs-candida-plan/

Can You Eat Too Many Healthy Fruits and Veggies?

Is it possible to overeat healthy foods? I guess that would depend on the context. The point of the article below is that it is possible to consume too many calories and gain weight, regardless of whether the food is healthy or not. Contrary to this type of logic however, when doing Dr. McCombs Candida Plan – http://candidaplan.com/, we find that eating plenty actually helps to increase weight loss. This is due to the fact that detoxifying the body takes lots of energy and you need to fuel this process. Many people comment that they “haven’t eaten this much in years and they’re still losing weight,” which brings us back to context. Here’s the short article anyway – http://www.sciencedaily.com/releases/2012/07/120724144423.htm

It may make you scratch your head, but in fact it is possible to overeat healthy foods, according to Loyola University Health System registered dietitian Brooke Schantz.

“While fruits are nutritious, too much of even a healthy food can lead to weight gain,” Schantz said. “The key is to remember to control the portion sizes of the foods you consume.”

Schantz reported that overeating healthy foods is easy to do, but the same rules apply to healthy food as junk food. Weight fluctuates based on a basic concept — energy in versus energy out. If your total caloric intake is higher than the energy you burn off in a day, you will gain weight. If it is lower, you will lose weight.

“I have had many patients tell me that they don’t know why they are not losing weight,” Schantz said. “Then they report that they eat fruit all day long. They are almost always shocked when I advise them to watch the quantity of food they eat even if it is healthy.”

Schantz said that one exception applies. Nonstarchy vegetables are difficult to overeat unless they are accompanied by unnecessary calories from sauces, cheeses and butter. This is due to the high water and fiber content of these vegetables coupled with the stretching capacity of the stomach. The vegetables she suggested limiting are those that are high in starch, such as peas, corn and potatoes. Foods that are labeled as fat-free or low-fat are another area of concern.

“People tend to give themselves the freedom to overeat ‘healthy’ foods,” Schantz said. “While the label might say that a food or beverage is low-fat or fat-free, watch the quantity you consume and refrain from eating an excessive amount. Foods that carry these health claims may be high in sugar and calories.”

Context, context, context!

More on Bacillus subtilis

Here’s a list of antibiotics that Bacillus subtilis is used with. It’s effects are against aerobic and non-aerobic bacteria. There is no differentiating between good and bad bacteria, as some people are lead to believe. That differentiation is something put out by the pharmaceuitical companies and MDs. The warrior model of destroying this and that as used in medicine, is antiquated and has been so many decades. The “holistic” approach used by many people is just a variation on the medical warriot model, whereby medications are substituted with something else to bring about destruction. The approach to destroying anything in the body, fails to consider that in doing so, we are destroying ourselves in the process. It’s okay if you want to support those groups, it’s just that the information is misleading.

All bacteria in a balanced system benefit the system. Create the balance and you also create the safeguards against anything that shouldn’t be there. Destroy that balance and you’ll see health start to slip away as the ecosystem starts to collapse into chaos.

As you’ll see below, Bacillus subtilis has been associated with food poisoning, disease conditions, and has been tested for biological applications as a biolgical agent.

Bacillus subtilis is the basis for many antibiotics due to its strong antibacterial function. This antibacterial function will create imbalance within the body by destroying bacteria. It also has a strong antifungal effect and is the basis for antifungal medications, but these, as we know, create other imbalances.

You’ll see below this list of B. subtilis-based antibiotics some more information on B. subtilis. It’s not a risk-free choice. Whatever your decision, make it an informed choice.


B. subtilis
does produce an extracellular toxin known as subtilisin. Although subtilisin has very low toxigenic properties (Gill, 1982), this proteinaceous compound is capable of causing allergic reactions in individuals who are repeatedly exposed to it (Edberg, 1991). Sensitization of workers to subtilisin may be a problem in fermentation facilities where exposure to high concentration of this compound may occur. Exposure limits to subtilisin are regulated by Occupational Safety and Health Administration (OSHA) (29 CFR 1900, et seq.)Biotechnology Program Under Toxic Substances Control Act (TSCA)

Bacillus subtilis Final Risk Assessment

III. HAZARD ASSESSMENT

A. Human Health Hazards

1. Colonization

B. subtilis is widely distributed throughout the environment, particularly in soil, air, and decomposing plant residue. It has shown a capacity to grow over a wide range of temperatures including that of the human body (Claus and Berkeley, 1986). However, B. subtilis does not appear to have any specialized attachment mechanisms typically found in organisms capable of colonizing humans (Edberg, 1991). Given its ubiquity in nature and the environmental conditions under which it is capable of surviving, B. subtilis could be expected to temporarily inhabit the skin and gastrointestinal tract of humans, but it is doubtful that this organism would colonize other sites in the human body (Edberg, 1991).

2. Gene Transfer

The transfer of gene sequences between strains of B. subtilis has been demonstrated when the strains were grown together in soil (Graham and Istock, 1979). In addition, Klier et al. (1983) demonstrated the ability of B. subtilis and B. thuringiensis to exchange high frequency transfer plasmids. Other studies have shown that B. subtilis has the ability to express and secrete toxins or components of the toxins that were acquired from other microorganisms through such transfers of genetic material. B. subtilis expressed subunits of toxins from Bordatella pertussis (Saris et al., 1990a, 1990b), as well as subunits of diphtheria toxin (Hemila et al., 1989) and pneumolysin A pneumococcal toxin (Taira et al., 1989). Although B. subtilis does not appear to possess indigenous virulence factor genes, it is theoretically possible that it may acquire such genes from other bacteria, particularly from closely related bacteria within the genus.

3. Toxin Production

A review of the literature by Edberg (1991) failed to reveal the production of toxins by B. subtilis. Although it has been associated with outbreaks of food poisoning (Gilbert et al., 1981 and Kramer et al., 1982 as cited by Logan, 1988), the exact nature of its involvement has not been established. B. subtilis, like other closely related species in the genus, B. licheniformis, B. pumulis, and B. megaterium, have been shown to be capable of producing lecithinase, an enzyme which disrupts membranes of mammalian cells. However, there has not been any correlation between lecithinase production and human disease in B. subtilis.

4. Measure of the Degree of Virulence

B. subtilis appears to have a low degree of virulence to humans. It does not produce significant quantities of extracellular enzymes or possess other virulence factors that would predispose it to cause infection (Edberg, 1991). There are a number of reports where B. subtilis has been isolated from human infections. Earlier literature contains references to infections caused by B. subtilis. However, as previously stated,the term B. subtilis was synonymous for any aerobic sporeforming bacilli, and quite possibly, many of these infections were associated with B. cereus. In a recent British review article, Logan (1988) cites more recent cases of B. subtilis infections in which identification of the bacterium appeared reliable. Infections include a case of endocarditis in a drug abuse patient; fatal pneumonia and bacteremia in three leukemic patients; septicemia in a patient with breast cancer; and infection of a necrotic axillary tumor in another breast cancer patient. Isolation of B. subtilis was also made from surgical wound-drainage sites, from a subphrenic abscess from a breast prosthesis, and from two ventriculo-atrial shunt infections (as cited by Logan, 1988).

Reviews of Bacillus infections from several major hospitals suggest that B. subtilis is an organism with low virulence. Idhe and Armstrong (1973) reported that Bacillus infections were encountered only twelve times over a 6-1/2 year period. Species identification of these Bacillus infections was not made. In another hospital study over a 6-yr. period, only two of the 24 cases of bacteremia caused by Bacillus (of a total of 1,038 cases) were due to B. subtilis (as cited by Edberg, 1991). Many of these patients were immunocompromised or had long term indwelling foreign bodies such as a Hickman catheter.

B. subtilis has also been implicated in several cases of food poisoning (Gilbert et al., 1981 and Kramer et al., 1982 as cited by Logan, 1988).

As previously mentioned, B. subtilis produces a number of enzymes, including subtilisin, for use in laundry detergent products. There have been a number of cases of allergic or hypersensitivity reactions, including dermatitis and respiratory distress after the use of these laundry products (Norris et al., 1981).

5. Conclusions

B. subtilis is not a human pathogen, nor is it toxigenic like some other members of the genus. The virulence characteristics of the microorganism are low. According to Edberg (1991) either the number of microorganisms challenging the individual must be very high or the immune status of the individual very low in order for infection with B. subtilis to occur.

B. Environmental Hazards

3. Hazards to Other Microorganisms

B. subtilis has been shown to produce a wide variety of antibacterial and antifungal compounds (Katz and Demain, 1977; Korzybski et al., 1978). It produces novel antibiotics such as difficidin and oxydifficidin that have activity against a wide spectrum of aerobic and anaerobic bacteria (Zimmerman et al., 1987) as well as more common antibiotics such as bacitracin, bacillin, and bacillomycin B (Parry et al., 1983). The use of B. subtilis as a biocontrol agent of fungal plant pathogens is being investigated because of the effects of antifungal compounds on Monilinia fructicola (McKeen et al., 1986), Aspergillus flavus and A. parasiticus (Kimura and Hirano, 1988), and Rhizoctonia (Loeffler et al., 1986).

Although B. subtilis produces a variety of antibiotic compounds in culture media, the importance of antibiotic production in the environment is unknown (Alexander, 1977).

B. subtilisis not a frank human pathogen, but has on several occasions been isolated from human infections. Infections attributed to B. subtilis include bacteremia, endocarditis, pneumonia, and septicemia. However, these infections were found in patients in compromised immune states. There must be immunosuppression of the host followed by inoculation in high numbers before infection with B. subtilis canoccur. There also have been several reported cases of food poisoning attributed to large numbers of B. subtilis contaminated food. B. subtilis does not produce significant quantities of extracellular enzymes or other factors that would predispose it to cause infection. Unlike several other species in the genus, B. subtilis is not consider toxigenic. B. subtilis does produce the extracellular enzyme subtilisin that has been reported to cause allergic or hypersensitivity reactions in individuals repeatedly exposed to it.

In conclusion, the use of B. subtilis in fermentation facilities for the production of enzymes or specialty chemicals has low risk. Although not completely innocuous, the industrial use of B. subtilis presents low risk of adverse effects to human health or the environment.

Candida and Inflammation in the Athlete

There’s a certain sense of loss in realizing that the best of each us is being eroded away, or lies wasting away, as hidden potential within the cells of our bodies. The gradual erosion of potential is often found in cases where there is an underlying imbalance in the body that creates chronic inflammation and the inability to absorb nutrients for normal function and repair. When chronic inflammation and nutritional imbalances are combined, degeneration of tissues advances at a far faster rate than it normally would. I have found this to repeatedly be the case in people who have been exposed to antibiotics and as a result suffer from the system-wide imbalances that are created from their usage.

In many people, this may look like a normal aging process. In the athlete, it usually is associated with excessive wear and tear on joints and failure of the muscles and the body to respond and perform as they once did. Athletic careers and pursuits can end prematurely, and the hopes and dreams of what could have been, remain forever as hopes and dreams.

Under these types of constant inflammatory conditions, the serious athlete or weekend warrior who pushes the limits of his body’s ability in pursuit of personal records and goals, will end up driving the inflammatory machinery that will eventually rob them of their potential for excellence. Exercise produces pro-inflammatory immune system responses and oxidative stress that play a role in repair and remodeling of muscle tissues. Intense exercise carries this response further, and over the long-run can produce immune system suppression and autoimmune-type responses. The following excerpt from Journal of the International Society of Sports Nutrition helps to explain a little more on this topic:

“DOMS (Delayed Onset Muscle Soreness) typically occurs after unaccustomed or high-intensity exercise, most commonly anaerobic. Soreness is usually noted at 24 hours post-exercise and can last as long as 5 to 7 days post-exercise. Although several models of DOMS have been suggested, researchers generally agree that muscle damage initiates a cascade of events leading to DOMS. The muscle damage and oxidative stress response following anaerobic exercise have been deemed necessary to promote skeletal muscle remodeling to gain benefit from the exercise, but enhanced recovery may be advantageous for more rapidly promoting an anabolic environment.

Exercise elicits mechanical and hormonal reactions from the body. The resulting muscle damage from these reactions elicits inflammatory and oxidative responses that may exacerbate muscle injury and prolong the time to regeneration. The hormonal contributor to muscle damage during exercise is derived through basic neuroendocrine responses to exercise demands. High intensity exercise triggers the activation of the hypothalamic-pituitary-adrenal (HPA) axis leading to the release of cortisol and other catabolic hormones. These hormones function to meet increased energy needs by recruiting substrates for gluconeogenesis via the breakdown of lipids and proteins. Through their catabolic nature, these hormones also indirectly lead to muscle cell damage.

Inflammation following anaerobic exercise functions to clear debris in preparation for muscle regeneration. The magnitude of the increase in inflammatory cytokines (such as IL-6) varies proportionately to the intensity and duration of the exercise. However, a prolonged inflammatory response can increase muscle damage and delay recovery by exacerbating oxidative stress and increasing production of reactive oxygen species (ROS). The increased ROS production seen with high intensity training can lead to oxidative stress such as lipid peroxidation (1).”

While intense exercise is usually associated with greater degrees of DOMS, inflammation, immune system suppression, and oxidative stress, mild-to-moderate exercise is typically associated with boosting the immune system and supporting greater health in the body. If however, there is an underlying state of chronic inflammation due to an infectious agent, then even mild-to-moderate exercise may result in many of the symptoms commonly found with intense exercise, as fuel is added to an already burning fire. Over a period of months and years, this can lead to shortened productivity and limited excellence in today’s athletes. In one sense, it is the equivalent of driving with the brakes on.

The most frequent infectious agent that fits this model is Candida albicans. C. albicans commonly exists as a yeast organism in the human body and is considered a normal part of healthy tissue flora. Due primarily to the effect of antibiotics, this yeast organism transforms into a pathogenic, problematic fungal form that has been associated with a multitude of conditions and diseases in the body.

Since the introduction of antibiotics in the late 1940s following WWII, there has been a remarkable increase in the research of candida-related conditions and diseases (2) with over 24,000 research articles being published since 1949. On average, that is enough for one research article per day in the last 51 years, with enough left over to fill another 6 years of daily research publications. With a one-to-one association between antibiotic use and the development of systemic fungal infections, implications exist for society as whole being afflicted with a post-antibiotic syndrome of fungal candida and immune system dysregulation.

In systemic fungal candida infections, ongoing pro-inflammatory reactions from both systemic and localized immune system responses combine with the virulence mechanisms of fungal candida to create a constant state of oxidative stress, pro-inflammatory hormonal imbalances, chronic tissue inflammation, and tissue degeneration. This type of smoldering, nonresolving inflammation becomes a constant component of the microenvironment within and is implicated in many diseases and conditions.

Joint restriction, pain, swelling and inflammation, weight gain, fatigue, blood sugar imbalances, nutrient deficiencies, slower post-exercise recovery periods and other symptoms are commonly associated with this underlying condition in today’s athletes and others.

In response to patients who had these problems, I developed a well laid out plan to counteract this post-antibiotic syndrome and subsequent systemic imbalances. Athletes who have followed the McCombs Plan have seen a decrease in the degree and amount of inflammation experienced during exercise, as well as pre- and post-exercise inflammatory responses with faster recovery times. Many of the conditions associated with fungal candida that impact human performance have been diminished and resolved. Marathon runners and Tri-atheletes found themselves competing without “hitting the wall.” Wrestlers, weight lifters and others found that their joint pains and restrictions decreased and disappeared. Increased energy and vitality that is sustained throughout the day has been a common response.

If we are to achieve the best that we can be, we must rid ourselves of these types of physiological limitations, or settle for less and be happy with what could have been.

1. The effects of theaflavin-enriched black tea extract on muscle soreness, oxidative stress, inflammation, and endocrine responses to acute anaerobic interval training: a randomized, double-blind, crossover study

Shawn M Arent, Meghan Senso, Devon L Golem and Kenneth H McKeever

Journal of the International Society of Sports Nutrition 2010, 7:11doi:10.1186/1550-2783-7-11

http://www.jissn.com/content/7/1/11

2. SciTrends of Biomedical Sciences

http://rzhetskylab.cu-genome.org/cgi-bin/trendshow?MeSHID=1191

Adventures of a Preterm Daddy: Part IV – The NICU at Cedars-Sinai

Immediately following the birth of our 25 week-old twins, I was whisked away to the 4th floor of Cedars, while my wife was wheeled to a 3rd floor recovery room following her c-section. In a somewhat numbed state, I entered the Neonatal Intensive Care Unit.

Like Alice, or perhaps more appropriately Alex in Wonderland, I had fallen down a rabbit hole into a very strange world of giraffes, jets, and isolettes. Cedars’ NICU has a capacity for 45 babies spread out over 6 bays and a couple of extra rooms for isolation purposes. Although its NICU is continually unranked in national polls, it is nonetheless an impressive display of the best that technology has to offer. It is equipped with the latest in climate controlled incubators called Giraffes and their smaller cousins, the isolettes. Surrounding each Giraffe, you’ll find monitors, ventilators, screens, and an assortment of tubes and wires leading to each of its inhabitants. Bays 1 through 4 are for more intensive care, while bays 5 and 6 are for those babies preparing to graduate and begin their lives amongst the rest of us. As fate would have it, we wound up in Bay 4, nicknamed “The crazy bay.” Two weeks prior to our arrival, business was so slow that two of the NICU bays had been shut down. The weekend of our arrival must have been High Holy days for preemies and other assorted special needs babies as the house was full. Amidst the flurry of activity and a chorus of various alarm bells and flashing lights, I was given forms to read and sign and instructions on what to do and expect. Through a haze of adrenaline, worry, and concern, I was introduced to Joan, the nurse charged with watching over our little girl. Joan’s presence was calming and reassuring, something gained from 28 years as a NICU nurse.

Cedars-Sinai’s NICU has a battalion of some 130 nurses that rotate on 12 hour shifts. As our midwife had pointed out to us, NICU nurses don’t work in the NICU just because they need a job. These are very special individuals filling a very special need. Some of the nurses, whom we liked to call our Super-nurses, filled that need extremely well. Our super-nurses were Joan, Gilda, Debra, Dalys, Vanji, Tysson, Pam, Kathy, Wendy, Yvonne, Anne, Monica, Macy, Lorna, Adrienne, Judy, Meera, and others. The nurses are the workhorses of patient care in every hospital and no less so at Cedars. Styles vary tremendously and while some embrace the parents in their rightful role as the primary caregivers, others treat them as the enemies. Many of the nurses that I spoke with talked of having dreams about the alarms going off. In this world, babies come and go, and live and die frequently. According to Cedars-Sinai, 27% of the NICU babies don’t make it. Nationwide, the average is much higher at 45% (http://www.csmc.edu/8921.html). For caring hearts, being a NICU nurse can be a very stressful way of life.

My wife’s entrance into the NICU wasn’t until the next day. Following surgery, mothers are first required to have a bowel movement prior to leaving their rooms. By the next day, she had two of them (sorry honey, but its part of the story). This became the hot topic amongst the maternity floor nurses. Nurse after nurse came into her room to inquire how this miracle of God had took place, as most mothers take several days to a week to accomplish this task. Like most medical centers, Cedars has very little knowledge about functional nutrition. Functional nutrients are proven to be more readily absorbed, transported, and utilized than most synthetic and inorganic nutrients. Cedars-Sinai relies heavily on synthetic nutrients to address the real-life needs of their patients. In the case of post-partum mothers, they use ferrous sulfate as an iron supplement to compensate for any blood loss during birth. Ferrous sulfate is a form of iron that causes constipation, bloating, and other symptoms. To compensate for the constipation, patients are given laxatives that work by irritating the bowel wall. Neither product works very well, leaving the mothers feeling miserable and longing to see their newborn babies. We used a natural food and herb-based product called Floradix to address her iron needs and trace minerals to assist with moving the bowels without causing irritation. In less than 24 hours, a mother and her babies were together once again.

To its credit, Cedars-Sinai has a unique philosophy toward the parent’s involvement in the NICU. Their philosophy states that the parent is the most essential and constant member of the infant’s health care team and promotes parents as active and equal participants in order to instill confidence and empower them in their role as the primary caregivers. Well, at least that’s what it says on the plaque on the wall outside the NICU. Inside the doors of the NICU however, it’s doctor’s egos, nurse’s preferences, hospital policies, standards of care, and defensive medicine that take precedence over the care, comfort, and individual needs of each child. If there’s room left over, then the parents might have a voice. This “voice” was something that my wife likened to hostage negotiations. Although they may be willing to listen to what you have to say, they proceed with their own agenda.

As the week began to creep along, my wife was discharged from the hospital and we began our daily treks back and forth between home and the hospital. Everyone told us that our lives would change once we had our babies, but this wasn’t the change we had been expecting. Both doctors and nurses told us to plan on bringing our babies home around their original delivery date, August 16th, some 100+ days later. With cell phones permanently on in case the hospital needed to call us for an emergency, our previous lives faded away and we waited nervously for what was yet to come.

The Adventures of a Preterm Daddy: Part III

As the second day of our stay at Cedars rolled around, my wife’s symptoms had slowly subsided. Our substitute OB doctor, Dr. M, made another appearance early on and brought along another colleague, Dr. X, whom he introduced as a specialist in ultrasounds and neonatal care. Yet another ultrasound later, our specialist had determined that the cervix had once again shortened overnight. At this stage, Dr. M recommended a round of steroids. Steroids are typically given during pregnancy to help a babies lungs develop at an accelerated pace when there is a risk of a premature birth. A baby’s lungs aren’t designed to begin the work of breathing until 36-40 weeks, depending on the new math versus the old math approach to what is considered a full term baby. Steroids can speed up the maturation of the lungs and give a preterm baby a better chance of survival with fewer complications. When I asked about the effect of steroids suppressing the immune system, Dr. M denied it, while Dr. X stated that it was true. We had observed that Dr. M was so quick to deny that medications ever had any side-effects, that he was now denying the opinion of his proclaimed specialist and colleague. They went back and forth briefly with Dr. X citing several studies and winning out. When I asked which steroid would be used, Dr M mentioned that it would be dexamethasone or betamethasone. When I asked about studies where dexamethasone had been implicated in brain damage and developmental delays, Dr. M once again stated that it never happens, while Dr. X stated that it was a possibility. Dr. X pointed out however that previous studies had been done with multiple doses of dexamethasone and he would only advocate one dose, which he believed to be much safer. After listening to the facts and the fiction, we decided to hold off on the steroids until our regular doctors were back and I could do a little more research. A note to Dr. M: Don’t challenge your proclaimed expert. Either way, you lose. You either demonstrate that they’re not an expert, or you demonstrate your ignorance by challenging and losing to the person that you’ve just introduced as an expert. Both results don’t instill any confidence in your patients.

By Tuesday, both of my wife’s doctors were back in town and made their appearances at Cedars. Her sonogram doctor, Dr. S, appeared and told us that he expected to be sending us home after the ultrasound. He mentioned that it was better not to stay at the hospital because they tend to look for things to treat. This resonated with the words of a nurse whom I had spoken to earlier that day. She had been at the hospital for its 33 years of existence and stated that she avoids doctors at all costs and would rather do anything than end up at the hospital. Such words coming from a nurse seemed to speak of the mismanagement that she had seen over the years. The message that I took away from both conversations was, “time to go home.” Unfortunately, the ultrasound didn’t bring us the good news that would signal a rapid retreat. Instead, the cervix length had shortened instead of stabilizing. What had been 3.5cm on Friday was now 1.6cm. This meant that it was time for the steroids, as we didn’t want to run the risk of preterm babies with the added burden of more lung complications. We opted for the betamethasone which has been demonstrated to be safer. Dr. S told us to rest and hold tight and he’d be back for a follow-up ultrasound on Sunday and hopefully send us home.

The rest of the week was very much like the beginning of any roller-coaster ride, where you go through a few minor ups and downs until you reach that gradual climb that leads to a final jaw-dropping descent. My wife’s cramping and bleeding episodes would come and go, and for the most part seemed to be on their way out. It was starting to feel more like a car trip through a hilly countryside than a roller-coaster ride at Six Flags. We ventured out a little bit more in our take-out habits and discovered Jerry’s Deli around the corner from Cedars.

By Saturday, we were looking forward to Dr. S’s return on Sunday and an ultrasound result that gave us our return ticket home. The baby’s heart monitors strapped to my wife’s belly gave us the reassuring sounds of two hearts peacefully enjoying their time in the womb. As Saturday night rolled around, the winds changed and we found ourselves once again riding the ups and downs of cramping and spotting. Although I managed a couple of hours of sleep, half hoping that these symptoms would fade away as the others before them had, my wife was unable to sleep. The cramping intensified and mild muscle relaxants and pain killers were having no effect. By morning, with the symptoms increasing, we anxiously awaited Dr. S’s return. He was called in earlier than planned and the ultrasound revealed that the cervix was now .5cm, and my wife was dilated 3.5cm. Now 3.5cm is not very large for a full term baby, but for a 25 week old baby, it was an open barn door. Dr. S made the call and preparations were under way for a C-Section delivery. The tension became magnified as a flurry of nurses went into action. Within 45 minutes, we found ourselves in the operating room.

Our initial hopes for an intimate home water birth had now been officially replaced by a 20-person production in a hospital operating room complete with surgeons, nurses, anesthesiologists, and assorted neonatal assistants. Sitting next to my wife’s head, I watched the entire surgery via an overhead mirror above and behind us on the ceiling. It was only two weeks earlier that I had been watching the same surgical procedure on the Discovery channel, unaware of what was to come. On Sunday, May 3rd, my wife delivered a baby boy, Ethan Kai at 1 pound, 10 ounces and a baby girl, Ana Sophia at 1 pound, 9 ounces. With these twin miracles, our ticket was punched for admission to the Cedar-Sinai’s Neonatal Intensive Care Unit, hereafter know as the NICU.

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