Friday, February 28, 2014

Place and Kind Of Birth

Like all brand new parents, the first decision you make right after the happy news of a pregnancy is about how it will end. The question of where and how the baby will be born must be settled ahead of all other decisions, sometimes cutting into the honeymoon glow of the good news. In our case, we had a difference of opinion on both subjects, although ultimately it is what she wants that will matter.

The difference in opinion arises from our attitude towards the role of medicine and interventions. I am for a natural or alternative approach to health care, and believe in the power of the body to heal and preserve itself given the opportunity. So medicines are a desperate last resort when I'm not feeling well, delayed until I have tried natural remedies.
When it comes to pregnancy and childbirth then, I believe the woman's body is designed specially to handle that challenge gracefully, albeit with lots of pain. Apart from emergencies and other serious risks, a pregnancy and childbirth should not be treated as a medical case, as if it were some kind of illness or anomaly. Before Obamacare, insurance companies used this excuse (pre-existing condition) to deny coverage. I think the practice of considering pregnancy a "health risk" is squarely misguided.

So obviously I voted for a natural birth in a birth center somewhere. Labor could start at home, and the birth setting would be quiet and private. A hospital would be close, and an obstetrician on hand in case of emergencies. I know it sounds idealistic, especially that I'll never experience these things, but I think that's what's best.
On the other hand is the Mrs., whose perspective of childbirth borders on traumatic. The stories she's heard about its mishaps have left her convinced that she needs the attention of an obstetrician during pregnancy, and must be in a hospital during labor and childbirth, in case of emergencies. This is the American default; it's not bad, but it could be better.


Colorado Springs doesn't have an alternative/natural birth center, but the two major hospitals have maternity wards designed to function as birth centers. The atmosphere though is still cold and sterile, and less than private. At Memorial Hospital and Penrose-St.Francis, the wards occupy their own floor. When we toured them, we also learned that they have adopted some practices advocated by midwives and doulas, specifically to empower women to experience labor confidently. Gone are the nurseries to which babies were carted right after birth. Most importantly, mothers have a whole hour right after birth for skin-to-skin contact with the new baby, and most post-natal procedures (except circumcision) are performed right there in the delivery room. Penrose-St.Francis has labor facilities and recovery rooms if the mother needs a few more days around the hospital. Also of note is the increasing role of certified midwives as primary care providers for pregnant women, with the backing of an obstetrician who has privileges in these birthing centers. This situation settles our first difference of opinion (the "where" part).

The non-compromise on the how the birth should happen: labor naturally as long as possible, knowing pain relief medicines are available when needed; avoid unnecessary medical interventions. Whatever the case is, the ultimate goal is for her to enjoy the pregnancy and get the support and relief she will need during labor and childbirth. We will do whatever she thinks is needed at the time, for her maximum comfort.

Saturday, February 22, 2014

Complete House Requirements

Our original list was 7 pages long. After the first few house tours, we decided to prune it of items that we either couldn't satisfy quickly, things an inspection will check up on, or that are not crucial to our comparisons. We also decided to change search strategy: we would make an offer on the first house that has 85% of what we are looking for including all our must-haves. We tour only houses we both agree may work for us; if we disagree on a house, we keep it among our possibilities but will not ask to tour it. Any given week, we've been visiting 2-4 homes only (so far only about 11 houses).


BUDGET
List price $180,000 - $230,000
Short-sale, foreclosure, or flip house? Would rather not
Monthly PITI < $1,200/mo
Property taxes < $1,300/yr
Sale history Stable or increasing
NEIGHBORHOOD
School districts D11, D20, D49
Elem/high school ratings 7+
Homeowner association None preferred
Community Planned, parks/services
Character Suburb, family-friendly, quiet, clean
Roads/streets City/paved, maintained
Safety Street lights, open view
Traffic/access Lights, alt. routes
Crime Low or none
Morning/evening walk/observe Walkable, bustling
Night perspective Quiet, safe
Other homes maintained Well
Who is around neighborhood? Kids?
Neighborhood home comparisons In same price range
City zoning Not flood zone, residential
Talk to neighbors
Any future regulation/zoning/development changes?
PROXIMITY
Emergency services (hospitals, fire stations) Within 5 mi.
Shopping center/restaurants Close enough
How far from workplaces? < 20 min.
HOUSE BASICS
Year built 2002+
Whether new construction? Would love newer
Type Single-family/detached
External wall material
Curb appeal Must have it ...
Orientation Faces west/south
Floor plan 2-story/ranch, open, not split-level
Finished livable space 2000+ sq.ft
Bedrooms 4+
Bathrooms 3+
Kitchen Big, with pantry
Dining room > 12x10 sq.ft, tile/carpet
Living room > 13x15 sq.ft, wood/carpet
Garage 2-car, attached, auto/remote
Additional parking 3+ cars, street
Windows Vinyl, thermo. Low sills
Roof Comp. shingle, <10yrs
Basement Yes, insulated
Office Available office or possibility
Energy efficiency (heating) 85+
Outside wall 8" insulation
Other rooms in house?
Heating/furnace (age?) Modern forced air/2008+
What we like most
What we hate most
What else is possible with the house?
Immediate repairs in next 9 months? None!
UPGRADES/DISCOUNTS
Any upgrades/cost?
Any discounts/promotionals?
SERVICES
Electricity Municipal/CSU
Water Municipal/CSU, not well
Natural gas Municipal/CSU
Sewage Central, not cistern
Trash service HOA or local
Cell phone coverage 3G/4G signal
Internet service Comcast or better
Home security ADT or equiv.
Average utility costs (elec+gas+sewer+water+trash)
PROPERTY/LOT
Landscaping Complete, sprinkler
Fence Installed as required
Drainage Away from house
Backyard For outside dog + dogshed
BEDROOMS
Flooring Carpet
Utilities 2+ electrical, 1 cable
Location All on same level (upper/main)
Master bedroom Own bathroom, walk-in closet
Nursery Immediately close to master bedroom
Access Locable doors, openable windows, closets.
Size > 13x15 sq.ft, master bigger
Rooms over garage Prefer not = noise/fumes
Ceiling fans Installed
BATHROOMS
Flooring Tile/composite
Amenities Mirror, lockable door
Storage Cabinets, linen closet
Counter space Generous
LAUNDRY
Flooring Tile/composite
Washer/dryer Installed/hookups
Location Same level as bedrooms
KITCHEN
Flooring Tile/composite
Plan Country sit-in, island
Cabinet space Ample top/bottom
Counter tops Granite
Appliances Stainless steel/quality/brand
Refrigerator Dislike vertical split
Sinks 2+, garbage disposer
Microwave oven Installed
Dishwasher Installed
Stoves/oven Not coils, gas better?
Pantry Reasonable
GARAGE
Access Clear, not steep/obscured entry
Completed walls Siding/frame, insulation
Safety Garage access door lockable
WOULD BE REALLY NICE
Vaulted ceilings
Fireplace
Porch/balcony
Hot tub/jacuzzi
Lots of storage (basement?)
Air conditioning
Humidifier installed
Floor-level ventilation
SELLER/DISCLOSURES
Review seller inspection report
Review seller disclosure document
Previous resident (owner, renter, vacant?)
Any federally-required disclosures?
Drug activity on property? No
Smokers or pets previous residents? No smoking
Homicides/suicides or natural deaths in last 5 years? No
Property/legal disputes? No
Our impressions of seller Honest, truthful, cooperative
Realtor's opinion of seller
ZONING RULES
Allow home office/business? Yes
Allow pets, sheds in backyard? Yes
Allow external remodeling, landscaping Yes
Allow visitors/RV/boat parking/streets Yes
TOUR NOTES
Notes from touring the house

Friday, February 21, 2014

What We Want In A House

Six months ago, we decided we did not like the latest rent hike for our apartment (about $100/month increase). We decided that it was time we got into our own home and begun building equity there instead. Besides, the apartment rules were beginning to irk us (mostly noise complaints about my electronic drum kit or loud music), and we still feel like we need more space than the 1000 sq.ft 2-bedroom suite.

Two months ago, we started researching what homeownership was all about - the houses, the loans, the realtors, our financial standing, our credit score, and what a 30-year commitment means. We also visited some model homes and open houses to get an idea of the kind of house we wanted. A month later, we had a 7-page requirements list that spells out everything we want in a home. The plan was that we'd use this list whenever we visited houses, but it didn't quite work out that way.

What has worked is taking a phased look at each house. You start with simple facts (perhaps from the MLS and pictures), then follow up with a viewing, and later dig deep to fill in the list. You can narrow down the choices considerably and avoid visiting too many homes. I have appreciated the alerts I get from Trulia and Zillow, though it is not always up-to-date or even accurate.

We are not looking for a starter home; no, we want something we can be comfortably living in 10-15 years from now with 5 children or relatives.
We want something for which the mortgage payments (including principle+interest, PMI, taxes, and HOI) will be less than what we are paying for our apartment right now. This is the biggest motivator for attaining the lowest interest rate possible, even if it means paying some discount points.
We want 4 bedrooms, 3 bathrooms, 2-car garage, a large and modern kitchen, ample living room and dining room (at least bigger than what we have in our apartment now), and a great floor plan. The master bedroom should be "awesome", with its own bathroom and big walk-in closet.
We want a big backyard where I'll someday build a shed for a dog. It'll be an outside dog since the Mrs. is allergic to them.
We want convenient space for a home office, preferably close to the front entrance so that my clients do not have to traverse the whole house to get to it.
We also want a lot of storage space (like a basement) for the things we'll inevitably accumulate, and a place for an acoustic drum kit that I may buy in the future.
We want to continue developing the property, so an unfinished basement with high possibility of an additional room and bathroom would be great.
We do not want a house that will require fixups and other home improvement work within 9 months of moving in.
We do not like homeowner associations, so it'd be great if there was none in the neighborhood.
And rather than fixate on school district ratings, we will accept a house if the most likely schools for our kids have a reasonably high rating. Nonetheless, only houses in school districts 20, 11, and 49 would be considered.
The neighborhood should have a low crime rate, have a great cell phone signal, use municipal utilities, and less than 25 minutes drive to our jobs.
Finally, the house cannot have been the scene or a gruesome homicide, a suicide, or drug activity. My Ugandan family has heard this requirement before, when I was buying land there.

We want a lot of things, but that is the first filter any matches have to pass. Perhaps the only compromises have been whether the house can be improved to meet our needs, if it currently does not. So if it has 4 bedrooms and one can be re-purposed into an office, it becomes a second-tier consideration.

Wednesday, February 5, 2014

Forgive My Unbelief

Why is it that even when we have put our faith in God, we wince in doubt when our wildest prayers are answered? We consider the evidence but still wonder whether it is real that God showed up or delivered on His promises. Had we really believed in the first place that "all things are possible for him who believes"? (Mark.9:23).

I found myself in a moment of disbelief the day we first realized we might be pregnant. The FAM data I had told a different story -- that we had likely missed the current cycle. The doctor had already provided higher dosage prescriptions for the next round of fertility treatments, and so we were just awaiting the start of the next cycle. In fact, we also had a growing frustration with the cycle -- then approaching 60 days long -- that we thought we might ask the doctor about possibly terminating it and jumpstarting the next cycle. But before taking such adverse action, we decided to take a home pregnancy test (HPT) in order to avoid having the doctor do the same test for $200 (charged to insurance) at our next appointmrnt.


In EXHIBIT#1, I did not believe it was positive because the documentation (especially the images) indicated that the test line would be darker than the control line. My wife believed it was quite positive nonetheless. So the next day, we did another test (EXHIBIT#2); we expected to see a full "+" but it only looked like 2 parallel bars. Hmmmm! The next day I personally picked out a digital HPT hoping it would remove all ambiguity (EXHIBIT#3). But even after that, I was not fully convinced until we could see a sonogram at our next doctor's appointment.

In my disbelief, I wondered about how often HPTs reported false positives, and whether it was possible to have appreciably high Human chorionic gonadotropin (hCG) levels when you weren't really pregnant. Indeed, if a woman has an ectopic implantation, a "chemical" pregnancy, or has recently miscarried, hCG levels will be high enough to produce positive HPTs. If she has ovarian/cystic cancer, a thyroid problem, or a hydatidiform mole, the hCG levels will also be elevated. Beyond these possibilities, I came across reliability complaints against Clearblue and the high incidence of false positives in their HPTs. It was as if I really did not want to believe the current evidence ... until I could see an ultrasound.

In that moment, I was like the disciple Thomas who would not believe that Jesus had actually risen until he could touch the scars himself (John.20:24-27). I was like the father who needed to believe that his child could be healed (Mark.9:21-24). And like him, I needed help with my unbelief. It is not like I did not believe we would get pregnant, but that the timing seemed off. I was at the familiar crossroad of science and faith, with the science weighing more on my belief than my faith.

The issue is practical faith and its precedence in our lives. On this journey of pregnancy, I realize we will need more faith than science as we see God orchestrate a new life in our midst (Psa.139:13).