Saturday, August 3, 2013

Genevieve's Birth Story

Let me just preface by saying that Genevieve has been nearly a complete opposite of her brother since the end of the first trimester. With him, I gained quite a bit of weight and developed Gestational Diabetes, but was relatively comfortable until the moment I went into labor. His labor was fast and clear--"neat", if you will. I was comfortably pregnant, then I was clearly in labor, then we went to the hospital and promptly had a baby. Not so with Little Miss.

My pregnancy was miserable. I felt ill more days than not; I had more food aversions than I could name; she "quickened" early and immediately started doing a sideways stretch that led one of my doctors to believe she was in a transverse lie at one point; I was exhausted all the time (partially because I became anemic); I was in almost constant pain (partially from carrying her weight and mostly from her physically beating me up from the inside); I had unbearable heartburn; and I was barely sleeping by the last trimester. Her brother had come earlier and faster than I'd expected, so I hoped for a similar experience with her. My doctors seemed pleased with how "smoothly" my pregnancy was going on paper and told me that she was measuring a little smaller than her brother, but not so much so that I should worry. Everything "looked" wonderful! I didn't feel wonderful. I wanted this baby out! 

By my calculations, I was "due" December 18th (my doctors set my "official due date" at December 12th). On Wednesday, November 29th I started having intense contractions. I was hopeful that this was it and tried to keep moving. For much of the afternoon, they were coming in steady 10 minute intervals, but as evening approached, they spread out more and more. "Surely," I thought, "this means it won't be long now, even if she's not coming today." I was so, so wrong. From that point on, I stayed in prodromal labor, complete with "real" contractions and nasty mucus.

On Sunday, December 2nd, I was surprised with a baby shower. Sadly, only my mother, sister, mother-in-law, and sister-in-law could make it, but it was way more than I expected for my second child and we had fun making a cast of my gigantic belly. Nothing like a few hours to focus on the joy instead of the misery! 

I was completely whiny and SO done with this prodromal labor nonsense when things picked up again! Early in the evening on Thursday, December 6th, I started having intense, regular contractions again. By 8pm, they were 4 minutes apart and staying strong and steady. Surely, this was it! Lukas had come fast, and at that point we suspected Genevieve was transverse, so I went ahead and called my doctor. I wanted this baby OUT, not high-fiving the kitchen floor because we waited to call. He said to come on in, so we dropped Lukas off with Grandma and away we went. I texted my sister and our birth photographer to warn them, but told them to hold off coming in until we were admitted. 

The hospital. Oh, the hospital. "When are you due?" "12/12" "What's your birthdate?" "12/12/85" "Really?" No, I just made that up to throw you off. "Yes, really." "Has your water broken?" "I don't think so, but I'm not sure--It could be a slow leak." "We'll get you a wheel chair." "That's OK, I'd rather walk." "Are you sure?" "Yes." Triage on the maternity ward was full, so into a regular room I went for evaluation. Three Nurses descended at once. Strapping on monitors, taking vitals, and quizzing me down. "When's your due date?" "12/12" "When were you born?" "12/12/85" "Really?" "Yes, really." On and on and on went the questions. The same as they'd asked at the front desk. Same as I'd filled out on my preregistration paperwork. (Why did I even bother preregistering?) My blood pressure was high (I have social anxiety and just had my blood pressure taken while being strapped to a bed and interrogated--gee, why on Earth would it be high?), but my water had not broken. I was dilated to 4 cm, but stalled (just like I had with Lukas) as soon as I'd gotten to the hospital, so they left me to wait for the doctor while on the monitor to see how things progressed.

I won't get into it all (mostly because I can't remember the specifics any longer), but the whole experience was terrible. The nurses seemed to write me off when I told them I wasn't interested in pain medication. They left me on the monitor strapped to the bed for over an hour at a time. At one point, I gave up waiting for a call-light answer and ripped the monitors off myself just so I could use the bathroom. Laying in bed was agony. No one seemed to want to talk to me and when they did, they were very ambiguous. Finally, I was basically told to start Pitocen or go home. I wasn't interested in a medicinal induction, so I went home. As I stopped for each contraction on my way back to the car, my sister announced, "This is such a bad idea."

It was after midnight when we got home. I knelt next to the bed, swaying through contractions until I basically gave up at 2:30am and crawled into bed, telling my body to just stop it. I was too tired. And it did stop it. Gradually, the contractions slowed down until they were 10 minutes apart, then 30, then totally irregular and less urgently strong. I slept as much as I could between contractions.

The next day, I saw my doctor for my 38 week appointment. He let me know that I was still dilated to every bit of that 4cm, that he wasn't bothered by my calling in the night, and not to even hesitate to call should it happen again. My anger toward the hospital experience turned to relief toward my doctors. We set up a 39 week appointment, complete with NST and hoped against hope that we wouldn't make that appointment.

The prodromal labor continued. We did have to come to the 39 week appointment. The NST showed that I was having nice strong contractions (which I already knew) and that they weren't bothering the baby, she was just fine. I refused a cervical check. I was already miserable and numbers would tell me precisely nothing at this point, so I didn't want to torture myself further. We made the 40 week appointment for December 21st and, yet again, hoped against hope that we wouldn't make it to that appointment!

I woke up with strong, regular contractions yet again on Saturday, December 15th. Was this FINALLY it?! Lukas had spent the night with Grandma, so I texted her to let her know that she might be keeping him, but I wasn't sure. By 11am, it was obvious that things weren't going anywhere and Grandma brought Lukas home. It was becoming clear that I was NEVER going to have this baby!

That Sunday night, I was up late watching TV and messing around on my laptop, as usual. Night time was miserable. The baby was super active and my heartburn was at it's worst until about 2:30am. I'd long since given up on sleep and just stayed up until 2:30 magically rolled around and I had half a chance at sleeping. I was finally getting ready for bed and had just gotten undressed when I heard Lukas start to cry. Into his room I went to check on him. He'd wet the bed. Poor baby! I consoled him and led him to the bathroom. We stripped off clothes and tossed them in the diaper pail. I had him try to go potty and then I went potty (seems like that's all us super-pregnant ladies do, really). We washed our hands and headed back to his room. He was freezing, so I helped him into his pajamas and then stripped the bed. I grabbed his extra bedding out of the closet and plopped it down in the rocking chair. As I leaned over to tuck the fitted mattress pad over the far corner of his mattress I felt something warm and wet drip onto my leg. "Did I just pee myself? Really?! I JUST used the toilet!" I thought. I stood back up and it happened again. "That's weird. I don't FEEL like I'm peeing myself..." I took a couple of steps back and a larger gush fell to the ground. "That's not urine...my water broke!"

I went to the bathroom to make sure it wasn't pee. It most certainly was not. I went to wake my husband, toddler in tow, leaving a trail behind me. Lukas was concerned that I wasn't wiping up the mess I was making on the floor. I laughed as I put a call in to my doctor's answering service. They told me to call again if I didn't get a call back in 10 minutes. I texted Grandma to let her know Lukas was coming over for the night. Everybody got dressed. I started packing Lukas's things. 10 minutes passed. No call. I called back. They put me through directly to my doctor. I told him that my water just broke.

The groggy voice came back over the line, "You're kidding me." I could hear him waking up as he spoke to me. Asking about contractions, etc. He told me not to rush, but to gather myself and meet him at the hospital. I hung up and finished packing Lukas's things so we could head out. I was getting nervous as we dropped Lukas off with Grandma; it'd been an hour and I'd hardly had a contraction.

We arrived at the hospital and I went in to start the check in process. Yes, my doctor knew I was coming. Yes, my due date and my birthday are the same day--REALLY. Yes, my water had broken. No, I did not want a wheel chair. Yes, I really did want to walk. Yes, I really was fine to walk.

They led me to a room and strapped on the monitors while they continued with the questions. I let them know that my sister was coming and that I had a birth photographer coming, as well. I was taking my placenta home to be encapsulated, so they needed to leave it alone. I did not plan on using pain medication. I wanted to be out of bed. My nurse assured me that she totally understood and that she was a "crunchy nurse". I warned them that I had tricky veins as they prepared to start the line in case I needed an IV for any reason. After two failed attempts by two different nurses, they called in the charge nurse, who managed to get it in. I'd been laying in bed for over an hour now and contractions were finally starting. They checked my cervix at a "stretchy" 6 cm. Laying down was so not comfortable anymore. I needed to move. As soon as the IV was in, they released me to walk the halls. No one else had arrived yet, so Andrew and I headed out on our own.

I'd only had a few contractions and they weren't really regular yet, so I intended to keep walking for some time. We were nearly back to the room after our first loop around when a contraction hit me so hard I could barely stand. A wave of nausea rushed over me as the nurses stood in the doorway looking prepared to catch me if I started to fall. As soon as it passed, they assured me that nausea was a sign that things were progressing quickly. I stumbled into the room and kneeled down next to the bed. The nurse set a bucket in front of me just in case and left me to my laboring.

I was shaking and retching like I had during transition with Lukas. Another contraction came. "If this is only 6 cm, there's no way I can do this," I thought. BAM. Something clicked in my head. That is the mindset of a woman in transition. "I think I'm in transition," I told Andrew. I was suddenly SO hot. I tore off the gown and crouched there in the silly mesh panties they'd given me so I could walk the halls without gushing water everywhere. The nurse entered. "She was hot," I heard Andrew explain. My eyes were closed as I leaned over the bucket, breathing deeply. I was very uncomfortable, but the contractions seemed to be spaced very far apart. "Doesn't bother me," I heard the nurse say and she left the room again.

As I groaned through the next contraction, I felt my body start to push. As soon as it passed, I warned Andrew, "That one felt pushy." He was gone. Into the hallway, telling the nurse. She came quickly and had me get in bed so she could check me. She told me I had a little lip of cervix, but I could definitely push past it. Then came another contraction. It was agony, but I couldn't make my body move enough to get up in the middle of it. I felt like I was being crushed to death and ripped apart at the same time. They wanted me on the bed, so as soon as it passed, I pulled myself up onto my knees again and raised the head of the bed. This way I could face the head of the bed and lean against the top while I kneeled on the bed, just like I'd been doing on the floor next to the bed. Ah...much more comfortable.

My sister found me like this as she entered the room with my pillow in hand, as requested. I rested my head against the top of the bed waiting for the next contraction to come. I heard my doctor enter behind me. He made a comment asking what we were doing and if I'd stalled because he was there. I knew I hadn't, but was too in-the-zone to step out and explain that my contractions were just coming really far apart. I was so not. going. to move.

Then the contraction came and I went with it and pushed. I felt that familiar grind of her bones passing through mine. The contraction faded. "Don't push. Let your body ease into it so you don't tear so badly," I thought, urging myself to wait for the next contraction. "KEEP PUSHING!" shouted the nurse and the doctor. I felt something pull and twist as I kept pushing and then she was born. (Later, I was told that the head and one shoulder had emerged with that first contraction. The pull and twist I'd felt had been my doctor supporting the head and guiding the shoulders through.)

I flipped around and lifted a leg over the cord so my doctor could pass her to me. Finally! There she was. "THAT is NOT a small baby," I thought as I scooped her into my arms and snuggled her against my chest. All 22" and 8lbs, 9.9oz of her.

The birth photographer did not make it (heck, my own sister barely made it!). My water had broken around 2:30 am on December 17th; I'd arrived at the hospital around 4:00am; her time of birth was 5:50am. I could not get over how huge she looked and how different she looked from her brother.

When all was said and done and everyone had left the room so Andrew and I could get some sleep, I turned to him and said, "I could go for never doing that again." We laughed and snuggled this sweet baby and got bits and pieces of sleep. Finally.

Saturday, January 19, 2013

Lukas's 3rd Birthday

Somehow, my baby turns 3 on Monday. I've seen other people posting about doing this 20 Questions thing with their children. The idea is that you have a list of 20 questions that you ask the child every year on (or near) his birthday starting when he turns 3.

Most of these types of things just seem like a lot of work to me without any real reward, but Lukas is very verbal and quite the character (if I do say so myself), SO I've decided that this could be interesting to see as he grows and his answers change and become more sophisticated.

It took 2 days and more attempts than I kept track of, but here are his answers:

1. What is your favorite color? Brown, like Zeke's fur
2. What is your favorite TV show? Thomas
3. What is your favorite movie? Veggie Tales: Duke and the Great Pie War (He's seen this maybe twice and never just asks to watch it.)
4. What is your favorite book? The fixing one (Right on Time Rescues)
5. What is your favorite song? My Guitar Song (A song he made up to sing while he plays his imaginary or inflatable guitar.)
6. What is your favorite toy? The Clothes (on Mommy & Daddy's bedroom floor)
7. What is your favorite game? Racing Cars (A toy he got from Demon for Christmas.)
8. What is your favorite animal? Giraffes and Fishes
9. What is your favorite holiday? Easter (This one took prompting; I don't think he knew what "holiday" meant when I asked him.)
10. What is your favorite thing to wear? Shirts
11. Where is your favorite place to visit? The Library
12. What is your favorite food? Pizza
13. What's your favorite beverage? Apple Sauce (I asked if he meant Apple Juice; he assured me that he meant Apple Sauce.)
14. What is your favorite candy? Golf Balls (I asked this one multiple times, explained that golf balls are not candy, and even offered up options like M&Ms or Gummies. He was adamant that Golf Balls are his favorite candy.)
15. What do you want for dinner on your birthday? Macaroni and spoons (Yes, spoons.)
16. What do you like to do outside? Slide down the slide
17. Who is your best friend? Baby Charlotte (He almost never sees her. Later, his answer was Demon.)
18. What makes you happy? Playing music
19. What are you really good at? Do-di-doo (I asked this multiple times as well; his answer stayed consistant.)
20. What do you want to be when you grow up? Go places. 

Monday, May 14, 2012

Failure to Look at the Baby: Part 4 - The End

I spent that entire day frantically trying to get my son to breastfeed. Trying to pump ANYTHING. All day, I sat on the couch with my son, crying as I fed him bottle after bottle of formula and wondering if this was going to be the end of our nursing relationship. I wasn't ready! We'd tried so hard! He was only 3 months old! I begged him, in tears, "PLEASE, JUST TAKE IT!" as he screamed around my nipple and turned his head away from me.

I recorded all of his feeds. How much he took. What he acted like afterwards. On Thursday, he started nursing a little bit again. So I added the amount of time he spent nursing onto my recordings along with how much I supplemented. I had finally managed to pump a tiny bit during all those missed feeds and noted when he was supplemented with breast milk and when with formula and how much of each.

I went through his baby book and wrote down all of his weights and heights to show Dr. M. I had my mom pull out my baby book so I could compare and I wrote those down, too. Then I packed up my baby and my plethora of note cards and went to see Dr. M for the first time since the morning after he was born. My mother-in-law offered to come with me and I was grateful for the support.

English is not Dr. M's first language. Instead of taking notes, she used a speech-to-text program on her computer, which made the initial interview rather confusing. She started out asking some questions and then pulled out her computer and spoke into it without warning. She said my son's name and that he was referred to her for Failure to Thrive. This was the first time anyone had used that term with me. I literally jumped when I heard it, felt my eyes widen, and shook my head, "No!". She ignored me and kept taking her notes.

She briefly looked over my cards and then asked if she could take photo copies of them. Then she took Lukas to examine him. She checked his startle reflex, noted his head control, watched him push himself up and try to roll over (he couldn't get any traction on the paper, but she took my word that he was capable of rolling front to back). She weighed him.

Finally, she sat us back down to talk about her decision. She agreed that he seemed perfectly healthy and, given the family history, he was likely just a long, skinny baby like his mommy and daddy had been. BUT she wanted us to get blood drawn just to be safe. My mother-in-law asked if she would recommend this even if Dr. F hadn't referred us as a Failure to Thrive case. She said that she would have and discussed it calmly with us for a bit.

So we headed over to the hospital to have blood drawn from my healthy 3-month-old. We waited for over an hour until they finally called us back. The lab techs could not have been more incompetent. They sat us down in the chair where they draw blood from adults. They were going to have me hold him while they drew from his elbow. Needless to say, that didn't work out at all. So they took him back to the room where they drew all of his biliruben levels as a newborn and attempted to hold him down and draw from his elbow. They couldn't get the needle in. They kept commenting on how strong he was...hello! You're drawing from a healthy baby, people, of course he's not going to lay around limply while you stick him full of holes! Finally, they decided to do a heel prick.

He was understandably upset by the time they'd finished, so I asked if I could nurse him and they left me in the room to do so. He, thankfully, latched right on and calmed right back down. Then they sent us back out to the waiting room because they weren't sure if it'd be a good draw (what?). So we waited. For another hour. Until they finally came out to tell us they'd need to draw again because the blood was no good. So they did the heel prick, again. And, again, I nursed him. And, again, we were sent back to the waiting room.

AND, AGAIN, the draw was no good. So they took us back and pricked my baby for the third time. Afterward, while I was nursing him, they commented that the draw was normally a fasting draw, but they couldn't do that for a baby with no warning. Taken aback, my mother-in-law chatted with them and we learned that the reason they kept taking blood was because he'd not been fasting. Why had no one told us this the first time? We told them they could use the blood they had, but we would not be bringing him back to do this again. They said they'd call the doctor and see if it was ok to use the results even though it hadn't been fasting. Shockingly (can you feel the sarcasm?), the doctor was not expecting Lukas to fast and was fine using those results. My 3-month-old had blood drawn two extra times because the lab techs were too incompetent to call the doctor in the first place.

Four hours after we'd arrived, we finally got to go home. I saw Dr. Fe for another follow-up to make sure everything was going ok after the nursing strike and she agreed to take Lukas on as a regular patient. We saw Dr. F for one last follow-up and walked away knowing we would never be seeing him again.

Why didn't I go somewhere else when I first questioned the advice to pump and bottle-feed instead of continuing to try breastfeeding when Lukas was just 5 days old? Why didn't I go somewhere else at the 2 month appointment when Dr. F was clearly not looking at my baby and set that bell off in my head? Why didn't I just switch to Dr. Fe after I first met with her and save us all that pain? Because I was a new mom. Because I didn't feel like I knew better than my doctor. Because I didn't have faith in myself and I thought I'd chosen a doctor I could trust. Because I really needed someone to stand with me and say, "Hey, this is ridiculous. You know your baby. This doctor is no good. You can switch to Dr. Fe!".

I've learned from this and I share my experience with other moms because I know that this should not have happened. I believe that no one should go through what we went through. I believe WE shouldn't have had to go through what we went through, but because I didn't have confidence in myself as a new mom, we were put through the wringer.

Shortly afterwards, I found support in other moms through a couple of groups in our area. Lukas went on to nurse for 13 months, when he self-weaned. Although we got off to an incredibly rough start, our nursing relationship ended gently and beautifully...but that's a story for another time.

Monday, August 1, 2011

Failure to Look at the Baby: Part 3 - Threats

I had a cold on top of allergies and after 5 days of suffering was looking for relief. Kellymom.com told me that Sudafed would not harm my baby and I'd taken it while pregnant, so I went ahead and took it. Every 4-6 hours.

We left for vacation on day 6 of this "cold" and the Sudafed didn't even seem to be helping anymore, but I took it anyway hoping to breathe. We drove through the night on a 14 hour trip to North Carolina to stay with family for a week. Lukas and I sat in the back seat together. I brought along my pump and a bottle of milk. I bottle-fed him the first bottle and then pumped the next one when he was finished so I'd have it ready for the next feeding.

While we were there, I kept up with my usual stash-building pumping. In the morning after his first feeding and before bed after his last. I had the nipple shield along "just in case", but he was really nursing without it at this point. We went to the beach and I nursed him on the beach. We went on banana boats and I nursed him while we signed the consent forms to go. I wore him around as we visited art galleries and I nursed him there, too. We supplemented a couple of times, but for the most part, we just nursed. I had my trusty Boppy and my bottles of Fenugreek and Goat's Rue--we were good to go.

I visited a clinic on our second day there for my week-long "cold" to learn that I had a sinus infection. The doctor there seemed perfectly knowledgeable and understanding when I told him I was a nursing mom with a 3-month-old. He put me on a 10-day cycle of antibiotics that were safe to take while breastfeeding. Perfect!

On our last days there, Lukas seemed less willing to take the breast. I tried the nipple shield, but it didn't seem to help at all. I went ahead and fed him as best I could, then topped him off with pumped milk as usual. We were going home soon and I could visit J and straighten him back out.

Then came our fateful drive home. I still wasn't feeling 100%. Lukas was being extra fussy. I begged my husband to stop and make it a two-day trip, but he and his step-dad chose to keep driving. I was in the back seat with Lukas again. I pumped...almost nothing came out. I pumped every 1-2 hours the entire trip home and was barely making enough to fill his bottles. We made it home around 3am on my very first Mother's Day.

I'd taken Sudafed for a week. My milk was nearly gone. I was literally pumping drops. Lukas was refusing to nurse. We went in to see J and weigh Lukas. I told her what was going on. She told me that anti-histamines can decrease milk supply. Lukas was on a nursing strike. He'd only gained an ounce in the week we'd been gone. Dr. F wanted us to come in immediately.

I explained to him that I'd been sick and my milk supply was down. I told him that Lukas was on a nursing strike. He told me to pump and bottle-feed exclusively. He told me to log all of Lukas's feedings so we could see what he was taking in. He told me that he wanted to have Lukas's blood drawn to make sure there wasn't something wrong with his liver or something. I talked to J about it. I saw Dr. Fe again. They couldn't give me an answer--this was something I had to come up with on my own. I decided that I didn't want to give up on the breast knowing that we were in the middle of a nursing strike. I would log his feeds at the breast and log how much I was supplementing, but I wouldn't give up breastfeeding completely. I was NOT having blood drawn on my healthy baby. I wanted to wait another week to see how he did before we decided to get blood drawn. I called Dr. F to let him know. It was a Tuesday and he wasn't in. I diligently kept my log and awaited a call back. Surely, he'd be pleased with this reasonable decision I'd made. We could all be happy and my baby could be fed.

Lukas was refusing the breast and I was pumping nothing but drops. My stash was dipping painfully low. I went to J's for more some More Milk Plus--I'd run out of Goat's Rue. I couldn't wait to talk to her (forgetting she was only in on Thursdays). As I pulled in, I got the call from Dr. F. He was clearly angry, but composed. He told me that he didn't agree with my decision and that we'd waited long enough. He told me that if I didn't do what he said, he'd have to file a report saying that we were endangering Lukas. I held back tears as I explained yet again that Lukas was on a nursing strike and I was trying to rebuild my supply and get him back to the breast. I told him again that I didn't want to put him through a blood draw. He told me that my only other option was to see a pediatrician and get a second opinion. I told him that I'd already been seeing Dr. Fe. He told me that she was a family doctor and that didn't count. I told him I didn't know any pediatricians. He said he'd refer me to one. There was only one in our area--Dr. M. HE made the appointment for me. I hung up and burst into tears. The doctor that I'd trusted wasn't listening to me and, worse, was threatening to take my baby from me. I was powerless to stop it.

Failure to Look at the Baby: Part 2 - Breastfeeding Help

Somehow, time rolled along as it tends to do and Lukas was suddenly 2 months old! I'd managed to get him to nurse from my breast as long as I used the nipple shield. At this point I was content to use the nipple shield until he weaned as long as he would drink from my breast. He nursed all the time, it seemed, and wet constantly so I knew he was getting plenty of milk. He fussed; I offered the breast. Yeah, it was tiring, but it worked and I knew he wasn't hungry if he was eating himself into oblivion every time (which he was). The only time he slept during the day was when he'd nursed himself to sleep in my arms. Often, he'd keep sucking and just drool the excess milk out his nose while he slept.

I happened to discover that I was using the wrong size flange when I pumped and he seemed to have a harder time nursing on the right side, so I thought maybe a different size nipple shield might help him nurse more easily. Luckily, there was a local breastfeeding boutique that sold all sorts of supplies and just happened to be run by the hospital's lactation consultant. I sent an email asking if she had what I was looking for. She not only went out of her way to find what I needed, but also suggested I come in so she could check out my pump and see if she could help get Lukas off the shield. I thought, "Yeah, SURE you can get him off the shield. Whatever, crazy lady.", but she'd been so nice and helpful that I agreed to go in anyway.

We met with J two days before Lukas's two-month check-up. We went over his birth, she looked him over, weighed him, and helped me try to nurse both with and without the shield. She even looked at my pump and gave me suggestions on ways to pump more effectively. She seemed confident that he was doing well, despite the dependency on a nipple shield, and so was I. I agreed to come back next week and work more with her on getting him to nurse without the shield.

I was in good spirits as I took Lukas in for his check-up. We had the doctor we'd wanted, we were past jaundice with it's heel pricks and bili blankets, we didn't need to supplement his feedings, and we were finally just starting to get the hang of this parenting thing. But that all came crashing down as soon as the doctor put him on the scale. Lukas only weighed 9lbs 9oz. As soon as the doctor saw the number, it became his focus. I was left with an image that will never leave my mind: Lukas lying on the scale with Dr. F standing next to him. Lukas had hold of Dr. F's finger and was pulling it around while smiling and cooing up at him. Dr. F was looking at me sternly and asked if Lukas was smiling yet. It took a few seconds for my brain to process that he was not joking. An alarm went off in my head, but I didn't know what else to do.

Despite the fact that my son had grown 4 inches in two months, was gaining weight, was meeting all of his milestones (and then some), and regardless of me telling the doctor REPEATEDLY that both Andrew and I were long and slender as babies and children, the doctor told me that the weight was a concern. He wanted me to go back to supplementing. Two ounces after every feeding. And he wanted me to cut Lukas off after 10 minutes on each side because he was just sucking to suck at that point and not eating any longer (which I knew was not true). I went home and gave it a try. Lukas's hunger shrieks as I pulled him away from the breast only solidified my knowledge that he wasn't just sucking to suck. He wanted us to come in for weekly weigh-ins and then have a 3-month check-up to reassess.

I told J everything when I went back to her and she jumped in to help. She offered up her scale for the weekly weigh-ins to save us the extra trips and co-pays. She made the calls to the doctor's office so I wouldn't have to. She worked diligently with us to get him off the shield and help him learn to suck more efficiently so he wouldn't take 45 minutes - 1.5 hours at each feeding. We did switch feeding (5 minutes on one side, 5 minutes on the other, 5 minutes on the first again, 5 minutes on the second, finished up with a 15 minute pumping session and feeding him anything I managed to express) and compressions to speed him up. After the first week, she had me change the switch feed to 10 minutes a side as long as he was still nursing well and not messing around at the breast. She also put a call in to another local doctor who specialized in breastfeeding to see if we could get a consultation with her. Unfortunately, she was on vacation and we couldn't get in to see her for another month.

By the time he was 3 months old, we were rarely using the shield and he was spitting up every time we supplemented.

We saw Dr. Fe for the first time. She spent a good hour and a half listening to our story and talking with us. She agreed that he seemed strong and healthy. He was just thin like his Mommy and Daddy. We made the decision to stop supplementing and let him nurse like a "normal" baby.

We saw Dr. F. He still wanted to see some more "meat on those bones" (complete with rib pinches). I let him know that we'd met with Dr. Fe for a consult and what had gone on there and I let him know that we'd been working with J as well and told him about all the progress we'd made. He wanted us to keep up with the weekly weigh-ins. I let him know that we would be going on vacation for a week, but we'd weigh him as soon as we got back.

I came down with the first sinus infection of my life.

We left for vacation.

Friday, January 21, 2011

Happy First Birthday, Screamy McWhinerton! (Lukas's Birth Story)

I went into labor Thursday morning around 10am. Our birthing class instructor had told us to continue about the day like normal for as long as possible, so I did. I took my shower. I tested my blood. I ate breakfast as best I could even though I really wasn't hungry at all. I hadn't packed my hospital bag yet, so I pulled up the list on my computer and started packing. While I was packing, Tracey IM'd me asking how things were going. I told her I was having contractions and was trying to pack my bag and had dishes I needed to do. She offered to come over and do dishes for me. I was having some trouble focusing on what I was doing with the contractions interrupting me every few minutes and there were a lot of dishes to do. So I told her to go ahead and come over if she wanted to.

I tried timing contractions, but they weren't regular like I thought they'd be so I was hesitant to call my doctor. Tracey and Andrew both told me to just go ahead and call. At 1:30 I finally decided that although they were anywhere from 2-5 minutes apart and didn't seem to be lasting a full minute long, they were pretty strong so I must actually be in labor, so I went ahead and called. The nurse I talked to asked if they were too strong to walk and talk through. I was still able to walk and talk through them, but I really thought I was in labor, so I didn't tell her that; I just said that they were "pretty strong". Since I had never had a cervix check (my next appointment was supposed to be Friday), she told me to come on in and they'd check me out.

I was so nervous about going in. I was sure they'd take one look at me, tell me it was false labor and send me home. They hooked me up to the monitors when I got there and I was having pretty strong contractions. Then the doctor came in and asked how dilated I thought I was (he joked that I might be at 6 cm and I was like, that'd be nice but I seriously doubt I'm more than 2 or 3). Then he checked me and goes "You're at 8 cm." I thought he was joking and just stared at him and was like "What?". He repeated himself and showed me how big 8 cm was with his hands because he seemed to think I didn't understand what he was telling me. I was just kind of in shock. I might have managed a little "Oh.", but I'm pretty sure I mostly just stared blankly like he was speaking another language to me or something. He told me we should head straight to the hospital. (We'd left our bags at home because I figured I hadn't been laboring long, so we could always just come back home and get them.)

As we were all walking out the door he asked what my plan was as far as pain management. I told him that I would probably want an epidural but that I wanted to go as long as possible without anything.

On the way to the hospital, we called our parents and told them to spread the word that I was in labor and already dilated to 8cm and we were on our way to the hospital. And we called Angie and Megan to let them know that they could head on over whenever they were ready to join us. When we arrived the nurse asked us if there were people we didn't want in the room. I told her there were two girls coming to join us for the delivery, but everyone else could stay out. She seemed surprised. We asked Tom to go to our house and bring us the bag that I'd almost finished packing and a couple little things that hadn't gotten into the bag yet. So we allowed him in. And for some reason both of our parents ended up in our room at some point, but didn't stay for long.
They asked me again about pain management and I repeated what I'd told my doctor. They put a heparin block in my hand "just in case" they needed to start an IV. I warned the nurse that I have difficult veins, but that did no good. It took her two or three tries and she blew the vein on the left hand before she finally got it in on my right hand.

I thought it was weird that I was 8 cm dilated and 100% effaced but wasn't in terrible pain. The nurse kept asking where I'd put it on a pain scale and I was like "…maybe a 2 or a 3...I've had period cramps way worse than this." So I walked around and used the birthing ball and rocked in the rocking chair while they hooked me up to monitors intermittently to make sure everything was looking ok. His heart rate stayed steady the entire time. I remember them commenting frequently saying things like "This is usually when the heart rate drops." or whatever, but my baby seemed unphased by this whole labor thing and just chilled with me through it all.

Around 7:20 pm the doctor finally came in to check my progress and break my water. I was still only 8 or 9 cm dilated at that point. So he broke my water.

The nurse, Helen, was concerned that the baby's head was crooked in the birth canal and may not make it out easily if he didn't turn all the way. She had me get on my hands and knees to try and get him to turn, but that was definitely not the position we were meant to be in. My knees, hips and back were just killing me in that position and the weight of the belly made it feel like my abdomen was going to drop off onto the bed. Out of nowhere I started vomiting. My sister handed over a hair-tie, which Andrew promptly dropped into my puke bucket while he tried to tie my hair back as I vomited. I don't know if they rinsed that one off or found another but he did get my hair up. The nausea passed as quickly as it came and I lay back down since the hands-and-knees position seemed to be making things harder on me and the baby wasn't budging anyway.

It wasn't long before I moved into transition phase. Helen was great and helped me reposition so I could best deal with the pain. She pulled out the squatting bar so I'd have something to lean against. And every time a contraction hit I'd sit up in a squatting position and lean against the bar. Transition was certainly the roughest part of the whole ordeal, though I don't think I'd rate it a full 10 on the pain scale. I tried my best to breathe through contractions and took great pleasure in relaxing between them. At some point during transition (in the middle of a contraction, no less), Andrew asked me if I wished I'd had that epidural yet. I remember shaking my head and gasping out "No." Nobody else ever asked me and honestly, I never even thought about it. I just breathed through contractions as best I could and relaxed fully in between.

Then I started feeling the urge to push. Helen checked me and said there was still a little bit of cervix left. I had a couple more contractions during which I really felt like pushing (and did a little bit while I was squatting against the bar--I couldn't help it!). Then I told her again that I really felt the need to push. So she checked me again between contractions and called for the doctor to let him know I was going to start pushing.

Then with the next contraction she had Andrew hold my right leg while she held my left and I started pushing. (The doctor still wasn't there.) I remember feeling relieved to be at the pushing phase finally. It was so much more comfortable than transition. The contractions didn't really hurt anymore, there was just an immense pressure like I was taking the biggest poop of my life. I remember thinking I'd have rated transition at a 9 on the pain scale and pushing at only a 5 or a 6. The nurse watched my first push and said something like "Oh, wow." And called for the doctor again because the baby was coming fast. She assured me that I was a great pusher and I think I had one more push and one more panicked call from Helen to the doctor before he finally came in to see me crowning.

In the middle of the first push the doctor watched he mentioned something about the perineum (my sister later told me he was saying that the baby's head was against the perineum) and I panicked thinking he was going to do an episiotomy because I'd never discussed a birth plan or let anyone other than Andrew know that I would rather tear than be cut. I remember finishing my push and then asking "What?". They told me to "Nevermind." and that I was "doing great." I was really angry that they wouldn't just answer me and treated me like I wasn't there when I was the one in the middle of this, but another contraction came so I focused on the pushing instead of yelling at my doctor.

On push 4 I felt the baby's head start to exit the birth canal, but then the contraction faded. I knew I should probably wait for the next contraction to help me out, but decided I didn't want to wait. So I started to sit back as the contraction faded, then instantly thought "NO, we are NOT doing this." and scrunched back up and finished pushing the head out hoping no one had noticed that the contraction had ended. It was such a relief to have the head out. The shoulder push was easier and once they passed it was like everything just rushed out of my body in this warm gelatinous flood.

After 19 minutes and 6 pushes (my sister said she only counted 5, so I'm pretty sure the nurse counted the head push as 2 because she was reading it off the monitor afterwards and I'd relaxed a bit when the contraction had faded), Lukas Andrew Nordman came into this world at 9:04pm on Thursday, January 21, 2010. His poor little forehead and nosey were bruised from coming through the birth canal so fast (and crooked--he never did bother to straighten out) and he had almost no "cone head". He measured in at 8 lbs 2 oz and 20.5 in long. He scored a 9 and a 9 on his APGARs. 



Andrew got to cut the cord and then Lukas was passed up to me for slimy cuddles and kisses. 

Wednesday, January 12, 2011

Failure to Look at the Baby: Part 1 - Jaundice

I follow a few different Breastfeeding groups online and the topic of "Booby Traps" has been coming up a lot lately, it seems. I've answered a couple of questions on breastfeeding surveys regarding booby traps and breastfeeding experiences and this particular story seems to be coming up repeatedly for me as I answer.

So I think it's a sign that it's time to share my Failure to Thrive story. 

This is a doosy, so bear with me. I've decided to break it into parts to make it more readable.

Let's start off in the beginning of the beginning. Somewhere along the line in the dizzyingly constant barrage of prenatal testing, I failed the Blood Glucose Tolerance Test. Before I go off onto a lengthy tangent about my feelings and experience with that one, let me just stop myself and sum it all up: GD went unchecked for a month, it took a few weeks to get under control, my morning fasting sugars were always high, I was put on insulin because diet alone wasn't doing it.

Lukas was born weighing 8lbs, 2oz at 38 weeks, 3 days gestation. His father and I were both born at 7lbs, 13oz.  I'm inclined to believe that his weight at birth was higher than it would have been had my body not been pumping extra sugar his way for at least a month and a half. He then proceded to lose exactly 10% of his body weight after birth.

I was lucky enough to have had an unmedicated, vaginal birth. I attempted to put him to my breast within the first hour, but couldn't get him to latch. I was told I had flat nipples so he couldn't tell as easily when he'd made it to the nipple to start sucking. Over the next 24 hours, I think I was shown every trick in the book to get a baby to latch on to flat nipples. Nothing worked. Every time he was awake, I paged for help latching him on. It took them so long to respond that he would fall asleep before help arrived every time. He'd been born at 9:04pm on Thursday. The hospital ran out of space for laboring mothers and discharged us at 10:00pm on Friday night, nipple shield and formula samples in hand, without Lukas having ever latched onto my breast.

Because it was the weekend, and the Lactation Consultant with the hospital wouldn't be able to see me at home until Monday and Lukas still hadn't nursed successfully, we were told to come back to the hospital on Sunday to have his biliruben and weight checked and get some lactation help.

While at home, I had some luck getting him to latch with the nipple shield. I could tell he was getting something because I felt my uterus contracting, there would be droplets of colostrum left in the nipple shield as evidence after a feeding, and he had plenty of wet diapers. By Sunday he was looking a little yellow and I still couldn't feed him without the shield. My milk hadn't come in yet and I wasn't sure how to use my pump.

As we prepared to go in for the hospital check-up, I naively debated whether or not to bring my pump in so the Lactation Consultant, who I was told would be there, could show me how to use it while we were there. In the end, I left it at home figuring I could just ask questions. She'd be coming to see us at home on Monday anyway. By then my milk should have come in and everything would be better anyway.

However, when we got to the hospital, there were only two nurses on shift. Neither of them had been there when we delivered and no one seemed to know why we were there. We could see our names written down on the calendar on their desk. What was the problem? Finally, they decided to take us back to the lactation room (basically a closet in the corner in the back of the maternity wing with a chair and a scale in it--nothing else would have fit). We were left there to wait.

For the next 45 minutes, we were left alone to wait in that tiny, hot little "room." Lukas started fussing almost immediately. I couldn't latch him on without enduring 10 minutes of screaming at minimum, so I elected to try and wait to feed him since someone was surely going to be with us soon. My husband went and searched out a nurse. Twice. As we were about to just leave, someone came in and checked his biliruben with a little wand thing they pressed against his forehead. She thought it looked high and checked again. Yep, high. Out she went. She rushed in and out, telling us very little and asking us a lot.

She told me that the Lactation Consultant would just weigh Lukas and check his biliruben levels tomorrow like she just had, so did we want her to cancel the appointment for us. Shocked, tired, hot, sore, hormonal, and 3 days post-partum, I asked "That's all she does at the home visits?" The nurse affirmed and asked us again if we wanted to cancel. Heartbroken that the savior I'd been waiting for didn't exist, I begrudgingly agreed to let her cancel the appointment.

She then wanted to have Lukas's blood tested because that'd be a more accurate reading. We'd been waiting so long that Out Patient was closed for the day. So they sent us down to the ER to get Lukas's blood drawn to check for jaundice. A mere 4 hours later, we returned home. Exhausted, beaten, and overwhelmed.

We didn't have an official pediatrician set up yet at birth because when I'd called my doctor's office asking about it, I'd been told they didn't set that sort of thing up until 2 weeks after the baby was born. Being a naive first-time mom, I didn't realize how silly that was and believed what I was told. So the hospital's pediatrician, Dr. M, saw Lukas at the hospital on Friday morning and was the one on file to follow up with the jaundice. On Monday, when my doctor's office opened, I called to set up the doctor I wanted for Lukas. All day Monday, I fielded calls from both offices. Both wanted me to set up appointments. Dr. M couldn't seem to understand that Dr. F was supposed to be Lukas's doctor. She told me I might have to drive out to her other office 45 minutes away. She told me to give him nursery water and to nurse him every 2 hours. I'd never even heard of nursery water and assumed she meant formula (I later learned that nursery water does exist and is not, in fact, formula, but special water to be used for such things as mixing formula.). I told her that I was nursing on demand. Dr. F scheduled us to come in early in the afternoon on Monday.

While we were waiting in his office, my milk finally came in. I was afraid to try and feed Lukas because that meant at least 10 minutes of Lukas screaming in a public place where everyone could hear me failing. Dr. F explained that Lukas's biliruben level was at 17 and that at 20, they had to start worrying about brain damage. He told me to express my milk and bottle feed him for the time being and gave us the choice of taking Lukas back to the hospital to be put under the bili lights or to use a bili blanket at home. We chose the blanket. We also needed to take him in to the hospital's Out Patient lab to have his blood drawn daily to check his biliruben levels.

When we got home, I pumped while my husband fed Lukas his first bottle of formula. At some point, while Lukas and I were napping, the Lactation Consultant called to check up on us because we'd cancelled our appointment and she was worried. My husband explained what was going on and she expressed concern about the bottle feeding. I was so tired, overwhelmed, and frustrated with our situation that I just assumed she was of the "formula is the devil" crowd and instantly wrote her off. She clearly hadn't wanted to help us anyway.

For the next 6 days, Lukas sat in his bouncer wrapped in the bili blanket unless he was eating or getting his diaper changed. It didn't take long for me to give up on trying to feed him without the nipple shield. It clearly wasn't going to happen. So he ate with the shield and we supplemented with expressed milk to make sure he was getting more than enough. We went to the hospital every day to have his labs drawn and followed up with doctor visits and phone calls.

On Saturday, we went in to get the lab drawn, knowing they would be closed on Sunday. We reminded them that they needed to page Dr. F with the results because his office would be closed in the afternoon. They assured us they would. We could tell he was no longer jaundiced and his numbers had been going down for the last few days, so we opted not to keep him under the lights unless we were called and told his numbers were bad. We got no call, so we assumed he was healthy.

Monday morning brought an angry phone call from the doctor's office wanting to know why we'd skipped the lab draw on Saturday. My husband fielded that call as well and explained that we hadn't skipped the draw, the hospital must not have paged the doctor with the results. The doctor's office called us back a little while later to let us know that we didn't need to worry about the jaundice anymore.

At Lukas's 2 week appointment he'd returned to a healthy 7lbs, 14oz. Still not back to his birth weight, but Dr. F agreed that his birth weight was probably inflated because of my GD. We were set free into the world with our baby and told we didn't have to make another appointment until he was 2 months old. We both breathed a happy sigh of relief. The horror was over. We could finally relax and enjoy our baby.