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Monday, June 28, 2010

It still talks!

I'm sure you will all be happy to know that my pump still talks. Ever since the baby arrived, I have been fairly torn about whether or not I should pump. I struggled with milk supply when I had Micah, and one of the mistakes I made was letting things go too long before I began to pump. I swore that this time, I would not make that same mistake.

In the hospital, before we even arrived at our room, I requested a pump. I had everything set up and ready to go "just in case." Much to my surprise, the baby latched really well at her first nursing session. She fell asleep for about 6 hours after that, but the lactation consultant said that they advise moms of preemies who will be exclusively pumping not to begin pumping until the 6 hour mark. She further suggested that if the baby latched well again and stayed on for 20-30 minutes, that she felt that I should hold off on pumping and only pump if the baby refused to latch or nurse.

Right at the 6 hour mark, we had another great nursing session. The baby continued to latch at least every 3 hours for 20-60 minutes each time. She had the requisite number of wet diapers (and stools, too), and by morning everyone was telling me how well she was nursing and how perfectly everything was going. In the back of my head, however, I kept wondering if it was just too good to be true. I mentioned my supply issues and my concerns, and most felt that if I were to face supply issues, it would likely not crop up for a little while as I should easily be able to meet the baby's early demand...I just might start to fall behind later. It made sense to me, so I decided to trust the "experts." Besides...I always hated pumping, and in the early days, you pump and pump and NOTHING comes out until after your milk starts to come in - who needs that frustration?

At the end of day two, I began to get nervous again. It was our first sign of trouble...salmon colored urine in the diapers. It is a sign that the baby is passing uric acid and not getting enough fluid. Once we saw that with Micah, everything went downhill quickly, so I was fairly concerned. We spoke to the nurse and to the doctor, and everyone pretty much told us it was "nothing" - just feed the baby more often. I asked about supplementing and I asked about pumping, and everyone felt that the baby was doing a great job on her own and I should just trust that it would be okay.

The salmon-colored diapers continued all day on Sunday (and even this morning). She is supposed to be passing 3 stools a day, and she has barely been doing one since Saturday (she did 3 on Friday, and then 1 on Saturday morning, 1 on Sunday morning and none since then). She is definitely hitting the requisite number of wet diapers, but I think my supply might be the issue. we called our pediatrician and we are going in later today for an appointment, but over the phone they said I should start supplementing.

So, this morning, after she nursed on one side, I bit the bullet...and got cozy with my pump. And yes, it still talks. I think it is still pretty salty, too. It started out telling me to "Let it go" and then it called me "Whacko." When my pump switched to the faster pumping setting, it started to tell me to "back up" - since it was hurting, I decided the pump was asking me to turn down the tempo to a lower speed, and I happily obliged. Then it started to say "back hoe" - I'm thinking it was trying to make conversation about our upcoming renovations?

After all of that pumping...I barely got 5ccs. I hate pumping! I know that I did breastfeed shortly before pumping, and that the pump does not do as good a job getting the colostrum out, but I just find the whole process so discouraging! I ended up giving the baby all 5ccs, and I called the pediatrician to discuss her salmon-colored diapers. The pediatrician who had answered the phone read me the riot act about not supplementing yet, and how it was necessary and the baby would get sick and dehydrate...so after giving her the 5ccs, I caved and gave her another 10ccs of formula. I decided that maybe that would be all she would need to "get over the hump" and I would wait and see what they said at her doctor's appointment.

At 2:30, we headed to her appointment. We saw a different doctor, and he thought she looked great and maybe put on an ounce or two. I was just thrilled she is no longer losing weight! We discussed the salmon-colored diapers, and he thought that it was not a big deal before my milk came in, especially since she was gaining weight. He thought her color looked good and everything else was perfect. Naturally, after our long discussion about her lack of normal urine, he checked her diaper and...you guessed it - a beautiful yellow-colored urine-filled diaper! The little stinker made me into a liar...or at least one of those crazy, hypochondriac parents. I am pleased to report she has had two more normal diapers since our appointment, so it looks like all the extra nursing (or perhaps the touch of formula this morning) did the trick. Now, we just need to get her pooping again...she has not pooped since about 5:00 am on Sunday morning. I'm sure when we have a nasty diaper, I'll be regretting WISHING for more poop, but what else can I do? We will return to the doctor on Thursday for another weight check. Hopefully, she'll continue to do well.

In the meantime, Micah shows absolutely NO INTEREST in his sister. I did manage to snap a few photos of him nearby - I'll try to post them soon. We've been doing well during the days - she is nursing easily and so far I'm trying not to worry about my supply. Elliot and I have been trying to take turns caring for each of the kids, and my parents have come by a few times to help out with the baby. She seems to get very sleepy in the late afternoon/early evening, and then is wide awake from about 10:30 until 3:00 am. Last night, she just did not want to be put down, and I was exhausted - since Wednesday night, I had only had 5 hours of sleep - TOTAL. I finally just latched her on, propped myself up in bed, and the two of us took a 3 hour nap together that way. Yes, I know it is a bad idea to sleep in bed that way, but we needed our rest, and I just could not figure out another way to make it work because she wanted Mommy and no one else to hold her. Hopefully, tonight will be easier, but we shall see.

She has been nursing VERY frequently all day today. The little lady has such sensitive skin - she has completely scratched up her face with her fingernails, and every time she rubs up against something she gets these terrible abrasions/rashes that can last 3-12 hours.

Okay - that is our update for now!

Saturday, June 26, 2010

Birth Story

As you all know, I had been waiting quite some time for little Miss Twoey to make her grand debut into this world. I started having issues with contractions and a shrinking cervix very early on in the pregnancy, and everyone expected that I would be lucky to make it as far as 36-38 weeks. So, all pregnancy, I planned for a very early delivery.

As is par for the course, someone up there must have been laughing at my plans! I scheduled regular work hours up through 36 weeks, and from weeks 36-38, I cut back on my schedule and for every meeting, I gave everyone the caveat "unless I go into labor." When I actually made it to 38 weeks, I was shocked. I continued to schedule some work meetings, but never more than a day or two in advance. I had completely cleared my schedule from week 39 and for most of June and July...with the exception of doing a 1 1/2 hour presentation at a conference on June 26 (what I had originally expected to be at least 3-4 weeks after Twoey's birth - my first "post-baby" tentative venture back into the working world). As the date drew closer, I started to worry about how labor would affect that presentation. Last week, when we concluded Little Miss Twoey would never arrive on her own and scheduled the induction, I was relieved - attending the presentation pregnant would be much easier than attending with a newborn baby. Ultimately, I decided to roll the dice and not cancel my presentation - I was certain I would be able to make that meeting.

After my appointment on Wednesday, I was convinced that Twoey would never arrive on her own. My contractions were regular and non-progressive, my cervix was not dilating any further, and after long stretches of intense contractions, the severity would subside. On Thursday morning, I went with the babysitter to attend Micah's classes. My contractions seemed to pick up during class, and I was quite uncomfortable. They were about 3-4 minutes apart and fairly intense. As had become my practice, I did my best to ignore them. They continued all day long, and often were too intense for me to walk or talk through. I had scheduled to meet my friend Heather for a manicure/pedicure at 3:00 pm, and for a few minutes, I hesitated to go in case I went into labor. I then scoffed as I recalled all the other times I stayed put for fear of labor, and decided to go pamper myself.

My manicure/pedicure were wonderful! It felt great to get a leg and foot massage, and I painted my toes a nice pink in honor of Twoey. My contractions continued throughout the appointment, and even on the drive home. I arrived home a little after 6, and Elliot and I fed Micah dinner. After dinner, Elliot ran a quick errand and came back and informed me that there was a nice outdoor concert happening down the street, so we decided to walk over. I warned Elliot that my contractions were quite intense, and I did not know how far I would be able to walk or stay out. We made it to the concert, and I found a chair (next to a friend I spotted). We sat and chatted, and every 3-5 minutes I had to stop to close my eyes and focus on relaxation breathing during the contractions. We stayed for the concert and then headed home. I found the walk quite difficult, and by the time I got home I was extremely uncomfortable.

We bathed Micah and put him to bed, and I took a shower to relax a bit. After my shower, I tried to stretch out and relax on the couch. Elliot has gotten so sick of my constant contractions that all of my whining about discomfort did nothing to elicit any response from him. I begged for a back massage or a leg massage...but Elliot was not interested in obliging. Instead, he told me his hand hurt!

I tossed and turned on the couch, and around 12:00 I managed to fall asleep for a few hours. I woke up at maybe 1:30 or 2:00 with a contraction, and once again needed to run to the bathroom. I decided to head upstairs and try to get comfortable in bed and get some rest. I was extremely restless and uncomfortable - I could not find a good spot in the bed, and every 10-20 minutes I needed to run to the bathroom. Elliot came upstairs to bed around 2:30 or so, and once again I whined about how much discomfort I was in from the contractions, and told him that I might actually be in labor. He asked me if I wanted to call the midwives, and I said that I knew if I'd called, they would either tell me to stay put until my water broke, or tell me to come in and get checked at the hospital...and then send me home because nothing had changed. So, we decided to wait it out. I asked Elliot to massage my back through some of the contractions...and he told me he was tired and going to sleep.

So, all night, I sat up by myself contracting and laboring. I was breathing through the contractions and trying to stay relaxed, but in the back of my head I was fairly certain I was in labor. At 6:00 am, I told Elliot that I thought I was in labor...and he said "okay" and went back to sleep. At 7:00, I woke him again and suggested that we should call my father to come down "just in case" because I did not want to be alone while he took Micah to daycare - I really felt like I needed more help getting through the contractions. I also wanted to call the midwives - possibly go in to the hospital or get checked at the office. We briefly debated the pros and cons of calling my father, and ultimately Elliot thought it would be easier for me to just wait things out at home while he took Micah to daycare. A few minutes later (7:39)...my water broke! There was no longer any time to debate what to do.

I immediately called the midwives and my parents. I was a bit sad because I knew that my mom had to go get an iron infusion, and I knew she would not be able to join me for the delivery. I've known this whole time that she was unlikely to be there...but I kept hoping that maybe Twoey had waited so long so that her Grammy could be with us. My mom started to get emotional on the phone, and I cut her off...I knew I just could not think about what was not going to happen, and I need to focus on getting through it. I then sent Elliot into Micah's room to wake him up and dress him while I hopped into the shower to rinse off. Like last time, I felt a bit of relief when my water broke...but it was short-lived. Within 5 minutes, my contractions were coming in intense waves - I was doubled over in the shower and barely able to stand or talk. I realized that things were happening quickly, and I worried that we would not make it to the hospital in time. We were out the door a few minutes after 8 (well, I was out the door and in the car waiting with Micah before 8, but Elliot kept forgetting things and needing to go back inside), and we drove Micah to the daycare. I was unhappy that I was spending so much time on my own trying to get through the contractions. Elliot literally dropped him off barely dressed, with milk and some cheerios and said "here he is - feed him!"

By the time Elliot returned to the car, I was extremely uncomfortable. The contractions were coming in waves so quickly and so strongly. Unfortunately, while I could play my ipod birthing/relaxation mix, I could not recline, get comfortable, or truly physically relax during the contractions. I was definitely squirming and antsy during the contractions, and trying to grab on to the car handle. As we started our trip to the hospital, I realized that I was getting nauseated - a symptom that hit about 20 minutes before I needed to push with Micah. Suddenly, I thought I might give birth in the car. Elliot drove like a maniac to the hospital to get us there, and about 5-7 minutes out, I told him I thought I needed to push. We arrived to the hospital, and Elliot had to go get a wheelchair because I could not walk. During one of the contractions, I had to get out of the car and squat down because the pressure was so intense.

We finally made it up to the admittance area around 8:45. The admitting nurse started to ask a ton of questions. I could barely open my eyes or focus, and all I could say was "I need to push." Next thing I know, they are whisking me into a room. I did not have time (or the energy) to change into a gown, so I simply took off my shorts and kept my shirt. The nurse came in and checked me and said "we've got time - you are only 6 cm dilated." I was scared...when I gave birth to Micah, it was about 3 or 4 hours from the time I was at 5 cm until he was born, but I was not really in any significant discomfort then (well, my back hurt during contractions, but they were very manageable as long as Elliot massaged my back). This time, I was experiencing fairly intense and quick contractions, and I really was not able to get in a comfortable or relaxed position because things had happened so fast. Elliot was focused on talking to the admitting nurse, so he really was not able to focus on massaging my back and helping me relax during the contractions. I was extremely nauseated, and worried that I would not be able to keep up that level of intensity for very long and experience natural child birth again. In my head, I started to wonder if I could handle it, and I started to think I might not be able to do this again. In hindsight, I should have realized that I was close to the end...I had the same 5 or 10 minutes of panic just before I started pushing with Micah!

They continued to try and ask me questions and try to hook me up to the monitors - all the commotion certainly did not make things easier for me. About 5-7 minutes later, I again repeated "I need to push." They checked me again...and much to their surprise, realized it was go time! I was so relieved...I knew that if it was time to push, we were almost there and I definitely could get through it. They suited up, and asked me to hold on for 1 or 2 more contractions. It must have been around 9:15 or so at this point, and I started to push.

Things were happening quickly - I could immediately feel the baby descending, and apparently the top of her head was easily visible. They kept asking me to push a little harder and longer, but she seemed to move down during the contraction then bounce back up. I could hear Elliot yelling encouragement to me (and I think he was holding my leg to give me support while I pushed). While things happened faster than with Micah, it was somehow more exhausting this time. A few times when I was pushing, I wanted to just stop and quit, and it just felt like maybe I wouldn't be able to push hard enough and finish this out. All of the sudden, I heard some whispering and the midwife sounded a bit anxious when she asked me to push a little harder and longer. My first thought was "I don't think I can" but I asked what was wrong and she responded that the baby's heart rate was dropping during contractions. I immediately knew that meant her cord was likely wrapped around her neck. I had a moment of panic...often, when they suspect the cord is wrapped around the neck, they rush to have you do a c-section. I then focused in on the midwife and did my best to push her out as quickly as I could. Since I was only pushing for about 10 minutes, it must have only been another 3-5 minutes. I think I pushed about 3 more times and finally felt her head push through. It stung for a moment, and then the relief was instant. A second later I did one more push and her shoulders started to follow. Immediately, the intense contractions were done, and I just felt relief wash over me.

I heard the midwife yelling "wait" and taking over from Elliot (who was helping to "catch" the baby). I then did one more small push and she was out! There was some scurrying to quickly cut the cord, and she seemed quiet for a minute. After what seemed like a very long pause, I heard her crying out! They then placed her on my belly while they finished cutting the cord.

I later learned that when she popped through, her cord was wrapped around her neck...twice. They scurried a bit to untangle her, and did not want me to finish pushing her out for fear that the cord would tighten. Because of the commotion, Elliot was deprived a bit of doing the final part of the delivery...but her safety obviously came first. They cut the cord and collected the cord blood. We also learned that there was some meconium in the amniotic fluid, so they had to bring in a neonatalogist to check her lungs. Luckily, she had started breathing on her own and her lungs were clear. I managed to escape without a single tear...no need for any stitches and minimal swelling/bruising.

Her apgar scores were perfect...9 and 9. She weighed 6 lbs 10 ozs and they measured her at 19 1/4 inches long. She has very long fingers and toes, and her feet are so skinny (unlike her brother who had wide and square feet). Her finger nails are actually long, too - even longer than mine! She will have beautiful hands and nails one day. I think we might need to go take her for a manicure this week! Her skin is very dry, and she has all this hangy...well, old lady skin on her hands and feet. Her skin appears to be very sensitive - she seems to be breaking out at every little thing (must get that from me). She has hair...but not nearly as much as Micah or as dark. It was also kind of curly. It is very long...just not as thick. Too bad - Micah had such great hear it would have been amazing on a little girl!

My friend Heather was waiting outside, and they sent her in a few minutes after I gave birth. About 15 minutes after she was born, we received another delivery - a pink teddy bear and some balloons from our family friends Gail and Steven! It was amazing.

They had to give her a couple of vaccinations, and then I got to breast feed for a bit. Unlike her brother, Twoey latched! She seemed to be doing well. They had to test her blood sugars, and those were perfect. About an hour or so later, the nurse gave her a bath and cleaned her up, and then we were moved into our current room.

My parents came by to visit as we were moving and got a chance to meet her. They only stayed for a little while, though, and then they went home to take care of a few things. They returned a few hours later, and my father and Elliot went to go pick up Micah from daycare. Micah met his sister around 5:30...but, to be honest, he was not so interested in her. In fact, he would not come anywhere near me while I was holding her! Micah spent most of the time playing with the balloons.

Around 7:00, my friend returned to the hospital with dinner for all of us - we sat together in the family room and ate dinner before everyone went home. It was a nice evening. I guess all I can say is that Micah, while indifferent to his sister, seemed just fine.

Remember that I mentioned my Saturday afternoon conference that Twoey conveniently mucked up? Well, they have been quite kind and are setting up a conference line for me, so I will be giving my presentation by phone from the hospital today. In the end, it all worked out!

Friday, June 25, 2010

Introducing...

Baby "Twoey" arrived at 9:27 am, weighing 6 lbs 10 ozs, measuring 19 1/4 inches long. We are both doing well! Name and birth story to follow...as soon as we decide on her name!

Here are some pictures to start you off:


















Picture Post

Just thought I'd share a few photos from the past few weeks. Let's start with pictures of Micah enjoying his new helmet and his bike seat.



Ice cream at Ben & Jerry's:


Fun at the basketball court:



Photos of Micah rolling around in bed saying "night-night":




Fun at the pool:










Belly shots:


Wednesday, June 23, 2010

Mixed Emotions

Today we had our 40 week OB appointment. They were very backed up, so we did have quite a wait to be seen. Chris, the midwife who delivered Micah (and who has been on maternity leave since February) was on duty, and it was great to see her!

I was initially hooked up to the NST (non-stress test) machine...and once again, Twoey was sleeping and not moving so much. Her heartbeat was not jumping around as it is supposed to - it was just very steady. I had Elliot go get me some apple juice, and luckily, she started to cooperate. Even better, my contractions returned and we got them recorded as well.

Shortly thereafter, Chris came in to see us. She was very kind, and talked to me about my situation. Naturally, we immediately began to discuss induction. I talked about my fears and she said she understood. She did say she felt that simply breaking my water would likely do the trick at this point, but she could understand why I would be concerned. Initially, she recommended waiting until 42 weeks to induce me (2 weeks from yesterday - July 6), but as we looked at the calendar and she reviewed my file, she waffled. Her concern was that I am flagged as a "possible" case of gestational diabetes (because I failed the 1 hour glucose test) and they generally do not like to allow people with gestational diabetes to go beyond 41 weeks. She suggested setting an induction for the end of next week - when I am 41 1/2 weeks (July 1 or 2). As we looked at the calendar for Thursday and Friday, we realized several things: 1) the midwife I dislike (Karen) is on duty those days and would be doing the induction; 2) that would put me in the hospital over the weekend when we do not have daytime childcare coverage for Micah; and 3) it is a holiday weekend (4th of July).

The more we spoke, the more we leaned towards doing the induction earlier in the week - on Tuesday or Wednesday (when the other midwife we like, Angel, is on call). On Wednesday, Angel is only on call until 6 pm. Our concern was that if simply breaking my water does not work, I could end up with needles, and that would like happen during the nighttime when the Karen (who is far less sympathetic) would take over. So, we decided that we would induce on Tuesday so we could guarantee which midwife would deliver Twoey.

After we tentatively set the induction, she checked me. I'm still 3-4 centimeters dilated and 80% (or more) effaced and the baby's head was nice and low (and pressing on my cervix). She said she really thought a few good contractions should kick me into labor, and she gave breaking my water a 75% chance of succeeding. We talked about all the "natural" induction techniques...walking, raspberry leaf tea, evening primrose oil, castor oil, black cohosh, pineapple, etc. She stripped my membranes AGAIN (not as uncomfortable this time) in the hopes it would stir things up. She said I should come back in again on Monday and have my membranes stripped one more time before the induction...or if I change my mind, I can postpone the induction on Monday and reschedule.

I really would like to have this baby...and sooner rather than later. I guess I'm hoping she decides to come on her own so that I don't have to think about induction options. The whole thought of induction just really terrifies me.