Saturday, February 14, 2015

The birth story of Rowan

From the time I was a little girl, I always dreamed about being a mother. I knew I wanted lots of babies, and could not wait to be pregnant, to give birth, to breastfeed. As a teen, I decided that when I did eventually have babies, I wanted to try natural childbirth. I imagined labor often, and thought I would be good at it--I wanted to try at least! 

The journey to motherhood was more difficult than I had imagined, but after two miscarriages and many months attempting to conceive again, we finally had a successful pregnancy. I began thinking and planning about birth early on--still sure that I wanted to try a natural birth. But, at 27 weeks when my water broke unexpectedly and I was told that due to baby being breech, I would need a c-section, my plans were quickly changed. I spent five weeks on bedrest trying to keep baby girl in as long as possible, and that gave me time to accept the need for a c-section and change my heart so that a safe delivery was all that mattered. When the time came, my surgery went smoothly, recovery was as good as could be hoped, and our daughter Adelyn Piper, though early, was healthy.

When I visited my doctor for my post partum appointment, I immediately asked about future births and whether I'd be a good candidate for a VBAC. I was told that was definitely an option, and I again began to dream of the birth I wanted. After another miscarriage and surgery to correct a uterine septum that was the culprit of the losses and complications, I became pregnant again 13 months after Adelyn's birth, and again began researching and learning about VBAC information so that I could optimize my chances for success. I tried not to worry about the fact that baby girl #2 was persistently breech, but as time went on, it began to be more concerning that she was not going to turn. After trying everything possible to turn her, I finally had to accept that once again, I was going to require a c-section for her birth. I knew that just like last time, the most important thing was a healthy baby and healthy me, but it was still very disappointing. Ella Kathryn was born healthy on her due date, and once again, my surgery and recovery went very well.

When I became pregnant again 13 months later, I knew I wasn't ready to give up on my dream, and that I was willing to give it my all one more time even if it meant being disappointed yet again. I began chiropractic adjustments early, switched providers to a practice of midwives very open to vba2c candidates, and picked out a doula who couldn't wait to cheer me on towards my goal. The pregnancy was my least eventful one of all, with no bleeding for the first time in 6 pregnancies, normal morning sickness, aches and pains, but no complications.

In the final weeks, baby girl #3 turned head down with plenty of time to spare--the first BIG hurdle was crossed, and my hopes were way up! I spent all of my time swirling on an exercise ball, doing pelvic tilts, watching birth videos, and reading birth stories. I was nervous, but so excited and loving the anticipation. I couldn't wait to find out how it would happen--would my water break? Slow and steady progression of contractions? Fast and unexpected?

At 39 weeks, I had my cervix checked during my appointment, and was bummed (though not surprised) to find out that I was "closed tight", but 50% effaced. I had been told previously that my cervix had scar tissue on it, and we weren't sure if that would interfere with dilation, so I was nervous that my due date would come and I would still be unfavorable for induction, and would be forced to schedule a third c-section. I had been using Evening Primrose Oil, Red Raspberry Tea, and for weeks to prepare my body as much as possible, but really struggled to trust that my body would know what to do in the right time, and so I spent a lot of time worrying and praying and trying to wait patiently.

Every night for a couple of weeks, I had contractions every 8-10 minutes that were painless, but consistent, and I tried not to get my hopes up each night as I timed them. I stayed up late each night, watching birth videos and eating popcorn and OJ (which is why I gained more weight than I had hoped)...Finally, a few days before my due date, I felt a few that were different--more painful, engaging different muscles, more intense...and I thought maybe something was beginning to happen. At 39+5, I finally had a day without heartburn. I told my husband (and Facebook) that we were going to Moe's for dinner and I was going to eat SO MUCH. Several comments on my FB post were accounts of Mexican food preceding labor, but since Eggplant Parmesan had already failed me, I didn't have much hope. I knew it would taste good and that was enough for me, so I went and did some serious eating. Afterwards, we went to church for our small group, then headed home where for the first night in a while, I didn't bother doing any hip circles or pelvic tilts, didn't drink any tea, and just hung out until bedtime.

 I went to bed with the usual pattern of contractions, but woke up a few hours later to painful, much more intense contractions that I immediately knew were the real thing. I got out of bed at 3am and went to time the contractions, finding them to be about 6-7 minutes apart. I woke up my husband (Nathan) and called my doula (Jerri-Anne) to let her know, but told her I thought I had some time and not to come just yet. I wanted to get in the shower and see what would happen to the contractions, and to gather my thoughts before letting things start rolling. Plus that's what always happens in birth stories, so it seemed like the right thing to do.

Pretty quickly after getting into the shower, I realized I was not going to be able to sit and relax and buy some time, but that things were progressing in intensity and I wanted Jerri-Anne sooner than later. I got out and messaged her on Facebook, still trying not to admit I was really antsy, but she picked up on it and quickly said she was on her way. Once she arrived, she sat with me and timed my contractions, and when 6am came, I called my mom to come get my girls ready to leave with her once they woke up. She came soon and the girls got up and snuggled me for a few minutes and had breakfast, and then Jerri-Anne suggested we all go for a walk to see what would happen to my contractions. We headed outside and began the circle around the neighborhood, I'm sure looking like quite a little parade at 7am.

As we walked, I very quickly had a contraction, but was able to walk and talk through it. A minute later, the next one came and I had to slow down a bit, but still kept moving. One more minute and another contraction came, and this one had me stopped in my tracks. They were painful, but still manageable, and I was trying to stay as relaxed as possible and wait for Jerri-Anne to tell me what to do next. After two laps and many stops, she told me the contractions were really close and she thought we should head inside and call my midwife, and I was pretty relieved to hear that suggestion.

I called and was thrilled when my favorite midwife, Meg, answered and told me to head on in, and that she would be there all day and all night. She had been the one I saw at 39 weeks and had spoken to on the phone about my options for passing my due date, and I had let her know my intent to try induction before consenting to a c-section. She had been very supportive and encouraging, so I was thankful that she would be there, already familiar with my goals and wishes.

My mom got the girls loaded up and I kissed them goodbye, and started gathering up our things,  mentally kicking myself for not packing and preparing in advance. I felt a sudden sense of urgency to get going, so we left pretty quickly to make the hour drive to the hospital (and totally forgot to bring any outfits for baby girl, including the one both of her sisters had worn home from the hospital that I hoped she would fit into as well!).

I had been nauseous ever since waking up, but Jerri-Anne and Nathan both were encouraging me to find something I could eat before getting to the hospital. I had tried some cold diced peaches with no luck, but finally settled on a smoothie, so we found a Panera on our way and pulled in, Nathan promising to hurry as he went inside. Jerri-Anne was already at the hospital, and after a lot of really painful contractions, we finally pulled in to the parking deck. As I got out of the car, another contraction hit me and brought tears to my eyes, and while holding on to the side of the car and breathing, I saw a lady watching me with a sympathetic smile. I realized I was REALLY in labor and about to have a baby, and I had to work to collect myself and stay focused. The walk from the parking deck to the hospital entrance seemed very long, and I had to stop several times to breathe, but finally we arrived and headed up to check in.

Once we got in to a triage room, I finally threw up all of the smoothie I had managed to drink, and tossed the rest in the trash. Meg knocked on the door around 11am, and as she walked in, my water broke. We joked about how she had made it happen just with her presence, but that I was definitely staying now no matter how far progressed I was. I told her I hoped to be a 12 because I was ready for action. She laughed and called me an overachiever, and then checked me, her face quickly showing that I was far from a 12. In fact, I was a 1. Baby was low, cervix was soft, but I was only 1/10th of the way done. Ouch. She told me that she could feel the scar tissue on my cervix holding it shut like purse strings, and she tried to break it loose and hoped that I would see some progress from that. She also noted that my fluid had very slight meconium staining, which meant when the time came to push, the NICU team would come in and in the event baby girl was not immediately crying, she would have to go to the warmer to get suctioned and evaluated by them instead of on my chest. I was not at all happy to hear that, as the biggest thing I felt I had missed by having c-sections was that first moment of having my girls straight into my arms, skin to skin, and able to breastfeed immediately. I wanted that moment SO much and was hoping I was not going to lose out on it again.

We got moved to a labor room and met our nurse for the rest of the shift--Michele. She was nice and we quickly got a good vibe from her, so conversation flowed easily between us all as she got things set up in my room. While Nathan and Jerri-Anne got my essential oil diffuser set up and some oils going (Thieves for germs and Orange for mood and energy), I went to the bathroom before getting in bed, and took a moment to collect my thoughts. I was not able to get a room with a tub as I had hoped, but was thankful for wireless, waterproof monitors available, so Michele got me outfitted with one and then had me get in bed so she could start my IV and run the antibiotics needed because of my GBS+ status. I think I vomited again somewhere in that time frame, and Jerri-Anne sat by my head with a barf bag and tried to distract me while the IV got started. Laying on my back quickly made my contractions harder to deal with, and I felt my ability to cope beginning to slip away. I started thinking about an epidural, but kept telling myself "just don't say it out loud...if you say it, it will happen". Jerri-Anne had asked me weeks before if I wanted some type of code word in place for if I was asking for an epidural so she could discern if I really wanted it or needed her to talk me out of it, and I had told her no, that if I asked for it, I would mean it 100%.

After a few minutes of trying to stay distracted and beginning to struggle, the anesthesiologist came in to talk with me and go over the options available to me. I knew this hospital was one of very few in the US that offered Nitrous Oxide, and I had planned to let that be my "last resort" option to help get through transition or pushing, but yet, at a measly 1cm, I was having such intense contractions every 2 minutes or so, and quickly losing steam, so I asked to go ahead and start trying the Nitrous. Even as I asked, in my head I was thinking "just give in, tell them to start setting up the epidural..." but I was determined to hold out a little longer. I had said all along that even though I wanted to try to go drug-free, that if my labor was very long and got super intense early on, I wouldn't hesitate to use the epi when the time came, as the VBA2C was more important to me than the natural labor goal, and I wanted to have the strength and energy to push well.

The Nitrous machine was brought in and I was instructed how to use it, and began trying to take nice deep breaths into the mask at the onset of each contraction so that it would hit me by the time the pain peaked. It only took a couple of contractions for me to find that I was feeling absolutely no relief from the gas, and I was beginning to get frantic during contractions, losing control of my breathing and gasping and crying instead. Jerri-Anne stayed right by my head, holding the barf bag as I continued to throw up off and on, and doing her best to calm me down and help me breathe. Nathan was on my other side, holding my hand or rubbing my back and encouraging me to breathe slower and relax. After a few more contractions, Jerri-Anne told him to go ahead and go get some lunch and take a break, and soon after he left, I finally broke down and told her I wanted the epidural, I was sure, I didn't need to wait for him to come was time. She agreed and went straight to find Michele and let her know, and I was very relieved.

Around 2pm, the anesthesiologist got set up and had everyone leave the room except Michele, and got the epi placed. I warned her that I have scoliosis, and she felt sure she could work around it, but then had trouble getting in the right spot and I could feel that the tube had gone to the right instead of center. She told me to give it a few minutes and just see, but as my right side grew increasingly numb and my left side stayed the same, I knew it was not working as planned. I finally convinced her to retry, and the second time it worked better, although still not affecting my left side as much as right. They got me positioned on my left in hopes of encouraging the medicine to spread that way, and Nathan and Jerri-Anne came back in, followed soon by Meg ready to check on my progress. I told her surely, this time I would be a 12, but once again, not the case. She told me I was still a 1-2, but then she did some serious manipulation of my cervix and finally said "there, now you're a 4--I just broke up all that scar tissue and I think now you'll be on your way quickly".

I was disappointed to still be so far from complete, as I had really thought that I would be closer. Looking back, I do think that I was in transition, but that my cervix was just stuck and unable to join the rest of my body, I was much more relaxed though and able to talk and rest and text updates to friends and family for the next hour or so. Michele told me that in NY, where she was from, VBACs did not exist and that it had been a surprise to her when she moved to NC and began working. She told me that up until a couple years ago, a patient like me would have terrified her, but that she was coming around to the idea of it more and more. Meg checked again and I was a 6, My pain started to creep back in on my left side in one spot, and over the next couple of hours intensified until once again, I was in a great deal of pain and struggling to cope with the contractions. I was checked again around 6:30pm and found to be complete and that baby was very low, but I was feeling no desire to push at all, so she agreed I could wait a bit and labor down and try to push when it felt right.

I was very nervous about pushing, as I felt like I had learned and prepared a lot for the rest of labor, but not at all for this part. Jerri-Anne asked me what I was feeling and I just told her I was nervous, not ready, didn't think I could do it yet. I had heard and read so much about the instinctive urge to push, and breathing the baby out instead of coached pushing, so I thought and hoped if I just waited for that, it would happen easily...

After about two hours, Jerri-Anne started trying to convince me to at least do some bearing down and see what happened. Nathan told me later that my temperature was starting to go up and he and Jerri-Anne could see the nurses exchanging looks that said they were getting antsy, so Jerri-Anne was afraid they were going to put me on the clock and begin pushing interventions if I didn't get started. I was feeling so tired and almost like I could just fall asleep between contractions if everyone would just leave me alone--I really wanted to just retreat inside myself and tune everything out, but Jerri-Anne kept telling me to try, so I did. I realized soon that not only did I not feel any urge to push, I also could not feel anything happen when I tried to tell my muscles to do so. I asked to try getting on my knees facing the raised head of the bed, and was able to move my legs well enough to get there, but attempts to push that way were still completely unsuccessful.

My pain in the one spot on my left side was becoming unbearable, and I was getting frustrated that I couldn't figure out how to even begin to push. I asked for the anesthesiologist to come try to fix my epidural to see if it would get rid of that pain, but she was unable to do anything about it, much to my dismay. Michele had been replaced by Lesley, who was nice, but less personable, but who wanted to help get pushing going at this point as well. At this point, my heart rate had crept up into the 150s-160s, higher than baby's, and Lesley felt that it was hard to discern on the monitor whose heartbeat was whose, so she insisted on an internal monitor on baby girl's scalp. I had felt strongly that I would not want that to happen except in case of emergency, but at this point didn't have the energy to fight it and just let it happen, knowing it wouldn't be for long. I was feeling pretty awful and sweaty and flushed from having my heart rate so high for so long, so we got out some Ylang Ylang oil and rubbed it on my heart, and thankfully it worked quickly to lower me back down into the 120's-130's.

I got back on my left side and Lesley started talking me through a few contractions to encourage me to push, and I did my best to listen, but still couldn't feel anything at all happening when I tried to push out her fingers, so even though occasionally she and Jerri-Anne would tell me I was doing it right and to keep going the same way, I had no idea what was different and couldn't feel any change, which made me really frustrated. I had a good cry for a minute at one point, and then pulled it back together and decided I had to figure out a way to do it. Nathan was on my left side, and rubbed some Peppermint oil under my nose to help me breathe after I had gotten totally stuffed up from crying, Jerri-Anne was on my right continuing to coach me through each contraction and try to find something that would click.

Finally, even though it didn't feel like I was doing anything right, baby girl's head moved down into sight and Jerri-Anne asked for a mirror so that I could see and hopefully better engage the right muscles that way. I could barely see what they were seeing, so it was much less motivating than I expected. Contractions had spaced out to every 6-8 minutes which was infuriating as I held my right leg up in the air, people surrounding me waiting for the next chance to coach me on... I tried to focus on the song I had planned for months to use during labor to help me stay calm, but found I couldn't get through the second line. Mostly I just stared at the mirror, not entirely happy with how things looked, but glad at least to see that it didn't seem like I was going to poop while pushing, something I had tried to get over fearing but failed.
 Holding my breath long enough to get more than two pushes per contraction was nearly impossible, and I was frustrated when everyone kept telling me to keep going, push again, don't let it out...and I just could. not. do it. I let myself get a little angry off and on, and tried to use it constructively, and then alternated praying and asking for help, pleading for the strength to get through what seemed so impossible at that point.

I kept watching the clock, wondering if I would get her out before midnight, my due date. Every time I looked up, it seemed time was going more and more slowly and I felt like I had been pushing for so long without progress. Finally though, I began to see a little more of her head with each contraction, which finally got me feeling a little more encouraged that I was doing it and COULD do it. Meg started hanging close by, and I knew that once they took out my catheter and called for the NICU team it would mean it was really close, so every contraction I wished for Lesley to say those things. Finally! She said she was going to take the catheter out. I was excited. I still wasn't feeling a lot of sensation that was helpful for pushing, and still feeling a lot of pain, but had figured out how to make my body do what it needed to push effectively. My left eyeball felt like it was going to pop out of my head with each push and was often the thing that made me let up when everyone kept telling me to keep going longer. I told myself surely it wouldn't actually pop out, and tried to ignore it, but the feeling was so intense and impossible to ignore.

Around 10:45pm, I could see almost her entire head, and could see that I was on the verge of tearing. I was focusing very hard on not letting her slip back up in between contractions, and waiting impatiently through the long break between them. I knew it was really time, and finally, Lesley called for the NICU team to head in and get in place. I pushed four times the next contraction--my best pushes yet, and saw even more of her head. It seemed impossible that she wasn't out yet, but I knew the next contraction was IT. Meg told me she wanted me to push her whole body out and not just her head, so when the next contraction came, I gave it every bit of energy that I had, and watched as my baby girl came FLYING out, crying immediately and therefore able to come straight up onto my chest. I instantly felt an intense flood of emotions as I looked at her, and felt the relief that I was done, I had done it, and this was finally the moment I had always wanted. She was big, beautiful, alert, and the feeling of having her in my arms right then was the most incredible thing I had ever experienced. I cried and laughed and looked around in amazement as we dried her off and inspected her, Nathan crying and laughing on my left, and Jerri-Anne on my right. It was 10:57pm, a whole hour and three minutes to spare before her due date.

I got my wishes of letting her cord stop pulsing before clamping it, and then since Nathan didn't want to cut the cord, I asked if I could and happily did--something I had looked forward to for months. Meg informed me that she was delivering the placenta and then pretty immediately needed to get started stitching my tear to try to stop some of the bleeding. I was already nursing happily and didn't mind most of the stitching, but it ended up taking about 90 minutes and towards the end was pretty uncomfortable. I had asked to see my placenta before they took it away, but somewhere in the midst of all the clean up, Lesley knocked it off the bed and it fell on the floor, so I never did get to inspect it.

Baby girl got taken briefly from my arms to get a diaper and weigh in, 8lbs 9oz and 20.5 inches--a good bit bigger than my other girls who were 3lbz 9oz and 7lbs 4oz! We still were undecided on her name for the next few hours, but once we were settled and resting, Jerri-Anne hugged us and congratulated us and headed home, and we got moved over to our post-partum room (after I very nearly passed out in the bathroom), and settled in there for the rest of the night. Somewhere close to morning I finally decided that her name was Rowan Amelia, one of the two names we had been stuck between for several weeks.

Recovery was a bit tougher than I had anticipated, though in many ways better than a c-section. Because of the significant tearing and stitching that I had, I was still in a good bit of pain and had trouble getting up and down from the bed. I also had a very hard time emptying my bladder for the first day and had to be re-catheterized (by a nursing student doing the procedure for her first time, eek!) in order to get relief from a bladder that I felt sure was going to burst any minute. Nursing got off to a good start, and Rowan and I enjoyed snuggling and nursing constantly throughout the rest of our stay and in the early days at home.

I am so very thankful that I found a hospital and midwives open to letting me have the birth I wanted, and that throughout my labor nobody talked about the possibility of a c-section, or made me feel pressured or rushed. I'm thankful for my husband and Jerri-Anne providing wonderful support and encouragement throughout the process, and that everything happened that needed to in order for my delivery to happen. Though most of my birth plan went out the window, I am still very happy with the way things went and know that I worked very hard to experience the hardest, strangest, most intense, and most amazing thing I could have ever imagined. I can't wait to try again and do it even better next time. I definitely think because of the scar tissue making my cervix unable to dilate as my labor got so intense, that I needed the epidural to make it through, but that it also made pushing and recovery a lot harder. I think that next time, without that factor, I am likely looking at a pretty quick labor, and hope that I can give it another shot at no meds.

Thursday, August 1, 2013

Ella Bella Bo Bella

Guess I took a pretty long blog-vacation, huh? Life has been busy and exhausting and honestly not all that exciting to write about, so I've been doing other super important things. Like watching all the seasons of Dawson's Creek on Netflix. And you know, dishes and laundry and stuff. But, anyway, we're alive and well and so very close to being reunited with the man in our lives, so we are excited about getting this month done so that September can bring him home to us!

I've had a lot of people asking questions about what's going on with Ella, since they've seen me post about her reflux, feeding therapy, I thought it would be easier to write it all out and explain what we've been dealing with for the past few months.

At birth, she was alert, hungry, and impatient for milk. Once my milk came in, we experienced a pretty blissful first couple of weeks, and I was quickly fooled into thinking I had a super easy baby and it was going to be way less difficult to adjust than I thought. But, starting around two weeks, things got complicated. Every late afternoon/evening, when I would try to feed Ella, she would pull away and cry and refuse to eat after a minute or two. It usually lasted for a few hours each day where I couldn't get her to nurse, but throughout the night and daytime until then, she was totally content and a great eater. I was perplexed.
Eventually, it started to affect more and more of her feedings, until we got to a couple of days where she was refusing every feeding and I was fighting to get her to eat a little here and there. It was SO frustrating to not be able to nurse her to comfort her, put her to sleep, I was at a total loss. I suspected reflux, and asked her doctor about trying meds, but he didn't want to put her on anything while she was so young, and he talked me out of that idea.

I got a lactation consultant to work with us and verify that I wasn't missing anything with her latch or my behavior, and she reaffirmed that I was doing everything right, and Ella appeared to have a classic case of silent reflux, which was causing her to associate eating with pain, and therefore refuse to eat. She encouraged me to get her on meds ASAP before the problem got any worse and affected Ella's growth. So, I called the doctor back, told him I definitely wanted the meds, and he agreed and we started on Zantac.

I gave it almost two weeks, and saw no improvement. If anything, she seemed worse in the hours directly after her dose. So I stopped that and asked to try the next option (many babies with refux need to try a few options to find the right one, and the right dose, so I expected that might happen). He offered Prilosec next, and at the same time, I opted to try chiropractic care to see if that might help. We started going 2-3 times per week for adjustments, and after the first two, I started to see improvements. I ended up not starting the new med, and continued with adjustments for several weeks with good results...finally we had some relief.

After a few weeks, her progress plateaued, and her feedings were still a struggle. A friend told me about her experience with her son, and his symptoms sounded SO similar to Ella's. She told me they got evaluated and did therapy for feeding issues, and recommended I get a consult with their former therapist. So, we did, and the evaluation showed that Ella definitely had major reflux going on, had a very strong gag reflex, had a poor coordination of her suck/swallow/breathe pattern, and had a lot of sensory aversion with her mouth/tongue. They recommended we get her on Prevacid and start therapy immediately.

So, that was our next step. We started working on a few things to help her with breastfeeding, and got her on the Prevacid to help control the reflux, and after a few weeks, things improved. It was a process filled with ups and downs...many times she would do great at one session, and awful the next, so we were constantly trying new things and working through new challenges. Slowly, feeding got better and better, and I finally felt like we were being successful.

Her therapist started mentioning solids pretty early in the process, which worried me. I am 100% a believer in waiting until 6 months to start solids, so I was fairly adamant that we hold off until then. At 5 months, Ella was sitting easily without assistance, picking up small objects, turning her head to say no...meeting all the criteria except age. Because we knew it would take a while to get her to be successful with solids, I decided to get started with the process a couple weeks early, and we switched the focus of her sessions to that goal.

Ella very quickly let me know it was going to be harder than I  had imagined to get her to eat. She did her best to refuse any attempt to put food into her mouth, and when I did manage to get a bite inside, she gagged, shuddered, coughed, made faces...definitely made her feelings known. Her therapist gave me tools and strategies, and we practiced, or rather tried, whenever we could. 

At her 6 month well-check (with the third doctor's office we tried, since we had not gotten great support or help from the first two), we met a new doctor who came in the room with a growth chart in her hands and a frown on her face. Her first words to me were "I am very concerned about Ella's growth."
I listened to her concerns, but really wasn't too worried at that point. I knew Ella's weight gain had slowed a lot, but I thought that was fairly reasonable considering what she'd been working through, and the fact that she was super active. I felt that the doctor looked at the growth charts before looking at Ella and assessing her overall health, and that seemed unfair to me. So, I took it in stride and without being overly concerned, decided to just keep an eye on things until her weight check, six weeks from then. I also agreed to make an appointment with a GI specialist, because I figured it couldn't hurt to make sure her reflux was under control.

Shortly after that, things started to regress a bit with breastfeeding. More fussing during feeds, more signs of reflux, worsening sleep habits, and the poop issue. Forgot to mention that part earlier. At some point around 3-4 months, Ella stopped pooping regularly. She went 4 days, then 7, then 10, then 16. I got mixed opinions...some people were horrified and thought that was VERY concerning, while others said for a breastfed baby it can be normal to go...a while. Nobody quite knew when "a while" becomes too long, but everyone had the same conclusion about one thing--when she did poop, it would be a HUGE mess. Except it wasn't. She finally went on day 16, and it was nowhere near the huge mess I was prepared that was odd. But, she went more regularly again after that...for a while.

So, back to 7ish months. Things were getting worse, and poop issues too. I began to get worried that she wasn't pooping because there wasn't any poop--she was holding on to every bit of milk she got because she desperately needed all of it. She made it 17 days this time, and yet again, no huge mess. I also started to notice she was getting thinner and not growing out of clothes or diapers...and I began to be a little worried. The GI specialist hadn't been able to get us scheduled until late August, so I started to get antsy wondering if there was more that could be done in the meantime.

I moved up her weight check with her pediatrician, in hopes that it would put my mind at ease and be no big deal, but it ended up being a bigger deal than expected. In almost 6 weeks, she didn't gain a single ounce. She also barely grew in height or head circumference, bringing her weight and head into less than the 5th percentile, and her height into the 25th, which is concerning since she started in the 90th for that. The lack of weight gain alone wouldn't be terribly concerning if she was growing otherwise, but the overall lack of growth made her doctor a bit more worried. So, they did blood work, tested her urine and stool, asked me a billion questions about everything, and are planning to get a barium swallow study and move her GI appointment up sooner if possible. We left the office with an official label of "failure to thrive". 

The good news is, Ella is meeting milestones like crazy, and appears healthy--bright eyes, healthy skin, big smiles. The bad news, is that she's not getting adequately nourished, and if this continues/worsens, it could affect her neurological development over time. So, we want to get things under control sooner rather than later.

For now, the goals I have, are to focus on upping my milk supply and pushing her to take more breastmilk--by offering more often, feeding without distractions around her, and being more mindful of her behavior during feeds so I can keep her going longer. I'm also going to work harder at offering high-calorie, nutrient-dense solids more frequently, and adding things like olive or coconut oil to boost the calories in other foods. Hopefully we can get the GI appointment to happen soon and rule out any structural abnormalities, and figure out if more measures can be taken to help with her reflux, or anything else they can recommend. We'll also be going for weekly growth checks to monitor her progress.

I'm not super stressed about it...I know she is definitely still "okay" and not in major trouble for now, but I want to be proactive in getting this managed so that we don't slip farther into this problem. Failure to Thrive has a big spectrum of severity--many kids get that label and it doesn't take much at all to get back on track and catch up, others take a lot more work, and for the most severe, it can cause major health and developmental problems and require hospitalization and drastic measures. So I'd rather not get past this early phase!

So, prayers are appreciated as I sift through information and advice and figure out what to do first and all that good stuff. Pray for rest--she's waking up a few times each night to eat, which I can't put a stop to when she needs those calories so much. Pray for wisdom for me, and for her doctors. Pray for time to fly by as we wait for Nathan to get home to walk through this with me!

Sunday, May 5, 2013

Playing catch-up

So, I have to admit I have fallen way behind on blogging. Mostly due to the fact that I started watching Grey's Anatomy on Netflix. And COULD NOT stop. Until it ended, and now I'm not sure what to do with myself anymore.

So, I have some upcoming posts planned, but for now I think I'll just catch-up and recap what we've been up to lately.

Nathan has been doing well in Egypt. Mostly he's a little bored and burnt out of playing Army man now, and not too excited about the 100+ degree temps that have settled in, but I don't feel TOO sorry for him since he posts pictures on Facebook like this:
Sure, my poor Irishman ended up with a blistering sunburn, but still...that's not exactly the hard-knock life. Hopefully he can make it through another four months of rising temperatures and come back just in time for his favorite season in NC.
We haven't gotten to talk much at all lately...our schedules make it hard and it seems like he always pops online right as we're about to get settled in for naps. We're trying to make it work, and even Skype dates that mostly revolve around me changing diapers and disciplining the whole time are worth it to see and hear each other.

Adelyn is rocking the terrible two's--tantrums galore. When she's not shrieking until she can't breathe, she's sweet as pie and loves to snuggle and sing and tell me a million things that are constantly on her mind. Her vocabulary continues to explode and she constantly amazes me by the new ways she can communicate. She was having a rough time with back to back ear infections, but after weekly adjustments by our awesome chiropractor, she has gone about six weeks without one now, and hopefully that means the warm weather will keep them away and she'll outgrow the tendency by fall/winter. I know tubes are pretty easy and can be a solution, but I'd rather avoid it if we can stick with the natural route instead.

Ella is about to be five months old, and time is just flying by! We have been battling severe reflux since she was two weeks old, and it has been a rough few months, but finally we are seeing a lot of victories. She's been on Prevacid for about six weeks now and I am hoping in a couple more weeks to start getting her off of that. She's also been getting adjusted at the chiropractor frequently, and seeing a feeding therapist weekly for several weeks. Last week she was doing so well that her therapist wanted to videotape us to use for teaching purposes, but once Ella saw the camera, she just started smiling and being cute and wouldn't eat anymore. That's pretty typical of her personality--she's a smiley, sweet, snuggly baby who makes friends everywhere she goes. If she could just learn to sleep at night, she'd be pretty much perfect. For now, she's still up every 2-3 hours, and I'm struggling a bit with direction on all of that. I have some ideas, and am just trying to figure out where to start and what to do first.
She has a tooth now--got her first one in at 19 weeks, exactly like Adelyn. She's also a champion roller, and is trying very hard to get moving on her belly--I think scooting is in our very near future.

Not much new about me. Now that we're all well, I feel like I have a little more of a handle on things than I did for a while there. With at least one, if not all of us sick for about 9 weeks straight, it felt like I just couldn't get my head above water. Now we're seeing the other side and it's a great relief for this weary momma.
I spent the last couple of months raising money for a walkathon to benefit our local crisis pregnancy center, and it was really exciting to raise over $1000 and then attend the event where we celebrated $150,000 raised for such a great cause. We got to try out our new stroller:

I think the girls are going to love that this spring/summer. I saved for it for a while, and hope to get a lot of good use out of it. Now on to saving for Ella's big-girl car seat!
I've joined a Bunco group with some of my mommy friends, and we play one Saturday night a month, rotating through different houses. It's a nice chance to get out without kids briefly. I'm not really interested in leaving the girls for longer than crazy as it is when I'm exhausted and they make me crazy sometimes, I really hate to be away from them! Short breaks here and there are nice, but that's about all I want.

That's about it for what's going on around here. We're glad it's spring (even though it has been kind of up and down with the weather lately), and we're trying to get out and enjoy nice days, make playdates when we can, and just cross off one day at a time until our favorite man gets home. We've made it more than halfway now, and that feels so good!

Saturday, March 9, 2013

Two years

It has flown by. Two years since I waited anxiously on the operating table to meet my baby girl. Two years since I heard that first little tiny cry that proved she was alive and breathing and okay. Two years since I fell in love with her at first sight.

In two years, she has gained 20 pounds, 20 teeth, and 17 inches. She has learned hundreds of words and can put them into two and three word sentences. She can count "one, two, three, four, five, six, nine, ten!" and say most of her letters. She knows all of the important colors, tons of animals and their sounds, all the words to the Blue's Clues theme song...and so much more. She knows how to be funny. She is shy, sweet, spunky, silly, stubborn, and so smart. She is finally becoming friends with other kids and learning to play and share and interact.

She is my big girl now, because she is the big sister. She is helpful, caring, curious, and funny. She loves to kiss Ella, give her blankets and pacis, rock her, and play with her. She watches all of the things I do with Ella and recreates them with her baby dolls and stuffed animals. She is rarely jealous, and is showing signs of being a great sister and friend to Ella.

She loves books--right now her favorites are Chicka Chicka Boom Boom, Ten Little Ladybugs, The Busy Little Spider, Brown Bear Brown Bear, and Dr. Seuss's ABCs. She loves to color, play tea party, build blocks, and push her baby in the stroller. She loves Curious George and Blue's Clues on Netflix...a little too much sometimes. Her favorite foods are pizza, chicken, sweet potatoes, broccoli trees, milk, and anything sweet. She loves baths, brushing her teeth, and going potty and getting applause and high-fives when she does a good job. She loves to play ball, slide, and jump on the trampoline outside.

She has grown and learned so much lately, and she keeps me laughing every day. She is exhausting and frustrating at times, but more than makes up for that when she's sweet and funny. I am loving getting to see more and more of her personality as she grows, and while I am sad to see her little years flying by, I am so excited to watch her grow into the precious big girl that she is becoming.

Happy birthday to my precious Adelyn Piper. I love you SO BIG.

Thursday, January 24, 2013

Chili weather

I've been meaning to post my chili recipe for a while now but haven't gotten around to it. In light of the arctic air that has blown in this week, I made a batch for a friend and got great feedback, so I promised her the recipe and figured why type it twice? Now you all can enjoy it. The recipe used to be my Nana's, then with a few modifications became my mom's, and now I've made it my own. All three taste great to me. Mine is different because it uses shredded chicken, but it isn't a white chili like most chicken chilis are. Try it and let me know what you think!
                                               (photo courtesy Caroline Frye, who loved my recipe!)

Nana's chili 3.0
4 boneless skinless chicken breasts (Nana used ground beef, Mom uses ground turkey)
2 Tablespoons olive oil (the recipe card says shortening, but who the heck uses that? I guess Nana did...)
2 Cups chopped onion (I use one--I'm not a huge onion fan)
2 Cloves garlic (we usually use 4-6...)
3 Tablespoons chili powder
1/2 teaspoon cayenne pepper
1 teaspoon salt
1 teaspoon paprika
1 teaspoon oregano
1 teaspoon cumin
1/2 cup chicken broth (the recipe says beef stock, but since we make it with chicken, we use chicken broth)
2 cans mild or original Rotel (the recipe calls for 28oz can of crushed tomatoes, but Rotel is more fun)
2 cans dark red kidney beans (the recipe calls for pinto--we have used those at times, but usually go with kidney)

I start with some olive oil in the bottom of my pot, add the onions and garlic, and stir until they are hot and slightly wilted. Then I add the chicken breasts whole (you can chop them up first, but I don't touch raw meat unless absolutely necessary) and the chicken broth, and bring that to a boil. While it's boiling, I add the spices, then drain and rinse the beans (you get rid of a lot of the excess sodium that way), and add in the beans and Rotel. Reduce to a simmer and cover. Stir occasionally, and once the chicken starts to fall apart, shred it and let it continue cooking as long as you want...we usually try for ALL day.

We serve it with cheddar cheese and Fritos, and I think a glass of sweet tea makes it complete.

Friday, December 28, 2012

Life with two littles

They're both asleep. Phew. Conventional wisdom says "hurry, run, sleep while they sleep!" and that's very good advice at times, but right now I am relishing having both of my arms free, and being able to sit and not bounce/jiggle/sway/rock. The house is dark and quiet...Ella is a few feet away sleeping in her Rock 'n Play sleeper--making little squeaks and grunts here and there, but mostly it's quiet. I managed to Swiffer my floors while holding her and that put her to sleep, and then I got the dishes unloaded, pumped a few ounces of milk, and now I sit...ah.

We're three weeks in to life with two littles, and it's been tough. Everything about it has been harder than I expected--from the recovery, the sleeplessness, the fussy-I don't know what to do with this baby-ness, to the loneliness of not having my favorite person to share it all with. Nothing can prepare you for how tired you become when you're not just AWAKE all night and day, but you're also caring for a little person (or two), worrying over their every sound and movement, and just so tense! Experience helps a tad, but it's definitely not simpler this time around.

It's beautiful though. Do I have to remind myself of that, constantly? Yes. But, it truly is a wonderful thing to watch not just one, but two beautiful little people grow and learn and experience the world. Watching them together is so sweet, and I have so many exciting plans for when they are bigger and can play together, share things, and really be companions. For now, there's a lot of "Don't touch her, she's sleeping!" being said, but the sweet moments are definitely there.

People have asked how Ella is sleeping--well, the answer is: "like a baby". Like a newborn baby who has no idea how to sleep. She has had a few four-ish hour stretches in the three weeks she's been in the world, but mostly it's a lot less at a time. She is very restless, still needs to eat often, and poops constantly, which is a bit of a sleep disrupter. How often is she eating is another thing I get asked a lot, and honestly, I have no idea. I committed to not watching the clock for the first four weeks. I feed her when she fusses, when she grunts, when she looks at me, when she flaps her arms...all the time. She eats a lot. It's exhausting, but I am establishing a great milk supply, and more importantly, a great bond. She is growing and thriving and that's all that matters for now. Schedules and patterns and some sort of sanity will come soon enough, I suppose.

Adelyn is doing better with the transition, but still struggling some. She has more separation anxiety than before, is more wary of other people coming around, and is asking for more attention to compensate for the time that I'm busy with Ella. It doesn't help that those pesky two-year molars are still bothering her, so it's obvious at times that she hurts and needs extra comfort for that as well.
She has been really interested in "helping" with Ella, and while it requires constant alertness and a lot of redirecting on my part, ultimately it's really sweet and shows a great sign that she is a nurturer. Gentleness and quietness aren't always her forte, but she means well.

We're getting by, day by day. We have had some great friends bring meals, come to lend an extra hand or two, and encourage me that I'm really doing okay, even when I feel completely in over my head. Family was exhausting and overwhelming on the days of celebrating Christmas, but I just had to remind myself that we are so blessed to be exhausted and overwhelmed by all of their love and care and nearness. If they would just not kiss my newborn on the face, life would be peachy. Did I mention there's a major flu outbreak? And stomach bug? And RSV? And Whooping Cough? Oh my. It's everywhere, and SO many people in our lives have had these things. We are so glad to be avoiding it so far, but it makes me cringe every time a visitor coughs, or tells me they have just gotten over being sick, or feel like they might be coming down with it...ah! It's hard to say no to people who want to hold and kiss and love on my girls, but any of the three of us getting sick would totally turn our world upside down, and it's precarious enough as it is.

So, we stay home a lot. If we do go out, it's a juggling act and I'm pretty proud of myself if I get everyone out the door with all the necessary clothes on. I'm usually the one missing a jacket or socks, but I still count it a victory. Baby-wearing is a great help, and will definitely be the only way I ever get both girls out to the mall, or Target. Plus, Ella looks so darn cute peeking out of my K'Tan:

Sometimes, we just go old home. In the midst of loneliness and chaos and doubt about myself as a mother, sometimes I just need my own to help me get through the day. 

And now that I HAVE gotten through this day, I am going to go enjoy a few more minutes of quiet, with a glass of wine and a grateful heart. I'm sure someone will be awake soon.

Friday, December 14, 2012

The birth of Ella

     Thursday night, it was time to get ready for baby day. I took Adelyn to my parents' house and had dinner with them, and even though I tried to get emotional and hug my baby girl a little tighter than usual, she was ready to go and have fun and quickly wiggled out of my arms and off to play. I cried a little on my way to Small Group, where I had a few wonderful hours of encouragement, prayer over my upcoming day, and fellowship with my wonderful friends. I got home later than planned, but set in to the final nesting--finishing my batch of chili for the freezer, cleaning everything, and getting the bags unpacked and repacked just right.

     I took my sleepy medicine, and got in bed for one last sleep. I managed to sleep until 2am, then dozed off and on until 4 when I finally had to get up and moving. I decided to give myself the pedicure I'd be wanting, and it was not a simple task at 40 weeks pregnant, but I think I did okay.
I then took a long hot shower, shaved very carefully since I knew it would be the last time for a while, and prayed over the day ahead. I took some final 40 week pictures for Nathan and the rest of the world, and tried to wait patiently for it to be 7:30 and time to go.
     Mom picked me up and we headed to the hospital, arrived a little early, but got checked in and headed upstairs by 8:30. The nurse who was waiting for me was one of my classmates from nursing school, so that was fun to reunite after three years, and to know I was in good hands. She started the monitoring, asked me tons of questions, and told me what to expect from the upcoming hours. She and two other nurses battled my tricky veins before finally getting a good one, and then we waited. We were told that we were getting bumped back from our 10:30 slot because of an emergency, and that there was a good chance of being bumped again because of another. I was really hungry since I hadn't eaten after midnight, and I was contracting and uncomfortable, but Mom and I did our best to pass the time.
     Finally, we were told the it looked like we should be rolling by 1pm, and my doctor came in to let us know she was ready and waiting for the word. A cRNA came in soon after 1, and began getting my history and checking me to be ready for anesthesia, and then we were ready to go! I walked over to the OR with the cRNA and my nurse, and they got me seated on the table for my spinal to be placed. The anesthesiologist was very nice, and I was told he was the best one, so I was happy to be in good hands. He took two attempts to get in the space between my vertebrae, and it was a bit uncomfortable for a few minutes, but nothing awful. He said my scoliosis is definitely still noticeable and made his job a little tricky. But, soon enough, the cold numbness was spreading down my left leg and up through my back. Finally it hit my right side too, and I was laid back on the table to finish getting prepped. 
     I was surprised by just how long I was left completely naked from the ribcage down while people went about their business getting things ready. It helped a little that I was numb, but it was slightly awkward to just be exposed like that, even though to everyone else in the room it was probably not even noticed. Finally, they got my catheter in and my belly scrubbed, and then draped me and got warm blankets for my upper body. While this was happening, a different cRNA came in and started talking to me, and when he heard about Nathan being deployed, he asked if we had Skype. I told him yes, that we were hoping as soon as I got to recovery or my room that we could connect and let him see our baby, and then he surprised me by saying it would be totally fine if I wanted  to Skype DURING surgery and let Nathan watch everything.
My mom was still outside the OR, and she had my phone, so I was dying for her to get brought in so we could get Nathan connected. 
     My doctor had come in and gotten set up on the other side of the drape, and when I looked up, I saw that I had a great view of the surgical field in the reflection of the light above me. I was surprised to see blood already, because nobody had told me they were making the incision. My mom came in just after that (also surprised to see blood when she hadn't even gotten to her seat yet), and I quickly told her to start telling Nathan to get on Skype! She couldn't figure out how, so I ended up getting on Facebook chat and Skype and telling him to hurry and call us. Yes, while I was being operated on. Weird world we live in, isn't it?
Just then, I heard someone say "here comes her butt" and I looked up and saw my baby girl being lifted, butt and back first, out of my belly. They pulled her upright and I was amazed to see a head covered in dark hair--totally not what I had expected!

     They held her up briefly for us to see her face, and I definitely teared up with the crazy emotional flood that comes with seeing your baby for the first time. She was so different than I had pictured, and so beautiful and perfect. It was amazing. Just after that, Nathan finally connected with us, and Mom was able to take the phone over to where Ella was getting cleaned up. He got to see her as they weighed her (7lbs, 4oz) and got her swaddled and ready to be held. Mom brought the phone back to me and I spent a minute talking to Nathan and marveling over our beautiful girl, then told him I'd call him once we were out and recovered.
Mom got to bring Ella over to sit beside me, and I started to feel really uncomfortable. Right after she was pulled out, a rush of gas pain hit my shoulders, and I felt nauseous and had a lot of pressure in my head and chest. The cRNA offered me some IV medication to help me relax, but I declined so that I'd be alert and able to hold Ella as soon as I could.
     A few minutes later, they finished closing me up, and we were taken down the hall to recovery. As soon as we got there, Mom put Ella on my chest and I let her start breastfeeding--she had been rooting around and gnawing on her fists since the moment she came out! She latched right away and I was amazed by her being in my arms, mine at was breathtaking.
     I relinquished her after half an hour or so to the "stork nurse" who came to assess her and measure her length (21 inches!), but got her back as soon as I could. She looked perfect and my assessment looked good as well, so we got to head to our room pretty soon.
     My recovery was tough the first couple of days--doing it alone at the hospital is not something I'd recommend after trying it myself, but thankfully my nurses were great  and encouraged me and kept me company as much as possible. Ella was starving and very angry until my milk came in on day two, but since  then has been so content and wonderful. She lost 9% of her birth-weight those first few days, down to 6lbs 10oz, but I knew once my milk was in that she was feeding great and would gain again in no time.We were released Monday, and since then she has been a beautiful addition to our little world. She is so sweet and content as long as she's fed, and while I am exhausted and sore, I am recovering very well.

     I can't wait for the lifetime ahead of this sweet little one--Ella Kathryn Timberlake is already stealing my heart every time I look at her. I am so thankful for 40 weeks of pregnancy, and a healthy girl who is thriving and well. God has been so good to us!