November 30, 2007

A Day in the Life

Can you believe it's the four week birthday already? Here's how we got there...

6am - I hear Pip stirring in the bassinet next to my bed. She's not crying yet but we've been asleep since 1am so she's definitely up for her feeding. I take the opportunity to go pee alone before picking her up. As soon as she starts nursing there's a series of farts without any screaming at all, and by 6:30 she's done the first side and passing out. Breast feeding has definitely gotten MUCH better! A diaper change wakes her up enough to finish the other side and we're back in bed around 7:00.

I know this may be controversial, but at this point I put her in our bed with me. The reason is pure laziness. If I put her down in the bassinet she has to be totally sound asleep or she'll cry until I pick her up and she's too young still for the "cry it out" sleep training. If I put her in bed next to me we get to fall asleep together with no crying.

10am - She's stirring again and this time we're awake for good, for a total of close to 8 hours sleep - not bad. She's a little fussy but latches right on and nurses until the poop explosion (they no longer happen at every feed). She tenaciously keeps latching on and trying to nurse, but she's dropping latch and wrenching up her little face into a very unhappy shriek, so I think it must be her belly and give her some Mylicon drops. Seems to do the trick. With all the fussing it takes almost an hour to get through with one side before the diaper change. Hiccups mean we're in the home stretch though. By 11:30 we're done.

Meanwhile J has made us breakfast and brings it to me in the chair. When I say the constant feeding isn't so bad, a huge part of it is that my college student husband is around to help out in so many ways. The division of labor isn't actually all that different than it's been since he quit working two years ago to finish his degree, we've just both got this new element. So many women do all of this alone at this point, and I shudder to think of how anyone manages while caring for older siblings.

Noon - I put the sleeping baby in the Pack N Play and sneak off to run some errands.

2pm - I get back to find Pip's been awake since 1pm when she woke up with a wet diaper. J changed her and played with her and she was just running out of patience when I got back. I feed her while I eat my lunch. Afterwards we weigh her - I can't believe she's up to 7 pounds!!

3:30pm - She's fallen asleep in my arms. It takes a while for her to go soundly to sleep, but then she's back in the Pack N Play. I start addressing birth announcements while she sleeps.

4:40pm - Tiny cries from the Pack N Play. In the last week or so Pip has decided to become a dainty little girl and cry whenever she has a wet diaper. Easily solved, but a pain having to nurse her back to sleep an hour after almost every feed. J changes her diaper but she's still shrieking.

5pm - Mylicon drops to the rescue and she's back on the boob. Within 15 minutes she's fallen asleep on me again. She's rooting around with her mouth in her sleep so I wake her up and get her to latch back on. She's fussy but hse's back on soon enough. Then a big belch does the trick.

5:30pm - She's back to sleep and putting out some loud farts. Jay's making dinner. I actually get to eat with my arms free tonight while she lays in the bassinet! As soon as I put my fork down she's crying though, wanting to be held. In minutes she's passed out in my arms and she sleeps on me while I catch up on all your blogs.

7:30pm - Furious screaming precedes diaper change and a particularly trying feed, wherein she yanks my nipple all over the place as she squirms around, apparently in pain. That makes two of us. After burping her she settles (sort of) into more productive nursing, with only occasional cries on her part and a bit less pain for me. Her tenacity and determination is very endearing. Its a very basic problem: she needs to eat to survive. She works very hard at it despite the fact that it hurts. Looking at it as something we're both working toward together helps me through it.

8:30pm - Has it really only been an hour? It feels like much longer. I'm exhausted and she's nearly asleep when we have a pee overflow. She's starting to outgrow preemie size diapers. A quick diaper change and back to the boob.

9pm - Sweet Jesus she's sleeping. I make the handoff to J and give my arms a rest.

9:30pm - Why is she chirping already? J is instructed not to so much as look at her. Thankfully she stays asleep.

10pm - J tries putting her down but it doesn't take; she wants to be held. Back on the boob. She latches fine but she's so tired and keeps falling asleep. If I feed her later it means we probably only get up once in the night instead of twice, so I snuggle her up to me and let her sleep while I rest too and watch TV.

11:30pm - 1:30am - Our last feeding before bed. It takes a long time before she's ready to drift off to sleep, but then she stays asleep until 5am.

In 24 hours, I got 8 hours of sleep and spent 8 hours nursing. What happened to those other 8 hours, I don't remember doing anything else?? At least I did get the birth announcements done. Maybe tomorrow I'll make room for a shower!

November 27, 2007

Shopping


First I want to pass along this fantastic idea from the Queen of fantastic ideas, Mel: Click here to shop for all sorts of cool things which will help fund other infertiles' journey to parenthood.

This rest of this post will be particularly annoying for those at that certain point in the cycle when you just can't stand to see a pregnant woman or pass by a baby boutique, but I feel compelled to give a shout out to this fabulous vendor of great baby stuff: Babysakes.com

A while ago I fell in love with a beautiful, award-winning baby book, but it was too early in the pregnancy for me to feel bold enough to buy it (i.e. anytime before 34 weeks). Then I was on bed rest and found myself pining for it but couldn't get to the store, and once I finally was able to get out it had sold out not to be restocked. After searching everywhere and hours of googling, I found the perfect cover design (pictured above) on the manufacturer's website, but couldn't find the book anywhere. Finally I asked the wonderful people at Babysakes if they could get it with this cover and they've decided to stock it, so now it's been added to their online store. AND at a better price than I've seen anywhere. You can see it and loads of other great designs here. Be sure to check out the beautifully illustrated inside pages (see below).

There's lots of other great stuff on their website too for anyone looking for cool baby gifts, and I can definitely say the people there are wonderfully helpful and responsive. Check it out!

November 26, 2007

Pictures


I have a bunch of things in mind I've been meaning to blog about. What I don't seem to have any of lately is time. If I could figure out how to feed her and type simultaneously we'd be good to go, but so far I'm not getting anywhere typing with one index finger. In lieu of any of that, here are some pictures, as requested.

Here you can see how tiny she is. This is from her first week home, when she was around 5 pounds. Now she's probably approaching almost six...


She still loves to be swaddled but she's enjoying more time unwrapped now too. Even the tiniest preemie clothes are huge on her, but she's growing into them quickly...


As you can see, she's quite pensive...


But she doesn't take herself too seriously...


This is her Yoda face...


Finally, a Christmas to smile about...

November 17, 2007

The First Two Weeks

So I mentioned delivery was the easy part. And I seem to have a pretty easy baby. So far.

The biggest challenge is definitely feeding. The baby had a great latch right from the beginning, but starting the very first day I was forced to give her supplemental formula feedings from the bottle every two hours. The pediatrician required it due to her small size, and it was either comply or risk having her admitted to the NICU if she lost too much weight after delivery. The formula feedings were a huge success and she lost only 2 ounces before being discharged, which was a record for the hospital lactation consultant.

The down side was that she then HATED the boob. Screamed bloody murder whenever I tried to stick it in her tiny face. It took about five days for my milk to come in and the colostrum couldn't hold a candle to the formula she was downing, plus there were nipple problems too. Nurses kept telling me not to worry, that my milk would be in any day and then we could quit the formula and eventually things would work themselves out. We do seem to be getting there, but it has NOT been easy.

We've been on breastfeeding only for a little over a week and it's still a challenge, but getting much better. I think our issue now is more digestive than boob-related because she basically screams and drops latch constantly until she has a big explosive poop, after which she settles down and sucks easily until she's done. The pediatrician explained something about a gastro-colic reflex that goes away at about one month, so hopefully we have just a few more weeks of the screamfest. It probably doesn't sound that bad, but it lasts anywhere from 5 or 10 to 30 or 40 minutes or crying and screaming before the poop explosion. And this is something I do every 2-4 hours, 24 hours a day. I basically spend about 10-12 hours a day feeding her, of which at least 3-4 hours are spent watching her push out her lower lip in the saddest little frown ever, furrow her tiny brow, turn beet red, and eventually wail her little heart out. Meanwhile she's frantically clawing away at my chest, practically ripping my nipple off, and kicking me in the opposite side boob.

My sister says I'm lucky that her cries don't really upset me. I hate that she seems so miserable, but it's true I do stay pretty calm. For one thing, I know that sometimes babies just cry. It's the only way they have of communicating with us. It doesn't always mean there's something tragically wrong that must be fixed. I think a lot of new moms feel like they're doing soemthing wrong if the baby cries, or at least not doing something right. I'm pretty convinced that the feeding cries are related to belly discomfort, and that frankly seems worth crying over. I've got some tips from the pediatrician on how to help ease it and I do what I can, but it seems to be mainly something she needs to grow out of.

I can see why people give up on breastfeeding and switch to formula. It is really hard and really draining, and if you have any problems at all, formula can be much much easier. I think what's helped me most is that I was prepared for it not to work well. It's my infertile training serving me well yet again. I went into it knowing it might not work, and that there were interventions and options that would be fine if the natural method failed me. I was pretty committed to making breastfeeding work, but willing to accept the alternatives if need be. But the key thing was that my sister had said to me something like: that's all fine and good that you're willing to accept alternatives, but you should know this: at some point, it probably will be really hard and you will want to give up, but if you stick with it for a few more weeks, it gets much, much better.

We seem to be getting to that point. There's less and less crying and the feedings seem to be becoming more productive. At her weight check yesterday, she was up to 5 pounds and 5 ounces (from 4.12 the week before), so the pediatrician was finally satisfied and we don't have to go back until her two month check up. Other than the feeding issue, she's really easy so far. She sleeps for usually 3-4 hours between feedings and I only get up once or twice in the night. And really, eating, sleeping and feeding her are the only things I have to do, so its okay if one of those things takes some extra effort. Even with the difficulty we've had, it's all in all much easier than I was expecting. Part of me is still waiting for the shit to hit the fan. Some people tell me that these little early babies take a couple of weeks to really "wake up" and become more difficult. For now, I'm enjoying it while I can.

November 11, 2007

Birth Story

Here, finally, is the long and short of it. For the short, just scan the headlines...

November 1
8:30am - Appointment with the perinatologist

We were sitting in the waiting room when the peri came out of an exam room. He took one look at me and from down the hall said "Still pregnant?!" He'd expected me to be delivered when he sent me to the hospital on Monday. When my scan was done he said the baby was measuring smaller for gestational age than before and he believed placental dysfunction was becoming a more serious concern. Before he told me what he his recommendation was, I saw him type "deliver within 48 hours" into the computer. He had me wait in his office while he called my OB. He said they couldn't get me in that day but to go home and wait for a call to schedule an induction for the next day. When we got home, there was a message from the OB's office telling me to go directly to the hospital, and that my doctor would let me know what the plan is when I got there.

We got our bags ready, I wrapped up some things in my office, and off we went. On the way there I asked J "What are we going to name this baby?" He said "Well I think we have to think about that." Me: "How about now?!!"

11:30am - Admitted to triage
No one knew what was going on when I got to the hospital. The OB at the office had called the OB on call at the hospital, but he was in surgery when we got there. I hung out in triage yet again waiting to hear what was going to happen. I was beginning to get so irritated with being sent back and forth to the hospital, especially after the 24 hour stay just two days before, and with the back and forth between all the doctors different opinions, that I was feeling a little more like maybe it wouldn't be so bad to get this over with. I'd been sent home with discharge papers four times now that read at the top "Discharged with: no babies."

When my doctor got out of surgery he came to talk to us about our options. He explained that they (the OB's) prefer to wait until 38 weeks; they just feel it's safer. He explained the potential risks of delivering at 37 weeks. It was a little frightening because I'd understood that 37 weeks was considered term, but here was the head doc from my practice explaining that no one really knows when between 34-38 weeks each individual baby will really be term, so at 37 weeks there are still risks like "blowing a hole in the lungs..." and other stuff too scary to remember. On the other hand he said, it was hard for him to recommend going against the peri's recommendation, since he's the expert. He asked me what I wanted to do. I said I didn't want to be the one to decide, I wanted my doctors to tell me what they thought was best. He said he leaned toward doing the induction. Ultimately I have had the most trust and confidence in the peri all along, so at this point I was comfortable with it.

2:30pm - Admitted to Labor & Delivery
Three hours after checking into the hospital and laying on that stretcher in triage, I had my own room. It didn't have the ugly wallpaper of the room I was in Monday and Tuesday, but it also didn't have the window that had allowed me to get a web signal on my iphone - bummer.

3:30pm - Started Cervadil
An hour later the doctor came in and inserted the cervix-ripening Cervadil, since I was still only 1cm dilated and 50% effaced. Not comfortable! He explained we'd let this work for 12 hours and then I'd have an hour off before we started the pitocin. During the whole 12 hours of Cervadil I'd need to be on the monitors.

It was a long afternoon. I watched TV and finished my Carl Sagan book - the one I'd been reading on the stretcher at the fertility clinic when we did egg retrieval back in March. J went home at some point to take care of the dog and I got a half hour nap. He came back around dinner time and we played gin. At some point he told me he was ready to agree to the name Piper, which for some reason I've loved since I was about 12. We still hadn't settled on a middle name though. We talked about some options but we really weren't sure.

My mom came by soon after and we all hung out until I decided I needed to sleep, which never really happened. They went home and I continued to have nurses come in every half hour and stick me, ask me questions, and who knows what else. Sometimes they came in just to introduce themselves after shift change. Great, thanks. Please go away.

November 2
12:00am - Contractions

I didn't realize what they were; thought I was just missing my fabulous body pillow. I'd been getting uncomfortable and kept switching positions, knocking off my monitors, trying to find some way to sleep. I'd shift around and get more comfortable, then need to shift again. It took me a few hours to notice the pattern and realize it was my position changing making me more comfortable, it was the contractions ending. At this point they felt about like bad menstrual cramps; those months when you've had way too much chocolate and wine and haven't exercised in way too long. More discomfort than pain.

3:30am - Done Cervadil
At the end of the 12 hours, the nurse came in to remove the Cervadil but it was already gone; fallen out. Not a problem she said, but I was still only 1cm dilated despite the contractions. Annoying. I was given an hour off the monitors during which I took a shower, which felt fantastic. Also good thing I took advantage of it because I wasn't up to taking another one the first day or so afterwards.

4:30am - Started Pitocin
I was started on a low dose of the pitocin. My contractions were about 1 minute long every 5-8 minutes at this point. They pretty much stayed this way for the next five hours while the nurses continuously ramped up the pitocin amount.

Although the contractions stayed about the same frequency, I started getting more uncomfortable. It was still not really painful, but it was now like my worst ever menstrual cramps; the kind you might have every few years that make you need to spend a day in bed. I asked the nurse when it would be time for an epidural. I had thought there would be a point when they came and offered it. I remembered something about waiting until you're 4-5cm or something, to let your body do it's thing first. She explained that they don't really do that with pitocin inductions. For one thing, pitocin contractions are notoriously much more uncomfortable, and also since it's not your body in charge anyway it doesn't matter, they will still be controlling things with the pitocin regardless of what you're feeling.

So basically she said most doctors would let you have the epidural whenever you wanted. I told her I still wasn't sure when I should ask for it. She suggested getting it early, before you feel like you need it. It's easier to have the actual proceedure when you're in less pain and everyone takes a different lngth of time to respond to it, plus you never know when the anesthesiologists will get booked up. I told her I'd like to request it as soon as it was allowed then, and the guy was there in minutes.

9:45am - Epidural
I had been pretty calm about everything up until this point, but I was nervous about the epidural. The anesthesiologist came storming in pissed off at another doctor for rescheduling some other procedure and fuming about it to my nurse. She calmly had me sit on the edge of my bed with my back exposed and hunched over while he continued to rant and rave about "how DARE he ask such-and-such..." He scrubbed the iodine over my back with a vengence and may have removed a layer or two of skin. The nurse gently whispered instructions to me "hug your pillow in front of you, and when I say so, tuck your head and chin all the way down and push your back out towards him...okay, now." And it was done. It felt sore going in, but went away quickly.

I tend to be pretty sensitive to drugs and the epidural kicked in immediately. I felt warm and tingly, but I also got major jitters and felt like crap. I started to regret asking for the epidural so soon since I wasn't yet really in pain, but those side effects had subsided within 20 minutes and ultimately I think it was best I had it early and had loads of time for it to sort of settle in. Just like I'd been told I would, I had to laugh at the monitor when I saw the next contraction and felt nothing. Ahhhh. Then nothing happened for basically the rest of the day. Oh except the catheter, which SUCKED. I don't know why it hadn't occurred to me I'd need one of those, but eventually I didn't feel that much either.

7:00pm - Water broken
After 14 hours of pitocin, contractions were still 3-4 minutes apart, as they'd been pretty much all day. I was now 2cm. A different doctor now on duty (the third since I'd arrived), decided it was time to break my water. It really does look like a crochet hook. For some reason I decided this was it. There was no turning back now! It was beginning to look like I might actually have a baby. The doctor gave her guess: 7am. She asked the nurse what she thought. "You may be right but I'm not going to say 7am, just because that's too cruel. I'll say 2-3am." Sounded like they were expecting things to get more painful from here on in. And that's basically the idea with breaking the water, without that extra cushion each contraction can put more pressure on the cervix. Hopefully things would advance a little more quickly.

10:00pm - Feeling contractions
Twelve hours after starting the epidural, I was still numb but the contractions were now strong enough that I could feel them through the epidural. Again they were more uncomfortable than painful, but I was aware of them, and I'd finally made it to 3cm. J and I fell asleep.

November 3
1:00am - Active labor

Around midnight the contractions became strong enough to wake me up, and they got stronger over the next two hours. Around 1am I started trying to wake J up from his nap on the very uncomfortable bench in the room. He's a heavy sleeper and kept opening an eye to check on me then dozing off again. By 2am he was finally awake for good. By then the contractions were strong enough that I has having to try some of the breathing techniques from class. I hadn't been big on all that stuff because I knew I was planning to have an epidural, but there was an exercise in class where we had to push with our hands against force with and without focused breathing and I was amazed at how much difference the breathing made, so I gave it a shot. It really helped. This will sound so corny but with each breath out I was envisioning my cervix widening a bit more, as if I was blowing it open. I don't know if I was actually making any progress with that, but it made all the difference in getting through them.

This went on for about 20 minutes before I started feeling like I wanted to push. More specifically, it felt sort of like I wanted to poop. At that point I was fighting the urge to bear down, so at 1:30 J went to let the nurse know. The contractions didn't look any different on the monitor so they weren't aware anything had changed. At 1:45 she checked my cervix and I was fully dilated-she said it waqs time to push. My nurse was amazing (thank you Staci, where ever you are!), and walked me through exactly what I needed to do; taking a huge breath in at the start of every contraction, then holding it in while I pushed as hard as I could before exhaling--about three of these during every contraction.

3:06am - Delivery
We kept going like this for probably another 30 minutes, not more than 10 contractions, before she went to get the doctor, who was stunned that I was ready already. When the doctor came in, I pushed just a few times before the big one. I felt the head pop out and I could tell it was tiny. The doctor and nurses were exclaiming things like "oh it's a TINY one!" I looked up at J's gaping dropped jaw, staring down at the baby half way in and half way out. I think they might have suctioned her nose and mouth before I finished pushing her out but I'm not sure.

Next thing I knew they put her right on my lower belly and were wiping her off. I was staring down at her and thinking "No I'm infertile. I don't make babies." I was looking at her, knowing she had just come from somewhere inside my body, but not remotely able to absorb the idea at all. I was happy, I was proud of myself, I felt excited and relieved, but I did not have this sudden magical moment where I finally Believed. It wasn't that anything was missing. It all felt perfect. It was still just so unreal.

They picked her up and washed her off and did the usual stuff (all very fuzzy now). I think it was during this time that they delivered the placenta. Finally we got the answer to the big question: the placenta was very small and not looking good, so the early induction was very much justified. The perinatologist had been right, and the OB confirmed it was a good thing we delivered when we did. She would thrive much better out in the world than in there dependent on that thing. Whew, major relief. But then the doctor had a problem stopping my bleeding. There was talk of sending me into surgery if they couldn't stop it. After a bit longer pressing on my abdomen, another peice of placenta came out, and the bleeding finally stopped. I'm not really sure what this means but will ask more about it at the 6 week check up, but basically we're felling really good about the induction decision.

They brought her back to me swaddled and with a hat on. This time I got to hold her close and have a better look and she was the most beautiful thing ever. It was still a few days before the reality of it began to set in and I'm not sure I still totally believe it, but I can say for certain that I'm loving every day of it.

And that's how we got our third 3rd (J and I also were born on the 3rds of our birth months), eight months after egg retrieval which, incidentally, was on 3/3. All in all, labor and delivery was really easy. I know, I know. I too have smirked at women who say this and whispered sideways to a friend that people with a story like that should just keep it to themselves. No doubt delivering a 4lb. 13oz. baby is a walk in the park compared to what most women go through. I also think getting the epidural early (thanks Holly) was key. The next few days were anything but easy, but I'll save that for another post.

November 7, 2007

And Delivered


Thanks to all who have already sent congratulations, and so much love to everyone who's supported us throughout this journey. So many of you know too well how much that support means. I hope this little bundle gives hope to those who need it. IVF really can make a baby, even if you refuse to believe it until the very last moment. More details when I can.

November 1, 2007

And Readmitted

Headed back to hospital now. Was told induction is scheduled for tomorrow, but then told to go directly there now--I assume to get the cervix-ripening stuff. Hope to be released while it does it's thing, but who knows? Will post updates when I can, but looks like today or tomorrow theoretical baby will become actual real-life baby.

Hopefully I've fixed the comments thing. Thank you all so much for your support!!!