Monday, November 26, 2012

The Office

...is now a nursery. Jackson had sock monkeys, and Matthew has owls. I wonder if this is shaping their personalities at all (we have supporting evidence for n=1 so far...).

 

Tuesday, November 20, 2012

Sweating Bullets

Orthopedic follow-up appointment number one: done. And another in 2 weeks. Hopefully the last.

It took for-fucking-ever to get to the office, thanks to a traffic accident literally just outside the medical office building that narrowed the road down to one lane (and Detroit drivers are Grade-A assholes, so merging peacefully and in an orderly fashion is for suckas). Then the parking lot was 100% full so I had to circle until someone was leaving, and didn't she just take her sweet time rearranging some shit in the backseat, and in the trunk, and then checking her makeup in the rearview, and then adjusting her seat. I hope she saw me flip her off while I waited. And then we sat in the waiting room full of elderly patients comparing notes on how bad off they were and playing Top-That with their injuries...

...and then finally, we were called back to see the pediatric orthopedist. It was a long, anxious time to wait to find out if your baby boy will regain full use of his teeny arm, and I have the pit stains to prove it. They opted not to do a follow-up x-ray today (but will in 2 weeks), but the knobby lump on his arm is evidence of healing bone and he passed the nerve function exams (fingers wiggled; elbow flexed; when pissed off enough, shoulder lifted). Although he doesn't voluntarily use his left arm much at all (only slight movement when he's repositioning or stretching) the current prognosis is that he probably does not have a specific nerve injury, and will gradually use that arm more over the next several weeks as it heals more. Between 6-12 weeks old he is expected to be good as new.

For reference, on his birthday, his arm looked like this:
It's still kind of a wait-and-see game, since there's no definitive test or treatment for any of this. But I feel encouraged. Now, I ask you, how do I explain this to my Munchausen-esque hypochondriac sister, visiting tomorrow, without letting it get sucked into her vortex of medical drama? And how do I keep steam from blowing out of my ears when she inevitably interrupts me to tell me about her friend so-and-so's kid who has/had/is having a worse diagnosis of something more awful (Top-That!). (We're putting her in a nearby hotel -- oh, she just got back from her third vacation since losing her job, but do you think she offered to pay for the hotel? -- so we don't have to deal with her 10am-wake-up and sit-around-all-day shiftlessness all week long. It's maddening.) And how do I stop feeling annoyed that my mother-in-law assured us she would come over and help and hasn't been here once since we left the hospital, and won't even try to hold Matthew? (I know she may be concerned about jostling his arm, but the sleeve is pinned down so his arm doesn't move. Anyway, after Jackson was born she mostly brought food. That would have been nice.) I can let that slide, since we have a part-time nanny starting next week. And Matthew is a quiet baby so far, so I think I'll be fine. Once I get past the holidays. Because holidays, man. They are the cause/cure for crazy.

But honestly, whatever, I'm thankful Matthew is okay and is expected to make a full recovery. And that's enough for me. Happy Turkey Day, all. Eat, drink, be merry, kiss the babies.

Oh, and today was his due date.

 

Saturday, November 17, 2012

The New Normal

We're settling in. Slowly. Some days feel like a gift, and others a chore. That is the way, I suppose.

Jackson is staying in school during the week and Matthew and I are holding down the fort at home. KB had the first week off, but because of some exciting once-in-a-career projects happening for him at work he's been back in the office this week. The part-time nanny is starting after Thanksgiving. Mama needs to make an appointment to get her straggly hair cut. And as soon as these cankles fully deflate, maybe a pedicure. Me-time. Not that having an infant on your tit or screeching through diaper changes every other hour isn't the best, but an hour or two here and there of solitude is bliss.

And the parents-of-two thing. It feels like we're each single parenting one child most of the time, but it's a game of divide and conquer. Jackson is still being lovely toward Matthew and likes to tell us when he's crying (in case we've become selectively deaf and can't hear it for ourselves) and tries to helpfully shove a paci in his mouth at random times. But every morning he runs into the baby's room to check on him (he calls him "my baby") and every night before bedtime wants to kiss him good night. It's sweet. What is not as sweet is the new tantrum phase Jackson has entered, which largely centers around getting into his carseat, getting dressed in the morning, and going to bed. He always capitulates as long as we (really, 99% KB) are patient and steadfast and ride it out for a few minutes. Like at bedtime, he throws a fit about getting into his crib and then merrily sings along to Daddy's goodnight song and crashes immediately. Another phase, maybe precipitated or exacerbated by the arrival of competition for attention. It's stressful, but we're all hanging in there and no one has completely lost their minds. Not yet. Stay tuned. There's always time for crazy to set in.

And Matthew. He's the anti-Jackson of newborns. Mostly quiet, happy to nap the day away without demanding I hold him the whole time, content in a swing or on a boppy. He hates being naked and having his boy bits wiped after a poop. Typical. He still isn't moving his left arm much, altough the bone should be healed/healing by now, but there's probably some nerve injury (the brachial plexus getting stretched is the most common injury after shoulder dystocia, followed by collar bone fracture, followed distantly by humerus fracture; FYI shoulder dystocia occurs in 0.5-1% of births and humerus fracture only in 4% of those cases -- stuck the landing on the shit side of statistics). Our orthopedic follow-up is on Tuesday and I'm hoping to see a healed bone on x-ray and that he'll confirm the nerve injury (they're calling it "pseudoparalysis" right now) will heal spontaneously over the coming weeks, which is true in 90% or so of cases. Need to be on the right side of statistics now. We paid our dues.

Not much sleeping for me, and it wakes KB up when I do the hourly feedings for the first half of the night. We get more sleep after around 1am or so, when my hungry hungry hippo sleeps for 2- or 2.5-hour stretches. He takes nice long naps during the day. I don't feel like a zombie in need of mainlined coffee during the day, which is my measure of acceptable sleep, so all is well. He'll start to sleep longer when he's ready. Not being clingy during the day offsets it a lot.

And then nursing. He still takes quite a few bottles of formula, but only because he seems to get so worn out by breastfeeding that he takes frequent breaks and/or gives up after 5 minutes or so. During the day I can be patient and let him do his nurse/rest/nurse/rest routine for a while, but if I did that at night I'd get zero sleep at all. Refer back to part about him being a hungry hungry hippo. He's getting a little better at nursing for longer periods every day, and he seems to really prefer nursing to the bottle overall, but he also never seems to get full from the boob. So we're supplementing and continuing to work on breastfeeding as best we can. He roots, latches, and sucks and swallows, so it's just an endurance thing. We'll get there. Or not. Whichever. As long as we feed the baby. And I'm just not willing to spend all my free time attached to a pump. Not this time. It made me a miserable human, and gave me mastitis. No thanks. A friend of mine had a similar issue with her first child (no L&D injuries, just a big, hungry boy) and supplemented for about a month or so, then didn't need to anymore. I'm hoping for something like that. Anyway, he's getting breast milk with all its goodies so there's that.

One day at a time. Only a few postpartum tears from time to time, and a beautiful family all around me. I'm doing alright. With some good news for Matthew on Tuesday, I'll be doing better.

 

Tuesday, November 13, 2012

The Longest Six Hours (Ever)

As one L&D nurse put it, Matthew did not make a graceful entry into the world.

My water broke at home last Monday morning (although it may have actually started on Sunday afternoon), but it was just a teensy trickle, enough to make me question whether it was really amniotic fluid or some random gross fluid that emerges late in pregnancy. I'd been having erratic contractions for days, and they didn't really pick up the pace or become semi-regular until Monday evening. We put Jackson to bed, watched our TiVo'd episode of Homeland (I wasn't about to be a whole week behind!) and called our neighbor to come stay at the house while we trudged over to triage to see if we were staying the night to have a baby, or coming back home. At L&D triage, sure enough I tested positive for amniotic fluid (and glory be, the internal exams, even with speculum, didn't hurt like hell as they did before...). I measured 3cm dilated and about 50% effaced, but contractions remained irregular and mild so augmentation with pitocin was required. Since I wasn't sure when the slow trickle of fluid had begun, it was assumed that we were on the clock and that I would need multiple rounds of antibiotics (I tested positive for group B strep again). Fair enough. I braced myself for a long night.

So off to our room, Lucky Number 13 (I should have seen that as a sign). The OB resident broke my water (the sac was still intact) and there was meconium. Strike one. Nobody panicked, though, and I measured at 5cm, so we figured things were progressing nicely and the baby would be out soon. I requested an epidural and the next hour was spent in agony as the anesthesia resident poked me no less than 5 times trying to get one started. Every time, he hit bone and/or fireworks shot down my right leg, so he would start over. His staff doctor came in and ordered him to stop and give me a rest, and I spent the 20 min break freaking out over the possibility of a fast, augmented labor with no pain relief. Around this time, the back labor started. Hoo boy. So they returned and the resident was told to take a seat, and his boss got the needle in on her first try. Ladies first, y'all. The flood of warm fuzzies down my spine into my legs was the most welcome relief I've had in ages. (Besides finally having my first postpartum poo at 6 days after birth. Whew.) Then of course, the itch began, and I spent the next hour rubbing the itch all over like a crackhead. But the pain relief, good sweet fancy Moses.

So the OB resident returned to check me a while later and I was stuck at 5cm. I don't know what time it was at this point, but hours had gone by and the pitocin dose had increased and there was no progress. I nearly cried. Then we all put 2 and 2 together and realized that my back pain prior to getting the epidural surely meant the baby was turned posterior, and we starting repositioning me every half hour or so to encourage him to turn so he could start to descend. Somewhere during that time, the resident and nurse waltzed in calmly to tell me he was having fetal tachycardia and that I would need to wear an oxygen mask and internal monitors and that we would need to get more aggressive about repositioning, considering moving to all fours if needed (it never was) to get him to turn faster so we could deliver him sooner. So, fetal distress. Strike two. I'm not sure how much time passed after that, only that I wrestled with the closest thing I've ever had to a panic attack inside my head as I focused on every single contraction, willing it to help the baby turn and move. Then around 3:30am (?) the pressure began. I felt him move very fast with each increasingly painful contraction (what epidural?) into the birth canal, and with every contraction the urge to push was stronger. I called for the resident to check me and I was only at 6cm. I gave up the pretense of "nearly" and just cried. Into my oxygen mask. With the urge to push getting unbearable, and only dilated to 6cm, I was full-on freaking out. About 3-4 contractions later I told the nurse I absolutely could not hold back from pushing anymore and I needed to be checked again, NOW. Within less than 10 minutes I was already at 9cm and "stretchy." Now tears of relief. My OB came in (he had popped his head in periodically to check on us) and I told him I really, really, was going to push now and couldn't stop it and he calmly replied, "Okay, let's see what you can do." Well. What I could do was push and scream like a crazy person because this was happening unbelievably fast, like nothing I could have been prepared for, and was unbelievably painful, in considerable contrast to Jackson's second stage labor during which I had felt no pain and was joking around with a med student in between pushes. The second stage contractions this time remained like transitional labor contractions, long and intense and little break in between. So I kept pushing while the OB and resident set up their tray of goodies, and after just a few pushes delivered the baby's head. That's when my OB called for an assist with "a shoulder."

Shoulder dystocia. Strike three. His shoulder was completely stuck behind bone, and 2-person maneuvers were required to free it, quickly. My internal panic bubbled over and came full circle, as I realized I had to pay attention and do whatever they said exactly as it was said, to deliver this baby in the next couple of pushes. Pain be damned. While they applied pressure in places I didn't know were capable of such pain, I pushed through it as hard as I could until I felt him emerge on the final push. No one even bothered to wipe him off, they just handed him to me, sludge and all, so I could hold him. And immediately he cried and rooted. No greater relief has been felt by anyone, anywhere, ever. His APGARs were 9 and 9, but his left arm was obviously injured as he wasn't moving it much at all. I just held on to the relief that he was here, he was (mostly) okay, and labor was over.

Oh. And he nursed right away, like a champ. Rooted for a breast and latched on like he was a pro. This gave me a fleeting moment of joy and additional relief. Until they checked his blood sugar, and it was super low. Even after nursing. So, hypoglycemia. In the game of birthing, strike four.

It turned out that all the maneuvers to free his shoulder failed, and so my OB had to (in a last ditch effort to beat the clock) reach in and essentially yank his shoulder to free it. Rather than taking my baby to my mother/baby room with me, we had to drop him off in the NICU for an x-ray and for formula feedings to stabilize his blood sugar. I spent the rest of the early morning and day alone in my room, getting updates from the nurses in the NICU and traveling by wheelchair to visit him when I could. I wasn't able to hold him until orthopedics had evaluated his arm. But I got to see the x-ray, which was heartbreaking. A complete and displaced fracture of the humerus shaft. Poor baby. After ortho came around and decided that they would not splint the arm, just pin his sleeve to hold it in position, I was allowed to hold him for bottle feedings but advised not to try to breastfeed just yet, since it requires a lot of repositioning that might cause him pain. I was encouraged to pump, but I honestly just felt so beat up and depressed about this whole turn of events, and have such a hate-hate relationship with the pump, that I told them to continue formula feeding and that I would work on breastfeeding him once we had a better shot at it (eg, when I could move him around a bit more and when milk came in). I felt surprisingly okay with this decision, but a few nurses and even the pediatrician on call gave me shit for it; although I'm sure they viewed it as "advice," it pissed me off considerably. I followed my gut (and guess what? Today I have milk in, with a vengeance, and he's nursing!) and didn't need to be questioned. Anyway, this ain't my first rodeo. I did my best to ignore them.

So now we're home, he's nursing and taking occasional bottles, I'm battling engorgement (bless his heart, he's still nursing even with that obstacle) and swollen feet and constipation and exhaustion, and his arm is healing. Our follow-up with ortho and an x-ray is next Tuesday and the surgeon expects to see a healed fracture. Babies are miraculous.

I've had a few pretty hard cries over how all of this happened, how traumatic it felt at the time, how alternately scared and determined I felt through the process. But he's okay, I'm okay, Jackson loves "his baby" to pieces, and we're figuring out this parents-of-two-children thing one day at a time.

Oh, and today was the scheduled induction day.

 

Thursday, November 8, 2012

Election Day Surprise

Matthew Emerson B____, born at 4:09am on November 6th and weighing in at 8lbs 5oz, 20 in long.

Labor was....well, that's a discussion for another day. [Context clue.] But he's here, we're all recovering, and we are most definitely in love. Even Jackson can't deny Matthew's charm. And it was a pleasure staying up to watch the election results with my new pal. He's pretty great.

 

Monday, November 5, 2012

The Prodigal Son

Oh, that's right, I have a toddler, don't I? He's swell. Here's what he's been up to:
  • He talks and talks and talks now. We understand him about half the time. He also repeats a lot of words he hears, so my potty mouth needs to wise up and shut up.
  • He's obsessed with playing guitar. We let him watch youtube videos, which started out as Sesame Street and Pooh Bear, and has progressed to concert footage of our favorite bands (puppetmastering parenting at its finest!). So he studies Avett Brothers and Neil Young and Aimee Mann and Queens of the Stone Age and then strums away on his guitar. It's freaking awesome. He's starting to learn the words and sing along. Best thing ever.
  • Every night before bedtime (which is still around 7pm) he goes up to the window and asks about the moon. He likes to find it in the sky. Sadly, it's been cloudy for several weeks, and we have to deliver this disappointing news, but he takes it well.
  • He picked out a teddybear as a present for his little brother, and selected a giant version of the same bear for himself. Actually, the process was reversed as he saw the big bear first and declared, "MY TEDDYBEAR!" then picked up the wee version for the baby. The big bear is named Georgie. Georgie now sleeps in Jackson's crib along with Elmo, Abby, two blankets, and a pillow. Oh, and a Detroit Lions nerf football. It's an episode of Hoarders.
  • He has peed in the potty exactly once, and it was at school. We made a huge deal about how awesome that is and encourage a repeat every night before and after bathtime, but no dice. It was a one-time performance, for the time being. I'm not too concerned about potty training right now as even the pediatrician advised we should wait until after the baby is here. Otherwise, regression and accidents and frustration and setback. But we still encourage him to sit on the potty and let him in the bathroom when we go potty so he can see how it works. He really wants to wipe with paper, and will grab a square and pretend to do it over his clothes, so we've got that move down. That's something.
  • He seems to understand the baby is growing (boy, is he) in Mommy's tummy and will lift up my shirt to pat the baby, or kiss him (way to slay the pregnant lady....), and recently started holding up his milk cup to my belly to feed the baby. Hilarious. He tries to pour milk into my belly button. But then he quickly loses interest and yanks my shirt down, declaring, "Put it away!" So fickle. He can say "brother" and can even say his brother's name. I've been telling him in recent days that soon Mommy will go to the hospital where the doctor will help take the baby out of my tummy, and that Daddy will bring him (Jackson) to see us and then after that we'll all be home together. Whew. That's a lot for a kid to process. After explaining this slowly and earnestly a few days ago, he nodded his head and asked, "Where's my guitar?" Keeping it real. I guess we'll find out how this affects him in real time. Huh.
  • We're not shy about nudity around here, not yet anyway, and Jackson has never paid much attention until the past few weeks. He just noticed (or at least finally articulated) that Daddy, too, has a penis. And he delights in pointing out the similarity to his own anatomy. And when asked if Mommy has one, he excitedly screams out, "No penis!" And last week he walked in my bedroom as I was getting dressed and he noticed my breasts (probably due to darker nipples, thank you pregnancy) and ran up to point and ask, "What is that for?" I explained that Mommy makes milk there for the baby to drink and that he used to drink milk that way. Cue hysterical toddler laughter. But now he tries to grab my shirt and peek down to see where the milk comes from and laugh about it like it's our inside joke. Hahaha.
  • He's been an all-around pretty fun kid lately, minus a few tantrums here and there. I'm really excited to see his reaction to becoming a big brother. I think he'll take to it.
 

Sunday, November 4, 2012