Saturday, September 27, 2014

Goodbye Fenu-farts, Hello Major Milk Makin' Cookies

You know you've entered a new phase of life when you begin singing "99 Bottles of Milk on the Wall" along your daily walks with baby. Hey, don't knock it. It's a great time kill when you need to entertain for an extended period of time. And while there may not exactly be 99 bottles on the wall (or in my freezer), I'm still sweating like an Iron Chef to sling the liquid gold across the counter just as fast as I can make it.

Unfortunately, it turns out the supplements I've been taking to increase milk supply (Fenugreek & Blessed Thistle) may have actually been causing, or at least adding to, the toot-a-thon taking place in Preston's pants. How do I know this? Well, I am not 100% certain, but I'm pretty sure it was causing some of the tummy trouble.

This week, we had a couple really good days as far as mood and lack of fussiness goes. I thought maybe it was because I'd been able to give so much breastmilk those days, but then it continued into a day in which I'd given quite a bit of formula as well. Maybe he's just growing up into a completely well-balanced mature child already?! Ha! Doubtful at this stage in the game.

I realize it could all be due to chance, but it just so happens I'd run out of my milk making supplements and was awaiting a new shipment from amazon. I didn't think anything of that piece of the puzzle at the time. Then, the new supplements arrived, and I began taking them again as usual. To my chagrin, the tummy trouble seemed to begin again almost immediately. I could literally hear the air pinging in Preston's belly. One night at the wee hours as I was snuggling him,  our bellies growled really loud at the exact same moment...which is when a light bulb went off!

Could it be more than coincidence that the worse of this ceased when I stopped taking the supplements and re-emerged once beginning them again? Why were we both having rumbling in there? It wasn't bothering me much, because I'm a grown adult and growling isn't that big of deal. But to his tiny tummy, it could be a pretty painful feeling I'd imagine. I just had this intuition it might be a factor.

From then on I became a fart detective and was noticing every little reaction to eating and how his belly was doing. I starting googling more about tummy trouble related to both Fenugreek and Blessed Thistle and wouldn't you know it; it's a very common side effect to have increased gas and watery stools...both things we've commented on several times as a concern. I already cut lactose out of my diet weeks ago, so I knew it wasn't that. Apparently, these supplements are well-known to be hard on the stomach, in both adults and breastfeeding babies (even though Blessed Thistle is also touted as a "digestive tonic") and even though it's so highly touted for milk production.

Strangely, I learned a couple other things I hadn't initially noticed...like the fact my pee smelled like maple syrup? Yes, very weird! Apparently, fenugreek can cause false readings of maple syrup disease in babies, and sure enough I realized I smelled like maple syrup every time I hit the loo. I am not being a hypochondriac either. It's like when you eat asparagus and can clearly smell it in your urine...except I actually smell like an IHOP! It's unmistakeable and so very strange.

Needless to say, I decided it's simply not worth taking these supplements if there's any chance it's causing any doo-doo disdain for Preston. They have definitely helped increase my supply, as I went from pumping only 0.5/1 oz. on both breasts per session, to now averaging 3 oz. However, many times a supply can be well established by 6 weeks, and we will be 6 weeks on Monday. Worth noting that I also rented a hospital grade pump for a month (Medela Symphony) to help bring in my stubborn to flow milk.

It's equally important, if not more important, to just keep creating the demand for milk by pumping, and that is something I'm continuing to do of course. I just returned the Symphony yesterday, because we don't need the $75/month rental fee. Instead, I will still be using my spiffy little Medela Pump In Style Advance that I got for FREE thanks to the Affordable Care Act. It's a $300 pump itself, so I will take what I can get even if it's not the very best available.

And because I'm one of those people who feels they need to be doing something more, I began searching for other natural ways of increasing milk production through nutrition alone. I made these Major Milk Makin' Cookies last night for the first time. Jackpot!!!



These cookies are seriously good, and I would feel pretty good about eating them even if I wasn't lactating. Outside of being full of galactogogues, they are pretty healthy for tons of other things...heart health for one. Maybe I shouldn't have told hubby they are for makin milk, because he needs these in his life too! I'm hoping he likes them, because unbeknownst to me, the recipe made almost 5 dozen. We've got some cookie eating to do!

Yum
This could be dangerous.

The magic milk making ingredients are oatmeal, brewer's yeast, and flaxseed meal...



You can read about all of the amazing properties of these foods here if you're interested. The blogger who posted this recipe @ DrMomma.org gives some fantastic info on how it works to increase prolactin, the key hormone related to milk production.

Only time will tell if/how my supply is affected, both from the dropping of the fenu-fart and discontinuation of the hospital grade pump, as well as the addition of the cookies to hopefully balance it all out. I couldn't help but notice after making the cookies last night (and proceeding to eat a few more than I'd planned) that my next pumping session I got 5 oz! It could be coincidence, but I rarely ever get 5 oz, so I'm hopeful they're a decent enough replacement. Hopefully I won't turn into a total cow eating them like candy either. Cow's are good for milk making yes, but not good to fit in my shorts. ha!

We've been using this really convenient iPhone app to track Preston's feedings and my pumping sessions. There are a ton of apps out there, but if you need something to help organize I highly recommend iBaby Feed Timer.

This is what the log looks like...




This is what data for our last 24 hours, week, and month look like...

Bottle Feedings
Pumping

The app allows you to input anything related to breastfeeding, pumping, feedings, dirty diapers, sleep, and make notes anywhere needed. You can share the account across more than one iPhone, so that means hubby or a caregiver/babysitter can track while you're not with baby. You can view all the data in real time as soon as the other person inputs something. Then, it also analyzes data so you can see trends over time. And, you can even email/print a spreadsheet of all the data at the click of a button...pretty handy if you need it to show your LC or pediatrician for any reason.

Fingers crossed I won't see a huge decline in supply due to the dropping of supplements and downgrading my pump, but if I do, I'll just drown my sorrows in cookies and almond milk.

Tuesday, September 23, 2014

Thank You letter to RE

There are many thank yous I've made along our journey to parenthood, but this one was long overdue. I ran into my RE at the beginning stages of pregnancy while visiting my MFM in the same building, and I proceeded to have an emotional breakdown. I could barely mutter a "thank you" at the time. I was just so overwhelmed with gratitude.  I truly feel that without IVF, we may not have ever had success starting a family, so I wanted to send him and his staff a proper "thank you." This is what a wrote...





Dear Dr. Vaughn,                                                                                                     8/23/14

I’m writing because there is no way I could ever convey my heartfelt thanks in person without sobbing buckets of tears…tears of joy of course. I sit here having just fed our absolutely perfect little boy, who just turned one month old. Preston Alexander joined our family on 8/18/14 at 21 ¾ inches long & 8 lbs. 8 oz.  He’s a very healthy and happy boy!

As you know, it wasn’t an easy journey for us to the place we’re at now. However, I don’t feel we would have arrived at this new and exciting chapter without your help. We came to you after being dissatisfied with another RE, and I knew from the moment I stepped into your office that you were the one to help us. There was a figurine on your desk which read “Babies are a gift from God” or something along those lines. This was only a very small clue into the humble, caring, patient, knowledgeable and just “meant-to-be” doctor that we invited into our journey…YOU!

It wasn’t an easy or clear-cut path. There were pregnancy losses, failed attempts, surgeries, and many tears. However, one thing remained constant; anytime you walked in the room, I immediately felt at peace. I knew that you were our strongest ally always. I felt I could trust you without a doubt and that you had our best interests at heart. A peace just fell over me anytime you were there, and when I felt like giving up, it’s like God whispered “Stay right where you’re at. You are exactly where you should be.”

I am just so glad we did! No question that you are truly in your line of work first and foremost to help people realize their dream of having a family. I have always believed that fertility medicine is not taking the place of God’s desires for us, but that He anoints gifts to certain people to help those who need it. You, Dr. Vaughn, are one of those people. I know he placed you in our lives for a reason. And even if it didn’t happen on our timeline at first, I can now say that I wouldn’t change it, because look at the amazing miracle we now have in our lives.

There are no words to convey our gratitude for everything you did to help us. You are making a HUGE mark on this world, one patient at a time. I know I am only one of thousands of people who feel this way about you and your life’s work. THANK YOU and your entire staff from the bottom of our hearts!


With Gratitude,

Matt, Emily & Preston



Wednesday, September 17, 2014

1 Month Foxy Hiccupotamus

Our hungry little milk monster has morphed into an uncontrollable hiccuper this week, earning him a new nickname...all credit goes to the hubs for that one. Brilliant! Apparently, the intense hiccuping I'd felt in the womb for the last half of the pregnancy is sticking around for a bit longer. Preston is getting pretty tired of it, and I was wondering if it was normal. Well, come to find out it is a normal newborn thing. The pediatrician says it could last until 6 months of age, so we have a ways to go before we say sayonara to hiccups and hello to some other nickname making fun of Preston's bodily functions.

Hard to believe, but P will be 1 month old officially tomorrow! He wanted to look foxy for the occasion...



He's already wearing 3 month clothing and has outgrown much of his newborn and 0-3 month stuff. This is probably not the most accurate way of weighing a newborn, but hubby weighs himself holding Preston, and then weighs himself without Preston to get P's weight. According to our very scientific calculations, he's about 12 pounds by now. Is that even possible? Um, I'm thinking YES with the amount of food that he's eating. Our new favorite line is "He can't be hungry again!"

I'm pretty sure when I wrote my last post, he was going through a growth spurt and was consuming a ridiculous amount of milk. Since then, I've really tried to make sure he's giving solid hunger cues before handing him a bottle. We're getting better at distinguishing his different cries, and even one which resembles a dolphin noise. Not even kidding, he sounds like Flipper, which makes us laugh every time. I'm not sure if it's because we're being better about trying other comfort measures before the bottle, or because his growth spurt died down, but his eating has normalized slightly and he's not requiring quite as much to satiate him the past few days. I WISH I could say the same about the amount of diapers he's blowing through (literally).  

Yesterday was quite a record breaking day. 15 diaper changes...an all time high. Preston tells us immediately when his diaper is wet and does NOT like sitting in it! We are not keen on just letting him fuss in the middle of the night and hoping he'll settle back down either. I mean, I wouldn't want to sit in wet diapers, and I don't feel right letting my kid do it either. 99% of the time it's guaranteed to escalate way past a wimper anyways. I'm hoping there will come a time when a tiny little wetness in his diaper won't create a blood curdling scream as if he's about to die, but for now we're at his beckon call changing diapers faster than a NASCAR pit crew.

It was also a good day, because for the FIRST TIME EVER I pumped enough breast milk to meet his needs. He drank 26.8 oz. of breastmilk & I pumped 29.5 oz. Get I get a hallelujah?! I won't say it was easy. I pumped around the clock every few hours, and it took 8 pumping sessions followed by hand expressing to get there, but I finally did it. Realistically, there isn't a huge enough surplus that I am confident I can do that every day, and I don't expect to. 30 oz/day is good on a day he's being a mild eater, but on days when he's absolutely frenzied and eating his hands off every 2 hours, I just don't see how I'll ever keep up. Still, I will keep trying my best and enjoying the feeling when I can give little to no formula. Preston enjoys those days too. His tummy is more settled, and he's happier and less fussy overall.

And on that note. I've got to run. I'm past due to pump, and the hiccupotamus needs a diaper change!


Thursday, September 11, 2014

3 Week Flailings of a First Time Mom

Excuse my absence. It's been a tad busy around here. I've been reading others' blogs during pumping sessions, which is my only time to be online lately. Taking out my computer has been a challenge, but let's see if I can actually get a blog in.

The last couple weeks have been a whirlwind! Talk about not knowing which way is up or down. Our "plan" seems to change daily around here, constantly adapting to what might work or not work. I think we've moved our nursing glider about 4 times now, as well as other furniture and baby entertaining devices. It's like musical chairs for clueless first time parents.

Whoever invented the Fisher Price Rock n' Play deserves a Nobel Peace Prize, by the way. Our little guy is totally addicted to it, and against everything I said we wouldn't do, he's actually been sleeping in it in our room at night. We tried having him sleep in the bassinet of his Pack n' Play, but he's just not having that. We also had him sleep one night in his crib (upstairs in his nursery with camera monitoring). He did fantastic for one whole night and then he wasn't having that either the next night.

Ultimately, we've decided it's still really early to have him away on a complete different floor from us. He's only 3 weeks old, and we want him near us at night. However, the RNP is the only thing that seems to make him happy, so RNP it is for now. I realize I may have a beast to tend with later when transitioning to crib (which obviously doesn't vibrate or cozy him like the RNP), but it's anything to stay sane and get a couple hours of sleep for us right now. Pediatrician says it's totally fine, so guess we get a free pass on that one.

Other than that, our life is ruled by feedings, diaper changes, random meltdowns, and celebrations of poopy diapers after long stretches of grunting and kicking in a very dramatic effort to poo. My life specifically has been ruled by pumping, which I try to do 7 times each day. In fact, I made the decision to stop trying to breastfeed for now and switch to EP (Exclusive Pumping).

I mentioned earlier than I was using SNS (Supplemental Nursing System) feeding. This was because my milk was really late to come in (took 1 week for it to even show), and even then I wasn't producing 100% of Preston's needs. The SNS is a little contraption that you fill with formula, but then attach a tube to your breast with tape right near the nipple. It delivers formula via this tube, but the baby thinks it's just coming from your breast, so the risk of "nipple confusion" later on when you do decide to solely breastfeed is lessened, because he's always fed right at the breast. Here is a pic of what that looked like...

When I didn't want to strangle myself with the SNS

Awe, don't we look so serene? DO NOT BELIEVE THIS PICTURE!!! LOL  Seriously though, this was during our "honeymoon phase" with the SNS while in the hospital. What you don't see is what ensued in the 2 weeks that followed this photo...of me and Preston and dad (yes, it took 3 people to make this work many times) awake at 2 AM feedings, getting the formula ready, attaching it to mom exactly right, getting baby in position on the breast friend pillow without making me gasp in pain from my C section incision, getting him to latch on to this tiny floppy spaghetti noodle tube taped to my boob, making sure it was aligned with his chin so that it was actually flowing correctly, and then him proceeding to fall asleep at nearly every feeding, at which time I would try every trick in the book to wake him (blowing on him, undressing him, caressing him, you name it) to keep him eating, and then try to keep the device working properly the entire time as the noodle flopped out or was yanked out by someone's curiously strong little hands. It was a giant PITA!

I really tried to make the SNS work, but it was NOT a long term solution, and my body wasn't upping it's game on the production front quickly enough. I also hoped I'd be able to solely breastfeed, but it just didn't click like I'd hoped. I met with 3 different lactation consultants while in hospital and had a really great one come to our home for a 3.5 hr visit afterwards. She put me on a "triple feeding" routine in an attempt to increase milk supply fast, where every 2-3 hours I would

1) feed Preston with the SNS, while simultaneously using manual stimulation of my own breast to make sure he was also getting breast milk along with the formula
2) pump with hospital grade pump for 10-15 minutes afterwards
3) hand express for 5 minutes after that


You guys, I did this routine 7-10 times per day for 2 solid weeks, and I just couldn't take it anymore. I saw some slight increases in my pumping amounts, but due to the fact Preston was also drinking some from the breast, I really had no clue how much I was actually making or delivering on any given day. It felt like I was giving formula all the time through the SNS and it was not an easy process. I was MISERABLE. I was not enjoying feedings like I should have been, and I'm sure Preston wasn't either.  We decided that we needed something simpler.

For me, the goal of breastfeeding has always been more about the nutritional aspects for baby than it was about the bonding (I know, opposite of many moms). However, I really felt like I could bond with baby better if I was A) happier and more relaxed and B) I had the time to do it. I wasn't having any time to just hold baby much after feedings, and snuggle and just be together. And so after many tears and discussions, hubby and I agreed that I'd try EP instead. This meant no more floppy spaghetti noodle taped to my boob. No more failed attempts at satiating baby at the breast alone, followed by cries for more food. Instead, I would just do my best to pump as much breast milk as I could. We would deliver through bottles (which would allow hubby to take on some responsibility of feedings too) and then we'd just supplement with formula when we had to.

So far, pumping is working much better for us. I won't lie. EP comes with it's own set of challenges. There is still zero down time. I don't work, and while this might seem easier, I can't take a "break" in a quiet room to pump and am not protected by any law stating I am allowed to take a break. I'm by no means saying working moms have it any easier, just saying I can't ever get away to pump, unless hubby offers to watch baby and/or he's sleeping. Baby always needs something, and only with the help of my amazing hubby to take on baby duties, it's made possible.

I really want to give Preston the very best I can, so I'm trying my best to stick with it.
I can't make any promises how long this will all last though. As I type this, I am already an hour overdue to pump, have just fed Preston, and he's strapped to my chest via his Baby Bjorn, because it was the only thing that would make him happy at the moment. Unfortunately, there are no holes for pumping in this carrier, so time will tick by until I do get a free moment to pump next. I actually enjoy just holding him more than pumping anyways, so I'm happy for the excuse to miss a pump on occasion.

Additionally, I'm not even sure how long I'll choose to pump, because the other clock that is ticking is my biological clock. We won't be able to TTC until my period returns, which will most likely never happen while pumping this much. If/when we decide to TTC naturally or pursue fertility treatments again, the pumping will have to cease altogether.

Speaking of clocks, here is a snapshot of what our day looked like yesterday just to give you an idea of what goes down on a daily basis...


11:00 PM- Bottle of breastmilk (57 mL)
10:45 PM- Wet diaper
10:25 PM- Wet diaper
9:50 PM- Bottle of breastmilk (60 mL)
9:45 PM- Pumping (100 mL)
9:30 PM- Wet diaper
9:00 PM- Wet & dirty diaper
8:35 PM- Bottle of breasmilk (120 mL)
8:30 PM- Wet diaper
7:00 PM- Pumping (110 mL)
6:30 PM- Wet diaper
5:55 PM- Bottle of breastmilk (120 mL)

3:40 PM- Wet & dirty diaper
3:35 PM- Wet & dirty diaper
3:20 PM- Bottle of breatsmilk (128 mL)
3:15 PM- Pumping  (110 mL)

12:15 PM- Bottle of breastmilk (90 mL)
11:35 AM- Pumping (90 mL)

11:20 AM- Wet diaper
10:45 AM- Wet diaper
10:00 AM- Bottle of breastmilk (120 mL)
10:00 AM- Wet diaper
8:00 AM- Pumping (120 mL)

7:30 AM- Wet diaper
7:05 AM- Bottle of breastmilk (120 mL)
5:40 AM- Wet diaper
5:20 AM-Bottle of breastmilk (80 mL)

5:20 AM- Wet diaper
3:45 AM- Pumping (100 mL)

3:20 AM- Bottle of breastmilk (60 mL)
3:15 AM- Wet diaper
12:45 AM- Pumping (125 mL)
12:45 AM- Bottle of formula (128 mL)


Phew! Anyone tired just reading this?!?! It's just me and hubby flying solo here, so no rest for the weary! This day I'm happy to say we were able to give mostly breastmilk, because we did more formula the day before, and I had extra breastmilk stockpiling in the fridge. I would love to give this much breastmilk every day, but I'm always racing to pump more. Outside of carving out time, my body has just needed a lot of extra help to do this it seems.

Apparently, some women with fertility issues also have trouble with milk production, and I'm thinking it's plausible I might be one of them. Sure, I'm producing more now, but it's taken a village and whole lotta work, and it hasn't just happened naturally like it's supposed to. I haven't had my prolactin tested to find out if it's hormonal....I need another "to do" like I need a hole in the head if you can't tell. Honestly, I'm really not interested in traveling down a path of having a bunch of blood tests done to figure out what the real culprit is in this. 

What I'm able to get now is exponentially greater than it was at first though. I'm taking supplements religiously to try to help increase my supply, like fenugreek, blessed thistle, and nursing tea...


I'm now making about 2/3 of what Preston needs at this point, and we're giving less formula than we were before.  I'm still striving to make enough for 100% of his needs, which is no small feat as this milk monster's appetite grows leaps and bounds. I'm pretty sure he's having a growth spurt this week, but I'm not giving up as of yet. Now yesterday, when I woke up to blisters on my nipples...I was ready to just throw in the towel and quit altogether! It's easy to feel defeated when you are in pain or things aren't playing out the way you'd envisioned them. But then, I tweaked a few things (bought larger flanges, did some first aid on the nips, started using nipple butter again at each pumping, etc) and I was right back to pumping.

As for formula, that's been a challenge in and of itself.
Preston's tummy doesn't agree as well with it, and we are now on formula attempt #5. We've tried several to see what works at the advice of our pediatrician and many other moms out there. None of them settle as well as breastmilk, but Similac Alimentum seems to be the best for us so far. Of course, we may need to take out a second mortgage to afford this stuff. Cha-Ching! Gotta be the most expensive formula you can possibly buy. Figures! We've also added Culturelle probiotic to one bottle daily and are using infant gas drops with formula feedings. Still nothing works 100%, but we'll keep trying to ease his discomfort the best we can. When you see your baby in pain from gassiness or trying to poo, it's all you can do to try to fix it.

I never thought I'd be so affected by someone else's bowel movements, but it's like a 4th of July celebration around here when Preston has a good poop! He's happier, we're happier. I swear, even the cats are happier, because he's not fussing and crying. I really look forward to his digestive system normalizing more, which I understand usually happens by about 3 months. I'm assuming that the farting will not stop there though, and that I have many years of boy farts to look forward to.

As crazy as it's been, I've got to say I'm proud of us as a couple. We really have no clue what we're doing, but we're making it work. We've somehow managed to keep a clean home, feed ourselves, and make sure our animals are still alive as well. CPS has not come and arrested us yet, and our baby is eating and pooping and gaining weight (Preston was 9 lbs. 2 oz. at his 2 week apt, up from 8 lbs. 8 oz. at birth)...he's got to be over 10 lbs by now. I keep reminding myself that if the millions of idiots out there can raise a kid, then so can we!

Plus, all of the hectic moments just melt away when we look at the sweet face of this little boy who depends on us for every little thing. He has such a sweet personality already, and makes us laugh at the smallest of things, like his soft high pitched wimpers when he's tired or the way he attacks a bottle like a caveman when he's hungry. Here are a couple snaps over the last couple of weeks...


First bath at home

Snoozing right now as I blog
Snuggle attire...check!
First walk around the neighborhood. Fresh air!

Monday, August 25, 2014

Meet Preston Alexander!


It’s a bird. It’s a plane. It’s another birth plan flying straight out the window! Can you tell I’m trying to have a sense of humor about this?

It’s a reeeeally good thing I am not some type of crazy perfectionist Type A planner, because if I was I might be having a hard time with the fact almost nothing went according to plan when Preston decided to make an entrance a week ago today.

And this is why, although I prepared the best I could to create the birth experience I wanted ahead of time, I always prefaced my plans by saying, “I realize at any point things can change.” In so many cases, they just do, and I've always been realistic about that.


Still, I don’t think I could have possibly predicted the course of events as they actually played out. Sometimes our bodies just do what our bodies want to do. Here are some noteworthy and “shake my head” moments from our delivery...


Saturday 8/16

10:45 PM - Stood up and felt something wet. Proceeded to lose my mucus plug, then felt a HUGE POP (my water breaking like Niagara Falls), and began feeling real deal contractions all within the same hour. This after my recent OB apt showed 0% effacement and 0 cm dilation just days before.


-I remember that my OB is now on his weekend anniversary getaway. How convenient!

-Call my doula, who is already working another overnight doula job. She instructs me to sleep and she’ll try to make back-up arrangements. Sleep. Ha! Losing water by what seemed like the liter with each gush and contractions are becoming stronger.

-Hubby urges me with each contraction to just go to hospital, and I continue to justify all the reasons why I don’t want to go too soon. We arrive at hospital 6 hours after waters broke. Our doula is able to meet us there.

-Arrive 90% effaced, yet only 1 cm dilated.

-On-call OB is already insinuating Pitocin is needed at this point. Shut it lady!

-Nurse, on the other hand, is awesome and totally backing up my birth plan.


Sunday  8/17

-Continue to labor naturally ALL DAY LONG in a multitude of crunchy ways (shower, birth ball, mooing like a cow, etc).

-Dilation occurring slow as 100 year old molasses. Yet, the contractions keep on coming and hurt like a SOB. This is mostly because my water broke so long ago and there’s nothing to cushion the blow of each contraction, so I’m feeling EVERYTHING times ten.

-Even though they’re strong, they’re stuck at 3-4 minutes apart forever.


-Shift change occurs. Receive 2nd nurse. Miss my old nurse.

-Learn that baby has not engaged his head, but as he’s come down a bit, he’s decided to turn face up (this is not what you want for a natural delivery).  OB is unsuccessful turning him, but will try again once he descends a bit more.

-After 18 hours of labor, I’m told I’m still only 3 cm dilated and that I’m not even technically maintaining “active labor” at this point. OK, now you’ve got to be joking, because I guarantee this has to be active labor. Nope, technically it’s not.

-After 24 hours, OB is now insinuating a C section is going to be needed, because she can’t turn baby’s head after multiple attempts and I’m basically not progressing.  Want to punch said OB in face, but ignore her and continue working with my nurse and doula on creative ways to avoid it.

-Consider getting an epidural at the slight chance that it can give me enough rest and reprieve to allow my body to just relax enough for things to turn around. (This does actually occur in a small % of people). I’m told there are no guarantees that the epidural won’t slow my contractions, but that because they are so strong on their own, it’s slightly possible the epidural could benefit me without “slowing down labor” necessarily. It’s worth a shot at this point if it can help me relax and build strength to try pushing on my own. What have we got to lose at this point? I get the epidural.

-Holy crap, I can’t feel a thing. I get a nap. I wake up and have them stop the epidural meds so I can regain feeling and try pushing this baby down some more. Contractions have unfortunately spaced apart further now though, which is what we were hoping to avoid. I knew it was a risk of course.

-I’m STILL only 4 freaking cm dilated. Laughable.


Monday  8/18

-I’m urged to do something to help things progress and am reminded that even ACOG would recommend using synthetic oxytocin (Pitocin, etc) to augment a stalled progression at this point  (18-24 hours post water breaking).  Neither I, nor my doula could argue that point. I agree to start a small dose of Pitocin (Damnit!), but told we can back off of it if enough progress occurs with contractions.

-3rd shift change, and I get back my original awesome nurse. Have we really been here that long??

-Pitocin is indeed working to increase contractions and dilate cervix. Want to cry tears of joy when they tell me I’m dilated to 8 cm. I really think I can do this.

-Because I want the best chance to push, we do something really brave and taper off the epidural as well to catch a window where I can just push to my heart’s content and actually FEEL what I’m doing. I know I am completely bat shit crazy by the way.

-As we all see it, we are nearing our “last chance” attempts to move baby down to engage and get him to turn on his own for better positioning. Everyone in the room (nurse, doula, me, hubby) are determined. OB is taking a nap somewhere.

-Epidural officially worn off and pitocin is in agonizing full force. That drug is PURE EVIL! I push for about 2 hours straight like this.  Can’t believe I lived to tell about it.

-Trying everything to push and turn this baby. Nurse has used enough olive oil to feed an Italian army, and I am like a contortionist trying to push sideways, sitting half way up, on all fours, squatting, you name it.


-We can see baby’s head and hair while pushing, but it always goes back up during rest.

-After 30 hours of labor, my cervix is stuck at 9 cm, baby’s head is still facing wrong direction and won’t engage.

-OB voices her opinion that we should seriously consider doing a C section. I’m told that I could labor for another several hours with no further progress, even though I’m currently 9 cm, but especially considering all that we’ve already tried. My body had not established a very consistent pattern of labor on it’s own since the beginning. Highly unlikely baby will magically turn to allow shoulders under the pelvis either.

-My nurse and doula discuss the choice with us as a couple. I wish that my water hadn’t broken BEFORE having contractions, but there is nothing I can do to change that now. I cry because this is exactly what I didn’t want to happen, but I know in my heart that we’ve tried A LOT to get this baby out, and he’s JUST NOT COMING on his own.

-With either choice there are inherent risks. I realize how lucky we are that baby has not gone into distress this entire time, but there are no guarantees he won’t. I'm completely exhausted mentally, physically, and emotionally. I’m ready for the pain to be over, and we’re beyond ready to meet our baby.

-We choose to go ahead and do the C section. The minutes seem like hours as we wait for anesthesia to arrive. There is zero rest between the Pitocin induced contractions at this point, and it makes me even more content with our choice to get baby out NOW. Just do it already!

-We’re moved into the OR so fast that the anesthesia doesn’t even have time to fully work apparently, because I can actually feel them opening me up…I’m not talking about “pressure” here people. I can feel OB performing the procedure.

-Shaking like a leaf from the anesthesia being pumped into me, but moaning from the intense pain. The OB is literally yelling across the curtain at the anesthesiologist to “Get this girl something for the pain!” I can’t help but feel like I’m trapped in a bad episode of Days of Our Lives or something. lol Is this for real right now?

-Trying to get a hold of myself mentally, and the thought of meeting Preston and becoming a family with hubby gets me through. The other staff in the room try to maintain a light attitude and play “guess the baby’s weight” around the room. I guess with confidence that he’ll be 8.5 lbs.

-A few minutes later, at 6:08 AM (31 hours after my water broke), Preston Alexander finally met us face-to-face. His cry was THE MOST BEAUTIFUL THING I’ve ever heard in my life, and I began bawling like a baby myself the moment I heard it. He was given to me right away for skin-to-skin contact as they stitched me up, and we resumed following what was left in our birth plan as far as bonding time, breastfeeding, etc. He received a 9 out of 10 Apgar Score, and guess what…He weighed exactly 8 lbs. 8 oz. :)



Tuesday 8/19- Thursday 8/21

-Admitted for the mandatory 3 days post C section surgery recovery. Dad and baby all stayed in room with me the whole time.

-Half way through our stay Preston's weight dropped below normal weight loss levels (10.8%). He was deyhdrated, and completely stopped having wet and soiled diapers. He tested in the "very high" category for bilirubin (which indicated he had jaundice). He was inconsolable at times. It was heartbreaking to see him not well after being so healthy at birth. Scary couple of days for us!

-Preston received phototherapy for over 24 hours straight and was put on formula supplementation (delivered through SNS/Supplemental Nursing System). I delivered his formula through a small tube placed at the breast while I continued to breastfeed colostrum to him simultaneously. (more on this later)



Friday 8/22

-Preston gained a little weight back and began pooping/peeing again. His bilirubin returned to a healthy range.

-Discharged and finally returned home after being gone a full week. So thankful to be home!


So there you have it. "Overprepare, then go with the flow" was definitely put to use for the birth of our first born child. He was worth every prayer, every book read, every expert consulted, every battle fought, every moment we waited, and every single tear of joy and pain shed on his behalf along the way. I still can't believe that Preston is actually here and he's ours. He's absolutely perfect in every way!

Born 8/18 @ 8 lbs. 8 oz.

Snuggleworm


Broke my heart to see him so unhappy like this under phototherapy lights.
I know it could be worse, but this was really hard. I didn't sleep a wink.

Having some fun one night on a break from phototherapy.
Michael Phelps has got nothing on this kid's armspan!
Doing MUCH better the next day. All ready for his big
debut into the real world. If only he'll stop snoozin!

Can't believe we are finally a family of 3. :)


My handsome little date.

My two main squeezes together. Love these guys!


Trying out his snugapuppy swing. Two thumbs up.

Continuing to get some sun at home to clear out any remaining jaundice.

This face just makes me melt. Perfection.

All of us are settling in little by little.

Thursday, August 14, 2014

Single Digits...Maybe?

The irony... The first half of this pregnancy I was so concerned with carrying a healthy baby to full term. Perhaps it's because so many people are delivering early these days and/or experiencing NICU stays; whether it's from carrying multiples, choosing to do elective C sections, OB's pushing inductions to accommodate busy schedules, or some just delivering early naturally. For the most part, I think most pregnant women would agree, it's like you sit there holding your breath to make it past the Week 20's and into the 30's, and then when you get towards the end, you just start getting antsy. So, here I sit patiently waiting to see if my body will show ANY signs of impending labor whatsoever at almost 39 weeks (8 days until EDD of 8/22).

Of course, I want a fully baked bun, which means going until at least 40 weeks. I guess it would just be nice to see SOME sort of indication that this baby has ANY intention of making his debut in the next week or two...or three if it comes to that. At last OB check, I was still 0% effaced and 0 cm dilated. My cervix is basically like Fort Knox right now.

I know that everyone is different. Some people show thinning of the cervix and dilation steadily progressing in the weeks leading up to birth. They may experience baby dropping into position and contractions for weeks before delivering. Then for others, it just kind of happens all at once in the matter of 24-48 hours right before giving birth. I would love to have some sort of sign that things are beginning to move in the right direction, but if my lack of progress cervically is any indication, I'm still just holding out hope that I'll be one of those last minute moms whose baby comes just in the knick of time, before any interventions are necessary.

So when would it be time to intervene (meaning induce...ick)? Before my OB read my birth plan, he suggested that he'd recommend inducing if I went 10 days past my EDD. I DO NOT feel comfortable with this. Why? Because only 5% of babies are even born on their actual due date, and it is not uncommon at all to go 2 weeks early or 2 weeks late. This is just a fact well known for thousands of years. So, no you're not going to pump me full of meds when I'm still in a very normal range for something to happen on it's own.

True story: I, myself, was born 2 weeks late @ 8 lb. 13 oz. My parents were so poor that my mom received no prenatal care whatsoever, not even a doctor's visit prior to giving birth to me. In fact, they decided at 9 months along to move cross country from Maine to Texas, because my dad could find construction work in Texas easier. So, they drove all that way with my mom about to pop. She figured she'd just go to the nearest hospital if/when she went into labor. Then, when I was born (at a charity hospital with a doctor she didn't even know), her labor just came all at once, was very short, and I basically flew out of her vagina with a full head of hair at almost 9 lbs. Ha! At least that is what she told me.

Furthermore, ACOG's most recent recommendations even state that post date is considered past 42 weeks....not 40, not 41, but past 42 weeks. As you probably know, artificial induction (Pitocin, cervadil, cytotec, etc). causes much more painful contractions than would occur naturally. Once you opt to induce, there is a higher likelihood that you'll then request an epidural, which can then actually slow down labor (funny huh), which can then lead to baby "not progressing" or having fetal distress, which then increases likelihood of a C section, and ultimately higher risks for mom and baby both. Sounds fun right!?  I am by no means dogging anyone else who's gone this route, and inducing doesn't lead to the entire domino effect of interventions 100% of the time. I'd just prefer a natural alternative ideally.

At the end of the day, a live healthy baby is the most important outcome, and everyone has to make the decision best for them. However, you can see why induction is the enemy to most people who want a NUCB. There are women who are induced that do make it through with zero pain meds, but they are the exception rather than the rule. I would really just like to avoid all that jazz if humanly possible. Luckily, my OB has not mentioned the "I" word once in these late stages. In fact his words at our last apt a few days ago were, "Don't worry. It'll happen. I promise." Talk about a weight being lifted from my shoulders to just hear his confidence in allowing baby and my body to do it's thing in it's own time!

We will cross that bridge if we come to it, but for now I have no intention of letting anyone pull the induction card on us any time prior to 42 weeks. Nor will we fall prey to the "big baby card"...saying our baby will be too big or something crazy like that. Nope, not buying it!

Hopefully ya'll know me well enough to know I research the crap out of this stuff before forming an opinion. Baby is being closely monitored already with BPP's weekly. As long as there are no health issues with mom or with the baby and there is no disfunction indicated for the placenta, there are no real risks to either of us. Baby may just come a little late, and that's OK! A fellow mom relayed a quote to me that was drilled into her head in birthing class, and it stuck with me. They said to ask yourself, "Is mom OK? Is baby OK? Then, what's the problem?" I like that line of thinking!

So, in the meantime, I'm doing my normal...praying about it and just living my life. I've begun to do all the typical "come on baby voodoo" as far as drinking RRL tea, using a birth ball to bounce on/sway on, having intercourse, exercising 7 days/wk, and will begin acupuncture again next week if little one hasn't made an appearance by then. Also, doing all the stuff I won't have time to do once baby is here. I guess you could say this is my mantra right now...


My most recent reads, all good ones (lent from my doula)...



Got my hair did (added in some strawberry highlights)...



Did my own french pedicure (pretty proud of this)...



Have some food prepped for easy healthy dinners post-birth...




Preston's wardrobe is all washed and hung...



Most things are ready for the hospital bag, and car seat has been installed too. Now all we need is a baby!

Monday, August 4, 2014

BRCA Test Results & Belly Ninja Update (37 Wks + 3 Days)

Well, I finally did it. I had testing for the BRCA 1 & 2 genes done. It's been a long time coming. I did a pretty good job of ignoring the doctors' recommendations for long enough...and those of my step-mom (an oncology nurse) and those of my sister (who already had the testing done). The urging from all angles had reached it's max, and I figured I'd just stuck it up and bite the bullet.

You may have heard of this testing because of the publicity it received when Angelina Jolie recently hacked off her boobies after testing positive. If you haven't heard of it, BRCA 1 & 2 are genes that have been linked to increased risks for certain cancers, namely breast and ovarian, but also pancreatic and prostate. Read more about it here...

Myriad.com
(Click to Enlarge)

Basically, only 5-10% of cancers are considered to be hereditary through a genetic link. While this is a small %, for those who do carry a genetic link, risk of certain cancers increases dramatically. So, for those carrying the BRCA 1 or 2 gene, the risk of developing breast cancer is up to 87% in their lifetime. Compared to an only 8% risk occurring in those with no familial risk in the general population that's a pretty big difference! You can see how risk compares in the general population with those who have familial risks and those with known genetic mutations here...


Myriad.com- Risk Factor Comparison
(Click to Enlarge)

Because the risks are greatly increased for those carrying this gene, the recommendations for treatment in women who test positive can range from increased monitoring (u/s, MRI's), to taking risk reducing medications (like tamoxifen), to having prophylactic surgery (ie. removing both breasts, having ovaries removed, complete hysterectomy). This is one big reason I'd been putting it off...because we are kind of in the middle of our mission to procreate and I wasn't ready to say buh-bye to my lady parts quite yet. Plus, the recos all just seemed so unnatural and barbaric in a way. However, the more I've read about it, the more I can see the usefulness in having this testing done for those with a family history. Ignorance is not always bliss in the long run.

You should consider BRCA testing if...
  • A personal history of breast cancer at age 50 or younger
  • A personal history of triple negative breast cancer
  • A personal or family history of male breast cancer
  • A personal or family history of bilateral breast cancer (cancer in both breasts)
  • A personal history of ovarian cancer
  • A parent, sibling, child, grandparent, grandchild, uncle, aunt, nephew, niece or first cousin diagnosed with breast cancer at age 45 or younger
  • A mother, sister, daughter, grandmother, granddaughter, aunt, niece or first cousin diagnosed with ovarian cancer
  • A family history of both breast and ovarian cancers on the same side of the family (either mother's or father's side of the family)
  • Ashkenazi Jewish heritage and a family history of breast or ovarian cancer

My mom was diagnosed with Stage IIIB ovarian cancer at age 45 and died at 52. Her aunt died from breast cancer at age 46. I am unsure of further familial history on that side, because although my mom had like ten siblings, she was adopted as a baby. Additionally, my mom did not have the BRCA testing done, which leaves a giant ?.  Since she didn't have genetic testing done, my sisters and I have no way of knowing if we carry either of the genes linked to these cancers (it's passed down). You can read more info. on the Komen website if you care to.


Another reason I decided to do it now is that we happen to have some pretty damn good insurance right now, although it's only temporarily being provided through COBRA.
Remember how my hubby got let go from his company of 9 years conveniently when I was newly preggo? Well, they at least covered our health insurance via COBRA through the birth of this baby. It was the least they could do if you ask me.  Hubby did get another job shortly after that (we thought everything was golden at that point!) but he was then let go again very soon after (Yep, complete asshats). Thankfully we never dropped our COBRA coverage. Phew!

Needless to say, there's no real source of income for us right now, but we are very blessed to have outstanding health coverage through Sept. 30th....$0 deductible, 100% maternity coverage, etc. So, I figured I better take advantage of awesome insurance while we have it! The BRACAnalysis is not cheap. It runs roughly $4000+, but as I stalk my claims online, it looks like our insurer is going to cover it 100%. Say a prayer that this pending claim turns green sometime this century please. I'm checking daily, and I think it should go through!

C'mon, turn green!


I'm really glad I had the testing done, especially because (drumroll please)...

In the clear! woo hoo!

I was found to have NO MUTATIONS for BRCA 1 & 2!!! When we got the call, I put the phone on speaker so hubby could hear the results alongside me. I cried tears of joy (which I did not expect at all) but they just bursted out.  I think in that moment, I was just thinking of everything my mom went through in her 7 years of ovarian cancer treatment. I am grateful that I won't have to make any hard decisions regarding removal of my reproductive organs now, or even after having kiddos. Realistically, this negative result does not guarantee I won't get cancer like both of my parents, but it does remove the greatly increased risks that would have been present if I did have the BRCA gene(s).

It's moments like those that help keep what's important in life in perspective. Hubby may be out of a job right now. We haven't really known how we're going to live, where we're going to live, etc. since February. Will we have to move? Will we make it out alive financially before we blow through our savings and lose our benefits? We've had to change a lot about the way we live our day-to-day. But, in the whole scheme of things, those "problems" just pale so much in comparison to the fact that we're both healthy, happy, and expecting a miracle in our lives any day now. There is nothing, and I mean NOTHING, more important than our health and the love that we share. Period!

And on an even brighter note, we got to see the belly ninja today. Even though we are seeing our OB weekly now, and they are performing BPP's (biophysical profile u/s) weekly, this may be our last official growth scan. It was one of my favorite apts. of this entire pregnancy.

During the BPP, they check for breathing, movement, responsiveness, and amniotic fluid levels. They like to see baby practice breathing at least once during the test. Babies tend to practice breathing about 30 sec. at a time during this stage. Preston was breathing steadily the entire test and did not stop once. This didn't surprise me, because I can see/feel him breathing all the time these days. I can literally watch his back going up and down through my belly. It's pretty surreal. Amniotic fluid looked excellent, and he was moving all over the entire test. He scored 8 out of 8 and passed with flying colors.

As far as growth goes, we were asked yet again "Um, has this baby been measuring big?" Yep, he's a fatty! I pressed the u/s tech on how much these u/s measurements can be off, and she was adamant that they usually guess within 1/2 lb from what she's seen (not the 2 lb. differential I hear many moms speaking of). So the head scratcher from what moms say vs. what all the medical professionals say continues. Only time will tell, but as of today he's supposedly already weighing 7 lb. 11 oz. and his head is in the 97th percentile of growth. He's in the 77th % of growth overall and is measuring 38 wks + 4 days (8 days ahead).

One thing we all agreed on is that most of the weight must be in his cute chubby cheeks. We saw him yawning a few times and opening his eyes...firsts for us. It's just amazing to see him maturing right before our eyes. I can tell he's really getting ready to meet us here in the real world. We are so in love and can't wait to meet him!



Preston
= hb @ 173 bpm (moving around A LOT!)
             = scored 8 out of 8 on biophysical profile u/s
             = head down and low on mom's bladder
             = measuring 38 wks + 4 days
             = weighs 7 lbs. 11 oz!

Mom = weight @ 158 (28 lbs. gained)
          = bp @ 118/76
          = 0% effaced, 0 cm dilated (cervix still closed tightly)