Tuesday, March 31, 2009

2 week pediatrician visit


My husband and I took Ian to the pediatrician today for his 2-week visit. We both went because it was the first time we were meeting the doctor we had chosen. We both thought the doctor was nice and knowledgeable. I thought it was a little bit weird that the doctor couldn't make eye contact with either me or my husband. He seemed a bit on the socially awkward side, but a good doctor nonetheless. He spent a TON of time with us and answered all of our questions and I liked that.

It turns out that Ian is very healthy! He weighed 9 pounds, 2 ounces, which means he gained 12 ounces in 1 week. That's right on track because babies are supposed to gain 1 to 1.5 ounces per day. He also grew 1 inch since birth and is now 21 inches long. His height, weight and head circumference all measured just above the 50th percentile. He has no hip issues and no heart murmurs. The doctor also said that Ian is a very strong baby (which we already knew because he's been lifting his head since he was in the NICU!).

In other news, we have thankfully discovered mylicon anti-gas drops. Ian has been suffering from some nasty gas and then we all suffer when the gas strikes at 2:30 am. So we've been using the mylicon drops for over 24 hours now and there have been zero periods of inconsolable crying. The doctor said it was okay to continue to use this product and so I'm going to medicate my son to high heaven! He was also surprised that the product worked, since it only seems to work about 33% of the time. He told me that I may want to avoid salads and dairy products, since that can cause more gas in the baby.

I feel like Ian is already growing so fast. I want to enjoy this time with my newborn while I have it. People tell me it goes by so fast and I feel like that is already happening. I want to remember how he frantically nuzzles at my breast searching for the nipple (and inevitably finding the pillow or the air without my guidance). I want to remember the little swallowing and gulping noises he makes when he is feeding. I want to remember how good his warm little body feels against mine. I want to remember how often he gets the hiccups and how cute he sounds when he has them. It's amazing how much I already love him.

Saturday, March 28, 2009

The Adorable Things

I was worried about being a mom. I've never been the nurturing type and I never dreamed about the children I would have. My husband and I decided to try and have a baby because "it was time" and it's "now or never." And when I first held Ian 2 hours after my C-section, I felt only a logical curiosity, but didn't feel that strong mother's love that I expected to feel. But man, that changed quickly. I love Ian so much now. I feel so bad when he cries from his diaper rash and I want to make him feel better when he is struggling with gas. I guess I had that mothering instinct after all, which makes me feel great!

Here are the things that I love about Ian:

1. His head/hair is unbelievably soft. I stroke and caress it every single time he is feeding.
2. He makes the most adorable, plaintive cries when he is just waking up and wants to feed.
3. When he roots around looking for my nipple, it is so cute. He makes these "ah ah ah" sounds and tries to find my nipple in either the air or the pillow. Then he fights me when I try to direct his face to the correct location. (All this from the boy who couldn't find his way out of the womb either!)

Ian has definitely had his fussy periods where he will cry for no apparent reason. But overall, I would say that he is a very good baby. He feeds well, every 2 to 2.5 hours. He sleeps when he should sleep. And he is just so darn cute!

Friday, March 27, 2009

We Survived the Bris

Ian's bris was on Monday, March 23rd, 8 days after his birthday. He got through it like a champ. The mohel said he was a very calm and alert baby.



My mom and my mother-in-law lit the candles, my nephew said the Ha-motzi, my father was able to hold Ian prior to the surgery, my brother held Ian's legs during the surgery and my father-in-law held the wine-soaked gauze in Ian's mouth during the surgery. And based on Ian's facial expression in the below picture, I think he got a little drunk!



The ceremony was short and our mohel did a good job. I started crying when reading passages from the prayer book with my husband, but I was able to watch the surgery without a flinch. I felt bad for my husband's grandmother, who sat in the corner and looked very distraught that her great-grandson was in pain and crying. I tried to feed the baby after the surgery, but he wanted none of it. He cried for about 5 minutes afterwards and then had a nice nap. His great-grandmother sat in the room with him and watched over him.

Ian is named for his great-grandfathers Isaac and Isay. His middle name, Ravid, is in honor of his great-grandmother Rachel. His Hebrew name is Itai Ravid.

Wednesday, March 25, 2009

Assplosion!

I wanted my next blog entry to be about all the wonderful things that I have experienced thus far with my son. But last night's events require coverage. The baby was fussy all night, which I suppose is to be expected. So I wasn't getting much sleep. He also seemed to want to feed every 1 to 1.5 hours instead of 2 to 2.5 hours. At 5 am, after a feeding, I went to change his diaper. I had previously learned my lesson (when the baby pooped all over the changing table) and made sure that after removing the dirty diaper, I put a new diaper underneath him. But I didn't fasten the new diaper because I needed to put oil on his diaper rash and a new gauze pad over his newly circumcised penis. I turned to get the gauze pad, heard a massive pooping noise, looked back at the baby and was very dismayed to see poop EVERYWHERE. The poop had flown 2 feet horizontally! It was all over the box of baby wipes, all over the scissors that I use to cut gauze and it even made it onto the diaper genie and the floor near the diaper genie! I woke my husband up to help me clean up because I was so overwhelmed. I never knew there could be so much force behind a poop from an 8 pound baby! Let's just say I have now changed my diapering technique even further to prevent that from ever happening again.

It was also just a bad night for me. I was freezing and couldn't warm up and so I asked my husband to cuddle with me. But the minute he put his arm around me, I started crying uncontrollably! I wasn't sad. I wasn't depressed. I think I was just so over-tired and hormonal and it just kept on coming. I'm hoping that we don't have a repeat of tonight!

Tuesday, March 24, 2009

Facts from my First Week with Ian

Now that I have gotten my birth story out of the way, I can take my father's advice and stop "looking backwards" and look forwards. My first week with my son has been absolutely amazing. First, some facts:

Weight:

March 16, 2009: 8 pounds, 6 ounces

March 17, 2009: 7 pounds, 13 ounces (it is normal for the baby to lose weight after birth)

March 18/19, 2009: 7 pounds, 10.4 ounces

I went home from the hospital on Thursday, March 19. Although insurance will pay for 96 hours in the hospital post C-section, I chose to leave the hospital 1 day early for various reasons. These include the fact that I had actually been in the hospital since Sunday morning, March 15. I was also unable to get any rest because there was a constant flow of people in and out of my recovery room, including the pediatrician, midwife, nurses, student nurses, cleaning crews, photographers selling their wares, and administrative types. And by Thursday, I definitely felt well enough physically to head home and wasn't worried at all about getting up the stairs at home.

However, because Ian had come close to losing almost 10% of his birth weight and because I was leaving the hospital 1 day early, the pediatrician on call at the hospital thought it would be best if Ian saw a pediatrician on Friday, before the weekend. So on Friday morning, my husband, me and Ian made our first outing to the Harvard Vanguard, Wellesley location. I was very happy to see that Ian had stopped losing weight and weighed 7 pounds, 11 ounces. So he gained .6 ounces in one day. The pediatrician had hoped for a .75 ounce gain, because that is typical of babies at this stage, but we were close. She told us that if we kept seeing the orange/reddish uric acid crystals in Ian's diaper (which looks frighteningly like blood), we should supplement his feedings with formula. My milk supply had really started coming in and so I was hopeful that we wouldn't have to supplement (but knew if we had to, we had good samples of formula sitting in our kitchen cabinet).

Because I left the hospital early, we also qualified for a nurse to do a home visit in the first 48 hours after being discharged. I thought a home visit was WAY better than another day in the hospital. So a very nice nurse came to our home on Saturday morning and we got to ask all sorts of questions. She also weighed Ian and I was pleased to see that he now weighed 7 pounds, 15 ounces.

We went to the pediatrician again on Monday morning to make sure that Ian was gaining the appropriate amount of weight. And he weighed 8 pounds, 6 ounces (back to his birth weight!) The pediatrician was extraordinarily pleased that he was able to gain 7 ounces in 2 days! Ian is a feeding machine and I, apparently, am quite the cow. :-)

Sunday, March 22, 2009

Birth Story - It's a Doozie!

It's been just over 1 week since my water broke and I wanted to write down the details of my birth story before it gets even fuzzier:

On Sunday morning, March 15 (my predicted due date!), just past 5 am, I got out of bed to go to the bathroom. As I stood up and out of bed, I felt a gush of warm water leaking out. I paused like a deer caught in headlights and then said "Oh!" and realized that my membranes released. I told my husband, "I think my water just broke" and then I sort of half ran to the toilet because more fluid was leaking out. My husband got out of bed and I asked him to turn on the light in the bathroom. And then I saw that my amniotic fluid was filled with dark green meconium. I had learned about meconium by reading my books and in childbirth education classes and was disappointed to see it because I knew it meant more constant monitoring at the hospital. I called my doctor's office and waited for the midwife on call at the hospital to phone me back. While I waited for the midwife to call (about 25 minutes), I packed the rest of my hospital bag (slippers, pillow, etc.), updated my Facebook status (:-)) and got dressed. When I talked to the midwife, I told her about the meconium and she said that we should come to the hospital right away. We left the house around 6 am and I could feel some contractions starting. At my insistence, we first dropped by the library and returned all the videos I had taken out. We had a very easy drive to the hospital because it was early Sunday morning with no traffic and perfect weather and we arrived in the valet parking area around 6:30 am. We checked in at obstetrics admitting and given that we were already pre-registered, went directly up to labor and delivery. I sat in the waiting room in labor and delivery for about 10 minutes. There was one other couple there and the woman was apologizing to the receptionist because she was leaking fluid on the chair. I remember the receptionist saying, "Honey, don't worry about it. It's not the first time someone has leaked on that chair and it won't be the last!" A nurse then took me to my private labor and delivery room. I did not need to go to triage first (as we had learned on our hospital tour) because I had meconium in my amniotic fluid.

In the room, I changed into a hospital gown and the nurse connected me to a monitor (Intervention #1). One monitor was following my contractions and the other monitor was following the baby's heart rate. We asked for a telemetry monitor so that I could continue to move around and to jump-start my contractions, my husband and I took some laps around the hospital floor. About 40 minutes later, the contractions were getting very strong and painful and we retreated to my private room. The contractions kept coming and around 11 am, the midwife (Sophie) finally did an internal exam. They were trying not to examine me too much because my water had already broken and the risk of infection was higher. It turns out that I was only 1 cm dilated and the midwife couldn't even feel the baby's head. The midwife brought in the OB/GYN and they did a quick ultrasound to confirm that the baby's head was even pointed down. It turns out that it was pointed down, but he just STILL hadn't engaged. Knowing that the baby wasn't breech, I continued my labor process. I was shocked at how fast and furious the contractions kept coming. I had learned in my reading that you get a break in early labor, but I would have 3 contractions right on top of each other without any rest in between. The midwife suggested that I go into the shower and I took her advice and headed into the warm cocoon. I sat on a birthing ball and pointed the warm water on my abdomen. My husband sat outside the shower and reminded me to breathe and relax. I kept my eyes closed, but I could hear his voice and it was very reassuring. He told me later that he felt very powerless and unhelpful, but I couldn't have done it without him there. He also reminded me to tip back on the birth ball every now and then so that the shower drain could work. ;-) While in the shower, I got very nauseous and ended up throwing up twice into a white bucket. I remember thinking, "there goes all the cheerios I ate this morning" and I remember thinking, "I CANNOT believe I'm puking." Apparently, 50% of women in labor throw up due to pain and hormones. After 1 hour in the shower, I got out and headed back to bed. I proceeded to labor on my hands and knees and the nurse started an IV to help me with fluid retention (Intervention #2). The midwife performed another vaginal exam and I had gotten to 3 cm dilation and the baby had descended to a -2 position. This was at 2:30 pm and I had been laboring without pain relief for over 8 hours. I realized that it was going to be a very very long day since after 8 hours, I was only 3 cm dilated and at this point, I asked for pain relief.

I was trying very hard to avoid having an epidural and so asked for the Nubain shot (Intervention #3). I waited the 15 minutes they said it would take for it to be effective and when 20 minutes went by, I was very upset and felt ZERO pain relief. They said it would take the edge off the pain but it did nothing like that. I only felt just slightly fuzzy-headed but continued to feel EVERYTHING. I then broke down and begged for the epidural. My husband did not try to convince me otherwise - he could see just how much pain I was in - and we waited for the anaesthesiologist. It took what seemed like forever for them to arrive. I think once I broke down and made the decision to get pain relief, I wanted it to be immediate. The anaesthesiologist came in and started the procedure (Intervention #4). The worst part about all of this is that my contractions never let up. I didn't have any time in between contractions for them to do the procedure. So for 2 very strong contractions, I had to sit on the bed, staying still, and let the doctor place the catheter. It was very very very hard to do this. Prior to this, I was able to rely on changing positions and rocking to help me through the pain. But I could not do this while the doctor was near my spine. So the midwife held my hand and my husband held my hand and I groaned a lot and didn't move and made it through. It then took another 20 minutes for the epidural to take effect and I FINALLY had pain relief at 3:30 pm, 9 hours after starting to labor.

The next part of labor was pretty nice. I was able to lie in bed and rest. I could tell that I was having contractions, but there was no pain. If I started to feel pain, I was able to press a button that delivered more medication through the epidural. The midwife connected me to a slow pitocin drip (Intervention #5) and I also got connected to IV antibiotics because my water had broken and I had meconium (Intervention #6). Vaginal exams showed that I progressed from 3 cm dilation to 6 cm and then to 8 cm. And the baby was descending too - he had made it to the 0 station. And I think I was able to sleep during some of this time and my husband was also able to get some rest and relax.

At some point, the baby started showing some distress. My pattern of contractions had never changed...I kept getting 3 contractions right in a row, followed by a longish break and the baby wasn't tolerating the 6-7 minutes of constant contractions. The midwife didn't like the monitoring that she was getting from my belly and suggested that we use an internal probe to monitor the baby's heart rate. I really didn't want to do this because it basically involves a fish hook in the baby's scalp. So I was able to put it off for a bit and convinced the midwife it wasn't necessary yet. I also started to feel a lot more pain. The epidural did not appear to be working anymore. I pressed the button over and over and the pain got worse and worse. It was probably around 2:30 am when this happened. I was very frustrated at this point because I didn't expect the pain relief to go away. So after so many hours in labor, I was feeling all the pain again and I was very tired and very drained. The anaesthesiologist came in and after poking me with what looked like a toothpick, he determined that the epidural was, in fact, no longer working properly and needed to place a new one (Intervention #7). My legs were still quite numb at this point and so they were able to place the second catheter while I was lying in bed on my side. In order to give me instant relief, they gave me a combined spinal/epidural and within 1 minute of the spinal, I got instant relief. I was told that this is the amount of medication they use for C-sections and that it would wear off in about 40 minutes and the epidural would take effect. This was amazing. My legs were COMPLETELY numb, but it felt amazing to feel no pain.

The midwife (Biddy) continued to allow me to labor after this, but began preparing me mentally for the idea that I might need a C-section. I begged for a bit more time as long as the baby could handle it because I felt like I had been making progress, albeit it slow progress. The midwife agreed but wanted the baby to have the scalp monitor. At this point, I did agree to this procedure (Intervention #8) if it meant I could still have a vaginal delivery. The midwife checked my progress again and I had made it to 9 cm dilation and the baby had descended to the +1 position. Unfortunately, 2-3 hours later, I had completely stalled at 9 cm dilation and +1 position. I felt the urges to push - it felt like downward pressure in my rectum - but I had to relax through them. They told me that if I pushed at 9 cm, I not only would not get the baby out, but I would cause swelling. In addition, the baby needed to be at +2 position for me to be ready to push.

The baby's heart rate continued to show that he was in distress through my rough contractions. They had to shut off the pitocin drip because my natural contractions were already strong enough. But this meant that they couldn't use pitocin to regulate the contractions. I was told that my uterus never got "organized." Too bad I couldn't organize my uterus along with my house! By 4:30 am, the call was made for me to have a C-section and I agreed (Intervention #9). The doctor was busy with another delivery and we waited another 1 hour, at which point the C-section became quite urgent. At 5:30 am, they wheeled me into the operating room and my husband had to stay outside while they prepped me. This was the first time all day I had cried. I was tired, I was drained, I was upset that I wasn't having the vaginal birth that I had predicted and it was a bit scary lying there on the operating table without my husband. At some point, he was allowed to come in and I felt better.

The doctors put the screen up so that I couldn't see anything and they began their work. I felt a lot of pressure and tugging. At one point, the doctor leaned over the screen and said, "Do you exercise a lot?" And I said "Yes." And she said, "Well, we can tell because your abdominal muscles are very tight!" So I guess, if you have to get cut open, it's nice to have a compliment about your strong ab muscles! The doctor commented two more times about how strong my ab muscles were. I think she was having a very hard time pulling out the baby. My husband peeked over the curtain once and said that it looked like the doctor was using all of her strength to pry me open. The anaesthesiologist videotaped my baby's arrival into this world. I watched it - it's very cool, like something you would see on the Discovery channel.

They took the baby and informed me that I wouldn't hear him cry right away. They did not want to stimulate him to breathe because they wanted a chance to suck away the meconium that was in his air passages so that he didn't aspirate it. It seemed like forever. I then I heard "1, 2, 3" and "1, 2, 3" and got concerned because I realized they were doing CPR. They needed to "jump start" his breathing. But then I heard his wonderful cry. It was pretty gargled because there was meconium left there, but it was a good cry nonetheless. And that's when I cried for the second time during labor. It was amazing to hear him cry. His Apgar score at 1 minute was a 2, which is pretty low and scary. But his Apgar score at 5 minutes was an 8, which means he really bounced back very quickly. I got to see him only very briefly before he and my husband went up to the NICU where he received IV antibiotics. I was then stitched up and wheeled back into the labor and delivery room to recover. I made a couple of phone calls to my parents, to my husband's parents, and to my sister and my brother. I tried to talk and sound brave even though I was shaking very badly and uncontrollably from the labor and anaesthesia. Roughly 2 hours after my baby was pulled out of me, I was finally able to hold him. And that felt really good. I finally had my baby. Ian Ravid was born on Monday, March 16 at 6:11 am. He weighed 8 pounds, 6 ounces, was 20 inches long and was absolutely beautiful.



Saturday, March 14, 2009

40 weeks!

Here I am. It's 40 weeks. According to the IVF doctor, tomorrow, March 15 is my due date. But according to all of the IVF calendars online, based on a June 21 egg retrieval, today is my due date. In the end, it doesn't really matter because I'm still pregnant. I've been having the usual Braxton-Hicks contractions - a lot of them in fact - but it still means nothing. I'm pretty sure the baby still hasn't dropped because I'm still gasping for breath every now and then. But I can feel the baby moving around in there and so I'm assured that all is well.

I was surprised to get on the scale this morning and see it read 169.0. This means that I've lost weight (2 pounds!) since last week and I'm only up a total of 26.5 pounds for a completely full-term pregnancy. That seems...wrong. I did swim 60 laps on Thursday and another 60 laps yesterday, but there's no way that this caused me to lose so much weight. Either way, I'll take it because perhaps it means that my baby isn't ginormous and can actually fit through me.

I'm officially done with work. I turned on my out-of-office e-mail assistant and changed my voicemail. I am free from being an attorney until mid-September! This 6-month maternity leave will be a welcome break (although as I've been reminded by many that it will still be "work"). Now I just need a freakin' baby to keep me occupied!

Thursday, March 12, 2009

3 days until Due Date...

And here I sit, on my couch, with 3 days left until my due date. I am technically "working from home" through tomorrow, but I basically have no work left because I have already transitioned off all of my matters. I saw my midwife this past Tuesday and asked her to do an internal exam. Unfortunately, there's not a whole lot that is going on in there. My cervix is still long and closed, the same as my week 37 exam. And the baby is still floating and not engaged.

The midwife tried to strip my membranes (although annoyingly she didn't tell me at the time what she was doing and so I was wondering why the vaginal exam was taking so long and becoming increasingly painful). But in the end, she wasn't successful because my cervix was still just too far back and the exam was too uncomfortable for me. I'm still having loads of Braxton-Hicks contractions, but given that I've had so many over the last 2 weeks and the state of my cervix hasn't changed at all, I'm a bit discouraged.

As far as next steps go, I will have an appointment with the doctor next Tuesday (2 days after my due date) and she will do another internal exam. The midwife said that the doctor will most likely send me to Boston Ultrasound so that we can double-check, through an ultrasound, that it is safe to continue to wait for me to go into labor naturally. I will then see the midwife again on Friday (if I'm still pregnant) and they will put me on the monitor to make sure all is well with the baby. After that, I could be looking at induction, but I'd really rather not do that. But they won't let me go past 42 weeks. So the most I have left is 2 weeks, 3 days. I guess I'll just sit back and relax and try to enjoy the downtime. I picked up a load of books and movies from the library and that will keep me occupied. And now that my cold seems to be better, I'm going to go swimming.

Saturday, March 7, 2009

39 Weeks!

I've made it to 39 weeks. The baby seems happy to stay inside me. Based on my side profile in the mirror, I'm pretty sure he still isn't engaged.

Although I am desperate to meet this baby, now I want him to stay inside just a little bit longer until I get rid of this miserable head cold. I started feeling bad yesterday and now I'm just one big ball of snot. I would rather not have to go through labor/delivery like this. It certainly won't make breathing through the pain very easy. After an entire pregnancy of no sickness, I guess I had this coming. I'm sure I caught the cold because I haven't been sleeping and my immune system wasn't at its best. I'm planning on drinking lots of tea this weekend and kicking this thing to the curb. And I'll work from home on Monday.

As of today, I am 171.0 pounds, which brings me to a total weight gain of 28.5 pounds.

Thursday, March 5, 2009

Elusive Sleep

I no longer sleep and I'm beginning to dread nighttime. I am so uncomfortable in bed. Body parts (including ears and shoulders) go numb after only a short time. I toss and turn from side-to-side and because I can't do this easily, sometimes I get stuck in a back-lying position, which just hurts. I have a contraction on my left side. So I switch to my right side, but the contraction gets worse. I switch back to my left side, grunting in frustration and discomfort. I get up to pee. I have a contraction. I empty my bladder, I have a contraction. I climb back into bed, I have a contraction. I'm currently 10 days shy of my due date. I'm thinking, "Hey, I can make it another 10 days." But I will say that I am now terrified of delivering late. I'm using all mental powers to banish from my mind the idea that I could still go 2 weeks PAST my due date. Sigh. The good news is that Friday, March 13 is my last day at work. At least after that, I'll be able to nap during the day when I'm so exhausted after a no-sleep night.

Monday, March 2, 2009

Snowstorm

It is snowing...and it is snowing a lot. The weather report says that it is currently 19.3 degrees with heavy snow, freezing fog and up to 35 mph wind gusts. On top of that, there is a slight chance of thunderstorms?!

I am PRAYING that I do not going into labor. I'm not sure we would make it to the hospital!