Sunday, June 21, 2015

Guess Who's Back

passing the car seat challenge at GW
I was both excited and relieved when Kraemer made it to the delivery room. I could hear nurses and doctors congratulating him on his way in, and a smiling but maybe a slightly nervous Kraemer insisting, “Don’t tell me!”

Unlike with Calder, we had a list of names – both boy and girl names – before we even stepped foot in the hospital. But like with Calder, it still took us nearly the entire hospital stay to settle on one. We picked Beckett Rider Lovelace, more than anything because we liked how those names sounded, but Beckett, of English origin, means “stream,” which coincidentally seemed to fit nicely with Calder’s meaning, “rocky river.”

The first thing I remember asking the doctors after delivery was whether my baby would need to go to the NICU. Turns out he had a healthy set of lungs, but his blood sugar level was dangerously low (hypoglycemia), so they recommended skipping the breast and going straight to bottle and formula in order to get his numbers up – he needed to meet a certain threshold, 45 mg/dL, to stay out of the NICU, and he was only at 27. We fed vigorously over the next 24 hours, as much as Beckett would allow, and kangarooed as much as possible to keep his body temperature up and respiratory rate steady. Despite satisfied responses from the doctors and nurses regarding his health, I was skeptical. Even after he passed his car seat challenge (just barely, I might add), I was waiting. My plan was to hold off on any celebration for eluding the NICU until we were discharged and home, and once that happened, I happily announced the birth of our son to friends and family.

home for a hot second and
meeting Grandpa (aka Papa?)
chilling with Grandma (name in
progress - ask Calder)
Alas, even then I had spoken too soon! At Beckett’s first visit to the pediatrician on Thursday, there was some concern about him being jaundiced. Upon seeing his skin tone, my mom called it immediately, and although I was seeing more red than yellow at the time, and trusting that the reading at the hospital had been accurate and had not increased, the next morning I could see yellow in the whites of his eyes and his gums. We weren’t surprised then when the pediatrician sent us to the hospital to have his blood drawn and tested. What’s acceptable varies according to how old the baby is, but the results we received that day were that his bilirubin levels were “bordering” the danger zone. We were instructed to feed him as much as he would take, and some doctor and nurse friends recommended we expose him to indirect (definitely indirect!) sunlight, before returning the next day for another reading.

first stop, the beach

The second reading showed only a slight increase, but that was enough to push him over the limits and to demonstrate that we were not moving in the right direction. Without giving us an option on hospitals, our pediatrician arranged to have us admitted to the Inova Fairfax Children’s Hospital’s pediatrics unit. We didn’t fight the choice, though – before we’d walked in the door, anticipating this outcome, we had already agreed Fairfax would likely be our top choice. Within less than a couple of hours I received a call telling us a bed was ready.

As we settled into our room and the nurses took Beckett’s vitals, we were still in pretty good spirits. Beckett was struggling with jaundice, but we’d caught it, a stint in his sunnies on the “beach” would fix him up, and we’d be home in 24-48 hours. The dry erase board with his name, his vitals and the names of our nurses and doctors for the day instructed him to eat, pee and poop, which all seemed easy enough. The room was set up with an open crib for Beckett, a hospital bed and a pull-out bed, which made it seem palatable to stay for a night, maybe two if need be.
Keeping B warm
Given that Beckett has had an extremely (and increasingly) low body temperature since we left GW, I was concerned that they were putting him in an open crib rather than an incubator since, for the lights to be effective, he’d only be sporting a diaper. The nurses nodded in agreement and set off to see whether an incubator was available.

No sooner had they left the room did the attending fly in, introduce herself breathlessly and explain that she *normally* doesn’t see people this quickly upon check in – but that Beckett’s vitals scared her enough to want to visit promptly. She cut to the chase and told us she was worried Beckett had meningitis and wanted to draw his blood, collect his urine and do a spinal tap. He’d certainly have an incubator. And an IV. The nurse behind her shook her head and looked at me sympathetically, mouthing not to worry. Not exactly what we’d signed up for – what happened to eat, pee, poop?

Now. That was Friday afternoon, and it’s now Sunday evening. We are hoping to leave tomorrow afternoon, Tuesday at the latest, but no one is comfortable yet projecting our discharge date. Although his blood work came back okay, and his spinal tap okay (ruling out the meningitis fear that instigated this whole mess), his urine sample has sprouted a growth, and they’re waiting for more information from the culture. His bilirubinemia has resolved but he is still struggling to regulate his temperature. They’ve still got him on prophylactic antibiotics. I cannot believe I’m going to say this – and I have to admit I’m not entirely sure I mean it – but I wish we were in the NICU. It’s not that they haven’t taken good care of us here but more that I feel I know and trust the neonatologists in the NICU more than I trust the pediatric attendings and residents here. I recognize that that probably isn’t fair, but on more than one occasion it’s been clear to us, sometimes directly stated, that they do not specialize or even frequently see children this young. Who can blame them? Our kid is only a week old TODAY and almost certainly should never have left GW without a few days in their NICU.

In the meantime, Calder is totally kicking it into high gear in the speech department. A few weeks ago I pointed out the moon to him on our way to get milkshakes one evening after dinner, and the other day when I pointed to the crescent moon in one of his books, he said “moon” for me! He says “(ba)nana,” “ball,” “door.” We get regular updates from my in-laws, who have graciously extended their stay in order to care for him while the three of us are holed up in the hospital. I miss him SO MUCH and can’t wait to go party with him.

Make mischief?

Wednesday, June 17, 2015

Hello, World!

Guess what? We did not have to wait quite as long as we thought we might to discover the baby’s sex: baby boy Beckett Rider Lovelace joined the party on Sunday, June 14, 2015, weighing in at a whopping 5 lb, 1 oz. As my father-in-law put it, we just can’t seem to have a vanilla baby – Beckett came at 34 weeks. My very first thought after delivery – heck, maybe this thought was occurring during labor, though I’ll get to labor momentarily, and I cannot say I remember much about it – and very first question for the doctors was, “Does he have to go to the NICU?” (Update: I’ll learn later the answer would have been different elsewhere.)
Beckett's first photo op

This labor wasn’t what I expected it to be but then again, when is it? I’d been told when I was pregnant with Calder not to have a birth plan, or at least not to be wedded to one, and I suppose that was good advice given the way things played out.

this is serious, everybody
Let me set the scene. It’s Sunday, and I’m planning a big day of being productive. Saturday we had taken Calder to the street just around the corner, one of my favorite streets – who wouldn’t want to live on a quaint, tree-lined street dotted with benches that are always hosting a friendly conversation – to a street fair. He had a BALL with the fire truck, the pony rides, the sprinkler … you name it. This also meant I got nothing done all day. So Sunday, that was going to be cleaning day. I’d also typed out a list of what I wanted to pack for the hospital (I was 34 weeks and not going to get caught unawares this time!) and written out some instructions for whomever might be caring for Calder while we were away, just in case it would be friends of ours who’d never watched him before and wouldn’t know where to find the sippy cups, you know? (shout out to Mary Ellen and Tommy, who do know where everything is, thank you thank you thank you!!) I needed Sunday to actually pack that bag and print those instructions.

It’s shortly before 9am and I’m standing at the kitchen sink loading the dishwasher after feeding Calder breakfast. A sharp pain in my side has me heading for the couch instead of breakfast, and I tell Kraemer I need to lay down. My voice has an edge, so he plays it cool and tells me to relax while he takes Calder out back. About 10 or 15 minutes later – I’m not timing – I try to stand, thinking I’m not getting another one. But the second I stand up, there it is, and it’s strong. "I think it's labor," I shout around the corner, and I’m going to go upstairs to lay down and do this labor thing from the comfort of bed. I’d been hoping to go into labor on a weekday so that Virginia (our nanny) would have Calder and Kraemer could be my full-time doula, but it’s beginning to look as though that plan will not pan out. 

After my first pregnancy, I’d read more into the phenomenon of  Braxton Hicks, and how if you move positions sometimes these false contractions will go away, so I decide to get up and start a bath. Hm, no. Contraction. I lay down. I call the doctor, and the answering service tells me they’ll return the call within one hour, two at the most. I get up to brush my teeth. Not so much. I call Kraemer upstairs and when he gets there, ask that he call 911. A one-hour call-back time isn’t going to cut it, and there’s no way I’d be able to a) sit up in the car to wear a seat belt or b) make it to the hospital in time if we have to get Calder into a car seat and heed the traffic lights. I’m still not timing my contractions, but that’s mostly because, well, I don’t have to time these to know they are too strong and too fast to just be getting started. After assuring Kraemer there is NO way I’m getting downstairs into our car, I hear him replying to the dispatcher that my contractions are, yes, less than five minutes apart. This must have all been over a span of 25 minutes.

To anyone who has been in labor before, whether you opted for an epidural or not, a 1.5-hour labor probably sounds pretty fabulous. Mmmm – it has its pluses and minuses. Thankfully, at this point I was 34 weeks, not 24, as I was with Calder, but I’m terrified I’m going to deliver a premature baby at home, where there are no NICU staff on hand. I can hear Kraemer in the other room with Calder, changing his diaper, maybe getting him dressed? When he returns, I can tell Calder is in distress, probably because *I’m* curled in a ball on my bed, distressed. Poor kid. Kraemer later told me he finally resorted to handing Calder his Wubbanub. And I breathe a huge sigh of relief when I can hear the sirens whirring toward our house, hopeful and certain this ride has to be mine. The paramedics clomp upstairs and ask whether I can make it down on my own. I’m skeptical but in a hurry, so the minute a contraction stops, I patter downstairs in my robe, into the street and onto the gurney, and no, I do not need shoes, thank you very much, but Kraemer is behind me toting Calder and hands the paramedic my flip flops, ID and insurance card and lays my cell phone by my side. Calder looks completely bewildered so I try to put on my calmest voice and tell him I’ll see him soon and then I’m in the back of the ambulance.

At this point, I’m more inside my head than anything else and keep my eyes squeezed shut the entire ride there. I’m certain labor and delivery CAN be a peaceful experience for some, and I’m trying to picture all of the relaxation techniques I’d learned about only a couple days before in a birthing class that will later (or rather had already) become a joke between Kraemer and I. Not that I’m in a position at this stage to really use any of them except for breathing in my nose and out my mouth, so I do. I’m sure that though challenging, generally labor is nothing to fret about, but I’m admittedly freaked out. My baby is early, I’m in transit rather than at home with a midwife or in the hospital with doctors, and I’m in the company of paramedics, not my husband.

I’ve got a death grip on the paramedic’s hand, who, by the way, has been great. By the time they roll me into L&D without stopping in the ER, as is protocol, I’m 8 cm dilated. The doctor introduces herself and apologizes for not having been able to return my call. The room is full of residents, nurses and doctors, which is probably normal but still a bit overwhelming, but I’m happy to have made it to the hospital, period. The paramedic tells me apologetically that at this stage she needs to get out the way, and no one steps in to take her place, so I find myself grabbing the railing on my bed. I realize that Kraemer, who has to find someone to watch Calder, isn’t going to make it for the birth. The doctor who has been seeing me throughout my pregnancy happens to be on a call and I feel a little bit of comfort when he walks into the room, a familiar face. I have two or three more contractions once in the room before having contractions where I feel the urge to push, and the doctors confirm it’s time.

Within maybe five more minutes, I have a baby. I probably yelled to wake the dead. Partly because, you know, it hurts, and I had no epidural, partly because I'm squeezing the awkward plastic rail on my bed instead of my husband's hand, and partly because the morning was TRAUMATIC and I'm having a preemie again -- and this time I'm familiar with what that could mean. Less than 90 minutes after my first contraction I hear him cry, a welcome relief, and they lay him on my chest -- the one part of the birthing experience I really wanted more than anything. Everyone comments on his nice set of lungs, and I’m already proud of him. I can’t wait for Kraemer to walk in and meet his son.

Sunday, June 7, 2015

freeing the speech

Don't think I can't reach the table on my tippy toes.
Or climb that chair and reach anything I want.
And why, yes, that colander is right where I want it.
Time to watch what we say – time, or long past – Calder is mimicking us like crazy these days! While it’s not clear it’s the new speech therapist that is making the difference, she has a very different, more metered approach, and we think she’s great. So does Calder! As long as Calder’s in the mood, he’s willing to make an attempt at anything. He’s also got a very small repertoire of words he’ll speak spontaneously: besides “uh oh,” he loves to say, “wow” and is starting saying “more” rather than only signing it. He has a special hybrid of “water” and “agua” he uses when he wants his straw cup with water – I haven’t decided yet whether he’s actually using the English or Spanish version. When prompted, he is starting to tell people “nigh(t) nigh(t).” Toddler speak is pretty much the cutest.

He’s also growing big-time, so it’s time to start watching what we put where.

For Father’s Day I bought Kraemer a Nats t-shirt, since he’s been aching to get to some games, and a little Nats ensemble for Calder as well, so that they could be stylin’ together for Calder’s first game. They went today and look like happy campers to me.

I recently ran across this article in the Huff Post about little tips or considerations to keep in mind while you’re raising your children. Not naggy advice, but fun stuff. I can’t wait to hear what Calder has to say about God and Santa Claus…

Sunday, May 24, 2015

sum, sum, summertime!

breakfast beignets!
That’s almost always the first question anyone asks when they find out a woman is pregnant, right? I waver back and forth between whether it’s “no big deal” to wait until delivery day to find out the baby’s sex and being on the edge of my seat. I personally have gone from being certain one way or the other at least four times. I’ve had two random women tell me it’s clearly a boy by the way I’m carrying – whatever that means. My supervisor is sure it’s a girl, and my nanny has gone from confident it’s a girl, to a boy, to pure despair that she has no idea. But I’m not anxious about it, or worried about having what we need for a specific sex; instead, I am just super, duper excited to see who joins the fam. And I get more excited about it the closer I get to my due date. We have a nice long list of names picked out for both sexes at this point; there’s gotta be a winner in there somewhere.

We’ve got a couple birthdays coming up in the family – Kraemer’s and Calder’s are within days of one another once we hit the end of June. I’ve been thinking of it for months but have never really felt the energy to plan and was also never sure whether I might have a newborn by then. I’m feeling more confident in a term baby at this point, but that could still mean delivery the first week of July. Even if I get up the energy to plan a party, the question is finding the time. There are still things on my to-do list from 1.5 years ago (no joke.) I’m assuring myself that as long as I provide a cake, regardless of whether there are guests (DC folks? Cake, anyone?), I’ll have met my duty. Calder won’t complain, right? 

kickin' it
Calder is still communicating primarily through some sign language and a lot of “ee-ing.” He regularly signs things like, “sorry,” “please,” “more” and has a few others up his sleeve, like “ball” and other things he may encounter throughout the day. He says “Cr-cr” for cracker and says “ga-ga” for, well, just about everything. He’s 23 months – I guess something like 19 adjusted. I’m not worried, and I don’t really plan to start worrying (can you *plan* your worrying?) until he’s 3ish. Even so, we are switching the speech therapist currently seeing Calder through the Strong Start program; this was precipitated more because our new nap schedule does not coincide well with the current therapist’s availability than anything else, yet I’m interested to see what a different therapist’s approach looks like and whether it engenders more progress than the last.

intro to swinging (as baby swing intro did not go so well)
patio surgery

beach boys tribute on the water
I have officially made it further in my pregnancy than before; passing the 24-week mark felt rather surreal! At the time, it felt a little bit as though I was embarking on an entirely new journey because, well, in some respects, I was. I’ve said before that though it surely sounds funny, there was a sadness that came with Calder’s early delivery that was separate from the anxiety and despair and …. well, all that stuff… that came from the scariness of being in the NICU. There was also this mourning I was doing for my pregnancy. I was sad I was no longer providing the safe, warm womb where my child could continue to be properly nurtured and sad that I did not have that little companion for as long as I had expected to – I always say, expectations are everything! So this time, despite all the “fun” side effects that come with the third trimester, where at times I will admit that, like any “typical” expectant mom, one who has not birthed a micropreemie, YES! Yes, I do sometimes feel eager for delivery day so that I can just be done with this pregnant body of mine! On the other hand, my (somewhat) atypical perspective serves to keep me in check, and I will endure as happily as possible whatever my body decides to throw at me.
Last pregnancy we did not have time to do a lot of things, one of which being a childbirth class. I’m quite sure it’s not necessary, that plenty of women deliver plenty of babies without doing any research prior to pushing, but as I’ve tried to explain to Kraemer when justifying the pending bill, there is more to it than pushing and Dad playing catch. We make decisions on most big purchases together, but I told him he didn’t get to fight me on this one. I expect that it will give me some peace of mind, along with information on things I don’t even know I don’t know, not to mention on a few questions I have related to epidurals, things specific to delivery at our hospital, etc. Or at least let’s hope so, or I’ll never hear the end of it from my husband. J

Saturday, April 18, 2015

Stepping Out

I ran across this site with a bunch of quotes from famous (or halfway famous) folks and was surprised by the depth of a few. 
"Before I had my child, I thought I knew all the boundaries of myself, that I understood the limits of my heart. It's extraordinary to have all those limits thrown out, to realize your love is inexhaustible." - Uma Thurman

How true. And what a wonderful discovery!

As of April 3ish (21mos, 17.5 mos adjusted), Calder weighed 22.5 lbs. At first blush, this sounded pretty good to me – but when you go to the charts, which we inevitably always do, just to be SURE he hasn’t stopped growing altogether – you find that he’s still barely *on* the charts. Thankfully, I’m at a place where I really don’t mind. As long as he isn’t totally stagnant, or regressing, I’m feeling pretty content. He looks fine to me. Sometimes, and I admit I don’t have much of a barometer, he even looks big.

At this stage, we have also fortunately wrapped up our last Synagis shot (for real this time! And thank heavens.) and we are gearing up to take the man out into the wild, wonderful world. As anxious as we are for him to experience all the world has to offer – namely kids his age and normal kid entertainment around here, like the park – we have been very cautious about popping his bubble. Calder has now been cleared by his doctors for public introduction but not for playgrounds and other spots swarming with children without any measures in place that control for whether they’re sick or not.

As we await full clearance, however, we’re going to do what we can. This past weekend we headed to the DC zoo (yes, there was lots of keeping him from touching everything at kid-height and lots of handsan involved.) At one point, as we were leaving the lions, Calder became interested in a relief about his height of various zoo animals. As he ran his hands along it, another little boy, a bit older, walked up and put his hands on it as well, getting right next to Calder – apparently too close for Calder’s taste. He leaned over and gently pushed the kid on his arm! Me being a total newbie to the play environment, I’m thinking, what do I do here? Of course tell Calder he shouldn’t do that – do I also apologize to the parent? Make eye contact and shrug, “kids?” We tried to explain to Calder the concept of playing nice. Ha. Clearly, we have some socializing to do. Other parents have assured me that no kids under 3 have manners or social skills, that Calder isn’t the only one a little clueless about or at times uninterested in playing with other toddlers.

Miss Virginia has also started to take Calder to the library two days a week for story time. At his first visit, while all the other little ones sat calmly in their parents’ or nannies’ laps, Calder sped back and forth up to the reader, craned his neck so that he could get underneath the guy (since he was reading, looking down) and gave him a gigantic silly smile. Sounds like my son.

i see a cheetah!
Things haven’t been completely uneventful on the pregnancy front, unfortunately. Though the phenomenon is tough to describe, I experienced an intense bout of what I can only call itching beneath the skin underneath my shoulder blades and rib cage. These days I relate every last sensation to my doctors, but thinking it wasn’t urgent, sent a message rather than made a phone call. A few hours later the triage nurse dialed me up and asked whether I could come in immediately; there was concern the itching was related to a condition (cholestasis of pregnancy) that could seriously compromise the baby. Fortunately, the blood results came back negative and the itching episodes ceased, eventually, so guess we’ll never know.
cherry blossoms are not to be missed
aww, mom!
too cool for school in the center
Not too long afterward, one of my biweekly ultrasound visits showed a significant shrinking of my cervix, plus funneling, which led to one doctor passing me to the next, until I’d consulted with four, resulting in increased bed rest restrictions. This precipitated a discussion about steroids and if and at what point I should receive them. The steroids are most effective two to seven days after they are administered and are typically prescribed to women between around 24 to 33 weeks pregnant who are expected to deliver within seven days. The question is, how do you make that call? As one of the doctors said to me, it really requires a crystal ball. If the woman does not then deliver within that time frame, but another assessment determines the risk remains, she can get multiple doses. But what are the risks involved? Do they outweigh the benefits? How many doses are too many? None of the four docs seemed to have very good answers to these questions, although a couple of them essentially told me what I’d been reading online, that multiple doses aren’t generally recommended, and that there isn’t enough research on the subject (a common refrain.) 
Dad flies a mean kite

Though I shouldn’t be, I’m still regularly amazed in the difference in opinion of various doctors. I saw four doctors at the same practice each with a – sometimes drastically – different approach to a concern. That's when I turn to the net. For anyone reading this post considering corticosteroids (betamethasone and dexamethasone) for possible preterm delivery, I found one or two pretty good articles that provide basics and an overview, as well as a couple studies. A few reported documented negative effects, including a discussion of women getting the drugs needlessly, one stating outright that repeat doses are not recommended, while another pointed out that the positive effects are still present via multiple doses. Then there was a site that sorta put it all together, a combined discussion of several studies.  It was a lot to think about. Ultimately, we decided to forego the drugs for now.

happy man