on feeding Max

I went into my pregnancy with Max wanting nothing more than to establish an exclusive breastfeeding relationship at least during my maternity leave.  I never got a chance to allow Jake and Alex to latch as I was simply overwhelmed with taking care of preemie twin newborns when the time came to try a breastfeeding relationship.  I instead began to exclusively pump from the day Jake and Alex were born and over the course of their first year of life I was able to almost exclusively provide Jake and Alex with breast milk.  I was proud of this accomplishment but I longed so greatly for a breastfeeding relationship with a baby.  It is also immensely hard to exclusively pump for a baby and I longed to avoid this time commitment with Max.  So I wanted to try my best to establish a breastfeeding relationship with Max.  But things don’t always go as planned…

Max had an extremely difficult time latching in the hospital.  He had swallowed a ton of amniotic fluid during his journey into this world and as a result he was “vomiting” a lot during the first 48 hours of his life.  I was also a hormonal mess in the hospital and spent much of the first 48 hours of Max’s life crying over EVERYTHING.  I worked several times with a lactation consultant but we ultimately decided to “spoon” feed Max expressed colostrum until he could get all the amniotic fluid out of his belly.  So I had the nurse bring me a pump in the hospital.  We eventually, after about 12 hours post birth, introduced a bottle to Max and I gave up on forcing Max to work on latching.  He needed a break and I also needed a break.  We also gave Max a pacifier.  Max was also a very big boy at birth.  And at the end of our hospital stay I was having a very hard time keeping up with my hungry little boy.  It was the last day of our hospital stay and Max had drank all the breast milk I had on hand.  He was grumpy and I was in tears.  I did not want to ask the nurses for formula (a post for another day) so I just decided to try the boob one more time.  It was more out of desperation.  And BAM … Max latched on to the boob like he had been doing it for years.  He spent the next 60 minutes feeding at the breast.  And every minute of it was amazing.  I just watched my little boy in amazement.  We were actually in the process of being discharged when Max decided to begin his breastfeeding relationship.  So we told the nurses to F-off until we were done.  I was not interrupting this moment.  I left the hospital bound and determined to breastfeed my little boy.  But things don’t always go as planned…

We found ourselves in a bit of a medical crisis when Max was only 5 days old (see previous post) and all we were told was that we needed to make certain that Max with eating an adequate amount of food every 2 – 3 hours.  The stress levels escalated to levels previously unknown in our household.  One of the greatest stressors with breastfeeding is that there is no way to know how much breast milk a baby is getting at the breast.  So we immediately went to bottle feeding Max expressed breast milk.  This was the only way we could guarantee his health.  And honestly had Max ended up with the health condition the physicians anticipated then bottle feeding was the only way we could actually guarantee Max’s life.  That’s how serious it was during those long weeks.  So I simply continued to pump on a very rigorous schedule.  It was fine.  I knew how to be an exclusive pumper.  And I knew that Max was getting all his nutritional needs met.  I just assumed that when we got the all clear with Max’s health I would go back to letting Max breastfeed.  But things don’t always go as planned…

It took weeks and weeks for us to get the all clear on Max’s health.  And when we finally did get the all clear I was back to working fulltime at work.  I had been exclusively pumping for about 8 weeks and because of that my body was producing an overabundance of breast milk on a daily basis.  It would have been a struggle for both of us to work on getting Max to latch again at the breast.  And so I decided that our breastfeeding relationship was over.  I was at peace.  The time I spent breastfeeding my son would never be taken away from my memory.  And I once again become an exclusive pumper for my child.  My new goal was to build up a freezer stash that would allow for me to wean Max around 9 months old and simply use the freezer stash until about 12 months.  But things don’t always go as planned…

I started to run out of freezer space much faster than I ever imagined in my brain.  I was, at my highest, pumping about 74oz of breast milk a day for a baby that only drank about 30oz of breast milk.  Those numbers have decreased to about 64oz a day now as I have reduced from pumping 8 times a day to only pumping 5 times a day.  We got to a point where I was going to have to start dumping out breast milk because we literally had no room in our freezer.  Plus we would be running against the “best use by date” of the frozen breast milk.  It turned my stomach into knots to think about dumping all that milk down the drain.  I began to contemplate donating the breast milk to a stranger.  But then a couple of very dear friends expressed a need for extra breast milk for their precious little ones.  And so before I could blink I was shipping some frozen breast milk across the country and a local friend was also dragging a big cooler across town to stock up.  And magically about 1000oz of frozen breast milk was now being used as a supplement for two other precious babies.  And my heart could not be happier.  I cannot even explain the emotions that overwhelmed my heart as I received pictures of these sweet kiddos drinking their bottles of breast milk.  All that had felt that I had “lost” in my inability to breastfeed Max long term had melted away in an instant.  So in the long run my feeding plans did not go as planned.  It went much better!

Mary

birth story

Our induction was scheduled for 8am on July 8th.  I wish I could say I slept soundly the night before the induction.  I did not.  But then again I'm not sure I was able to sleep soundly (or comfortably) for the last 4 weeks of the pregnancy.  I was in constant discomfort.  Between the near constant (but unproductive) contractions and the hip pain I was more then ready for Baby Max to make his grand entrance.  I never imagined that we would actually make it the induction date.  I was 39w1d.

We got the boys off to Grandma and Grandpa's house in the AM and then we promptly showed up to the hospital about 30 minutes early.  What can I say?  I was afraid of getting stuck in traffic!  Kara and I sat in the parking lot discussing how our lives were about to change AGAIN!  We also both took guesses ... Kara thought Baby Max would be born at Noon (so sweet) and would weigh 9lbs 1oz.  My official guess was Max would be born at 7pm and would weight 8lbs 5oz.  We walked into the hospital (one final time) and so many feelings rushed through me.  How many times had I waddled into this hospital during the pregnancy?  I remember the walk to L&D at 16 weeks where Kara and I were convinced we were going to lose this pregnancy.  And now here we were about to meet our little baby boy.  There was no looking back.

The L&D floor was very quiet upon our arrival and they were waiting for us!  My hospital band was sitting on the front desk.  (cue the S&IT about to get real moment!)  We got all checked in (i.e. financial paperwork) and then we were directed to our L&D room.  Our nurse for the day was Chelsea.  We immediately took a liking to Chelsea and for that I was extremely grateful.  I always get nervous that I'm not going to match well with the L&D nurse and that would make for a very unpleasant (and LONG) experience.  Chelsea immediately caught on to our personalities and went with it for the duration of our L&D experience.  I got all changed into my wonderful hospital gown (with some assistance from my very knowledgeable wife who apparently took Hospital Gown 101 in college) and then we waited for Chelsea and Sarah (another nurse) to come into the room to get the show on the road.  Chelsea worked through all the "paperwork" while Sarah worked to get my IV done.  I think I made Sarah a bit nervous because I asked her a thousand times if she was "good" at putting in an IV.  But in the end Sarah did a great job and got the IV on the first attempt.  I was also put on the contraction monitor and baby boy was put on the monitor to track his fetal heart rate.  I was just a bit nervous (wink) so of course my blood pressure was sky high.  We got through all the "paperwork" and then Chelsea checked me for the first time prior to starting on the Pitocin.  I was STILL only about 3cm - 4cm dilated so I was extremely glad we were doing an induction now.  I had been having days and days of painful braxton hicks contractions and obviously the contractions were nonproductive and doing nothing to prepare my body for labor.  I think Baby Max was in my belly for the long haul.  We then had to wait for the resident OB on the L&D floor to come in to approve the start of the pitocin.  The plan, as set by my OB, was to begin on a very low dose of pitocin to see if my body responded in any manner.  The dosage of pitocin would be increased about every 30 minutes.  The resident OB finally came in about 9:30am and made certain I did not have any questions.  I did not.  So it was game time.  Let the induction begin...

I was having very sporadic contractions when I first got to the L&D floor but the contraction monitor on my belly was not really picking them up at all.  So Chelsea had to mess with the contraction monitor several times before the monitor began to actually register my contractions.  I thought for a moment I was losing my mind.  On the lowest dose of pitocin my body did not really do anything at all.  So Chelsea would "sneak" in about every 30 minutes and up the pitocin dosage.  I would always respond with "Geeze.  Thanks. I appreciate it." when she came into the room to up the dosage.  I promise I never became the crazy screaming pregnant lady and in fact I kept my humor about the whole situation and tried to embrace every moment.  This was going to be the last time I ever got to have a L&D experience.  It was about an hour into the process when I looked at Kara and I was like ... "Yep.  Now these are contractions!"  I had never really experienced "true" contractions with Jakob and Alex as my water broke spontaneously and as soon as we got to the hospital I was given an epidural.  I had definitely not experienced any pitocin induced contractions prior to today which many folks say are much more painful than contractions not induced by medication.  The contractions were extremely low in my uterus, like the world's worst menstrual cramp, and the contraction would wrap around my lower back like my entire back was being squeezed by a vice.  I was getting uncomfortable on the bed so I asked Chelsea if I could get up and move around a bit.  Plus we were quickly learning that Baby Max did not like staying on the fetal heart rate monitor unless I was laying on my left side.  There were multiple occasions during the entire induction process that my room would fill up with a boatload of nurses because Baby Max's heart rate would drop extremely low (often between 40 bpm - 60 bpm).  The fetal heart rate became a concern during the L&D process.  I never panicked though as I knew I had a wonderful team of nurses and physicians watching all of us.  I just kept silently begging a higher power that this experience would not end in a c-section.  I was finally able to get out of bed to labor.  I would alternate between bouncing on the exercise ball during a contraction or standing up and "swaying" through a contraction.

I would also always have Kara do counter pressure on my back during a contraction.  That would help a lot.  Kara and I were left alone during most of the "labor" part which was very calming and peaceful.  The calm in the room (i.e. silence) helped make the entire "labor" phase tolerable.  Chelsea had actually adjusted the fetal heart rate monitor, on my belly, for Baby Max when I initially got out of bed to "labor". That fetal heart rate monitor became the bane of my existence during my contractions.  I kept telling Kara "I need this monitor off of my belly.  It is becoming more painful then the contractions. I need it off NOW."  I literally felt as if I was being stabbed in the belly with the monitor during each contraction.  But I also knew it was important to monitor Baby Max's fetal heart rate during each contraction and for ONCE Baby Max was actually staying on the monitor.  The last thing I wanted to do was complain about the fetal heart rate monitor.  I ended up working through active contractions for about 3 hours.  And as a side note (especially for other pregnant ladies) ... My contractions never followed a "normal" pattern or at least a contraction pattern as I understood to be explained by my OB.  I would have a "very painful contraction" which would last a minute and then "almost" disappear but the contraction pain would never go completely away. The "very painful contraction" would then be followed by two "somewhat painful contractions" about 30 seconds apart and 30 seconds long before the series of contractions would end and I would get about a two minute break before the cycle started again.  My contractions followed a somewhat similar process the entire time.  ... I always made Kara laugh because I could watch the monitors and every time a new series of contractions was getting ready to start I would go "OH BOY!" and then proceed to close my eyes and put my hands over my head (no idea why I did this) and I would enter a different world.  I was never a screamer during active labor but I was definitely a "hummer" and for some reason I kept humming "When The Saints Go Marching In" (I'm a strange creature.).  It was my way of focusing the pain somewhere other than my body.  My "OH BOY!" was always Kara's cue to jump on the counter pressure on my back.  So as I mentioned we labored without an epidural for about 3 hours.  It was about 1pm, our nurse was at lunch, and the nurse covering by room came in to do the "What is your pain level?" and let me tell you I was now at a good "8 or 9" pain level.  The nurse indicated that it might be time to get my epidural.  I thought that sounded like a perfectly wonderful plan.  I was starting to get very tired during the contractions.  I could also tell that my body was starting to fight hard against the contractions.  Chelsea came back from lunch and did another cervical check and I had not really progressed at all, I was still a good 3cm - 4cm.  I'm not going to fib.  I panicked a ton.  I thought my lack of dilation would mean (1) it was too early for me to get the epidural and/or (2) Baby Max was just too big to move down into the birth canal.  Chelsea made a call to my OB (they were in constant contact with one another all day long via cell phone) and my OB immediately agreed to let me have the epidural and then proceed with breaking my bag of water.  The OB thought that I would only dilate once my water was broken.  The OB also thought I would dilate very fast too.  I had to have an entire bag of fluid, via IV, before I could receive the epidural so this was started right away to speed up the process.  It was also at this time that I told Chelsea that I could not stand the pain from the fetal heart rate monitor any longer and she needed to readjust it ASAP.  And of course Chelsea responded with "Why didn't you let me know earlier?" and I said, "Baby Boy actually stayed on the monitor.  You don't make your son mad on his birthday."  But then when Chelsea took the fetal heart rate monitor off my belly her eyes grew very wide and she responded with "Oh God!  Kara please don't come look at this."  Needless to say the fetal heart rate monitor left a very good bruise on my gigantic belly!  Chelsea was finally able to make the call to the anesthesiologist and request my epidural.  We only waited about 10 minutes for the anesthesiologist to arrive to our room.  There was a nursing student in the room with us for a good portion of my labor process.  It was this student's very first day on an L&D floor.  So of course the anesthesiologist jumped all over the opportunity to let the nursing student watch the epidural (from a safe seated position in a chair).  I'm all about teaching the future generation of nurses but the anesthesiologist took it upon himself to narrate the entire epidural process.  So imagine ... I was having active contractions.  I was told NOT to move an inch because "big ass needle going into my back".  I was in a God awful seated position while arching my back.  Did I mention I was having painful contractions?  AND the anesthesiologist was narrating every step of the epidural process.  ... Needless to say I was holding onto Chelsea with all my might and trying not to pass out from the narration going on behind me.  I finally whispered to Chelsea "I really need that man to stop talking NOW." but thankfully all was done and the epidural was securely in place.  I had survived the process.  I laid back down on the bed and within minutes I felt like a million dollars.  I had not been this pain free for the last 10+ weeks.  It pure bliss.  Like the best drunken buzz EVER.  And per Kara I kept repeating the same phrases over and over again ...

"You should really offer these to all pregnant ladies at home.  Like you should be able to get them prior to labor."
"Who in their right mind does not get an epidural?"
"No really I can't fell a damn thing.  Am I giving birth?"
"Let's have a party."
(and my favorite) "Thank You Epidural Man."

I feel like this epidural was a bit "stronger" then the epidural I had with the Jakob and Alex.  Perhaps it was just how my body reacted to the drugs this time around.  But I literally could not even lift my legs up.  They were like rocks.  This time, however, I could still "feel" the contractions (also different then with the boys) but the contractions simply felt like braxton hicks contractions.  I could deal with that.  No problem.  The resident OB came in about 30 minutes later to FINALLY break my bag of water.  I had been waiting for this moment the entire pregnancy.  It did not disappoint.  It was the most bizarre feeling in the world.  It felt like someone poured several buckets of water out of me.  I could immediately breath again.  And my stomach literally deflated in size.  I definitely was carrying around a lot of fluid!  The fluid was perfectly clear which was great.  I labored on my left side after the epidural as Baby Max still did not like for me to be in any other position.  It was only after a short time that I began to feel my contractions again but only on my lower right side.  Chelsea told me to give a holler if I found myself breathing through the contractions again.  I noticed within minutes that I was actively working my way through a contraction again with a rousing rendition of my song.   The anesthesiologist had given me a patient controlled button to use to dispense more medicine should I need it.  I don't think that damn button ever did a thing for me! I eventually told Chelsea that I was struggling through the contraction pain so she called the anesthesiologist back into the room to take a look.  Because I only felt the pain after the OB resident had broken my bag of water the anesthesiologist thought that the catheter in my back had simply moved out of place when I was rolled over onto my back to have my bag of water broken.  The anesthesiologist adjusted the catheter in my back and also gave me a "boost" of more medicine.  And within minutes I was feeling like a million bucks again.  Thank You Epidural Man!  It was also during this time that Baby Max started to have some regular drops in his heart rate during each contraction.  His fetal heart rate always seemed to come back up after a contraction but he was definitely struggling a bit on the decent down the birth canal.  The nurse gave my OB another call and it was decided to put internal monitors on both Baby Max (to measure his fetal heart rate) and on me (to measure the actual strength of my contractions).  This meant we could get rid of the monitors on my belly.  I was OK with this all.  The monitor for Baby Max was attached to his scalp and the monitor for me was attached to the inside of my uterus.  The resident OB came in to place the monitors.  There was no pain in doing this procedure as I could not feel a thing with the epidural.  I did however fell like a beached whale anytime I had to move around in that bed.  Did I mention how numb I felt?.  I felt a lot of calm and peace once I knew the physicians and nurses were getting a 100% accurate read on Baby Max's fetal heart rate.  I continued to labor on my left side for about another hour.  I was not in any pain.  My blood pressure on the other hand began to drop VERY low.  This was actually the first sign that I was entering the transition phase of labor.  But then at one point my room filled with about 5 different nurses and I got a feeling that perhaps my blood pressure was getting just a wee bit too low.  My blood pressure was consistently hovering around 80/50 and for a person with a normal blood pressure of 120/80 I was beginning to feel some side effects.  Let's just say I wouldn't be getting up to try and walk across the room anytime soon.  They moved my blood pressure cuff to my leg and started to monitor it every 5 minutes instead of every 30 minutes.  It was also during this time that I got extremely nauseous and I could NOT stop my body from shaking uncontrollably.   All of these were signs of transition in labor.  Both the nausea and the body tremors were not new to me as I also experienced them both during the transition with Jakob and Alex.  I never did throw-up during labor.  The body shakes also ended as soon as I got through transition phase of labor.  It was about 3pm when Chelsea came back in to check me again ... I was fully dilated!  Max was still very high up in the birth canal though and so it was time to "labor down" just like I did with Jakob and Alex.

So I remained on my left side and Chelsea shoved a giant peanut ball between my legs to open up my pelvis and encourage Baby Max to follow the light and find the exit!  I remained like this for what felt like an eternity!  It was also during this time that I began to feel my contractions on my right side again.  I think "pissed off" would understate how extremely frustrated I got at that point.  I mentioned the pain to Chelsea again but because I was so close to delivery the anesthesiologist wanted to back down on my epidural.  So I found myself in a different world as I went through the labor down process. It was rough.  But I knew that we were only a short time away from meeting our little boy.  I attempted a "practice push" about two hours after I began the labor down process.  It was about 5:30pm.  My OB was technically no longer working for the day and as is the case my delivery should have been transferred over to the OB on call for the weekend.  That was not my OB but an OB with another practice. But my OB was adamant on being the one to delivery Baby Max.  And while I would have totally understood if the OB on call was the one to deliver Baby Max I was so excited to actually have my OB present for Baby Max's birth.  It was such a great experience.  She was absolutely wonderful and I feel like we came full circle in the care I have received from her beginning in December 2011 when I got pregnant with Jakob and Alex.  So I attempted my first "practice push" and of course Baby Max had a major deceleration in his fetal heart rate.  My stomach dropped a bit.  How was I going to push this baby out if Baby Max didn't do well during a contraction?  My OB gave instructions to hold off any pushing until she was able to arrive at the hospital.  The OB needed to be in the room to make any quick decisions should Baby Max continue to show signs of distress.  My OB was waiting for her husband to get home from work and planned to be at the hospital no later than 6pm.  Not a problem!  So we all just kind of hung out for about 30 minutes.  I started to feel an increased pressure to push about this time.  So needless to say the 30+ minutes of waiting were somewhat intense for me.  However, I don't feel as if the pressure ever became "unbearable" as I had remembered it so vividly with Jakob and Alex.  I was also beginning to get stressed out because I did not know if I was physically going to be able to push for a long time like I did with Jakob and Alex.  I noticed as soon as the pressure to push came about that the pain I was feeling on my right side was gone.  Yay! I now wonder if the pain, the second time around, was simply Baby Max trying to make his way down the birth canal.  It was about 6:15pm when my OB wandered into the L&D room.  It was time to start pushing.  My OB told me to once again try a practice push.  I was able to move Baby Max down a bit more into the birth canal but again Baby Max showed signs of distress with a steep drop in his fetal heart rate.  My OB looked at me and told me that while she was confident I was going to be able to have a vaginal delivery she wanted me to know that it might require the use of forceps.  I just wanted Baby Max to arrive safe and sound.  My OB made a call up to the NICU unit to have a nurse come to our room for the delivery of Baby Max.  I really tried my best to not panic.  I did not want Baby Max to go to the NICU but I was confident in the decisions being made by the team around me.  And I felt included and up to date on all the decisions that were being made in regards to Baby Max.  So once the nurse from the NICU arrived in the room it was GAME TIME!  I would wait until I got a contraction, which I could still feel, and then I would do a series of 3 pushes each contraction.  No one in the room actually counted during the contraction which I LOVED.  My wonderful team of supporters would just scream at me to keep pushing and I could take a breath whenever I needed to do so.  I initially had Chelsea and Kara holding my legs to help me push but Kara was really trying hard to get pictures of the actual birth so the other nurse Sarah (who we met in the AM) offered to take over so Kara could get all the pictures!  Sarah had come into the room to assist with Baby Max after the delivery.  It was during this first contraction that I realized everyone in the room was super excited.  What I didn't realize was they could already see the top of Baby Max's head.   I pushed through another set of contractions and again the room was all jazzed up!  Baby Max still did not like the contractions but his fetal heart rate was not dropping as low as it had been previous to my OB arriving for the delivery.  I also kept oxygen on my face in between contractions to help bring his heart rate back up.  I swear during contraction #2 it finally registered when someone actually said, "I see his head." so of course after contraction #2 I finally asked the room, "Hold up.  You can already see his head?" and I got a resounding "YES!".  My OB offered me a look and I jumped at the opportunity ... There was the top of Baby Max's head.  HELL YES I COULD DO THIS!!!  So contraction #3 arrived and I again pushed with all my might and realized, from watching in the mirror, that Baby Max was going to be here very soon.  I glanced at the clock after contraction #3 and made a comment to Chelsea "I planned this all along.  I wanted to make sure the baby arrived before you got off work at 7pm."  It was like 6:43pm at the time.  And then on contraction #4, after only 15 minutes of pushing, out popped Baby Max's head!  And then his shoulders got a bit stuck ... This was the only moment of panic in the room. It was the only time I could feel a bit of fear from the nurses and my OB.  I knew Max was a big boy and this was his opportunity to prove it to us all.  My OB turned Max a different direction and the nurses pushed as hard up on my legs as possible and I pushed with all my might and out popped Baby Max (who proceeded to tear me apart with that single shoulder move).  And suddenly my precious baby boy was screaming up a storm on my chest.

It was 6:46pm.  (Do you remember that I guessed 7pm?) I lost my mind.  It was this moment that I had longed for for over 4 years.  A healthy newborn baby plopped on my chest the moment after delivery.  I could not hold back the emotions.  It was all like a dream to me.  Max was doing wonderful and as a result never left my chest for the first two hours of his life!  It was perfection.  And I drank up every single moment of our time together.   I never even noticed the delivery of my placenta or my OB stitching me up.  I had a 3rd degree tear that was a result of Baby Max's shoulders getting stuck.  My OB was done with everything within an hour of arriving into our room.  It was a perfect delivery!  I simply could not ask for more.  My recovery had been okay considering the 3rd degree tear.  I am now 2.5 weeks out from delivery and I actually feel fairly normal now.  I continue to take it slow and not overdue it too much.  But that is hard with preschoolers in the house.  

Mary

when your world just stops

We received a dreaded phone call from our pediatrician on July 13th.  I had just finished feeding Max and so I let my phone go to voicemail.  We had just had a pediatrician visit the prior day and Max was doing so wonderful that we were told to not come back until Max was one month old.  Max was born at a weight of 8lbs 8oz and at the pediatrician appointment his weight had only dropped to 8lbs 5oz.  He was perfect.  The pediatrician repeated this a handful of times during the appointment.  So needless to say my heart dropped to my feet when I listened to the voicemail message from the pediatrician.  The message still exists on my phone.  I can't seem to delete it.

"Good Morning Ladies.  It's Dr. Y.  I was calling to check on Maxwell.  I got one of his state screen tests back and I want to talk to you about it.  So I'll try some of your other telephone #s.  If you get this message please call the office and ask to speak to me ASAP."

That's the moment the world just kind of stopped for us.

I glanced over at my newborn son who was sleeping peacefully with a belly full of milk and remember thinking "Huh?  He's perfect."

We immediately called back our pediatrician and we were told that Max had an elevated level, on the state of Ohio newborn screen, for a fatty acid oxidation disorder (FOD).  We were told to take Max immediately to an off campus lab for Nationwide Children's Hospital (NCH) and have an acylcarnitine profile done on Max.  We were also told that we could not let Max go any longer than 4 hours without eating.  The pediatrician reassured us that it was very common to have a false positive on the newborn screen and that there was currently no need to worry.  

The state of Ohio newborn screen tests for 36 rare to very rare genetic disorders that can be found in a newborn.  These genetic disorders are screened on all newborns because if a disorder is caught ASAP then an infant has a chance at survival.  Otherwise many infants, with one of these diseases, often die because parents do not know that their child is affected with a disorder.

So off we went with our 6 day old son to have bloodwork done to check particular levels of fatty acids.  Max did a wonderful job.  It was simple prick of the heel where there simply collected a few drops of blood.  We were told the results would come back in 24 - 48 hours.

My phone rang on July 15th @ 8am and I knew immediately in my heart that this was not going to be a good phone call.  The results were still abnormal.  An appointment had been scheduled for us on July 18th (stupid weekend wait) @ 10am with the genetics department at NCH.  It was also reiterated to us again that we must not let Max go more than 4 hours without eating.

No problem.  This will be a great weekend.

I never asked the pediatrician for the name of the specific disorder.  I knew I would Google it and I was determined to let a qualified physician give me information instead of the Internet.  I did know however from the Internet that the state of Ohio newborn screen tested for approximately 9 different FODs.

We met with the Chief of the Genetics Department at NCH on July 15th.  I remember thinking to myself about a hundred times during the appointment, "We got an appointment with the Chief of the Genetics Department at the 4th largest pediatric hospital in the country in (technically) less than 24 hours.  This must be serious."   The physician also gave us his business card and told us to call him direct 24/7.  Ok.  Serious.

The newborn screen showed that Max has an elevated C16 level which indicates a + result for either Carnitine Acylcarnitine Translocase deficiency (CACT) OR Carnitine Acylcarnitine Translocase deficiency Type II (CPT-II).  The physician quickly iterated that he could not confirm that Max has either disorder simply via the newborn screen.  There are 150k babies born in the state of Ohio each year and a newborn is diagnosed with one of these disorders every 2 or 3 years.  So it is VERY RARE.  It is a recessive genetic disorder which would mean that both myself and the donor would have to have a broken copy of the gene.  And then any offspring would have a 25% chance of receiving both broken copies of the gene and approximately 1 in 3,000 people are a carrier for this disorder.  So basically it's like hitting a really bad jackpot.  The team at NCH initially did a statistical analysis based on Max's blood test results where his C16 levels were compared to all babies that had previously received a + newborn screen for these disorders in Ohio and approximately 7 other states.  A lot of times, if a blood test result is low enough, then Max could easily be deemed "not affected" by the disorder and the physician would close the case.  But Max's blood test result were in a "gray area" where some babies were eventually diagnosed with the disorder and some babies were eventually found to not have the disorder.  So the physician suggested completing a DNA test on Max that would tell us with 100% certainty whether or not Max received 2 broken copies of the gene and is thus impacted with either disorder.  It will take 3 weeks for us to get results of the DNA test.

The greatest risks associated with the disease occur if Max would have any period of fasting.  Both of these disorders interfere with the body's ability to turn fat into energy.  This can cause low blood sugar, seizures, extreme weakness, difficulty breathing, and heart damage should Max go into any period of fasting from food.  Because it is common, with an illness of any type, for a child to lose his or her appetite, we received, a letter from the physician that we can present to any ER should Max go a period of time without eating.  Max would receive immediate attention (ie.  go to the front of the line) with the specific treatment protocol outlined in the letter.

We will begin working closely with NCH should Max be officially diagnosed with either disorder.  We are, however, optimistic that the DNA tests will come back negative and we will be able to put this nightmare behind us.

And just as a side note Max was a trooper during the blood draw for the DNA testing.  The lab tech had to was unable to get blood from the initial stick and unfortunately another tech had to try in the other arm.  I think I cried more then Mr. Max.  I was a mess.

Mary

welcome to the world

Maxwell Jude
July 8, 2016 @ 6:46 PM
8 lbs 8 oz
19 1/2 inches

Baby Max was born, via induction, at 39w1d.

I will get the birth story posted ASAP.

Mary
 

38w5d

Can you believe it?

We are at t-minus 72 hours until our scheduled induction.  I am in complete shock that I did not go into labor on my own.  And slightly disappointed ...

There are so many feelings at the moment.  The anxiety is extremely high.  I am anxious about the induction process in general.  I worried that something will be wrong and baby boy will still have to go to the NICU.  I'm worried about my ability to effectively manage the pain that tends to be increased with the induction of labor.  I'm worried about being able to avoid a c-section.  I'm worried about Jakob and Alex.  We can tell them a bazillion times that their baby brother will be coming home this week but I know they don't really "grasp" it.  I worry about our ability to adapt to our new life.  I worry about sleepless newborn nights.  I worry about breastfeeding.  I worry about putting too much stress on Kara.  I worry about Kara's overall health.  I worry about my ability to heal quickly so that I can finally go back to being a good Mama to Jakob and Alex (and of course baby boy).  I worry about returning to work in only 6 or 8 short weeks.  I have worked tirelessly for months to get a team member trained on my day to day responsibilities but I worry so much about her ability to get the job done.  So  many worries... No wonder I don't sleep much at night.

I have my final NST test at the hospital today (38w5d) and then I have my final OB appointment tomorrow (38w6d) and then our induction is currently scheduled for 8am ET on July 8th (39w1d).  The induction time could get moved up by several hours if a spot becomes available at the hospital.  

So here we go...

Mary    

37w1d

We made it to TERM!!  That alone deserves an entire post.  I reflect on the conversations Kara and I had in January 2016 when we both thought I was going to miscarry this pregnancy at 12+ weeks.  And then all the fears we had surrounding the possibility of another preterm birth.  My mind is blown and my heart is exploding with happiness.  I know there is always still many risks associated with pregnancy so I cannot completely relax.  But I am simply grateful for this accomplishment.  And we cannot wait to meet our little boy in less than 2 weeks.

So what is new ... NOT A LOT.   I had an OB appointment this week and I am 3cm dilated and the baby is launched and loaded for departure!!  But that can mean absolutely nothing.  I continue to have periods of contractions.  I had an episode of regular contractions this past weekend from about 10pm - 3:45am and then they just fizzled out.  But I believe those contractions might have been a result of Baby Boy dropping lower in my pelvis.  I have definitely lost my mucous plug too.  But that also means nothing.  So we just continue to wait, wait, wait ... He still has an eviction date at 39 weeks.  So we do have less than 2 weeks left in this pregnancy.   I continue to have NSTs and Baby Boy is doing wonderful at those appointments.

I am super uncomfortable all of the time.  I have periods of rather uncomfortable contractions.  I had a massive contraction during the NST yesterday (like off the charts) and the nurse was like, "Did you feel that?" .... Really?  Yep.  I felt that!  What do you think?  I still have heartburn like crazy.  My patience is very limited all the time.  Kara and I are just both simply on edge.  Just waiting to continue the next chapter of our lives and not sure exactly when that will happen.  And it unfortunately trickles down to the boys who have both been acting out like crazy.  I think we all need a break from one another.  I know that Kara needs a break.  I just wish I could give it to her.  But I cannot.  So we truck along.  We apologize to one another when things get rough and just take it day by day.  I am so grateful for my amazing little family.

So let's see what next week brings...

Mary

36w1d

• I am now 36w1d pregnant.

• I had an OB appointment at 36w0d.  I am STILL 2cm dilated (no shocker).  My platelets came back at 137k which is a bit lower than the 142 k from about 28 weeks and a bit lower than the normal range of 150 k – 450 k but still over the 100 k required to get an epidural.  So there is not too much of a concern at the moment.  The hospital will check my platelets again once I go into labor.  I am STREP B negative.  So no antibiotics during labor!!  And my TSH came back at 1.6 so I do not have to worry about changing my synthroid dosage until after delivery of baby boy.  The appointment was otherwise uneventful.  I go back next week.

• I got my final P17 injection!!!  (there is a part of me that believes these shots are keeping little boy in my belly)  I had a total of 23 injections over the course of the pregnancy.  I’m so grateful that I was approved, by my insurance company, for the shots.  It brought so much peace of mind.  But my BUTT is so glad they are done!!

• I am now going to the MFM 2x a week for a NST.  And baby boy passed with flying colors.

• Both the nurse at the NST and the OB mentioned that baby boy had a lower than normal (for him) heart rate.  It has always been between 140 bpm – 160 bpm and at the OB appointment it was 122 bpm, at my P17 appointment it was 128 bpm, and during the NST it never got above 141 bpm (and that was an acceleration point).  Anyhow both the OB and nurse mentioned that a lower than “normal” heart rate are signs of (1) running out of room and (2) nearing labor.  I’m going to go with option (1) because while I was worried about preterm labor for so long I now believe baby boy would love to hangout in my belly for another 6 months!!

• I am analyzing every symptom as a possible “symptom of labor” and it is starting to drive me CRAZY.  I am OK with baby boy making his arrival at anytime now.  I know that 37 weeks would be the ideal scenario but I will not lie … I AM DONE!  I am not able to sleep at night.  I am uncomfortable all the time.  The physical limitations are starting to wear on me.  I am carrying a full term baby (estimated at close to 8lbs now).  I have heartburn all the time.  I cannot focus at work.  I cannot get comfortable at work.  The baby has dropped low into my pelvis with basically feels like carrying a bowling ball between my legs at all time.  Any kick feels like a bruise to my ribs.  Is it possible for him to break a rib?  Haha.  

• We still have an eviction date of July 7th.  

Mary

bullet point updates

• I am currently 35w1d pregnant!!

• We had our final MFM appointment on June 8th.  My amniotic fluid levels are within the “normal” range at 19 cm.  Baby Boy #3 also passed the BPP with flying colors.  The u/s tech also did a quick growth u/s which estimated baby boy to be slightly over 7lbs at 35 weeks.  YIKES.  I take this with a grain of salt though because I believe the measurements are getting thrown off due to a very large head circumference.  Baby Boy #3 had a head circumference measurement of 40w1d at our 34w6d appointment.  I imagine this measurement to be fairly accurate considering Baby Boy #3 is about to be born into a family of large heads!!! But we finally got released from the MFM!!

• I had my 35 week appointment with the OB on June 9th.  I got the GBS test done.  I was worried I would go into labor before I was able to get tested for GBS and I do NOT want to receive antibiotics again during labor.  So I was glad to have made it to this milestone.  And of course, because my pants were already off (snicker), the OB decided to do a cervical check.  My cervix is currently “very soft” and I am 2 cm dilated.  What does this mean?  Absolutely NOTHING.  I could walk around 2 cm dilated for the next 4 weeks or I could go into labor tomorrow.  It will be interesting to see what sort of progression I make over the next few weeks.

• I am now seeing the OB on a weekly basis and I will start 2x a week NSTs beginning in week 36.

• I got my TSH level and platelet level checked at my OB appointment.  I should get those results soon.

• I get my final P17 injection on June 16th.

• And we have a tentative eviction date for Baby Boy #3.  Do you remember that I mentioned the VERY big noggin?  That big noggin has promoted me to an induction around July 7th (or 39 weeks).  The OB (and me) are extremely concerned that waiting past 39 weeks is only going to increase my need for a c-section.  The OB is confident I can still have a vaginal birth but wants to get the ball rolling by the beginning of week 39.  It is very weird to know that Baby Boy #3 will probably be in our life very close to July 7th.  YIKES!!!

• I am doing OK.  Our little boy is big.  And as such I have a lot of pelvic pressure and lower back pain.  I am struggling big time with pregnancy insomnia.  I tend to fall asleep from exhaustion by 10pm each night and then I am wide awake anytime between 2am and 4am.  It is making me drag a bit during the day.  I’m not too uncomfortable when I am asleep but I struggle with a lot of pain when I get out of bed.  I feel like Baby Boy is going to drop out of my pelvis and I often struggle to get my back straightened out.  The contractions are not too bad.  I get maybe 2 or 3 contractions an hour.  They still all feel like BH contractions.

Mary

growth u/s and BPP

 We had a growth u/s and BPP today.  The great news is that baby boy looks absolutely perfect and passed his BPP with flying colors.  That could also be because I ate a peanut butter and banana sandwich immediately before the appointment.  I had to give him a leg up on the competition!  And we found out he has some hair on his head!  It’s adorable.  The growth u/s also looked great overall.  Our big boy is still definitely a BIG boy weighing in at an estimated 5 lbs 13 oz (84th percentile).  I am 33w1d today.  Just to give a comparison, Jakob was measuring at an estimated 4 lbs 15 oz at our last u/s with the boys at 33w5d.  He was born at 5 lbs 3 oz a couple of days later.  My amniotic fluid levels are also still high.  The technical term is polyhdramnios.  The MFM still does not believe there is a reason for the high fluid level.  But my levels are measuring at 26 cm (95th percentile).  So we are now scheduled for weekly BPP appointments.  We go back, for another sneak peek of baby boy, on June 2nd.  There is an increased risk of stillbirth in cases of polyhdramnios.  So we just need to make sure baby boy remains happy and healthy in my belly.  I’m OK with that.  The u/s tech also said that baby boy was really low in my pelvis and probably now wedged too tight to flight again.  

Mary

how about another ...

I was getting out of the shower last night and my b*ra was laying on the bathroom floor.  Jakob reached over and picked it up off the floor and the following conversation took place ...

Jakob: "Here Mama.  You need to wear this."
Mama: "No.  Moms take off their b*ra at night."
Jakob: "No.  Mommy doesn't."
Mama: "Yep.  Mommy takes off her b*ra at night too."

Jakob walks out of the bedroom and over to where Kara is sitting with Alex on the recliner.  He walks up to Kara and proceeds to reach up and grab her br*east.  (The grabbing of our br*easts is actually not totally uncommon in our household.   The boys are a bit obsessed with everything br*easts.  But I assure you we are working on directing the boys in the appropriate time to grab a woman's br*easts.  As in NEVER.)

Jakob: "You take this off at night?"
Mommy: "Why did Jakob just grab my br*east?"
Mama (from the bathroom): "He doesn't know the word for b*ra.  He doesn't believe that you take your b*ra off at night."
Mommy: "Yes Jakob.  I take off my b*ra at night."
Jakob: "Ok.  Good."

 .... because boys.

Mary

stats for Alex

1 :

height: 28.75 inches (13th percentile)
weight: 18 lbs 15 oz (3rd percentile)

2 :

height: 33 inches (13th percentile)
weight: 23 lbs 6 oz (4th percentile)

3 :

height: 36 inches (10th percentile)
weight: 27 lbs 0 oz (7th percentile)

4 :

height: 38.5 inches (12th percentile)
weight: 31 lbs 0 oz (10th percentile)

stats for Jakob

1 :

height: 28.75 inches (13th percentile)
weight: 20lbs 0 oz (9th percentile)

2 :

height: 33.5 inches (23rd percentile)
weight: 26 lbs 10 oz (31st percentile)

3 :

height: 36.6 inches (18th percentile)
weight: 31 lbs 0 oz (44th percentile)

4 :

height: 39.5 inches (22nd percentile)
weight: 34 lbs 3 oz (33rd percentile)

32w1d

A quick baby #3 update.

I’m shocked to admit that Kara and I are still going back and forth on a name for this little guy.  We know the first name and the middle name but we cannot decide, for the life of us, which name should be the first name and which name should be the middle name.  We have decided that we need to meet the little guy and that we would probably know the answer right away.  But it is weird because I feel like I referred to Jakob and Alex by name ALL the time when they were in my belly and poor baby #3 gets no recognition.  A lot of this is because Kara and I don’t want to discuss the name in front of the boys for fear they will tell the world.  If you ask the boys, baby #3 is either going to be called Baby Corey (Alex) or Fred (Jakob).  This is all thanks to our neighbors who keep telling the boys that those are the names of the baby.  It’s cute.

I am doing OK.  I’m just super uncomfortable most of the time.  I get a lot of Braxton Hicks contractions.  I keep an eye on them and at no point have they concerned me too much.  I feel like I can tell the difference between a real contraction and a Braxton Hicks contraction.  My uterus just hates me and gets irritated with each little movement that either I or baby boy makes.

I am down to 4 more P17 shots!!  I’m am so grateful for all the protection the shots have brought in this pregnancy but I am SO done with them.  My body is literally starting to reject the shots.  I can only do the shots on my right side.  If I have the nurse do the shot on the left side then I wobble like an old lady for an entire week.  But the skin is getting really irritated on my right side from the oil and just doesn’t have enough time to heal.  So I spend a lot of the week scratching my “butt” area.  Haha.  The injection site looks almost like a giant hive about the size of an orange each week.  And all I can do is scratch, scratch, scratch.  It starts to heal and then it is time for another shot.  It’s a vicious, but worthwhile, cycle!

My sleep is down the drain.  I surround myself with 5 pillows each night.  We have a really firm pillow that Kara has been telling me to use on my back and I finally gave it a try last night.  She’s never getting it back.  It was perfect.  I think sleep is rough because I wake-up so often because I have to pee.  And I literally feel like my hips are separating every time I roll out of bed.  I also have major pregnancy insomnia.  I tend to fall asleep about 10pm each night but then I am typically awake for at least 2 hours in the middle of the night.  Then by the time I finally get super comfortable and fall back to sleep it is time to get up.

I have to have my feet up most of the day at work.  I use a trashcan under my desk.  If I let my feet “dangle” on the floor I get nonstop contractions.

I’m still eating a lot.  But these days I am craving more and more sources of protein.  I cannot seem to get enough honey roasted peanuts at the minute.

I have my next OB appointment and MFM appointment next week.  I alternate between believing this little boy will make an early arrival, like the boys, at around 34 weeks and feeling like I’m totally going to remain pregnant for 40 weeks.  I am not embarrassed to admit though that if we can get to 37 weeks I’m going to be doing everything in my power to get baby boy to come out!!!  I’m done being pregnant and I just want to meet the little guy.  But I only want to meet him if he is on time and doing great!

Mary

because boys

(I can thank my coworker for the blog title and what I anticipate my first book to be called)

This conversation took place last night.

The boys were in the bathtub and I hear from Alex "Mama.  Come here.  Now."

I walk into the bathroom and Alex is standing in the tub pointing to his test*icles "Mama.  What are these balloons?"

"Those are your test*icles."
Alex "What you say?" (this is his famous quote)
Mama "Those are your test*icles.  Do you remember what you need to make a baby?"
Jakob "A spe*rm and an egg." (I think, at this point, that I'm a parenting genius!)
Mama "That's right buddy.  A daddy has the spe*rm and a mommy has the egg.  So your test*icles are where your spe*rm live."
Alex "So I just need to find an egg?"
Mama - "Yep.  When you get older you would need to find an egg if you want to have a baby."
Alex "Jake - The birds laid eggs out in our tree.  We go get one of those."

Not exactly how I thought that conversation would end.

And the other winner of the night.

I am sitting at the kitchen table eating dinner and Jakob walks out of the bathroom completely nak*ed.

Mama "What are you doing Jake?  Did you have an accident?"
Jake "I need new clothes."
Mama "I see that.  Did you not make it to the potty in time?"
Jake "No.  I made it.  But my pen*is was stuck to my leg. So I missed."

What???

Mary

our big boy

We had our growth u/s today with the MFM (high risk doctor) and silly us thought it would be our last appointment at the hospital until we gave birth.  But little boy is being a bit stubborn.  The growth u/s started with the normal cervical length check and amazingly my cervix is still holding strong at 4cm.  No change between week 18 – week 29.  So we are officially done with those u/s checks.  The u/s tech moved onto getting measurements of baby boy.  He looks fabulous but is measuring about 2 weeks ahead with an estimated weight of 3lbs14oz (83rd percentile).  That in itself is OK but my amniotic fluid level is also measuring high at approximately the 90th percentile.  I passed my glucose tolerance test with flying colors so gestational diabetes can be ruled out as a reason for the high level amounts.  The MFM took a bunch of blood work just to make certain I don’t have a strange infection of some sort (unlikely).  A high amniotic fluid level can be indicative of a chromosomal problem with the baby but we have had extensive u/s screenings and we also had the free cell DNA test done.  All has looked perfect.  So in all probability the fluid levels are just “normal” for me.  The MFM decided he wanted baby boy to pass a biophysical profile (BPP) today because of the high amniotic fluid levels.  This is where baby boy got stubborn.  He failed the practice breathing part of the test.  He is required, within a 30 minute timeframe, to show practice breaths for at least 30 seconds.  He never did this.  So he failed the BPP.  This granted us a pass to take a non-stress test (NST).  We had to wait for about 45 minutes before we could take the test.  And of course our 30 minute appointment had now turned into 3 hours and this Mama had yet to eat breakfast.  I was CRANKY.  But thankfully baby boy passed the NST within 10 minutes of being on the monitor.  We are due to go back to the MFM in two weeks for another BPP.  You better get your crap together baby boy!!  So who knows what will continue to happen in this grand adventure.  We simply want baby boy to be a healthy newborn so we will continue to cross our fingers of reaching that 37 week milestone.  But I won’t lie … I’m a bit terrified of birthing a big baby.  OH … And baby boy was head down at the appointment today.  Let’s hope he stays put!!!

Mary

tap tap tap

I’m still here.  I’m still pregnant.

I’m not even certain the last update I provided on this blog.  I am officially 28w4d pregnant with Baby #3 and officially I am entering the uncomfortable phase of the pregnancy.  I typically feel fairly decent when I wake-up each day but because my job requires me to sit at my desk all day I really get uncomfortable around Noon each day.  It makes the afternoon extremely long.  I get a very bad backache.  It is mostly in my upper back and in the middle of my back.  I am also starting to deal with BH contractions on a fairly regular basis.  They seem to increase in intensity depending on the day of the week.  This is either due to the P17 shot wearing off each week by Thursday or simply because by the end of the week I have been sitting still for a long time.  I feel best on the weekends when I am up and moving around a lot.  But then again, I receive my P17 shot every Thursday, so perhaps I feel good on the weekend because the shot has had time to kick-in.  So WHO KNOWS???  The BH contractions do not worry me all that much.  They more just annoy me.  I feel comfortable in identifying whether or not the contractions become problematic.  I guess because this is not my first rodeo!  Other than the BH contractions my only other symptom is heartburn.  But typically the heartburn can be reduced just by popping the TUMS.

I did my one hour glucose test today.  Yuck!  I explained to Kara that the taste equivalent is “letting 50 orange popsicles melt into 11 oz of thick liquid” and then forcing yourself to drink it all in less than 5 minutes.   I managed to finish with 60 seconds to spare!  But it was a struggle this time around.  I think because my glucose test was early in the morning and so I found myself chugging this drink at 7:50am.  My eyes were watering like crazy and I found myself holding back the vomit on several occasions.  But I made it!!!  Now I wait to find out if I passed.  PLEASE LORD!!!  I should find out the results in the next few days.

The remainder of the OB appointment was extremely uneventful.  I always find myself wanting to rush into the OB office and run out as fast as possible before they find something wrong!  It’s kind of hilarious.  The OB has declared during my last several appointments that I’ve become “the world’s easiest patient” and I just want to be like “YOU HUSH YOUR MOUTH!”  But I just remain grateful for each day I wake-up and Baby Boy #3 is still snug in my belly.  And speaking of … This little rascal has been breech this entire pregnancy.  I’m going to need little boy to get his rear in gear and start changing positions.  I really am OK with whatever way little boy makes an exit as I literally have no birth plan except for doing all I can to make sure I deliver a full term infant.  But I will add that my heart breaks a bit each time I hear “still breech” in conversations with my doctors.  We go for our last (hopefully) appointment with the MFM on April 28th and we will see for certain if little boy is still breech.  But the OB indicated today that his head was up near my ribs.  Time to head south little one.  I can draw you a map.

We are officially ready for little boy.  (that is reason #144 that you can tell we are the parents of NICU graduates)  The hospital bags are packed.  The nursery is done.  All the clothes are washed and put away.  All the diapers are washed and put away.   I even have the breast pump parts all clean and ready to be used at anytime (with hope that the breast pump is only used upon my return to work and not because I have a kid in the NICU).  The glider has arrived and been put in our bedroom.  We have the rock-n-play set-up in our bedroom.  The car seat is in the car.  We have gifts purchased for the new big brothers and those are wrapped and hidden in my car.  I have registered at the hospital.  We have all the phone #s in our cell phones.  I have my replacement completely trained at work.  Yep.  We are set.  Now we just want baby boy to stay inside for another 8 weeks (or more).  But we figured if we got all prepared then we wouldn’t have a problem!

I am officially getting TIRED of people asking me when I am due.  I get asked ALL THE TIME.  And then they are flabbergasted when I respond with … July 14th.

We officially have 3 pregnant ladies in my office now … 12 weeks, 28 weeks, and 37 weeks.   And the office only has 40 females so it’s actually a very high percentage.  So that has been fun.  We find ourselves chatting often and complaining about other people.  It’s nice to have a little pregnant posse at work.

The boys continue to be super sweet to their baby brother.  They “talk” to him often (and by talk I mean scream at my belly) and they give my belly a kiss every night before bed.  I think they understand that we are getting closer to baby brother’s arrival.  We have talked a lot about how baby brother will be born.  They understand that I will go to the hospital and a doctor will help bring baby brother into the world.  They both know that Grandma and Grandpa will stay with them at home until little brother arrives and that Grandma and Grandpa will bring them to the hospital to meet their brother.  We have also driven by the hospital so they could see it.  I know there will be a transition period but I am really optimistic that they will both do great.

I am on week 14 of the P17 shots.  I’m actually starting to get some track marks on my butt from the shots!!!  I have only been getting them on my right side because for some reason my left side hurts a ton.  And as the nurse mentioned last week … You look like a drug user.  I really believe the injections are helping to reduce my BH contractions.  I am usually very uncomfortable and in some pain at the end of the injection period each week.  My final shot will come at week 36.  So this makes me believe that little boy will arrive at some point during week 37.  It’s just my guess at the moment.  I am forever grateful for my OB approving the use of the shots.  They have been expensive (we have a high deductible insurance plan) but I will gladly shell out the cash each week if it gives me a better chance of getting to full term.  And as I mentioned we have our final cervical length check with the MFM on April 28th.  We should then officially no longer be at risk of preterm labor.   So cross your fingers.  I still get nervous.

That’s all for now.

Mary

a Jake-ism

It's been a while since I posted anything about the boys.  So here is a Jake-ism to keep you entertained.

Jake crawled into our bed at 6am today.  He typically crawls into bed at 11pm and that typically forces me to retreat to the boys bedroom to get some sleep.  But this morning I got to enjoy some cuddles with my little boy.  A rare moment for me.  Here is the conversation that followed ... at 6am ... and in March ...

Jake: "Why did Santa only eat a bite of my cookie?"
Me: "Santa visits a lot of houses on Christmas Eve.  He can't eat all the cookies.   He'd get a stomach ache."
Jake: "He didn't drink my milk."
Me: "He drank some of it."
Jake: "He should drink it all."
Me: "But then Santa would have to go to the bathroom.  Where would he go to the bathroom?"
Jake: "At a gas station.  He would stop at a gas station."

My boy.

Mary

I will never...

I will never get tired of watching Jakob and Alex love on their baby brother by giving my belly hugs and kisses every night before bed.

I will never get tired of feeling baby boy kick me over and over again.  I even get excited when he kicks my bladder and makes me wet my pants!

I will never get tired of watching Kara’s reaction every time she feels her son give a swift kick to my belly.

I will never get tired of baby boy getting all excited an moving around whenever Kara and I get into a “passionate” conversation (even if it usually revolves around politics).

I will never get tired of watching my belly grow bigger each and every day.

I will never get tired of hearing baby boy’s beating heart on the fetal doppler every week.  I especially love it that baby boy is always moving around and the nurse has to constantly chase him around my belly to measure the heart rate.

I will never get tired of watching my calendar turn to Thursday each week and monumentally marking the day as another week closer to baby boy being born on time and healthy.

I will never grow tired of any u/s appointments we have that give us a chance to see baby boy.

I will never grow tired of the opportunity to reach down and rub my every growing belly.

I will never grow tired of the songs I sing to baby boy or the conversations I have with baby boy as I drive to work each day.

I will never grow tired of guzzling my chocolate milk in the car each morning just so I can feel baby boy move around.

I will never grow tired of imagining the day when baby boy enters the world, on time and healthy, and our family becomes complete.

Mary

pregnancy

WARNING:  These are my personal thoughts and feelings.  And by sharing them with the world I know that I might offend another person.  I do not care.  This story is for my unborn son.  Not you.

I get asked a lot, much to my surprise, a version of the below question…

“Don’t you just love being pregnant?”

I have literally been blown away by the number of times I have been asked that question in one form or another.  It just happened again a moment ago.  The question is mostly posed by well meaning coworkers who are completely oblivious to the fact that it is inappropriate to discuss a pregnancy with an acquaintance in such a manner.  That is perhaps a harsh statement.  But it is true.  These coworkers also know that I have kids at home.  So I guess simple elementary math allows them to make the assumption that I must LOVE to be pregnant.  But guess what … My pregnancy is NONE of your business.  I also do not care that your feelings are hurt because I “hide” my pregnancy until 20 weeks.  No.  I did not hide my pregnancy from you.  I do not believe I was under any obligation to let a day to day acquaintance know that I was pregnant.  Did you want me to hire an airplane and write a message in the sky?  Did you ever take into consideration that if I announce my pregnancy it might emotionally impact one of the 40+ women in this office who have might have experience with miscarriages?  (Oops.  I got off on a tangent.)

My standard (polite) answer to this question has always been “I feel blessed that I have been given the opportunity to hopefully hold in my arms a healthy little boy in July 2016. I know others are not so lucky.”    

I believe every part of this answer.  I am so extremely blessed.  I do not take it for granted for any minute.  But let me share with you the response I want to give to so many people around me.  The story I want to share with others.  The true story behind all of my pregnancies.

“No.  I do not, under any circumstance, enjoy being pregnant.  Would you like to know why?”

• It took 6 IUIs to get pregnant with Jakob & Alex.  It was all medical.  It involved 35+ trips to a DRs office.  It involved getting naked more times than I care to count.  It involved many different pills and more u/s appointments than I can ever track in my brain.  It involved a miscarriage at 8 weeks that was triggered by an injection of methotrexate (a drug that is often used in chemotherapy).  A miscarriage that brought so much heartbreak.  It cost us upwards of $6k to get pregnant with Jakob and Alex.
• A twin pregnancy is automatically a high risk pregnancy.  Please do not tell me how lucky I was to have been pregnant with twins.  Was I blessed to be pregnant?  Yep!  I wouldn’t trade my little boys for the world.  But my little boys came at the same time.  I automatically was putting their lives at risk by carrying them together.   Do you know how stressful that is to a parent?
• I had suffered a previous miscarriage.  I worried each and every day that I would miscarry this pregnancy too.  The DRs start to think you are crazy because of how paranoid you become in a pregnancy after a miscarriage.
• I went into preterm labor at 26 weeks.  I had a conversation with a neonatologist about the chances that Jakob and Alex had to survive should they be born now.  And if they did survive how many problems they could encounter in their life.  All because my body could not handle twins.  My fault.  I got to experience the joys of IV magnesium over a 48 hour period.  That drug is horrible.  I couldn’t even get out of bed to pee.
• I was on bed rest for 8 weeks.  I did not leave my house for 8 weeks except to go to doctor appointments.  I had contractions almost the entire time I was pregnant.  I woke-up each day and worried as to whether or not my little boys would be born too early.  No one saw me when I was “big and pregnant”.  I didn’t get to experience any of the normal pregnancy excitement.
• Jakob and Alex were born at 34w0d.  I had zero control over my labor experience.  I laugh when people tell me … “but my birth didn’t go as planned” … I was in bed.  I was hooked up to monitors.  I had an epidural.  I gave birth in an operating room with bright lights and 15 of my closest friends.  I never got to hold my babies after they were born.  I did not see Jakob and Alex until they were 4 hours old.  I did not get to hold Jakob and Alex until they were 24 hours old.  I never got to breastfeed my boys.  I was attached to a pump for the entire first year of their life.  I left the hospital without my baby boys.  I walked to the car alone with an empty belly.
• Did I mention the NICU bill?
• I worried for the first year of their life that my boys would have extreme developmental delays.  All because I couldn’t handle a twin pregnancy.
• We decided to try again.  We naively thought it would all be so simple this time around.  We would not have a twin pregnancy.  We would use no fertility drugs.  My body could handle it.
• I found out I’m old.  I found out my eggs are crap.  I found out my body once again sucks as supposedly doing what it was meant to do.  I found out I might not get pregnant.
• More DR appointments.  But this time only 15+ appointments.  No miscarriage.  We got pregnant on try #1.  Lucky.  Lucky.  Lucky.  But the costs were the same … We didn’t know we would get pregnant on try #1.  Our donor had been removed from the program.  We had to purchase extra vials.  So this still cost us $6k+.
• I had multiple massive bleeding episodes starting at 12 weeks.  Not a tiny bit of spotting.  The type of bleeding where you are simply waiting for the baby to drop out of you.  They type of bleeding where blood just pours down your legs.  I heard “there is nothing we can do” over and over and over again.  I still have the hematoma.  But now I hold my breath that it doesn’t cause me to go into preterm labor.  Now I worry that my baby boy will be born before viability.  Now I worry that my baby boy will be born shortly after viability and face a lifetime of medical challenges.  All because my body sucks at being pregnant.  All I do is worry.  I pray I don’t see blood every time I go to the bathroom.
• I worry about miscarriage every single day of this pregnancy.
• I’m old.  This puts the baby at an increased risk for genetic issues.  No worries.  There is a test for that.  It will only cost you $750.
• More bleeding at 16 weeks.  The OB tells me to go to L&D.  Just to get checked out.  No worries.  That will only cost you $1,500.  An OB appointment would have been $80.  But now I am 16 weeks pregnant so I have to go to L&D.  If I don’t go to L&D and something is wrong, then how would I ever forgive myself.   Did I mention we are a one income family now?  So no stress. No worries.  It’s just money.
• I get to pay $170 a week to receive a big ass injection in my butt.  I get to do this for 20 weeks.  I get to have all my coworkers stare at me as I walk a nurse through the office.  And we don’t even know if it will actually keep baby boy cooking inside me for long enough.  I can still have a preemie.  We know nothing.  We can only guess.
• I get to visit the high risk doctor on a monthly basis.  This costs money too.  
• I worry each time I pick up one of my little boys, only looking to be comforted by Mama, that me lifting my child will cause me to lose this baby.  How do you explain that to a crying 3 year old?  How do you explain to your 3 year old, when you lose your temper, that you are simply worried about their little brother in my belly and that your anxiety level is high? How do you explain to your 3 year old that you worry every day that you will have to find a way to tell them little brother isn’t coming home to live with us.  How do you explain to your 3 year old that you are terrified you will have to go on bed rest and you will be even less of a parent than you are now?  How do you explain to your 3 year old that you  worry constantly about being able to financially provide for  our family?

So NO.  I do not like being pregnant.  I hate it.  I hate it all.  But I want what a lot of people want in this world.  I want the hope that a child brings.  I want to leave a legacy behind.  I want to create a life.  I want to watch that little life grow.  I want Jakob and Alex to have a sibling.  I want us to all be a family.  Many people would say that I am being selfish.  Well bite me.  I don’t care.  I only have so many cares in the world to give and what another person, outside of our family thinks about my pregnancy is not one of my cares to give.  But I’d rather show-up at the hospital and have a stork hand me my child.  

So that’s really how I want to respond when someone asks me “Don’t you just love being pregnant?”

Mary

19w1d

Can you tell I am pregnant with baby #3?  This blog kind of falls by the wayside.  This poor child probably won’t have any pictures either.

We had our anatomy scan with the MFM last week at 18w1d.  Our baby boy looked absolutely perfect.  And for that we could not be more thankful.  Despite all the stress this pregnancy has brought the one thing that has remained constant is our little boy.  We actually had the same u/s technician for our anatomy scan as we did while we were pregnant with the boys.  We were thrilled about this.  The u/s tech did a quick measurement of my cervix and it is measuring at 4.4cm.  This is great.  We obviously didn’t have any problems with my cervix length until 26 weeks during my twin pregnancy but I will still be content with the results at this past u/s.  The u/s tech then spent about 40 minutes measuring every single part of our baby boy.  And let me just tell you that baby boy would not hold still for anything.  He was moving all over the place.  He actually completely flipped over at one point during the u/s.  Do we have another Jake on our life?  Our baby boy, who was clearly a boy on u/s, was measuring approximately 18w4d on every measurement except for the head.  SHOCKER.  Another baby with a super large head.  Our baby boy was sporting a head measurement of approximately 19w6d … YIKES.  The u/s tech even repeated the measurement six times to make sure it was accurate.  I could hear Kara giggling over in the corner.  What can I say?  My genetics create humongous heads.   The u/s tech was still able to see the hematoma on the u/s too.  It is measuring rather small (that’s great) at about 2cm x 1cm and it is not located near the placenta (that’s great) but it does still exist and as a result increases my risk in this pregnancy.  The hematoma is situated between the uterus wall and my bag of water.  So it can, if it grows, put me at an increased risk of PPROM (preterm premature rupture of membranes ).  Just add it to my list.  So for those you counting at home my current risk factors are …

(1) AMA (advanced maternal age)
(2) previous preterm birth as a result of PPROM
(3) I have an elevated TSH measurement.
(4) I have a measurable SCH (subchorionic hematoma) that has already caused significant bleeding episodes and is still visible in the 2nd trimester.

So all of these risk factors get me a continued pass to visit the high risk doctor.  We go back at 22w1d for another growth u/s.  And in the meantime I will continue to hold my breath that all goes ok.  We continue to inch ever closer to viability and yet as we inch closer and closer to that date I get more and more nervous.

We also got to record the heartbeat at the u/s.  That was neat!  The u/s tech gave us a teddy bear that had the heartbeat recorded on it but of course our fabulous boys at home managed to erase the recording within 5 minutes of being home.  Oops.  But thankfully we have the recording saved on our phones too.  Yay!

I continue to get the P17 injections.  The appointments are very quick each week but I appreciate them nonetheless.  I get to hear the heartbeat on doppler and it brings me some reassurance.  The nurse also checks my BP and then gives me the weekly injection.  The injections do hurt but the pain/burning only lasts about 10 seconds.  I seem to have less soreness on my right side so we have resorted to doing the injections on that side.  I tend to get an upset tummy with each injection but that has been my only symptom.  I do think the injections have kept my uterus a bit more calm.  I have had fewer Braxton hicks contractions with this pregnancy.  But then again it could be because I don’t have twins this time.  No one will ever know.

Our upcoming appointments include the OB at 20w4d and the MFM at 22w1d.  I will also continue to have weekly P17 injections through week 36 (only 17 more to go OUCH).

Mary

16w4d

I’m going into this week hoping for it to be quiet and extremely uneventful.

I am starting to feel baby boy move around on a sporadic basis.  It happened about 4 or 5 days ago.  I can feel the “bubbles” on occasion and know that it is baby boy.  I had felt the movement starting early last week but passed it off because I didn’t think baby boy was sitting up so high on my belly.  But my uterus has actually already reached my belly button and when a nurse used the fetal doppler last week I suddenly realized all the “bubbles’ were baby boy.  I don’t feel them on a regular basis but there are some times he can really get kicking up a storm.  Just imagine dumping a bag of Pop Rocks candy in your tummy.  Our baby boy gets especially active after I drink my chocolate milk in the AM.

My insurance company approved the P17 injections.  This brings be so much relief despite the hefty price tag that come with the injections.  I had my initial P17 injection at 16w1d.  A nurse actually comes out to my workplace 1x a week between weeks 16 – 36.  All the medicine was shipped direct to me.  The nurse will touch base with me each week and make sure I’m not showing any signs of preterm labor.  If the nurse would have any concerns, then she would forward them onto my OB.  The nurse also takes my BP and we get to listen to baby boy’s heartbeat on the doppler each week.  (I LOVE that part.)  The injection itself was not too horrible.  It’s a big a&& needle because the progesterone is compounded in castor oil so it is extremely thick in nature.  But the nurse, who spends all day giving these injections, did a great job.  I had very minimal soreness.  I am experiencing some tummy troubles though that might be related to the surge of progesterone in my body.  I am optimistic that these shots will help to keep baby boy in because …

We already had our inaugural trip to L&D last week.  Sigh.  I have continued to have some intense cramping accompanied by spotting of old blood.  I woke-up last week and when I went to the restroom passed only won’t I can equate to my mucus plug.  I FREAKED OUT.  I called the OB and much to my surprise and a bit of my disappointment the OB told me to go to L&D.  My disappointment only surrounds the fact that we have a high deductible insurance plan and I was not expecting to meet that deductible until later this year.  So off Kara and I went to L&D.  I felt a bit silly.  Kara loudly declared she was going to pack a bag so that way we could be guaranteed that we would be sent home.  Smart Little Mommy.  My BP was high when we arrived at L&D but that was because I was very nervous.  It went down.  We listened to baby boy’s heartbeat and all was good at 150 bpm.  They did a quick check and there was no sign of my cervix dilating.  Also good.  They then did a couple of u/s to measure the length of my cervix (OK) and to check the position of my placenta.  My placenta is laying low in my uterus which they believe is causing me to continue to have old blood spotting.  The placenta is irritating my uterus.  I have been told that the placenta “should” move up and out of the way in the next several weeks.  They will check the position again at my anatomy scan in a couple of weeks.  But in the meantime I am keeping all physical activity at a minimum so that I don’t go bothering anything in the old uterus.  You just have to be careful with the position of the placenta because it can be a risk to both baby and mom if there would be any bleeding.  The good news was that it appears the hematoma has completely resolved itself.  It was not visible on the u/s.

So that is my most recent update.

Mary

some good news

We found out we are having a little .... BOY!!

We originally planned to be surprised by the sex of the baby at birth.  But this little one continues to keep us on our toes.  We felt a strong desire to get to know as much about the baby as possible.  We also wanted to give the baby a name (which will remain a secret).  So we had the free cell DNA testing done last week.  Not only did the results tell us that the baby tested negative for Trisomy 13, Trisomy 18 and Trisomy 21 but that we were having a little boy!

So a brief story.  I often listen to music at work.  I had turned on a random Spot*ify playlist minutes before I received the call about the free cell DNA test.  The song, One of Us, was playing when my phone interrupted with the telephone call.  After what continues to be an extremely stressful pregnancy I took a lot of solace in the timing of that telephone call.

If God had a name
What would it be?
And would you call it to his face?
If you were faced with him in all his glory…
What would you ask if you had just one question?

And yeah, yeah
God is great
And yeah, yeah
God is good
And yeah, yeah
Yeah, yeah, yeah

What if God was one of us?
Just a slob like one of us
Just a stranger on the bus…
Trying to make his way home

If God had a face
What would it look like?
And would you want to see it?
If seeing meant that you would have to believe
In things like heaven and in Jesus and the Saints
And all the prophets

And yeah, yeah
God is great
And yeah, yeah
God is good
And yeah, yeah
Yeah, yeah, yeah

What if God was one of us?
Just a slob like one of us
Just a stranger on the bus…
Trying to make his way home

What if God was one of us?
Just a slob like one of us
Just a stranger on the bus…
Trying to make his way home
Just trying to make his way home
Just trying to make his way home
If God had a name
What would it be?

The tears immediately began to fall after I hung-up with the nurse.  We are beyond thrilled to be adding a little boy to our family.  I actually surprised Kara with the news after work that night.  I bought a little bib that said, "Mommy's Little Guy" and gave it to her after work.  Her reaction was priceless.  I got it on video.  She really had not idea that I was revealing the sex of the baby to her.  And when she realized what was going on she got a look in her eyes I will never forget.  She then turned to the boys and said, "OHHH NOOOO!  You are having a little brother."  It was great.

So that is where I leave this post.  Only good news.

Mary