Tuesday, December 9, 2014

12/8/14 Tongue Tie

Since one day old, we knew Timothy had a tongue tie. We had it evaluated by a lactation consult who referred us to his pediatrician and told us we could also go to an EENT if we preferred. At his first Dr. appointment we were referred to another doctor in the clinic that actually does clip procedures. Today, we had that appointment. We learned she clips anterior tongue ties on infants up to 2 months old and refers the more complex ties and older babies to an EENT.
She asked about his symptoms. We told her how painful nursing is even with a nipple shield, how he does a lot of biting when he tries to latch, that it can take him up to 2 minutes to latch even with the shield, how he has trouble taking a pacifier, how he fatigues with nursing, how he looses suction frequently while nursing, and about his weight loss with only minimal gain back. (His weight today is the same as at his doctor's appointment Friday 7lbs 11oz, no increase.)
The doctor examined Timothy by checking his suck on her finger, watching him cry, and feeling around in his mouth. She said that his tie isn't horrible but is limiting his upward movement quite a bit and his forward movement somewhat. She said she wouldn't know for sure if he had a posterior tie until she clipped the anterior one, but that he isn't showing obvious signs of one. She said that if he does have a posterior tie they would refer us to an EENT doctor that does those. I am assuming that would be the same one that the lactation consultant mentioned.

She gave Timothy sucrose prior to the procedure saying it helps with the pain. She didn't do any numbing, maybe so that he could nurse afterword. I was a bit nervous about the lack of numbing, but trusted that she does these ties pretty frequently and if she didn't think it was necessary she was probably right. She told us most parents are surprised how smoothly it goes and how little discomfort the baby has. She swaddled him in a sheet, had her MA hold his head, she used something to hold his tongue up and clipped his frenulum with a shears. She held pressure for a minute or so until the oozing stopped. Bryan said that part seemed more uncomfortable for Timothy than the cut. She watched him cry a bit to see if she had released it enough, and then he was handed to me to nurse.
He nursed fairly well. He latched much more easily.  He was able to nurse much more deeply than before. He still lost suction a couple times. I kinda wonder if that's more the fault of the nipple shield than the tongue tie. I don't remember at all if that happened with Josiah. When Timothy was done and I saw the inside of his mouth, there was no blood, he can stick his tongue out and it goes up to the roof of his mouth sometimes when he cries.
The doctor came back in after Timothy nursed. I told her how he did, and she was pleased. She doesn't think he needs anything more done. She said it's mostly about how he nurses that determines if this procedure is enough or if we need to do anything more. She is hopeful this will be it, and now we'll watch for weight gain. She asked me to weigh him Wednesday (because that's when I can use the lactation clinic's scale) and call her with the number so she can make sure he's doing ok.
Over all, it seemed about the same amount of trauma that a baby goes though with shots without the lethargy afterword. He has not been fussy at all today, and he has nursed really well. He was even able to achieve a good latch without the nipple shield! I wasn't brave enough to try it more than once, only when conditions are perfect. I am still sore enough that I don't want to get bit. We'll take the weaning process slowly.  Overall, I am quite pleased.
Timothy loves to stare at the christmas tree. 
Josiah playing with the tow truck Christmas ornament. 

Sunday, December 7, 2014

12/6/14 Home as a family of 4

I am really glad that we stayed 2 nights in the hospital. I think we needed the recovery time. They tell you to go home, rest, and try to do nothing for 2 weeks, but the number of follow up appointments that we have is a real hinderance to that. Only one of these appointments is my choice, and that is newborn pictures.

We came home Tuesday. My mom was here, had the house all nice clean and warm, and had made us lunch. It was very nice. She had a lot of boxes to move out of our leaking barn room down to her house, but said she was available if we needed her. I napped with Timothy, and Bryan dealt with Josiah, keeping him busy while we slept. The Bentleys brought us dinner and we got to visit. It was good to see them and nice to not have to worry about cooking. It sounds like Jason's new schedule, and Nike trialling working from home on Tuesdays, is going to be a really good thing for them. Remmy was pretty interested in Timothy and wanted to hold him many times. It was pretty cute.

Wednesday I had what was supposed to be an hour and 15 minute lactation consult that took 2 hours. I learned a lot about tongue ties and how Timothy's tie might affect him as he nurses and as he grows. The Lactation nurse was quite scattered and not a good communicator, so it was hard to get all the information out of her, but eventually I pulled out the pieces I needed. She didn't seem to understand my milk over production, so I quit trying to get information out of her related to that. I did get her to tell me about stool and what it looks like if the baby is getting too much foremilk, it turns bright green. After day 5, Timothy should have mostly mustard yellow colored stools. She talked about how injured my nipples were and then wanted to latch Timothy onto my more injured side without the nipple shield in a position that hurts the most for me. I declined to do that and did my own thing to nurse him. She must be so used to trying to check latching and teaching new moms the football hold that she was going to do it to me. I was there about his weight loss, my overabundant milk, and his tongue tie– not at all about latching or positioning. Timothy's weight had started going back up since we left the hospital, which I found very encouraging.  He was 7lbs almost 8 oz when we left, and he was a solid 7 lbs 8 oz at the appointment.  He had a 10% loss from birth weight, but he's not loosing any more. He is nursing longer, and there is plenty of milk for him.

After the long appointment, we had a nice lunch with Kisha at the soup and sandwich place just down the street. It was delicious and really good to see her and chat with her. I was pretty exhausted and had a hard time focusing on the conversation and keeping Josiah content, but I think I managed ok. We got home around 2pm. Bryan was able to get Josiah in his bed asleep, and I took a nap again. Laura picked up some groceries for us when she went shopping earlier, and she and Jess delivered them and visited in the evening. It was really nice to not have to go to the store for just those few things.  It was fun to hear of their Tulsa adventures and how Jess just took it all in stride.  Jess got rather jealous a few times when Laura was holding Timothy, but he got over it without her putting Timothy down each time.  He was even ok when she told him that some day this would be a reality for him to have a sibling.  It also took Jess a little while to be willing to go play with Josiah. He did eventually, but Josiah tried to drag him around and steal his snacks like he does to Remmy.  Jess has learned to fend for himself being around his cousins all week, so Josiah had a good lesson in not being able to force his way.

Thursday we had newborn pictures with Erin in Vancouver. We had to get there at 10, but I was shooting for before 9 so we could keep Timothy awake for long enough to be sleepy for the pictures. We left the house at 7:40ish and made it to the McDonalds near Erin's house before 9. We ordered some grease for breakfast and hung out in the play area to keep Josiah entertained. It was also an attempt not to bother everyone eating there if Timothy got really fussy, but there was a staff meeting in the play area.  The door said the hours for the play area were open, so I figured it was their fault for planning a poor location to meet and for not reserving the room, so we didn't try to be quiet at all. Timothy wasn't too unreasonable with is fussing.  He fussed and cried at times, but we figured out ways to keep him from all out crying the whole time. He nursed really well, off and on, until I couldn't wake him to interest him in on again. Then, Erin took over and worked her magic.
Watching the set up of one of the first poses
The resulting image
Set up with colors I requested
The resulting image
Set up for the hammock pose
Hammock pose resulting image - I LOVE this!

Josiah was not at all cooperative with a laying on the floor sibling shot, so we just entertained him until he was done with a Cliff bar snack, and then Bryan got him to go to sleep in the carrier. He got Josiah laid down where Erin had planned the sibling shot, and we have a shot of both of them asleep together!
Sleeping Josiah
The pose.  I don't have the resulting image yet.
Bryan trying to get Josiah back to sleep for another pose.  No luck, but a cute memory for me of Timothy's not so big brother. 
She did a lot of amazing ones. It's always amazing to watch her work.  Bryan spent part of the time at a coffee shop/ kids play place with Josiah.  It all worked out really well.  We didn't leave there until 3:30.  My mom invited us over for dinner, so we didn't have to figure that out.  We ate delicious spaghetti, then left Josiah there and went home.  My parents said they could keep him busy for a while for us.  I was so grateful to get to go to bed early!  I nursed Timothy and was asleep by 7:30ish. I woke up to hear my mom bring Josiah home around 9, but I didn't get up.  I just stayed in bed until morning. Well, except I get up and pee and take meds and change timothy's diapers and nurse him and stuff. But, even with intermittent sleep, I got quite a bit. I have been successful in nursing Timothy with the shield laying down, which helps me feel even more rested.
Set up i have yet to see the finished image of

I think my mom will love this one.
Friday was Timothy's 1'st Dr.'s appointment.  It was at 10:20 and took about an hour. The doctor was pleased with his weight gain.  He is up to 8 lbs 11oz. She said his tongue tie isn't horribly restrictive, but it could help me with nursing him to get it clipped. She set up a consultation Monday with an in house Pediatrician who does the procedure. She'll look to see if he needs to be clipped, and if so, she will be able to do that right then.  We don't really see any down sides, and would like to do it if it helps him eat without injuring me.
While waiting at the Dr.'s office I attempted to take a picture timothy's blue eyes. Fail.
Before heading home, we went to REI for some webbing they didn't have, and to Costco so we could have more easy to prepare food in the house. We had hot dogs for lunch. Gotta love feeding a family of 4 for $4.50. We played with Josiah and tidied up a bit when we got home. Bryan had a chiropractor appointment at 5pm on 28th and Burnside, so he tried to put Josiah down for a nap for me before leaving to minimize the amount of time I had to spend managing both kids on my own.  It worked, and Timothy and I fell asleep as well! It was a glorious long nap too. I woke first after an hour and a half and got to eat a meal and work on the birth blog before Timothy woke up.  I got Timothy mostly nursed before Josiah woke up. Turns out Timothy wanted seconds. So he cried a bunch while I got Josiah up and took him potty.  Josiah played nicely while Timothy ate more, then it wasn't long before Bryan came home.  He set up the house for "pizza night".
40 weeks Timothy is here!
We had my parents over and ate pizza, chicken, and salad. We watched some YouTube clips and passed on the movie since it was past 9 when we would have started it. It was nice to just be home and not have a long drive afterword. Their house would have been just as nice and no dishes for us, but not as warm or as many places to sit as their wood stove still needs the pieces to connect the pipe and they have yet to move the majority of the furniture.
Today has been the first day where we didn't have to be somewhere in the morning.  It is so nice! Also, even though I went to bed late. Timothy let me sleep from midnight to 5 and from 5:45 to 9am!!!! So I am pretty well rested in spite of the late bed time last night. The Halls are bring us dinner tonight so we don't have any prep for that. We have just relaxed and played with Josiah.  Bryan napped while I worked on writing all of this down for my memories.

It was great to visit with the Halls. We had fun trading babies and watching a football game. At one point Josiah saw Melissa and I both holding a swaddled baby and he wanted one too. So, he went and got Billy (the doll) and tried to swaddle him, but mostly he just mummy wrapped his head. Papa helped him do it right, and he excitedly took the swaddled doll to his rocking chair and rocked him for a while. It was really cute.  Ellie really enjoyed the Christmas tree.  She just stared and stared.  It was a very nice evening. I am so glad they came!

Friday, December 5, 2014

12/3/14 Birth Story

39 weeks 1 day taken Saturday
Timothy Jacob exited the womb and entered the world at 8:02 November 30, 2014. He weighed 8lbs 6oz, was 21 inches long with a head circumference of 13 3/4 inches.
I had a lot of wishes come true with this labor. I got to eat Thanksgiving dinner with my family on Saturday. My list of things I wanted done before baby came was completed for me by my amazing family. I even got to play some games and take a walk after dinner.
I started having contractions as usual at night on Saturday while playing games with Twi and Jason. We had moved onto a kind of game that frustrates Bryan, so he chose not to play and went to bed around 11pm, so he got a bit if a nap before the action. We played that game until 1am. When we were done, I went to the room, got ready for bed, laid down, and started talking to Bryan. He was trying to tell me about a show he found on NetFlix, when I felt warm wetness coming down my vagina. I interrupted him with, "That's weird, I think my water is breaking." He ran for a towel and got it under be before any of it got the bed. We do have a waterproof mattress cover. I guess Bryan didn't know that, but he's still pretty pleased he saved the sheets from getting wet at all. I made it to the toilet with the towel between my legs. Every time I moved more water came out. I guess you could say I had the kind of brake that was more like a big leak but not a burst by any means. 
When my water broke, the contractions got immediately stronger and were coming every 2-3 minutes. I could still talk some during them but it was like forcing myself to remain conscious when my blood pressure drops and I don't want to faint. I am there, but not really all there.
I called the midwife clinic and they said that Joanna was on call and would call me back. In about 10 minutes she called and wanted to know the color and amount of the fluid. I told her it was pink and that it soaked everything from the waist down every time I changed positions. No large sanitary pad could contain it. She said my contractions although frequent weren't too horrible yet since I could talk though them. She said I could stay home a while and try to deal with them, or we could head in. She said she would wait until the nurses checked me when I arrived before she went in. We decided to leave for the hospital after soaking though 10 more sanitary pads and several pair of underwear, shorts, pants and skirts. It was crazy awkward trying to stay quiet, and decent (doing this because Twi and Jason were staying at our house).  With the cold weather (cold front with a low of 27 for the night) making for possible icy roads, and a 45 minute drive to the hospital with already bad contractions, I was pretty sure I didn't want to try to stay home as long as possible. Packing up took a while. Bryan got some heat packs ready for the truck ride to help with contractions. He put the hospital bags in the truck and started it so it would warm up. He made a fire for everyone staying at the house to keep it warm. We packed me in the truck wearing a skirt and warm top layers at 3am. I sat on a towel and had a change of underwear and some track pants to put on for walking into the hospital. On the drive in I practiced complete relaxation though contractions and applied heat. It made them tolerable for the most part with the exception of bumps and occasional tight corners breaking my concentration. We got to the hospital just before 4am, I changed out of my skirt, and we walked into the ER. They wheeled me up to the labor floor after getting some information from Bryan. I was pretty nonverbal and inattentive at this point. Surviving contractions was all I could focus on and then resting between.
My nurses and the pretty art the doula Melissa drew for us
I was in triage for about 45 minutes to be monitored. It was strange that I wanted to lay in the bed. I found that all my complete relaxation practice in the truck made the contractions better when I laid down and relaxed than when I was up moving. I didn't know it at the time, but Timothy, although head down, was sunny side up which may have been the reason I felt better laying still relaxing than moving around. I was really thirsty the whole time, but they wouldn't allow me to drink anything until they got admit orders for me. My urine was dark in hue when I gave the sample, and I knew I was dehydrated. I guess I wasn't going to fix it with water at that point anyhow. I survived the thirst. Timothy wasn't very active at first on the monitor, but eventually moved enough that the nurse felt she had a "reactive strip" whatever that means, and they checked me into my L&D room. While we waited for the nurse to come in I suddenly felt nauseous and hung out on the bathroom floor in front of the toilet. Oh, did the contractions hurt in that position, but I didn't know where else to go if I was going to throw up. I managed not to, and the nurse arrived soon after. She gave me a graduated cylinder to hold onto just in case,  and I went back to the bed. She took my blood and asked me if I wanted her to just start an IV in the process. I told her that was a good idea and asked for an IV bolus because I was so thirsty and I remembered having such low BP after Josiah was born. I got the fluids and a lot of water to drink. I was shivering like crazy. IV fluids always make me very cold. Warm blankets helped a little. Melissa, the doula from the midwife group, arrived about the same time as Joanna the midwife. Joanna checked me because I was afraid to trust that my body would not try to push before my cervix was completely dilated. I was at 7cm, so I continued resisting any pushing urges. I didn't want to tear my cervix. They got me in the tub which felt good and stopped my shivering. I was able to completely relax between contractions, but the contractions were bad. I started asking Bryan for counter pressure during them. Poor guy, having to lean over the tub to squeeze my hips so many times. He thinks I was in there 2 hours. I think it was just one. (I think it was something like 4am in triage, 5am arrive in the room, 5:45 finish IV bolus and get in the tub, 6:45 out of tub, notice it's daylight outside, get situated in the chair to push because I can no longer resist it.) I had several strong contractions that made me want to be out of the tub, because i could hardly resist pushing with them. Melissa had me try one on my knees leaning on the back of the tub, and that didn't feel as good as standing before I ever got in the tub did, so I got out. I stood though a few contractions with Bryan. I just rested my head on his chest my arms on his and just swayed my hips and relaxed my muscles while Melissa, the doula, squeezed my hips. I think we just did 4 contractions like that and I ended up pushing a little with a couple of them because I couldn't stop myself. The nurse had the birth chair ready for us. It is a crazy looking thing but boy was it nice. Bryan sat in back like on a motorcycle looking back seat. I sat in front on a bit more than half circle seat and had a sheet to hold onto dangling from above and Bryan to lean back on. At first or second push in the chair, I broke a "fore bag" of water.  It was quite a satisfying push. It made me visualize and dream of pushing him out in just a few pushes. No such luck. After 30 minutes of pushing, Joanna checked me and said there was a small anterior lip of my cervix. Melissa suggested that maybe I try leaning back more when pushing since the lip was in the front to try to push the baby under it. I could feel him coming down a lot more when pushing that way so I continued. I really liked how I could feel the movement and progress with pushing in the chair and could adjust my pelvis and the tilt of my body to help him come out. It didn't seem like too long before Joanna said she could see the baby's head. Right then Patty came in. I guess it was time for her and Joanna to change shifts. Joanna told her to get dressed. Lots to burning sensations, tons of discomfort in rest periods, and 4 pushes later Timothy's head was out and he was face forward. They were all surprised since I didn't complain of back labor. There was lots of instruction to go slow, to slow down, but I think I only waited one push and all of Timothy came out. They handed him up to me and I got to hold him. Bryan cut the cord after about 3 minutes when it finished pulsing. It was just minutes after that I got uncomfortable and pushed the placenta out.
cutting the cord

cutting the cord

getting cleaned off a little

At that point everything becomes a whirlwind. I got dizzy leaned back on Bryan. I am sure I had little to no blood pressure. Since it was shift change for the midwifes and doula's and there was a baby nurse and my nurse, they all kinda just picked me up and put me in the bed. I think they gave me a 1/2 liter of fluids and some pitosin. I kept shaking from exhaustion and cold from the IV fluids. Bryan and the doula were putting warm packs on my thighs and warm blankets on me.  I was crying out in pain form the pushing on my abdomen. Also the Doula was trying to help Timothy latch and that hurt like crazy and made me jump and  yell. The poor surgeon who was stitching up my tear kept asking "Was that me?" It never was. She got me pretty numb. I moaned once from a stitch right at the end that I could feel but the rest of the discomfort was the nursing attempts and trying to compress my uterus. I guess Patty got the surgeon because the tear was partially into my rectum and she wanted to make sure it was done right for function and cleanliness.
When the stitches were done I was so happy to put my legs back together again. I just turned on my side and snuggled with Timothy. I was trying to preserve that sweet first moments with my son that I get robbed of with all the medical stuff that happens to me right after birth. It got better from there on. I did have trouble peeing and had to be straight cathed once. It took until 12:30 in the afternoon before I could stand without much dizziness. They moved me to the postpartum room at that point. Things got even better there. We got rest, had visits from family, got to see Josiah and I got to eat a lot of food. We stayed in the hospital for 2 nights and went home Monday at noon. They even wheeled me and Timothy through my unit so I could greet everyone and show off Timothy. I am so happy he's here.

first bath

foot prints


we're all exhausted