4

Please No More Doctors!

I have the utmost respect for doctors but I would like to stop dealing with them for quite some time. In happy news, I have stopped taking labetalol for my blood pressure. Apparently I had postpartum pre-eclampsia, which I didn’t even know existed. My mom, the emergency room doctor, asked me for the numbers of my blood and urine results and now that they have gone down considerably she told me she had been worried. Hopefully my results are even closer to normal or actually normal now because I am at the lab to do what I hope will be my last set of tests to confirm that there are no other lingering issues.

In other news, Lyla is now a formula fed baby. Really she has been for weeks but we were attempting breast feeding at each feeding and she was getting about 20ml from me. Unfortunately there was no gain in my supply or her weight over the last week. I started domperidone but it would take 6 weeks to see the max effects. I was very stressed and dreaded feeding. We decided we would switch to formula only if 1) the max dose of the domperidone wasn’t enough, 2) I couldn’t handle the side effects, or 3) Lyla continued to not gain weight at this week’s appointment. However, I got a call on Saturday that my mom was pulled off her plane and sent to the hospital to have her appendix removed. It was the straw that broke the camel’s back and I couldn’t take anymore stress. J was already hoping we’d just switch to formula so I said we would and then he said he’d feed Lyla next time so I could go see my mom. I still feel guilty and like I made the switch for mostly selfish reasons (although the lack of weight gain was a big concern for me), but I also feel relief. I can see how much she is eating and we can hopefully start establishing a routine. Maybe if I had held out longer the meds would have done the trick, but Lyla is also a lazy eater and nearly impossible to wake (and impossible to keep awake and calm enough to latch) so it was a bad combination. The what if of that bothers me, but I think we made the right decision for our whole family at the time. Through this experience I have discovered that so many women I know have struggled with nursing and most of them did switch to formula. Before I thought people just didn’t try hard enough but now I have a whole new perspective. Typing this out I can see how people might think I did t try hard enough, after all 6 weeks isn’t that long to see if something works, but these 3.5 weeks have been so hard on me emotionally that I didn’t think I could mentally handle 6 more.

1

First Two Weeks as a Mom

I’m going to write a sort of hodge podge, point form post of the events in our lives during Lyla’s first two weeks of life.

  • I was initially kept an extra night in the hospital because of my third degree tear, an elevated pulse, and higher than they’d like blood pressure. Then we were given the option of staying a third night because Lyla’s jaundice levels were on the borderline of too high and they typically peak on day 3 so the nurse practitioner was confident that if we were discharged, we’d need to readmit her for phototherapy, which would have to be at a different hospital and would likely involve a wait list. Being proactive and cautious people, we were all for staying another night and getting the phototherapy then to nip things in the bud.
  • While Lyla was wrapped up in the biliblanket (the phototherapy method), she was fussier, which is apparently common. In the night, she refused to latch and screamed so much that my roommate was offered her own room. I was at a complete loss. The nurse suggested she take Lyla to the nursery to calm her down and let me get some sleep. At first I said no because I felt like saying yes would make me a bad mom, but the nurse convinced me tat I needed it. Shortly after, another nurse came in saying that Lyla wasn’t settling and she asked permission to give her formula. At that point I felt desperate so I said yes. Over the course of the night, Lyla had 2 bottles and I resumed nursing in the morning, but I felt guilty.
  • Ever since the phototherapy/formula night, Lyla hasn’t been feeding as well. She was so sleepy and difficult to wake to eat. She often let go of the latch quickly as well. She wasn’t peeing or pooping much at all and she still had uric crystals when she did have a wet diaper, so we called Healthlink and they sent us to the ER at the children’s hospital for fear of dehydration. Luckily the doctor there said she was fine and some babies just don’t poop every day and it’s ok to still have uric crystals past 72 hours (the number that Healthlink kept referencing – at the time Lyla was 77 hours old). They had me pump a bottle at the ER and she hungrily gulped it down. I had been afraid she had failure to thrive, but clearly she was willing to eat when it was easy for her.
  • We had a visit from the public health nurse, which everyone here gets when they have a baby. Based on the concerns with Lyla’s output, we were asked to go in for another appointment the next day. Based on that appointment, we were told to start supplementing with formula and for me to try to pump and supplement with expressed milk when possible. As a side note, the second public health nurse was surprised they made me come in (instead of another home visit) because of my tear. Little did I know I was actually supposed to be resting it considering I was running all over the city from doctor to doctor!
  • We also made an appointment with a doctor who specializes in lactation and have had 2 appointments with her so far. The second appointment was yesterday and Lyla has gained her birth weight back plus another 10%, so we’re giving her less formula per feeding now, but still have to follow up breastfeeding with a bottle. We were instructed to buy the Medela Calma bottles because unlike standard bottles, babies have to work to get the milk; they can’t just clamp down on the nipple or get accustomed to a quick, easy meal. Unfortunately, the bottles are on sale for $22 a piece! Luckily, I don’t have to wake her every 3 hours anymore and she appears much more interested in eating now when I wait for her to cue to eat. Her output is much better now too!
  • I was sent to the ER one night myself because of my blood pressure. I was so upset being away from Lyla and forced to deal with my own issue when we were at the height of our stress over her lack of eating, peeing, and pooping. Based on the blood and urine results, I was put on medication for 3 weeks. Apparently postpartum hypertension tends to clear up in 2-3 weeks. I’ve been referred to an urgent internal medicine clinic to follow up.
  • While I was at the ER, J was an absolute champ! Neither of us expected him to be left alone with her so soon, or even myself for that matter. He bottle fed her exclusively since obviously he can’t even attempt nursing. He also had a moment straight out of a comedy when he went to change a dirty diaper, only to have her spit up all over herself. He panicked about her choking, picked her up really quick (without a new diaper on) and she pooped ALL OVER his leg! So there he was, with one dirty diaper laying to the side, spit up all over his baby’s face and head, and poop all over his jeans! He got her and himself cleaned up and all was well. Luckily he was able to laugh about it and when I got home and found out, I felt so lucky to have him in our lives.
  • I’ve also been referred to a pelvic floor clinic and registered for a physio course based on a call from them. The class may be all I need, or I might need more individual help from them.
  • In total, in the first week we were in the hospital for 3 nights, had 2 appointments with public health nurses, went to an after hours clinic based on another call to Healthlink when Lyla wouldn’t stop crying for hours on our first night home, had a trip to the ER for Lyla, a trip to the ER for me, got blood work for Lyla to check her bilirubin levels, went to my maternity clinic for the customary first week appointment for Lyla and myself, and had a lactation appointment. This week was calmer with “just” blood work for myself, a doctor’s appointment to check on my blood pressure and go over the blood results, and another lactation appointment. Next week, we have  lactation and the internal medicine appointments booked and then a few more appointments booked for 6 weeks. All of the appointments were incredibly stressful for me and J! We’re hoping to develop a sense of normalcy in our new status as a family of 3 now.
  • My parents came to town almost a week ago and were scheduled to stay a week. With everything going on and how stressed I’ve been, my mom rearranged her work schedule and is staying an extra week. I am SO unbelievably thankful because she has been an amazing help! Unfortunately, my father has often caused me more stress because, in typical fashion, he seems oblivious to others’ needs and prioritizes his own. I was expecting him to be warmer with Lyla because my mom had told me how excited he was and she had previously said he was more used to little kids than he had been when I was young, but when he got here and my mom asked if he wanted to hold her, he just said he would hold her tomorrow. I was hurt. And then I became frustrated when my dad kept making requests for things on his timeline and for us to go more out of the way to fulfill his requests. In my mindset, I would set aside whatever creature comforts I’m used to getting when I visit and just try to make myself useful as possible, or at least stay out of the way.
  • Murphy’s law – our above range microwave broke all of a sudden on the weekend. J once again surprised me with what he’s able to do around the house (my dad was never a DIY kind of man). He was able to remove the old microwave, found a new one from the same manufacturer and then installed it the next day. I was expecting to be without a microwave for weeks, which definitely foiled my plans with the frozen meals I had made. Not to sound like a broken record, but I love my husband and am lucky to have him!
  • This post has been mostly complaints because I needed to vent. I found our first week and a half/two weeks to be extremely chaotic and it was hard to fully enjoy the time with Lyla. Nursing was a defeating experience and there was little to no opportunity for rest. Now, I feel much more positive and although we still need to put extra time and effort into feeding, things are going better. I have never doubted my love for my daughter – it’s the depth of that love that made the pain of not being able to figure out what she needed and feeling like I was failing her so cutting. But now I am able to just gaze at her and take in the fact that she is my daughter and I have my whole life to love her, watch her grow, contribute to her development, protect her, and give her the space to try her own things. Today, my mom and I took her for her first walk around the block and it was such a peaceful, simple activity. It’s the kind of activity I pictured us doing during the first week, but that we never had the opportunity to do. It’s the kind of activity I hope we’ll do more and expand upon in the coming weeks.

 

2

Push Present Revised

Awhile back I posted that I thought push presents were a bit ridiculous (Push Present). I now revise my opinion because J surprised me with a beautiful starfish Tiffany’s necklace the day after we got home from the hospital. The necklace itself is beautiful but I love the gift more for the sentiment than anything. J had bought a new CD and he told me there was something else in the HMV bag. I opened it up and saw the little blue Tiffany’s bag. As I opened it, J said, “Thank you for pushing.” The fact that during such a busy time he thought to do something sweet and surprising for me was so touching. So I wear my necklace with pride and it is a reminder of the love and gratitude of my husband, as well as the miracle of my daughter.

11

Birth Story

At around 1:15 am on October 31, 2013, I heard/felt a tiny pop and then what felt like a little bubble of water flow out of me. I jumped up and ran to the bathroom as more fluid rushed out. My underwear were soaked and once I sat on the toilet, I found I also had to pee. The sensation of peeing was entirely different from the feeling of the fluid that just flowed with no muscle control. I woke J and told him my water broke. Because of our false alarm and first trip to labor and delivery, J asked if I was sure. I told him I was sure my water broke. About 15 minutes later I started getting contractions. They were definitely more painful than what I had previously mistaken for early labor contractions. We drove to the hospital and contacted our doula who came to meet us. At L&D, they did a test and told me it was negative for amniotic fluid. I was like “you’ve got to be kidding me; this cannot be another false alarm.” While in triage, my contractions really kicked in and they were strong enough to make me vomit once. The doctor offered me morphine and gravol. I turned it down saying I didn’t want it to affect my baby. He told me I likely had a long road ahead of me and it would wear off by the time of delivery. He also said it would help take the edge off so hopefully I could sleep and conserve the energy I’d need later. I still said no. He said that it seemed like I was in early labor but I was only 1cm dilated and 90-100% effaced. It was also possible that the contractions would just stop. I was feeling pretty frustrated and defeated, as well as in pain. I was about to ask the next nurse/doctor I saw for the morphine when someone came in and said, “Are you sure you don’t want the morphine?!” So I jumped at the chance – strike one against my birth plan.

We returned home and the doula went to her house to await our call that we needed her. I labored on the floor, leaning over a yoga ball and on the bed for a bit, then on the toilet and in the shower. Time had no meaning to me during labor. Hours passed without me having any understanding of it. So eventually (no idea how long it was), we went to the living room where I continued to kneel over the ball. I was laboring in just my bathrobe because I had been in the shower, but when Jeff called the doula to come, he suggested I put on some underwear. So I switched to a bra and underwear. Definitely less modest than I expected to be in front of the doula who I still didn’t know well.

I alternated between the living room and the toilet while laboring at home. Pressure on my lower back and massage were definitely my friends. I can’t remember the specifics of how the pain felt, but I remember feeling the need to push during contractions and constantly being reminded to breathe deeply. Finally, our doula suggested we get going to the hospital. J got me some clothes and helped me put them on. I was dreading the car ride because I had heard and figured it would be toughest being locked into one position with less access to my support people and massage. However, I actually found I calmed down in the car. When we got to the hospital, the main parking lot was full, so J dropped me and the doula off and went to find a spot. I remember having 3 contractions along the length of a bench, needing to stop to grip it each time. Then we waited in the hospital lobby for J and I’m pretty sure my guttural, primal moans were frightening a child nearby (sorry little girl). When J came in, they got me a wheelchair and we headed up to L&D. This time my trip to triage was very short! I was asked by the nurse if I had the urge to push. When I said yes, she gave a little laugh and said that’s because I was 9.5 cm dilated and they might even be able to just push the little lip that remained aside while I pushed. I was so excited because for once I was further along than I had expected. When we got to the hospital I told myself that if I was less than 7-8 cm, I’d ask for an epidural. I feared they’d say I was only 4 cm (or maybe even less). So here I was, almost past transition, without realizing I was even in it!

I expected that stage 2 (pushing) would be over in as little as 20-30 minutes since the average is apparently 30 mins-2 hours. At one point, oxytocin was recommended to increase the frequency of my contractions because throughout my entire labor I had clusters of very close together intense contractions and then nothing for awhile (strike 2 – I didn’t want IV fluids). I also needed continuous fetal monitoring because of meconium in my mucus (strike 3). There were two in and out catheters as well. Again, I didn’t feel like as much time had passed as it had, but 4.5 hours later, the doctor advised forceps and if I was going to go that route, he strongly suggested an epidural. I looked at J, feeling so exhausted, and said, “I just can’t do it anymore.” I think I was looking for permission to consent to it all and he more than freely gave it. He later told me he wanted me to take the epidural and wiped tears away while I pushed because he hated seeing me in so much pain. Again, I don’t really remember what the pain felt like (a blessing I’m sure).

So I had a one shot epidural, which I do remember hurting as it went in. Well a combination of pain and pressure. I could still wiggle my toes, but everything felt numb. After apparently 18 hours of going without, I had committed strike 4 for the purposes of strike 5 (forceps). During the forceps delivery, strike 6 happened – episiotomy (2 little snips that happened so fast because her heart rate started to drop and I heard the doctor say he wanted the baby out now). As a result, I ended up with a third degree tear (for those who are new to tear degrees as I was, it goes up to 4 – my anal muscles were spared).

When Lyla was pulled from my body, it was so surreal. I didn’t cry at first because I couldn’t fully process that she was real and she was mine. I looked at her and then J and he was crying. Just picturing his face when he saw her is enough to make me cry tears of joy now. Then I looked back at her and burst into sobs. They were sobs of joy and relief. I even saw our doula crying. She later said the doctors probably thought she was nuts.

The things I wanted to try that I got to included different pushing and labor positions, showering, massage, warmed compresses to prevent tearing, delaying the routine tests and medications (eye drops and vitamin K), and, most importantly to me, immediate skin to skin and breastfeeding as early as possible.

As a bit of an aside, I LOVED our nurse but when she went on break, the replacement drove me nuts. I have to say, I think I was a very polite laboring woman. I said please and thank you when asking for water or ice chips, I didn’t swear, and I consciously held back from snapping a couple times when people were not there to massage as quickly as I wanted or were annoying me with the way they were telling me to breathe. My doula later said she thought I might have been in transition at home but normally women are much more vocal at that point. The one time I snapped was at this nurse. She asked me a question, I think about if I wanted to change positions while I was in the middle of pushing and totally in my zone. When I didn’t answer her, she moved around to my head, got right in my face and asked me again. So I yelled, “No!” J and the doula thought she was annoying too.

I feel like our birth story is a positive one, despite it not following the preferences I had laid out. I was definitely sore after from the tear and I remember the pain of the first bowel movement (cried so loud my roommate called the nurse) more vividly than the pain of labor and delivery. The tear means I need a referral to the pelvic floor clinic and I was super afraid of what it looked like (I pictured ground beef all sewn together haphazardly). But it’s healing and hopefully my new hemorrhoids will soon too! Regardless of the recovery, everything was and is worth it!

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8

Lyla Juliet is here!!!!

On Halloween at 7:09 pm our 7 lbs., 20.5 inch precious girl entered the world! I will eventually post about her birth story but right now we are trying to get feeding under control (may have to switch to formula completely, primarily supplementing now), as well as my postpartum hypertension (high blood pressure – on medication now). These 9 days have been much harder than I expected but I can’t imagine a deeper love.