Flip

Christmas is coming.  I'm excited and looking forward to it.  At least on the outside.

Inside, I've been feeling more conflicted, anxious and irritable lately.  We are coming to the point in our lives where we have to decide whether or not to try for another child.  I want to start my Masters in September 2014 (I can't do this night shift stuff forever!!) and we'd like to be done procreating the summer of 2014 at the latest. I've known since Kaia was born that we would have to make this decision at some point, but back then it was comfortably far in the future, no need to worry about it too much...  Except the time is now and the reality of it is starting to hit me. 

You know how it goes:

1) The 'trying' (fun for the first time or two, stressful after that).  And if it does work...

2) The 'finding out' (No going back now...  Should we do betas? What if they don't rise as expected?  Do we do an early ultrasound?  What if it doesn't show a heart-beat? Definitely want to be on progesterone...will my doc prescribe it? Cue the stressful watch for spotting EVERY TIME I go pee. Plus, if everything goes well there is still the nausea ad. nauseam to look forward to.  Oh and don't forget that all day crushing tiredness. "Kaia, Mommy is not to be woken up prior to full daylight for at least the next 12 weeks. You're good with watching Backyardigans and Dora all day while I pretend to watch but really try to nap here beside you, right sweetie?!")

3) The second trimester. (Usually other couples are doing the happy dance at this point. 12 weeks! Way to go little fetus!  Smooth sailing from now on! Time to get the grainy ultrasound photo up on facebook and start planning the registry!  Except in our case this is historically when the shit hits the proverbial fan. Do we tell people we're pregnant at this point?  It will likely begin to be pretty obvious, but then we'll also have to say "yes, but as per our previous pregnancies it's not a sure thing yet...we'll keep you posted".  Also, this is when my stress levels will sky rocket since at this point I'll be afraid every.single.twinge. is disaster beginning to strike. "Kaia darling, Mommy would like to lie here quietly until we hit at least 24 weeks and would prefer to spend all our free time in the ultrasound suite scanning for abnormalities in your little sibling's placenta. That's cool with you right?" Fun times all around.)

4) After that? Who knows.  Let's label it: the great unknown (???)

So while all this is stewing around in my brain, it didn't help that I had a few tough shifts at work lately.  The worst was looking after a little baby the night before his family had to withdraw life support due to the absence of brain activity.  This is sadly not a terribly uncommon thing in our NICU, but what made this particular baby's case so personally stressful for me, was that his mom was also very sick.  She was on life support, with a very guarded prognosis.  She had a pre-exisiting medical condition (like me) which led to complications and then her heart stopped when she was within spitting distance of a full term pregnancy. The baby would go on to die the next day leaving mom to either get better...or not. My heart broke to see the family members come in to get the news regarding the baby's prognosis.  Because, what do you say to a family in a case like that?  Sorry your whole life has just imploded. Sorry you got the exact opposite of what you expected. Sorry you are living my worst nightmare.  Sorry...sorry...I'm just so...sorry.  I settled for "I'll take good care of your baby tonight"...which I did, but it hurt my heart to do so.

I worry maybe even more that I ever did before about something happening to my own health, or to our possible future baby's health now that Kaia is around.  Because right now, life is pretty good.  Kaia is thriving.  I could stand to lose a few pounds (after Christmas, I promise), but otherwise, I'm pretty good too.  Our life feels good, with manageable amounts of stress.  It's daunting to consider tinkering with that.

Then of course, in my personal life, friends of ours have become another cautionary tale.  They just had their 3rd child.  They have two school age daughters, but Mom really wanted another baby.  So they had one....at 28 weeks.  Her first two were preemies as well, but were both over 32 weeks.  Their third wasn't so lucky.  As far as we know, he's doing well in the hospital, but he'll be there awhile, and visiting their tiny son in his isolette was not exactly how they planned to spend the holidays.  The kicker is his mom had a doctor's appointment only days prior to his birth in which she was told she had 'no signs of impending labour'.  Good call OBs.  Guess you forgot to look in your crystal ball that day.  It makes any predictions that we are 'unlikely' to have a recurrence of any of our previous problems seem like a shot in the dark.

On the other hand, I hate to live my life ruled by fear of the 'what ifs'.  Afraid by what I see at work, or with friends, or on the news. I don't want to be afraid to make my life what I want it because something might go wrong.  All of that discounts the possibility that something may go very right.  Might turn out wonderfully.  Might be a healing and happy and normal experience.  Despite the challenges we faced last time, my baby did come home.  It is possible.  I don't want to live with regrets.  

I'm just not sure what I would regret more.  Something awful happening, but knowing 'well, at least we tried', or the never knowing what could have been.  

Maybe I'll have to flip a coin or something.

All That Was Lost

The first thing I thought of was the presents.

When I heard about what happened in Connecticut last Friday, I couldn't stop thinking of how, this Christmas, the gifts meant for those children would remain unopened. Gifts requested in letters to Santa in big exaggerated first grader print. Boxes already wrapped and hidden away in a closet or under a bed awaiting the big day and the big reveal. Moms and Dads and Grandparents secretly just as excited to give the gift as the child who was suppose to receive it.  It was going to be magical, as only Christmas can be in the eyes of a child.

But not this year.  Not for those families.

I thought about those gifts left behind in their hiding spots. Wrapped and taped and sealed away. Unopened boxes and unloved toys. Too much a reminder of what should have and could have been.  

Just one small symbol of all that was lost.



 

Genealoging

I'm working on a better, longer post right now but I thought I should update because I feel I've been away too long.  Nothing terribly special is happening around here to take me away from my blog, however I have gotten back into my genealogy project, which is taking up (all) of my free time. 

When I tell people I'm interested in genealogy, they probably think I'm a total nerd and love hanging out with the blue haired old folks in the archives section of the local library.  While I have spent some time in those musty alcoves, more and more genealogical records are becoming digitized.  This means that most (if not all) of my research is done online at this point and I'm able to search for records all over the globe.  Another pay off is that it's made me a whiz at internet research, so I feel that kind of ups the coolness factor, if only just a smidgen.

My interest in genealogy started way back in grade 7. For my history class we had to do a family tree, which I immediately thought sounded kind of interesting.  We had to include as much detail as we could, and everything had to be neat and easily legible.  Then my teacher showed us an example of a student's work from the year prior and my heart sank.  She had SO much detail.  She could go SO many generations back.  There were literally like 60+ people on her chart!  And it was so pretty, and neat! Oh woe is me, how could I ever compete?  

Although I didn't manage to get very far back on that first family tree attempt, I can now proudly say that my tree would blow miss Awesome Student's out of the water.  I have over 8200 people connected to me.  Many of these are not blood relatives (as I'm not from Utah!), but I have started tracking down family trees of people who married into the family just in order to have something to keep working on.  The first question people ask when they find out I do genealogy as a hobby is "how far back can you go?". The farthest I've been able to connect back is through one line on my mom's side: 15 generations.  This line initially started in England back in the late 1500s and came to the U.S. on the Winthrop Fleet in the 1630s. Even 150 years later, some of their descendants must have been pretty attached to their British roots, because they decided to high tail it to Canada when things started to heat up for the Loyalists around the time of the American Revolution.  I should pause to state here that I have not done all of this research on my own.  No, no, far from it.  The trick in genealogy is to do as much as you can, and then connect up your relatives with someone else who has done further research.  Kind of like if I work on half a puzzle and then you work on half a puzzle and then all of a sudden we realize we're working on one big picture and we can match it up along the seams where it all fits together.  It's a great feeling when that happens!

An interesting part of genealogy is to see how major public historical events match up with your ancestors lives.  For example, today is Remembrance Day in Canada, and I've been able to track down many of the war records from various family members who have served in many different wars.  One of the recent lines I have been searching for is a great-great-great Grandfather b. abt 1834 in Ballymena, N. Ireland (near Belfast) and who served with the British Army in India.  He married a woman of British ancestry while he was in India and they had 7 children together.  I was so pleased when I came across their children's Baptism records on Family Search.  Sadly, what I also came across was 4 out of their 7 children's death records.  First child died age 6 months, fourth child died at age 2 years, sixth child died age 2 years and seventh child died age 1 month.  It doesn't say what they died of, but I'm guessing it was likely due to communicable diseases, probably made worse by these children's innate lack of immunity due to their parents not having Indian ancestry, as well as to their youth, which puts them at much greater risk.  My 3x-great grandfather's family could serve as a poster case for public health entitled "Reasons to Vaccinate".  Some might say, oh, but that's INDIA, a tropical country....who knows what kind of diseases people might run into there?

Okay, well then I also found my 3x great-grand uncle who was living with his wife and 5 children in 1889, right here in Canada, only a short drive from where I now sit over 100 years later typing on my computer.  Him and his wife were living a quiet life in a small town raising their 4 girls and one boy, ages 12, 10, 7, 5 and 2 1/2.  Then diphtheria struck.  Within three weeks, 4 of their children were dead.  Two died on the same day.

There would just be no words for the horror.  Not only for the parents, but for the sole remaining seven year old daughter.  The house would have gone from people filled, noise, laughter and screeching children running around, dirty clothes and hands, lots of mouths to feed, children to organize, things to get done...

....to two adults and an only child.  No more brothers and sisters to play with.  No more sisters to look up to.  Only one remaining daughter to get up for every day.  No more sons to carry on the father's name and occupation.  A family reduced by over half. 

It's shocking how often this occurs when you really look on family trees.  Yes there are the rare families where every single child survived to adulthood...but that gets rarer the farther back in time you go.  Along time ago, men and women had to get married young (if possible) and have lots of kids (if possible), just in order to try to ensure some would make it to bury their parents.

For this reason it kind of irks me when I hear of people complain about vaccines.  I mean, I know there are lots of people who are wary of them, or feel too many are given, or are given too early, or fear they can cause potentially worse problems (autism, I'm looking at you, although according to research I don't need to).  These people have the right to their own opinion and I know lots of smart, well educated people who, for whatever personal reason, decide vaccination is not for them...but, really?  Does my family evidence (and probably yours, and yours and yours) not speak for itself?  

I say, BRING ON THE VACCINES!!!  

What do you say? (And yes, I know I might be opening a can of worms...fortunately I LOVE worms!)

Dreams, Wishes and Unicorns

Last weekend I had a pregnancy dream where I was further along than I ever was with either of my babies. In my dream I could feel the baby giving me some good hard kicks. This was interesting, since when pregnant with both Aidan and Kaia I never really felt anything that could be described as a 'kick'. Rolls, taps, pushes and nudges for sure, but nothing that would be painful or hard enough to make me stop what I was doing (if I had been doing anything at all, as let's face it, I was on bed rest). Funny that I could experience in my dream what I've felt in real life.  Even dream me was thinking "this is so cool!" 

Perhaps I ate too much at my birthday dinner the night before, no?

***

I'm reading a good book.  It's fictional but it has some really moving passages.  One of the characters says this about dreams which I thought was very appropriate given the above.

"A dream is the place where a wish and a fear meet. When the wish and the fear are exactly the same, we call the dream a nightmare."

***

I troll the internet every few months using the search word "Breus mole".  I feel a bit like someone routinely checking up on the convicted murderer who killed their family member. Just checking in on you Breus Mole. Just want to make sure some researcher somewhere is still keeping tabs.  Finding out exactly what makes you tick.  Don't think you can get away with it forever...

It was during one of these searches that I came across an abstract for a presentation by a doctor from the hospital where I received care during both of my pregnancies.  The title of his presentation was "Prenatal Diagnosis and Clinical Outcomes in Pregnancies Complicated by Breus’ Mole". The presentation was 15 minutes long and given during the annual research day on May 4th of 2012.

Since that was just this past year, they were talking about me.

Not only me, of course, but that someone out there was using my experience for research got me all fired up.  My immediate reaction was "Why was I not invited to this presentation??!!  I want to know exactly what's going on??!!" So I wrote an e-mail to Dr. K., the placental specialist who saw me during my pregnancies and diagnosed the Breus mole in both cases.  The guy is a research nut and I knew he would be happy to share his team's findings.

He wrote me back (in blue).  My (mental) responses are in bold.

(Our hospital) has the largest experience now of Breus’ mole (16 cases)   

16 cases is the LARGEST experience of any high risk pregnancy centre???..and this is counting me TWICE!!!  What a way to make a girl feel special.

1. Only one (you) person has a recurrence – that we are aware of.  Obviously it is because I am awesome and rare like a unicorn.
2. We have followed 5 subsequent pregnancies (approx, I don’t have data in front of me) and most are fine and we can decide this accurately at 20 weeks. Would this include my subsequent pregnancy?  Cuz if so, it totally was NOT fine at 20 weeks. 
3. There is no genetic test yet for the condition, but deleting one specific gene in mice (Wnt2) gives a picture like Breus’ mole.  Cool, but unhelpful unless you can check me, Brian and any of our offspring for this particular genetic mutation (and I'd totally be willing to let you).
4. Survival of the baby is possible in about 35-45%, as in your situation.  Um...not exactly what one wants to hear about the survival rate of their baby. But, I suppose it's better than the 0% chance that Dr. S. gave for Kaia's likely survival when my water broke at 17 weeks.

After reading his e-mail 3 or 4 times, I can safely say that no where did Dr. K. promise that any subsequent pregnancy we try for now would TOTALLY end up okay and healthy and happy and full of rainbows and butterflies.  I'm also sorry to say that he did not add that NO WAY could I have a 3rd Breus mole...like NO WAY. I'm self-aware enough to realize my dead baby broken heart would really like a guarantee of normal, healthy pregnancy, so I wouldn't feel so guilty, selfish and anxiety filled (Russian roulette anyone?) if we decide to try for another child. I'm also rational enough to realize I'm not going to get it, and that we will have to make our decision based only the information we have now (which is basically a *shrug* and is not helpful at all).

I am not a person who likes to gamble.  I never buy lottery tickets and I would consider it a waste of time and money to go to Vegas (except for the reportedly awesome shows!!!)  I am also not a person who just settles when told something *might* be out of reach, especially if it's something I really want. To do so seems sad and wasteful.  You never know until you try, right?

I feel like we got a pass from the universe with Kaia...might it be too much to ask for another one?

***

For Halloween Kaia is going to be a unicorn.  My special, adorable rare little unicorn.

  

A (Birthday) Wrap

As of today, I'm 30. 

Or 29 again, as I like to say.

***

I haven't done a Kaia update in awhile, so here goes:

We had her 15 month appointment with the pediatrician today.  Kaia's doctor kept saying how great she looks, which is always nice to hear.  Kaia is above the 50th% in both the weight and height categories for her corrected age of 13 months which means she's just below the 50th% for her actual age.  She seems to be catching up to her 'July 2011' peers. 

Kaia's also catching up in terms of her gross motor skills.  She stands steadily while holding on to a support and can bend down to pick something up as long as she doesn't let go.  She cruises around our furniture and will walk fairly quickly and purposefully when holding on to someone's hands.  She is also able to get into a crawling position and sort of pull herself forward with her arms while her knees slide along the hardwood floors. The crawling position has been the hardest as it requires her to bear weight on her knees with her legs close together, which is basically the opposite of the cast position.It seemed like it took awhile to build up to, but then suddenly overnight she was doing some of the smaller, but no less important gross motor skills too, including going from laying down to sitting up and going from kneeling to standing.  Those transitional movements seemed to be made harder due to the residual stiffness from the cast.  

I'm very happy with her progress.  I figure if you take her actual age of 15 months, minus the 2 months for her prematurity, then minus the 3 months she was in a cast, you get 10 months and she's at least at that level, if not a bit ahead.  It makes me very glad her surgeons decided to do the Spica cast when they did.  I couldn't imagine having to keep her immobile now.

Kaia continues to have good fine motor skills.  She can stack 4 blocks on top of one another, which never fails to impress me.  She might only get all those blocks stacked up 1 try out of 20, but man is it ever amazing to watch her try over and over and over in order to get it right.  You can tell she is so pleased with herself when she gets it too.  She will turn to us, with a big grin and clap, urging us to clap for her too.  She loves to wave 'Hi' and 'Bye', although she's starting to show signs of shyness.  My uncle dropped by last weekend to give me a birthday present and Kaia seemed kind of wary of him. She wouldn't wave or clap in his presence.  Then as soon as the front door closed behind him, she immediately started to wave.  It was pretty cute.

We took her to the zoo last weekend for a walk on a lovely fall day.  Since our first time at the zoo back at the end of April, you can tell Kaia's much more interested in the animals.  She was pointing at the hippos, the meerkats and all the brightly coloured fish. It's interesting to watch her become more aware of these other living creatures. She even seemed a little afraid of the young gorilla who was right up at the glass looking at us and studying Brian's iphone. I love taking Kaia to the zoo and I'm really glad we got a seasons pass.  We'll definitely be renewing our membership next year.

I stopped pumping at the beginning of September.  It was time.  I don't miss being hooked up to that machine every day, although I do miss being able to provide milk for Kaia (and I really miss her not getting every single illness within a 1 kilometre radius, but that could just be a coincidence. I don't know if my boob juice was THAT powerful a germ buster). We easily switched her over to Homo milk and she gets that now at nap and bed time in a bottle.  My friend who exclusively breastfed avoided bottles entirely and switched her daughter over to sippy cups at a year. Kaia drinks water from a sippy cup the rest of the day, but I'll admit I'm loathe to give up the bottle before sleeping time.  She likes it and it calms her so much and I don't know if a sippy cup would have quite the same effect.  For right now, I'm okay with her getting a bottle twice a day.  We'll reevaluate in a couple of months.

Kaia has begun to have a few more feeding likes and dislikes. She WILL NOT let you feed her anything with a spoon.  She turns her face and pushes away the spoon.  However, she also won't feed herself with a spoon or fork (even though I KNOW she could do it).  This is frustrating, as now EVERY single meal has to be something she can pick up with her fingers.  She also does not like anything mushy.  She takes each piece of food her in hand and squishes it and turns her nose up and avoids anything with a 'mush' factor.  This means her formerly favourite snack of yogurt has turned into an 'unedible'. It also vetos soups, pasta sauces, chilli, stew, mashed potatoes, mushy banana, etc. etc.  She does love cheese though.  And bread.  Ummm...cheese and bread.  Can't say I blame her.

Her language skills are just so-so.  You can tell she understands a lot, but doesn't really talk much.  She says Ma-ma and Da-da although not necessarily in relation to us (she says Mama for just about everything).  She says 'up' but it sounds like 'puh-puh' and she CAN do 'ump' for 'jump' and 'ooot' for 'out', but these are hit or miss.  She also says our cat's name "-inx" (Lynx) on occasion.  I wish she could say a few more words, as it would likely help with some of her frustration at times, but I'm sure the words will come soon enough and then if she's like me, she likely won't shut up.

She is honestly the cutest, sweetest, happiest kid.  No, really...I got stopped in the hall at one of her doctors appointments with someone saying "that's the happiest baby I've ever seen!" She smiles a lot.  She's great out in crowds.  I can only think of one time in her whole life where she's really gone nuts in public for no reason (immunization and uncomfortable medical appointments don't count).  She doesn't cry when being left with her grandparents or at the babysitters. She's good at occupying herself for relatively lengthy periods of time (20+ minutes or more).  She will play with her blocks, her xylophone, her books, or her activity tray and never seem to get bored no matter how many times she comes back to them.  She giggles like a crazy person whenever we 'animate' her stuffed monkey Molly.

She is so pleased with herself whenever she learns something new and loves to make us happy with these new skills. She's learned to wave hi and bye and will turn her wave inwards towards her nose when you say "Pee-yew". She throw her arms up in the air holding her xylophone sticks when we say "rock and roll!!!" just like a real drummer, and will hold on to the couch while standing and rock back and forth when we say "Ultimate Warrior" (don't ask, it's some wrestling thing from Brian's youth).  She will also point to her belly and giggle when we say "Kaia...who's the baby?".  She does the same thing for "Kaia, where's your belly?" and will lift up her shirt if she's not wearing a onesie to show you her bellybutton. She has a thing for light switches and loves pointing to and looking at the photos on the wall, including those we have up of Aidan.  One day when I pointed to the picture of Aidan and us, I said "Mommy, Daddy and Aidan" and I swear she said "A-dan", which just about broke my heart and made me smile all in one go.  I'm looking forward to sharing him with her.

I often can't believe how lucky we got with Kaia.  How amazing she has done given her 'odds'.  It seems unreal that she was Acorn, the baby we were so worried about for so long, so afraid she would die.  She's so healthy, so normal, so ALIVE.  We are lucky beyond measure.

As always, my birthday falls right near (Canadian) Thanksgiving.  It's easy to say what I'm thankful for.

***

And of course, I must include what people really read these types of posts for: pictures!

Last cottage day for 2012

Drummer!

Why yes Mommy, I do know that this is the EXACT same motion you would like me to do with a spoon...

Grass is not mushy, therefore it is tasty

Cruisin'

Why yes, all that crap in the background is my toys.  No, I do not feel the need to pick them up.

Clap, clap!

Rock and roll!!!!

Fell asleep during dinner after refusing to nap at the babysitters.

Help, I'm trapped!!!!

Cutest face ever.

 And that's a (birthday) wrap.

Resuscitating Old Memories

It sort of happened.  I had my first PTSD moment surrounding my job, although it wasn't at all what I thought would trigger it.

It wasn't caused by a patient, or a family, or a real live situation.  Nope, it was caused by a book.  A book that I had to read for a course I have to take in order to ensure I am competent to work in the NICU.  The book is more of a manual and it's called "Neonatal Resuscitation Program, 6th Ed". I had to read it before taking the course to get re-certified in neonatal resuscitation. The book is divided into 9 lessons.  Lesson one states that 90% of babies make the transition to extra-uterine life without any other interventions than drying, warmth and stimulation. They go from that awful blue-grey to pink and screaming while everyone laughs and cries and hugs.  However, about 10% of babies need some extra help.  Lessons 2 through 8 work through these extra steps using a handy flow chart.  Generally the steps become more and more invasive. They including suctioning, providing free-flow oxygen with a mask, initiating positive pressure ventilation ('bagging' a non-breathing baby), starting chest compressions, intubating, giving epinephrine and fluid boluses to get the heart rate and blood pressure to rise, and needling the chest in case of a pneumothorax.  

Lesson 9 covers "End of Life Care".  In the rare event Lessons 1 through 8 fail to solve the problem.

Lesson 9 begins with a 'case study' of a woman who is admitted at 23 weeks in labour with ruptured membranes and a possible infection.  The health care provider is suppose to sit down with her and her support person prior to delivery and rationally discuss what the family would like done when the baby is born.  The health care provider should be sure to include in their discussion both survival rates, possible complications, as well as the possibility of providing only 'comfort care' to a baby who has a low chance of survival or a high possibility of 'morbidity' (ie: likely to have on-going life threatening problems).  The family is then expected to tell the health care professional what they would like done, and the health care professional is suppose to respond that they will do everything possible in order to honour the family's wishes, however plans may need to be changed depending on the condition of the baby when he or she is born.

Yes, of course, this all sounds reasonable and well planned out.

Lesson 9 made it sound so simple.  So clean.  So clear.  Books are like that.

But I remember that exact situation being much more messy, painful, confusing and terrifying.  There was shouting, bright lights, running feet, blank faces, pain, pain and more pain.  

The question asked by the delivery team moments after Aidan was born:

"What would you like us to do?"

Save him, of course!? (But he's so small...it's too early)

Don't hurt him?!!!  (Oh, baby boy, I don't want them to hurt you)

*beat*

....?

"What's his condition?"

"Do what you can."  

(Make this better.  Make it stop.  Turn back time.  He doesn't belong on the table over there.  He belongs with me.  Inside me...  Sorry baby boy, mommy's so sorry.)

***

Lessons 1 through 9 brought it all back.  Brought back the pain of both deliveries.  Aidan's that was the beginning of the biggest tragedy of my life, and Kaia's that could have been.  It made me panicky and shaky thinking of all that Kaia went through after she was born.  I remember reading her chart in the hospital during her first week of life, and noting how long, and how much effort it took to get her oxygen saturations to normalize. She was in a 100% oxygen at one point and they couldn't get her sats above the 60s.  That's when they started nitric oxide...a method generally of last resort. I thank my lucky stars every day that it worked.  It's scary to even think about what could have happened.

And I thought a lot about Aidan.  His delivery.  How rushed and overwhelming it was.  How unprepared we were.  How that question of what to do is not so easy when it's asked of you.  I remembered how awful the NICU doctor was who came to 'assess' Aidan.  He spoke with the nurse, took one look at Aidan, shook his head, turned around and walked out.  He never came to tell us what steps had been taken to revive Aidan (oxygen? bagging? I don't *think* they intubated him...but I'm not sure....). The neonatologist never spoke with us at all.  After he walked out, the nurse asked if I wanted to hold him.  It was obvious he was going to die.

Reading that manual made me think back. How hard did they try to save him?  Did they do everything they could?  Could they have done more?  What steps were taken?  How far down the flow chart did they make it? I never asked.  Maybe I should have.

Maybe most of all, it made me remember how wishy-washy our answers were when we were asked in the delivery room what we wanted done. We didn't scream "SAVE HIM!!!  I don't care what you have to do!!!"  Brian didn't follow the doctor when he walked out of the room, pulling at his sleeve, yelling "Get back here and do something!!!"  I quietly accepted when they asked if I wanted to hold him, knowing what it meant. We accepted that he wasn't going to survive without any protest.  What parent does that?  Certainly not some of the parents I encounter in the NICU.  The really tenacious ones reject any possibility of ever turning off the ventilator, insist everything be done, and often refuse to believe any bad news at all. Maybe if we had done that, Aidan would have survived.  Maybe they are better parents than I am.

But, how hard would I have wanted them to try?  My overwhelming thought in the delivery room after 'save him' was 'don't hurt him'.  To save him, he would have had to hurt.  Possibly a lot.  Probably for a long time. Possibly for his whole life.  I don't believe in life at any cost.  Not for myself, and therefore, not for my child.  Resuscitation worked and worked well for Kaia.  My gut tells me it wouldn't have for Aidan.

***

The Neonatal Resuscitation Program condenses 9 lessons into a one page, easy to read and follow flow chart.  This helps health care workers make fast, evidence based, critical decisions when newborn babies face life threatening situations. 

If only such a flow chart existed for parents.

Did you have to make life altering decisions around your child's birth/death?  Did you ever question those decisions in hind-sight?  Was the medical care your child received transparent in its application and to your satisfaction?

Hi ho, Hi ho...

I've been back to work in the NICU for a few weeks now and it's actually going quite well.  My manager gave me 7 shifts 'buddied' which means I've been working with another nurse to cover one assignment so I have time to get my skills up to scratch without worrying about being totally 'in charge' of the babies.  I'm kind of surprised how much I (so far) enjoy working and don't long to be home with Kaia (at least not TOO much).  I realize how much I missed the NICU and how much I like 'high tech-ness' of it compared with the contract job I did in between pregnancies.  The NICU is a much more difficult job and a more stressful place to work, but more interesting too.  I'm only doing 2 shifts a week though, so I think it will be manageable.

Being with the babies does bring up a lot of feelings though.  I've been missing Aidan and thinking about my pregnancies more than I have in awhile.  Partly that is due to working with people I haven't seen in over 2 1/2 years who of course, want to know what I've been doing all this time. (Was on bed rest, had a dead kid, worked somewhere else, was on bed rest, had a live kid, then looked after her and pumped breast milk for a year. Thanks for asking!)  A lot of people have sort of kept up with me via facebook and immediately ask "How's your daughter?!"  It's a safe thing to ask.  Every parent likes talking about their kid.  It's nice to be able to respond about how well she is doing.  How happy she is.  How healthy.

No one mentions Aidan unless I do.

In between taking care of the babies, and when there are no parents in the room or while we're on break, I've shared with some of my colleagues what we've been through in the last few years.  What it's like having a pregnancy that's in danger.  What it's like having a child that died.  What it's like having a baby in the NICU.  As much as my colleagues 'get it', since they work with families in similar situations to mine every day, it's an impossible situation truly to understand until it's you.  The fear.  The anger.  The hope. The disbelief.  The sense of loss.  

Seeing the babies isn't as hard as I expected.  I haven't had any really strong reactions or flashbacks or feeling like I can't cope. That being said, I haven't had to look after a brand new extreme preemie yet (< 25 weeks).  I'm kind of dreading having to admit a brand new 23 or 24 weeker, but I'll cross that bridge when I get to it.  I know it will be difficult looking after a child who is closer to Aidan's gestational age.

There are a few babies on the unit who are former extreme preemies.  One I looked after a couple of weeks ago is now many months old and still not doing well.  May never do well.  This baby may have spent months and months in the hospital, parents hovering, hoping, praying; enduring many, many painful and invasive procedures and surgery...and may still die.  In situations like this, my colleagues have a hard time wholeheartedly agreeing with the parent's decision to continue care, and 'nurse me' gets this.  It's awful to watch a child have to endure so much suffering day after day.  As a medical professional you begin to feel more like you are hurting the child, than helping him or her.  You begin to question what type of life a child is going to have after surviving so much.  Will he or she grow to enjoy life, able to actively participate in society?  Are you doing the family a service by saving their baby?  Or will life be a constant battle from one medical crisis to the next?  It's also a struggle to balance the wishes of the parents who may want to continue no matter what, while being afraid you are no longer 'doing good' for the child.  How much is too much? There are no right answers.

However, coming back to work I find I am much more sensitive to the decision making processes that parents of these types of children might face.  I have a much better appreciation of what it's like to have to make very hard choices when there is a lot of doubt surrounding the outcome. How hard it is to keep up hope day after day, in the face of so much adversity. How angry you feel at doctors, nurses, social workers, as they look at you with pity, as if you're not *quite* understanding how serious the situation is. As a parent you feel it's your job to have hope for your child.  Hope that he or she will be okay, that your baby will end up on the good side of statistics.  It's hard to do this when you never get any good news and never see much progress.  I have a feeling, this will be another area I might have difficulty coping with.  Identifying too strongly with the parents of 'hopeless' cases.  We'll see how it goes.

One other thing that I have found really interesting is that I'm finally beginning to have that sense myself as a changed person.  The one I was 'before Aidan' versus 'after Aidan'.   I often read on others blogs how they feel they are a very different person person before and after their baby died.  They don't recognize their 'before' self in photos.  They don't identify with the same values or concerns they had prior.  They feel like a changed person.  I honestly never really felt that way after Aidan died.  I definitely saw the timeline of my life as 'before' and 'after' but I couldn't say I really felt like a different person.  I felt like me, only sadder.

Being back in the NICU, I'm really getting a sense of myself 'before' and 'after'. I realize that I never entirely assimilated back into who I use to be, because I never returned to all the same routines that comprised my life before him.  Aidan died, and then I started a whole new 'work life'.  I had new colleagues, I worked different hours and I worked on a different floor with an entirely different patient population. I didn't have to make myself 'fit' into my old life entirely, because I just never went back to it.

And now I have.   

I will say, it's weird.  I belong and yet...I've experienced so much. And I realize that changing jobs when I did, was entirely the right thing to do.  I'm glad my career moved in a different direction after Aidan died.  It helped me cope, and not just because it removed me from 'the babies'.  It helped pull me out of myself by having to interact with new people and learn new things.  It kept me feeling like I was moving forward rather than just that awful feeling your life 'circling' after your baby dies.  I've realized that that would be my advice to anyone who has lost a child.  Once you come to the point where you can get out of bed and walk out the door, try something new.  Anything.  It doesn't have to be as big a change as a new job.  Just change your routine, even if it's something small.  It helps to get you out of that mindset of what 'should' be and helps you to focus on what is.  That, in my opinion, is an important step in moving forward.

Coming back to the NICU, I feel like I'm picking up where I left off.  It's strange, but also kind of good.  My life is different now.  I'm mom to a living baby, and mom to a dead one.  I've faced some of the situations that were my worst nightmares.  I've grown and lost and gained and hurt and survived so much that I realize I'll never be able to truly go back to the person I use to be.  I'm not the same person that I was on my last 'before' shift in January 2010.

And now, that's finally okay.

Do you feel you are a different person 'before' and 'after'?  Does that bother you?  What do you think of my advice to change your routine after your baby dies?  Would you agree or disagree?

Melancholy and the Infinite Sadness

I have a much longer post that I'm working on about my return to work (which is actually going rather well), but I don't feel like being happy and positive tonight. 

Tonight I feel like being a bit sad.

My cousin (finally) had her baby.  16 days over due. (!!!!)

I know, right? 

Dead baby mom me was screaming "holy crap....get that child out now!  It's fully cooked!  You don't want anything to go WRONG AT THE LAST MINUTE!!!!"   It didn't.  (Whew).

It was a boy. 

Since their family lives on the other side of the continent and I likely won't see this little guy very often, I was slightly surprised to feel a twinge of envy mixed with sadness.  Perhaps I should come to expect this when hearing about the birth of a baby boy.  Especially one born so close to both Aidan and Kaia's due dates. (It's kind of odd that he was due two years plus a day after Aidan and he was actually born one year plus a day after Kaia's due date.)  Just like when my nephew was born back in February, I'm very grateful the baby is healthy, and happy for my cousin and her husband who have waited a lot time for this, but there is that lingering heartache about hearing of another healthy, full term first baby boy.  Someone other than me got that wonderful moment of giving birth for the first time and hearing a cry.   Happy for them.  Sad for me.

It's also coming at a time where I feel we really have to decide whether we are going to try for another baby or not.  Kaia is 14 months old now and more and more every day she is moving away from babyhood.  It makes me a bit sad to look back at her pictures and think "my goodness, how she's changed! She's not a baby anymore!" On the other hand...hallelujah!  She's a lot of fun at one! She often sleeps through the night. She's becoming much more communicative.  She eats by herself in her high chair and easily holds her own bottle or sippy cup.  She gives hugs now.  She has 7, and is working on 8 teeth.  She is *just* starting to cruise a bit along the furniture, although I think it will be awhile before she walks independently. I sense that both Brian and I feel more relaxed about Kaia. She is thriving.

So...where do we go from here?

Do we keep with the status quo?  Do we settle into being a one child family?  Do I start to focus on my career, free to return to school in a year or two to work on my Masters?  Wave good-bye to my baby making days for good?  This would be the safe, comfortable way to go.  It would be easier financially, physically and possibly emotionally.  I know it's what some of my family members and friends would like for us.  They don't see a reason to ever risk it again.  Twice was enough.

But it's hard to let it go.  Both Brian and I would like another child.  Not desperately the way we wanted (and needed) Kaia, but there is a definite desire there.  We love her so much.  We love watching her grow.  Love watching her develop into her own person.  We would love for her to have a sibling.  Kaia should have an older brother.  Someone to play with, to learn from and to rely on, but she doesn't.  Since we and she can't have Aidan, maybe we could create some one new.  Not a replacement, but an addition.  I see so many parents with two or more kids, and how they have such love and pride watching their children interact.  I want that too.  I want that for us.  I want that for Kaia.

There is also a definite desire on my part to have the happy pregnancy and birth experience.  I keep wondering if 'next time' could be wonderful.  What if I don't risk it?  What if I never find out?  Would I regret it?  Could I deal with it if it's not?  Could I go through everything again only to have another terrible outcome?  At the end could I say it was 'worth it'?  I don't know.  The entire pregnancy process alone seems daunting. From the 'trying" (is our timing right?) to the 'finding out' (is that a line?) to the blood work (doubling betas?) and ultrasounds(does that placenta look okay??!!!) and doctors visits (hours and hours in the waiting room) and worry, worry and more WORRY.

It's a confusing muddle.  I wish the answer would just come to me.  I wish the outcome was already known.  

I would do it all again in a second to have another outcome like Kaia...but not for another one like Aidan.

Maybe that's my answer.

Birth Days and Craze

Aidan should be two today.  It's his two year 'due date anniversary', which isn't a day you celebrate or really even think about when your child is born alive and healthy, but somehow seems significant when your baby didn't make it home.

Two.  Wow.

I know other people feel sad on these 'anniversary' days that are related to their dead child, but over two years later, I sort of look forward to them.  His birthday, his due date, the anniversary of the day we found out I was pregnant...these are days when the veil between the time we spent with him and now seems somehow thinner.  Even though he never actually lived to SEE an August 15th, it will forever be the day that is branded into my mind as the day our family of two was suppose to grow to include a small, squishy, bouncing baby boy.

A cousin of mine (the one who we had the shower for back in April), is due tomorrow.  As her pregnancy has progressed I've been able to mentally keep track of exactly how far along she was as I can easily compare to my pregnancy with Aidan.  In late April, when I saw her at the baby shower, I mentally did this equation because it was about a week after Aidan died (so 23 weeks + 3 days + 1 more week than we got with Aidan = mid 24 weeks).  I'll probably always be able to do this with her child (Aidan's suppose to be age - 2 years exactly = cousin's baby's age).

I've been thinking about this particular cousin a lot right now because she lives in the States and is planning on having a home delivery with a midwife.  As I mentioned in an earlier post, we've recently cancelled our cable and got Netflix so when Kaia's napping in the afternoon I've been watching documentaries.  I've watched two recently that were about the state of maternity care in the States and the sky high intervention (induction, epidural, forceps, vacuum) and C-section (30%) rates.  Both documentaries were by film makers who had planned or had home deliveries with midwives and heavily slanted in favour of reducing C-section rates, and encouraging and supporting more women in having medication free, vaginal deliveries.

The talking heads in the movies (medically trained outspoken advocates for natural birth) cite many studies that show home deliveries are as safe as hospital deliveries (for healthy moms and babies, of course).  One documentary film maker even goes to Holland where 80% of babies are born at home.  In Holland deliveries are CHEAP (about $800 for the attendant) and women's attitudes towards birth seem to be "why wouldn't I want to have my baby at home? I'm not sick, so why should I have to go to the hospital?".  How novel!

Both documentaries talk about how C-sections in the States may be done for the convenience of doctors (ie: the highest rates of C-sections are at 4 pm and 10 pm. The first so the doctor can be home for dinner, the second so the doctor can be home to go to bed).  Also, they both go into how inductions are now so common (mostly done on a Monday-Friday, again for convenience sake) and around 50% of the time, result in a C-section.  The induction flow chart often looks like this (especially in cases when babies are being induced with no signs of impending labor): induction > contractions very strong, very quickly > epidural as woman is very uncomfortable > labour slows down due to epidural effects and because woman no longer able to move around > increase pitocin for 'stalled' labour > contractions increase in size and strength > baby begins having decels due to very (too?) strong contractions > physician jumps in and says "your baby is in distress I think it's time for a C-section in the interest of your baby" > baby is born via C-section and everyone says "whew, glad doctor was there to get baby out in time".  That this occurs is not at all a surprise to me.  In one of my women's studies courses in university I did an entire paper on the history of midwifery in continental Europe, and it was fascinating to see exactly how medicine (read: male physicians) took over birth as a way to increase revenue and appropriate knowledge that had always been in the realm of women, touting it as "science".  That insurance companies, time management strategies, technology and pharmacology has made things even more complex and heavily weighted in favour of hospitals and doctors doesn't surprise me in the least.

I generally agree with a more natural approach to delivery, and less intervention versus more.  People seem to have lost sight of the fact that having a baby is a natural process.  Like digesting food, or recovering from a cold, or learning to walk, things humans do every day with very little incident.  Women's bodies are MADE to deliver and carry a baby.  We were doing it for THOUSANDS of years before epidurals, and C-sections and fetal monitoring showed up and somehow the species survived.  Not to mention that all other mammals except humans seem to do just fine with very little or no 'scientific' intervention. These documentaries portray the delivery that I would have loved to have had.

Of course, my experience was a little bit different.

At her baby shower, my cousin was talking about her decision to have a midwife and how she planned to deliver at home.  She stated that of course, if there was a problem, she would obviously want to be transferred to a hospital and then said "in those cases, I think a woman knows if something is going wrong.  You just have to listen to your body".  And while I want to agree...I know from experience, and from reading many of your stories, that no, in most cases you DON'T know that something is going wrong.  You might worry about it, or wonder about it, or feel off, or feel anxious or question if something is normal or not...but rarely do you know in a way that allows you to act.  In my case, I was a nurse, with contractions every two minutes at 23 weeks pregnant with a pregnancy that I KNEW was in danger...and it took until I was minutes away from delivery and they were announcing that I was 6 cm dilated before I really GOT that I was going to have a baby and he was going to die.  I was in so much pain that any decision making at that point was out the window. I knew 5 hours earlier when I started having bad back pain that this was likely 'it', but I didn't want to let myself believe.  It's that ever helpful/harmful human state called 'denial'. 

The natural birth advocates in the documentary, who talk about the flow of hormones that are released after a woman delivers naturally without meds (which they say are impeded with an epidural), talk about it being such a 'high' and so 'critical' for the mother-baby bond.  Maybe so, but after I delivered Aidan naturally, without meds (who was all of 1lb 4 oz and less than a foot long), all I wanted to do was pass out...my blood pressure was in the tank and I felt woozy and exhausted.  This probably has more to do with having a death to deal with rather than a 'birth' and my heart condition, but in the weeks after having Aidan, thinking of the physical pain of giving birth I remember saying to Brian "don't ever let me do that again without an epidural".  Ha...so much for my 'elated high'.  It also puts down the many many women who have epidurals and also give birth 'naturally'.  Did they not push out a baby too.  What exactly was 'unnatural' about that?  And if it was any other condition where someone was in pain, you'd think it barbarous NOT to have pain medication.  Take out my appendix with out anesthesia? Um, no thanks. Yank out a tooth without freezing?  Not going to happen.  I fell and broke my leg in three places...holy hell, where's the drugs??!!  Who am I to say how much is too much pain for someone else?  Should proper preparation, support and other more natural pain relievers/modifiers be available for labouring women so they feel confident and comfortable saying 'no thanks, I'll work through these contractions on my own".  Of course.  (As an aside, I wonder what the cost benefit ratio would be of employing an army of doulas/midwives and/or better trained nurses, comfortable birth suites, and other pain reducing/coping methods of child birth compared to C-sections, anesthesiology time and medical supplies?)  However, I wouldn't want to put down anyone who says "nope, I'm done, where's my epidural?".

The documentary talked about the evils of C-sections and how they aren't the panacea of awesomeness that modern hospitals would have you believe. From an NICU nurse's stand-point this is obviously true. Babies are designed to endure labour, in fact, labour often helps to 'ready' them for the outside world.  Passing through the birth canal helps to squeeze out fluid in their lungs and the stress hormones set off by labour help ready their bodies for the transition to breathing air.  It's no coincidence that babies who are delivered by C-section (especially via a 'cold C-section' where no labour has occurred) have higher rates of breathing problems at birth.  Breathing problems that keep them in hospitals for many more days then they might have been if they hadn't been delivered via C-section (cha-ching $$$).  But, C-sections can save babies lives (and sometimes moms lives) too.  They can also be mental life savers for women who have had previous losses or other traumatic birth complications.  I had a C-section, and honestly...it wasn't that bad.  I had no complications and my scar healed fine...in fact, it's probably the prettiest scar I have (and I have many).  I have no idea if it impacted my future fertility (if we even see fit to use my uterus again), but I wouldn't DREAD having another C-section (under much different, healthier, happier, higher gestational circumstances of course).

It's also probably a no brain-er that most babies could be born at home, just fine.  Another cousin of mine had a midwife for her third baby.  She planned a hospital delivery, but did most of her labouring at home.  She met the midwife at the hospital *just* in time, and had her daughter.  She spent a day or so in hospital and came home with her healthy, full term, baby girl.  My cousin told me, "what they did for me in the hospital wasn't anything that I couldn't have done for myself at home".  This is probably true in most healthy, normal deliveries.  Anything that humans have been accomplishing in fields and huts, in snow and in desserts, with attendants or all alone for thousands of years can probably be done just fine in a modern, lighted, comfortable home, with a trained, knowledgeable attendant, complete with running water, towels, a comfortable mattress and strategically placed pillows.  But...in the small percentage of cases...what if being in a hospital is the difference between life and death? Or the difference between health and disability?  Or maybe less dramatically, and more likely...the difference between FEELING 'safe' and feeling 'nervous'. That most of us wear a seat belt all our lives and never need them doesn't make it smarter to not wear one or anyone less grateful that they exist. This is obviously why most people deliver in hospital...on the off chance (hopefully not CREATED by the medical establishment) that an intervention might be necessary.  It's also why the doctor who delivers babies in Holland at home says he's generally within 15 minutes of a hospital, for safety (a feat more easily accomplished in a country only 33,889 km in size, compared with say, oh, my country Canada which is 9,093,507 square km).  It's also why, my heart condition and previous birth history aside, I would probably never opt for a home delivery, even if I could have one.  I'm a worry-wart by nature.  I just couldn't be comfortable having my baby at home, no matter how 'natural' and 'low-tech' I wanted or felt I was capable of.

In any event, I'm anxiously awaiting the arrival of my cousin's baby. Hoping she has the midwife attended, medication-free, uncomplicated natural birth I always wanted, and the alive and healthy August baby I never had.  Wish that it could be that way for all of us.

What do you think of the state of birth in your country?  Hospital or home, midwife or doctor for you? Would you ever consider a home based birth?  What does your loss make you think of these types of practices?

Olympic Melancholy

It's Olympic time again.  A time when the world comes together to play and to celebrate athleticism. Where people gather to cheer on their country or their favourite and hope to see them collect a bunch of precious medals.

Except me.  I'm not watching.

The last Olympics were held in Canada, my home country, in the winter of 2010 from February 12th to 28th.  At those Olympics, Canada won the most gold medals of any country, and placed 3rd in medal count over all. It was a proud time for Canadians and thrilling to watch.  I remember those Games very clearly because I watched almost every Canadian winning performances LIVE.  I didn't hear about them second hand, or watch a replay...nope I was glued to my TV, reveling in every moment.

The reason I could spend hours and hours watching round after round of eliminations and finals is because I was on medically ordered bed rest. 14 weeks pregnant with Aidan suffering with (what we thought was only) a subchorionic hemorrhage.

It had been a scary January 2010.  Lots of bleeding.  Multiple trips to Emerg.  Finally I was told by a kindly ER doc near the end of January that I needed to be off work, resting, so the blood clot in my uterus would bleed out/reabsorb, shrink and disappear.  Leaving behind a healthy, growing baby.  It was just a matter of time. This advice was confirmed on February 10th by a maternal-fetal medicine specialist from the high risk pregnancy program who even questioned why I was there to see him.  My pregnancy was normal (aside from the giant blood clot)...lay down, rest, everything will (likely) be fine.  See you in a month....

So it was with this comforting information that I sat for two weeks and watched the XXI Winter Olympics unfold.  I watched my countrymen and women slide, jump, skate and shoot to earn an amazing 26 medals.  I loved watching all the drama unfold only a few short (okay actually quite massive) provinces away.  I knew I would never forget Alexandre Bilodeau win Canada's first ever gold medal on home soil by sticking the landing on that amazing final jump. Or Clara Hughes win her 6th medal in speed-skating, the only Canadian to win medals in both the summer and winter Olympics  Or Jon Montgomery as he marched through a crowd of fans after his gold medal win singing the national anthem and drinking a beer. Or my personal favourite: the replays of crowds of Canadians from coast-to-coast leaping to their feet milliseconds after Sidney Crosby scored the winning goal in the men finals hockey game against the US. It still makes my heart swell with pride.

And I couldn't wait to share it with my baby.  

To say "I know you were born in the summer, but you and me baby...we watched those games together! While protecting you and making sure you were safe, you were right there with me. When those amazing events occurred, you were the size of a lemon...but you were there".

Little did I know, that even while I was watching, and feeling confident that (probably) eventually things would be okay...it was already too late.

You see, on the morning of the February 12th, unbeknownst to me, my water broke. At the time, I thought it was the clot, bleeding out, leaving me and my baby unharmed...  But it wasn't.  I know this for a fact now because my water breaking felt exactly the same way when it happened a year later with Kaia.

So while I was watching the opening night of the Olympics, happy, thinking "oh good, I'll have something to keep me busy while on bed rest the next couple of weeks"...my baby was in trouble...and I didn't even know it.  I wouldn't know it until over a month later when the Olympics were over and an ultrasound showed something very, very wrong. That opening night, I was blissfully unaware of the events that were about to unfold.  That in just over a month the same doctor who had been so positive just a few weeks earlier would look at us with a completely different expression on his face as he explained what he was seeing on the screen.

***

It's 2012 and it's Kaia's first Olympics.  She hasn't watched any of it.  Neither have I.

It's just not the same. The Olympics are in England, not Canada.  It's summer, not winter.  We no longer have cable in order to save money because we rarely watch live television anymore (who has time with a baby?  Plus with Netflix and the internet it's kind of redundant).  I'm too busy.  I'm planning my back to work schedule. Working out babysitting arrangements.  Sending lots of time outdoors with Kaia, soaking up the good weather.

The Olympics are here again.  

Too bad the 2010 baby isn't.

But the Games will always remind me of him, because during the winter of 2010 we watched them together.  Back when I thought everything was possible.

Was there a big event that sticks in your mind back from 'before'? What does being reminded of that time feel like?

Here we go

It's official.  I'm heading back to work in two weeks.  And...(cue dramatic music)...I'm going back to the NICU.

*Thunder, lightning bolts*

I spent a good two hours a day the last few months looking for a new job. One that would be personally fulfilling, not too stressful, easy to get to, allow me to maximize my time home with Kaia and provide enough of an income and benefits in order to sustain our lifestyle...and I just couldn't find anything else that felt like it was going to fit.  Unlike Goldilocks and her three beds, I'm giving up on *just right*.  No matter what, I'm going to have to make sacrifices.  We are not in a position where I could be a SAHM, and honestly, I'm not sure that I really want to be.  I LIKE having a career...I worked hard for it.  I've got *mad skillz* and it really is a shame if I don't use and build on them.

But...

I'm going to miss being home with Kaia every day.  The days that I work I won't see her at all. I still can't quite wrap my head around this yet.  Won't.  See.  Her.  At.  All,  What?!  My baby girl!  My Kaia! My lovely little barnacle that's been attached to my arm for the last year will be half a city away for almost 11 hours a day while I'm at work... with an (almost) stranger??!  How can that be?!

But...

Maybe it will be good for her?  Kaia LOVES interaction with others.  She's a people person and gets a kick out of going places outside her norm.  She takes everything in with her eyes wide open and seems genuinely happy when around groups. She has adjusted well to every situation we've put her in the last year, so maybe she'll be happy to have a change of pace. So far, the babysitter we have lined up doesn't have any other kids to take care of, but that might change.  If so, Kaia will have other kids to play with.  Kids that will talk to her, play with her, teach her things, fight with her and challenge her.  We may never be able to provide a sibling for Kaia, and if that's the case, I feel we need to start building in opportunities for her interact with other kids...so why not start now?

But...

I'm nervous about going back there.  The last shift I worked in the NICU was the night before I started GUSHING blood when I was pregnant with Aidan at around 11 weeks pregnant.  So much has happened since then.  The NICU is such an intense place, with such high standards.  It's physically demanding being on the ball (and on your feet!) for 12 hours at a time.  It's never knowing when you are going to get a break.  It's placing the demands of not just the patient, but the TEAM above your own (hey, look it's almost 5 pm and now that everyone is squared away I can finally eat lunch!!!).  It's never knowing what's going to happen next (the baby was fine...and then 20 minutes later he wasn't).  It's switching your days and nights around and working weekends and holidays (sucky, made even more sucky when you're missing your kid enjoy fun family times). I know I can do the job.  I'm just not sure about the toll.  Will it be too much?  Just before, and when trying to get pregnant with Aidan, it was too much.  I was anxious about getting pregnant and it led to depression. I felt overwhelmed with the fear of what was going to happen and it translated into insomnia. I was consumed with the fear of what could go wrong when having babies, because I saw it every day.  I never had that safe bubble of "that won't happen to me", because I saw it happen to people like me all the time.  I'm not saying I'm psychic or anything of that nature, but the year before Aidan died, when it came to my anxiety level, it was almost like I was pre-grieving his loss.  It was like I *knew* something was coming...it just ended up being because of my placenta instead of my heart. Going back to the NICU is bringing all this up, so maybe it's understandable that I'm nervous.

But...

Maybe it's time to pay it forward.  Go back to help patients and families who are still in the thick of it as they struggle to make it through, hopefully (but never guaranteed) with a well baby at the end of it all. I may find I have a lot more to give because I've grown a lot in the last two years.  I've had experiences that directly relate to the people I'm trying to help.  I've had two terrible, frightening, complicated pregnancies.  My first born died.  I grieve for him.  My second lived, and spent 50 days in an NICU being cared for by someone other than me.  I've (cyber) met all of you.  I've read so many powerful stories of women (and a few men) who've lived through the worst too and lived to tell about it.  Your stories have given me strength, hope and sometimes even made me laugh when I didn't think I could.  In my own life, I've had to learn to roll with things.  Learned to relax.  Learned to let go.  I had to.  It was that, or fall apart.  I learned I'm not in control.  I can't fix everything.  I can't be everything to everyone.  I can plot and plan until my heart's content, but that doesn't mean it's always going to go my way, it just means I have to keep trying.  All I can do is my best, and hope the rest falls into place.

But...

I'm still nervous...and I'm really hoping it all goes well.

Supportive comments appreciated, as always.

"The Girl Who Lived" Turns One!

...and she partied like a rock-star.

It was a busy week in the lead up to Kaia's party. After a major house cleaning over the July 1st holiday weekend, and much shopping, baking, tidying, errands, multiple trips to the grocery store (Brian: Do you need more butter for your baking? Me: Yes, the answer is always yes.) and a last minute trip to Party City the morning of (apparently the canisters of helium you can buy to take home during this helium shortage do not allow your balloons to float for more than 6-8 hours...so don't blow them up the night before thinking you can be all 'prepared in advance'. You will wake up to them on the floor. Party FAIL), we were ready.  I must say that all the work was worth it and Kaia's party was a smash!

We had 26 people at our house, (10 men, 9 women, 2 kids, 3 toddlers and 2 babies) and while I had hoped that maybe our little backyard might be fun to play in for the kids, the weather didn't cooperate, so everyone was in our living room/dining room/kitchen. Brian barbecued (note: it's awesome to have a summer birthday here in Canada since your party can include barbecued hot dogs rather than boiled).  I baked (my ass off).  My mom and mother-in-law brought side dishes.  Everyone ate and drank and had a good time.  Kaia got presents and had her first taste of icing (after putting it in her hair).  What more could a one year old ask for?

When I thought about Kaia's party back in June, I decided that while I generally think the "rainbow" baby term can be a little overly schmaltzy (and I'm not), it would be a perfect party theme. Plus it was an excuse to use colour...and I love colour! Our rainbow theme was my own special nod to big brother Aidan as well as to how miraculously lucky we feel every day when we think about how well Kaia has done. She lights up our lives and I'm blessed to have her.  Happy Birthday my Kaia-Papaya.

And here are some photos!

Would you like some cake with your butter?

Kaia chillin' with her toys the morning of the party.

Home made chocolate cupcakes with rainbow frosting.

Kaia in her party hat!

La  "piece de resistance". The Rainbow Cake! It was covered with white icing and people actually clapped when I cut into it.  Super gratifying considering it was A LOT of work to make. It tasted amazing too! Score!

Kaia eating icing for the first time.  I gave her a purple cupcake. The frosting was a nice accessory to her yellow dress.

One of Kaia's new toys.

Parties are fun!

Balloon!

"So tired Mommy...I think I'll just stare off into space".