Friday, March 30, 2012

So long Spica! Don't come back now, ya hear?!

4 days until Spica Freedom!

Babyhood definitely goes by in stages.

For each 'stage' that Kaia has gone through I've developed a daily routine. I had a routine when she was in the NICU. Brian and I worked out a routine when she first came home, then he went back to work and I had to learn how to take care of her during the day by myself. Then the cast came and we entered Kaia's "Spica phase". Since the cast time is coming to an end, I have a feeling that Kaia and will be entering another stage. A more mobile one. While the cast has been a bit of a hurdle, it wasn't as bad as I feared. Kaia has still developed a lot even though she's immobile and I just thought I should record what she's up to these days because as of Tuesday (4 more sleeps!!) it will be all different!

Kaia was 8 months old on March 9th (6 months corrected). It was a Friday and when I got her up I noticed two little spots on her lower gum that I hadn't seen the day before. All of a sudden, as if by magic, two little bottom teeth are starting to poke through. It's now three weeks later and bottom lefty is winning the growth race over righty. The teeth are becoming more obvious each day and if Kaia chews on your finger (which she will if you get your hand anywhere near her mouth) you can feel the jagged (SHARP!!) edges. It reminds me a bit of the little crocuses that are poking through the soil around here. It seems to take them FOREVER to get started, but once they take off, it seems like overnight you've got flowers everywhere!

Much to Brian's pleasure, Kaia had stopped doing that long drawn out inhale noise that she was partial to a few weeks ago. One day we suddenly realized she hadn't done it in days. Brian was glad that was over as he HATED that noise. Then all of a sudden, a few days ago she started doing it again! It was like she remembered "oh yeah, I forgot about this!!!" (Cue long drawn out air sucking noise). She still doesn't use the typical baby consonants like 'ba-ba' or 'ma-ma' or 'da-da' (I'm partial to ma-ma...) but loves 'ahhhh', 'wwwhhaaaa' and "ooooohhhhh'. She gets a huge kick out of us repeating her own sounds back to her. She's quite vocal and almost seems to 'sing' sometimes. She'll start saying "Ahhhh" and then raise her voice to an octave where it's so squeaky it almost disappears and then kind of hover there getting louder and softer "AAAAaaahhhhhhHHHHHH". It's freakin' adorable.

Kaia has gotten pretty good at passing toys from one hand to the other. It's hard for her as she has her 'cast boobs' in the way. She can't bring things close to her chest where she could better manipulate them, but she does better than I expected with small toys even having to hold them at arms length. She still loves her 'Spica chair' that Brian made her and often sits there while I make dinner. Recently I've noticed she doesn't mind being left lying on the floor on her back with toys strewn around her. As long as she can reach something interesting, and she's not overly tired, she will play (read: bash toys around) for a good 20 minutes or so. A few days ago, I almost got all of her bottles washed before I realized "hey, she's quiet, she's not asleep and I'm not entertaining!" Kaia's also gotten to the point where if I hold her at the table on my lap I have to be careful of whatever is on top, because if she gets a hold of it, it's going flying. Paper, plates, glasses, and cutlery are all at her mercy. Fortunately we've had no accidents yet, but it's been a close a few times.

We've started to give a few bites of 'adult food' but we are still waiting until she's out of the cast to really get going on that. This is despite the 'advice' of all the doctors I've seen. I don't know what the magic of rice cereal is, but holy smokes, doctors are all over that like they're getting kick backs from Gerber. I keep getting asked "have you started rice cereal yet??! Like it's the greatest thing since sliced bread. It looks disgusting if you ask me. However, Kaia has tried mashed up banana, strawberry and raspberry via a spoon. She's also had a few bites of frozen yogurt at the mall, and I've attempted cracker type bread, but that's a no go. She really isn't at all interested in any harder solids and makes a "this is disgusting! Why are you putting this in my mouth?" face when we try them. Then if they make it past the tip of her tongue, we get gagging and coughing. For those of you who have done baby led weaning, is this a stage that she just has to get past? Brian gets very upset with the gagging and I'll admit it's not pleasant to watch. I'm hoping a few more weeks will kick start her love of solids.

One of the things that I know will have to change when Kaia is cast free, is our comfort with leaving her in high places unattended. I know, I know, I sound like a neglectful parent, but she literally CAN NOT roll by herself. Nor can she get up the momentum with just her arms to even tip herself side to side. She's basically the human equivalent of a paper weight. This means we've been comfortable leaving her for a few minutes on changing tables, on the kitchen counter where we do her bath, or on couches. It felt totally weird when we first did it, but it's become habit by now. We'll have to break that one real quick!

Yesterday for the first time since being in the cast, I did notice that if left on the floor for a while with toys *just* out of reach, she will do this head shaking, back arching thing and can very slowly (very slowly, it took her 10 minutes to go 90 degrees) revolve in a circle on her back in order to get closer to the toy. I can see how bigger kids could figure out how to move in a cast. I don't think Kaia's going to get to this point since we only have a few days left, and hopefully it will be her last time in a body cast.

Kaia continues to get only breast milk and I haven't touched my HUMONGOUS stash of frozen breast milk in our deep freezer (literally I could feed her for well over a month with all the milk that's down there). I'm still pumping 5x a day, usually just over a litre. Pumping is not the most fun thing to do in the world, and there are sometimes when it's the absolute last thing I want to do, but overall I've found ways to work it into my schedule. It really helps that Brian is very supportive of it. He knows if I have to pump, he's in charge and doesn't rush me. I do try to do it when Kaia is sleeping for the most part, or when Brian can be around to keep her entertained, and my last pump of the night when Brian and Kaia are sleep is actually quite relaxing. Pumping does take a lot of time, which is probably the worst part. About 2.5 hours of my day is spent hooked up to the pump and this doesn't include the other jobs of washing bottles and actually getting all that goodness into our girl. However, Kaia only had one tiny cold over the winter and if breast milk helped fight off any germs at all, I'm glad I went this route. It's cool to be able to grow a human from scratch.

In terms of her size Kaia was 7.07 kg at her doctor's appointment on March 14th which is just below the 50th percentile based on her adjusted age (6 months), and about the 10th percentile for her actual age (8 months). I think this is great. I'm thoroughly pleased at her weight. I don't know what her length is, as it's unmeasurable in the cast, but she's looking very long to me! I can't wait to get a look at all of her on April 3rd!

Kaia's current favourite Toys are her Elephant "Mr. Bo Jangles" and she loves diaper change time because that is where "Toucan Sam" and "Gerry the Giraffe" hang out (Brian likes naming all her toys, that way we know who we're talking about when we say "Can you go and get _____"). Sophie the Giraffe is also a favourite but she lives in Kaia's diaper bag, and is brought out for special occasions like visits to Grami's house, or trips to the doctor. I'm hoping to preserve some of Sophie's 'specialness', so that if ever a melt down happens when we're out, Sophie will be somewhat new and exciting. I'll let you know if this works.

I'm going to knock on wood before I type this, but nights with Kaia have gotten so much better. Sometime within the last couple of months we moved her bed time from around 10pm to 7-8ish pm. I was prepared for possibly needing to get up earlier...but it worked REALLY well and Kaia doesn't usually get up 'for good' until somewhere between 8:30 to 10 am! Since I'm not at all an earlier riser and tend to have sleep issues of my own, this is PERFECT. Our daily routine is something like this:

Kaia wakes up anywhere between 5am and 7am for her first bottle. I change her diaper and feed her and then she goes back in her crib. I then have to pump, usually I have breakfast at this point too, and hopefully she has fallen asleep by the time I'm done and we go back to bed until anywhere between 8:30 am and 10 am. If she's still making noise when I'm finished pumping I'll bring her into bed with me, and we'll both fall asleep there.

By 10am Kaia is in our room, still in her jammies and sleep sac, but awake and ready for bottle #2. This is the hardest pump of the day because she generally wants to be entertained, but it's difficult to hold her while pumping. So I give her toys to play with (sometimes my hand is the best toy of all) and I watch TV for an hour while Kaia eats and I pump.

At 11am Kaia sits on her potty. She almost always pees. Yeah! Good job. She gets a new diaper and we figure out what the weather is going to be like and get dressed appropriately.

By 11:20 or so, I get 'brunch'. The last little while we've been going for a walk a few times per week. It's been nice out and I could definitely use the exercise. Kaia likes the stroller too and sometimes even falls asleep for 20 minutes or so as we go through the ravine near our house. If it's crummy weather we'll stay indoors and play with toys or listen to music while I clean the kitchen. It's much more fun going for walks.

We're usually home by 1pm. Sometimes we need a bottle at this point and sometimes not. This is when I check my e-mail, blogs and Facebook and Kaia plays in her swing or with toys on the floor. Sometimes we listen to music or read a book. By 2 or 2:30 pm she's ready for afternoon nap. She sits on the potty again, has a diaper change, has another bottle, cuddles for a few minutes in the chair in her room and then she's off to sleep.

From 2:30pm until usually close to 5pm is what I like to call me time. Sometimes chores get done, often they don't. Okay, it isn't ALL me time. I have to pump around 4pm and then get dinner started.

By 5pm Brian is usually home and I'm in the kitchen. Kaia gets up from her nap at this point, gets her diaper changed and Brian does the bottle while I attend to dinner. We've usually finished all of this by 6pm or so.

From 6pm to 7pm is different depending on the day. Often it involves a bit of clean up/playing with Kaia time. Sometimes I'll do Kaia's bath at this point. Sometimes we need to go shopping. Sometimes we'll just sit around and chill.

By 7pm we are starting to think about putting Kaia to bed. Brian often does this which includes sitting on the potty again, diaper, pajamas, giving her vitamins, reading a story and another bottle before bed. I usually wash bottles and pump again.

By 8pm Kaia's usually asleep. Brian and I watch TV, or he plays video games and I'm on the computer.

Brian goes up to bed by 9:30pm or so. He gets up for work at 5:45 am so he likes to relax in bed and play on his Playbook for awhile. I possibly have a shower, get in my pj's and then get ready around 10pm to pump for the last time. I usually drag this one out because I'm on the lap top catching up with some of you, or reading a good book.

Around 11:30pm I get Kaia up for her last bottle of the night. Yeah, you read that right, I actually wake my sleeping child up to give her a bottle. We were told when she went in her cast that she shouldn't be left for longer than 4 to 6 hours in one spot without changing positions and her diaper usually needs to be changed in order to prevent overflow into the cast. I don't mind this bottle as usually it's very quick. 10 minutes or less and she goes right back to sleep. This is the bottle I'm hoping to cut out once the cast comes off. I'm hoping she won't notice the omission.... Ha...fat chance.

So there you have it. Kaia's schedule for the 'cast' portion of her life. Changes are coming and while I'm excited, it will be another adjustment. Kaia might be sore and uncomfortable and maybe even a bit freaked out to be suddenly 'free' of her fiberglass prison, but hopefully she adjusts quickly! Good bye Spica...don't let the door hit you on the way out!

What's new with you this spring?

Sunday, March 25, 2012

pPROM: May the odds be ever in your favour

Medical Definitions:
ROM: Rupture of membranes, also known as 'breaking the bag of waters'.

PROM: Premature rupture of membranes, ROM prior to the onset of labour but after 37 weeks gestation.

pPROM: Preterm premature rupture of membranes, ROM at any point prior to 37 weeks gestation.

Emily's definitions:
pPROM??!!!: My worst nightmare.Link
The definition of pPROM doesn't really capture the possible outcomes very well. Your odds of bringing home a healthy baby depend very much on a host of factors and possibly a little bit of luck. For example: a woman whose amniotic sac ruptures at 36 weeks + 5 days gestation is considered to have pPROM. So does a woman whose water breaks at 17 weeks. The odds of the first woman bringing home her baby are very good. The odds of the second women? "Almost zero", according to my OB. Unfortunately I was that second woman. Not once, but twice. Rupturing with my first baby at 14 weeks and the second at 17 weeks. The first baby died, and the second survived.

I don't know why the odds were in my favour the second time. I know the 15 weeks + 2 days that I maintained my pregnant status after rupturing on March 24th 2011 were the hardest days of my life. Initially I considered giving up and going with the termination offered. I had done the bed rest, the hoping, and the waiting, just one year prior, and it ended with a scary ride to the hospital in the middle of the night and dead baby. Aidan was born at just 1 lb 4oz and died 54 minutes later in his daddy's arms. I felt panicky and despondent when I considered doing it again.

So what stopped me from terminating? It wasn't an objection to termination on moral or religious grounds. We just really wanted a baby. More than anything. After my second pPROM my doctor didn't feel confident that he could offer me anything to prevent it from happening for a third time. So, I could terminate, only to face the same decision at some point down the line. That sealed it for me. There was no choice at that point, but to see it through. I had done it for Aidan (albeit somewhat unknowingly since I didn't realize I had ruptured until many weeks later), so I couldn't abandon the second.

Today is the one year anniversary of my first full day on bed rest with Kaia, my second pPROM baby. It is a day I don't even remember clearly, it was such a black hole. My husband and I could barely move the despair was so heavy. But, one can not stay in that state indefinitely. Even despair gets boring. So I started Googling. And if there is one thing I'm good at, it's Googling. I found the pPROM board on babycenter and personal blogs of women who had beaten the odds and delivered healthy pPROM babies. I found medical journal articles detailing some positive outcomes with early pPROM. I tried to find research that would explain my personal cause of pPROM (a poorly developed placenta called a Breus mole). Over the next few weeks I spent many hours on my computer. But that was fine, it wasn't like I was going anywhere.

In honour of my one year rupture date, I wanted to write down what I did during my time on bed rest that I felt contributed to my overall health and well being and may (MAY) have contributed to Kaia's survival. If you are finding this blog because you or someone you love has early pPROM, I'm sorry. It is not an easy road. Know, however, that some babies do survive. Some do thrive. Not always, but sometimes. I don't know if you will be one of them, but I hope so. As one of the books that served as a good distraction during my weeks on bed rest would say: "May the odds be ever in your favour".

-I drank 4-5L of water a day, plus other beverages. My doctors were not the ones to tell me to do this. Increasing fluid intake does seem to be the starting point for those with pPROM, so I tried to back it up with research I did on my own. I found one study which showed a small transient increase in amniotic fluid production after the pregnant women drank a lot. Not much to go on, but better than nothing. Make sure however, that you are getting enough nutrients if you are drinking a lot. Water and juices shouldn't replace actual food, since you need to be getting good nutrition. Also, make sure your doctor is aware of your increased fluid intake. If you have any health issues such as high blood pressure, heart defects, kidney issues, or diabetes you might want to make sure a large increase in fluid intake isn't going to be a problem.

-I took extra Vitamin C, Vitamin D, Colace (a stool softener), Fish Oil caplets (Omega-3), Collagen powder (Types 1&3), Calcium, Acidophilis tablets and Prenatal Vitamins. The only one which I came up with on my own (the others I got heard about from women on the babycenter pPROM board) was the Collagen powder. I read an article saying that women who have pPROM were shown to have lower reserves of a certain type of collagen in their bodies (Types 1 and 3), so I decided to add it. I ordered it online and it came in a powdered form. I added it to orange juice daily (it's absorbed and works best with Vitamin C). I have NO idea if it did anything (other than make my skin, hair and nails look somewhat nicer), but I figured it couldn't hurt. If nothing else it was a little added shot of protein for Kaia.

-Stretch! If you can, set up a daily exercise 'routine' for yourself and continue to use your body as much as you can. If you don't want to chance getting out of bed at least lift small weights with your arms, do foot flexes, ankles rolls, neck stretches etc. I did some stretching daily, usually on the floor, mainly because my body hurt a lot from inactivity. I would do Yoga positions that were somewhat 'inversions' to avoid leaking, like downward dog or cat stretch. I don't know if this is recommended or not, but I needed to do it for my physical well being. I wish I could have had a physiotherapist come in and monitor my progress, just to keep me on track and provide some support. It may have saved me from a bad back when I finally got off bed rest.

-I used antibacterial wipes after bowel movements only. I didn't want to over use them as I was peeing so much and didn't want to cause skin irritation.

-Wash your hands (or use hand sanitizer) before and after going to the washroom. I set up my hand sanitizer on a table that I went by on my way to the bathroom. That way I had clean hands for doing any personal care and clean hands when I went back to bed.

-Change your pad often to avoid bacterial overgrowth. I probably changed it every other time I went to the washroom.

-I had people who lived with me be very careful of being clean, especially in common areas. I had them wipe down the bathroom daily with cleaner and made sure they washed their hands before preparing my food. It can't hurt and it might help!

-Ensure that someone is available for you 24 hours a day in case you need them. They don't have to be with you, if that's not possible, but make sure someone could come to your aid within a short period of time. I say this because I delivered Aidan, my first pPROM baby, within 5 hours of feeling what I would describe as a 'sore back'. The pain got bad incredibly quick and it was one of the scariest 5 hours of my life. I was starting to get an infection which is why my labour went so fast. My body knew that it had to deliver in order to keep me healthy. If you are still at home on bed rest and are alone for any period of time, make sure someone is available in case you need them. Also, if you are home alone on bed rest and you aren't feeling well DO NOT WAIT to 'see if things get better'. Go to the hospital, or call an ambulance. An infection could be very serious. You can always come home again if things settle down.

-It is very hard being pregnant with such poor/uncertain outcome. All the joy is gone, and fear and anxiety and stress are left in it's wake. Let yourself feel sad, frustrated, angry, numb or depressed if you need to. My "community boards" on babycenter that I visited a lot while pregnant were: pPROM Support Group, 2nd/3rd Trimester Loss Support and Carrying a Pregnancy Despite Poor or Fatal Prenatal Diagnosis. Not a lot of happy mommy's there I can assure you, but a helpful group if you're feeling down and want some support.

-After my pPROM with Kaia, I began to prepare for her death. I was 17 weeks pregnant and had very little hope that she would be okay. Since I had been pregnant with Aidan and lived through the death of one baby, I knew better how to prepare. I looked into funeral homes while I was still pregnant. I did not like the one we used for Aidan and found another place that I was happy with (note: some places will not charge you, or only charge a small fee for collection of a body of a baby, so ask). While this may seem incredibly morbid, it helped me to feel like if the 'worst' happened, I would be better prepared. We are so grateful it didn't come to this a second time.

-I had a bag packed and ready to take to the hospital very soon after finding out I ruptured, knowing I could deliver at any time. Along with clothes/toiletries I might need, my husband went out and bought a special blanket, and a small toy for the baby. These blankies work very well as they are small and soft and are the perfect thing to cuddle a very small baby in. We learned with Aidan that no matter what happened, we would want all the physical reminders we could have with baby # 2. If your baby dies, or is very sick with an uncertain outcome, a blanket or toy that belongs to him or her that you picked out can take on huge significance.

-In the bag that you take to the hospital, have comfortable and practical things packed for your partner too. He (or she) likely won't want to leave your side to go home and get things like underwear, socks, a toothbrush, or any medications he (or she) needs.

-Bring a camera. Make sure the batteries are charged and a memory card (or film) is in the camera. Have it with you at delivery if possible, even if the worst is happening. The most perfect picture I have of my son (the header on this blog) was taken shortly after he died while he still looked somewhat 'alive'. I wish we had taken a photo as soon as he was handed to us, while he was still alive. The only 'living' photos we have of him are ultrasound photos and with pPROM those photos are often blurry and indistinct due to lack of fluid. Even if your baby dies prior to birth, he or she will still 'look' the best right after delivery. Taking photos of a child who has died may not be for everyone, but I can say it definitely helped me. I wish I had more.

-People were always suggesting things for me to 'do' while on bed rest. I don't know how many times people told me I should knit, scrapbook, draw, organize my computer files, learn a new language, etc etc. All things you can do while stationary surely, however I just didn't have the energy or focus. I was so worried about what was going on with my body and the baby that I didn't have it in me to do much else. If this is you, don't feel bad about this. pPROM is incredibly scary and taxing both physically and emotionally. If you can distract yourself with a project, great. If not, don't worry about it. I read a bit and watched a lot of TV. Both times on bed rest I watched the "Buffy the Vampire" and "Angel" series. They are my favourite, and don't talk much about babies so it helped 'remove' me from what was actually happening in my life. I also watched a lot of HGTV (Home and Garden TV). It was nice to ogle or criticize something so mundane as home improvements and and that channel barely ever mentions babies. A nice change from TLC that plays non-stop "Bringing Home Baby".

-Friends and family will likely not understand the gravity of the situation and may think that 'since you're still pregnant everything is going to be okay'. People don't know a lot about early pPROM or the stresses you may be facing. In order to keep friends and family updated from my bed during Kaia's pregnancy, I wrote an "Update" e-mail every couple of weeks briefly explaining what was going on, what my next goals were and how people could support me (I suggested people make a frozen or easy to prepare meal for us if they could, or contribute to our 'parking' fund, as parking at the hospital was VERY expensive). I didn't do this during Aidan's pregnancy and I regretted it afterwards as no one really knew what had happened and some people did not even know that I had been pregnant when they learned he had died.

-My doctors were very negative during Aidan's pregnancy and during Kaia's I didn't hear anything very hopeful from them until after 27 weeks (ie: after being ruptured for 10 weeks). While this is VERY hard to hear, recognize that your doctor likely doesn't want to 'get your hopes up' because while a good outcome might be possible, pPROM prior to viability historically doesn't have a great success rate. Doctors have to give you information based on medical studies and their own practice experience and probably both tells them that early pPROM has a high fetal mortality rate. It's also a very powerless position for them to be in. Doctors are trained to DO for their patients, and with pPROM there is very little to do. It's mainly a wait and see. So recognize this and accept that you will likely have to be your own cheerleader.

-I explain it best in this post, but after rupturing with Kaia, I felt very despondent. I did not really believe I was going to have a good outcome. I emotionally felt I had more in common with women who chose to carry a fetus they knew had a poor or fatal diagnosis. While people on the pPROM board often talk about hope, I didn't want to have any. I spent my pregnancy with Kaia loving her, not expecting her to grow to be anything more.

-Work is another stress that I had to deal with. As I live in Canada I was on EI (Employment Insurance) for the entire time I was on bed rest for both pregnancies. This means I was still receiving an income while I was off work (albeit much reduced). Look into whatever is available in your area. If you don't know, look online, ask your occupational health or human resources department at work or ask to talk to a social worker who works with your doctor. Social workers are the best people to help you with financial concerns when you are off work due to medical reasons. Your doctor should be accommodating and write you a medical leave of absence note. Make sure you keep on top of whatever paper work is necessary to ensure you continue receiving your payments. In Canada you have to report (online) to EI every 2 weeks to state that you are still on medical leave and after 10 weeks of being off you are required to hand in a medical note (someone can do this for you). EI also only lasts for 15 weeks.

-Keep your employer in the loop, but don't feel you need to go into great detail. If your employer knew you were pregnant you can just state that you are having problems with the pregnancy and your physician feels it best you remain on bed rest. You can go into more detail if you wish, but it's not necessary. By law, they cannot ask about your medical history or your medical records. Those are private. Be careful of confiding medical details to work friends unless you are okay with those details being shared at your work place.

-Your partner is probably under a great deal of strain as well. pPROM was incredibly difficult for my husband to deal with. He was very worried about me, about the baby, about our finances and about having to cope with all the housework and chores by himself. On top of that he couldn't sit around and mope like I could because he still had to work. What helped us was making sure we spent as much time as we could relaxing together. We also relied a lot on family to make meals, help us with chores and do some shopping. This is definitely a time where it's okay to ask for help. It's also a time when your house doesn't have to be spotless and the meals don't have to be world class. As long as everyone is safe and staying sane, that's the most important thing.

The hardest thing about pPROM is that it is a waiting game and your ability to stay pregnant, retain fluid, and continue growing a healthy baby depends on so many things that are out of your control. It is a very hard and powerless position to be in. I hope that someone stumbling upon this blog who is experiencing the same thing, or who knows someone who is, will find these suggestions useful.

Wednesday, March 21, 2012

Crap shoot

It's hard to believe it's the first week of spring around here, it feels more like summer. Kaia and I have been out in short sleeves and last night her Angelcare monitor told me it was 26 C in her room! (like 80 F for all you Americans). Brian and I were sweating and uncomfortable but agreed that we CAN NOT turn on the air's MARCH for crying out loud! Makes me concerned for the polar bears...

Today is also T-minus 13 days until the cast comes off! I've already bought Kaia some PANTS! Although if the weather stays this warm we'll have to move on to shorts real soon...

Anyway, on to the point of this post:

Two weeks ago, I had my friend A. and her daughter A.M. over for lunch. A. told me that A.M. had recently been to see her pediatrician and once again they had a referral to see a specialist about something her doctor was concerned about. A.M. is just over two and is currently being seen by 4 different specialists at our local Children's Hospital, with this latest referral making #5. None of the things 'wrong' with her are life threatening, and most are fixable or 'watch and wait-able' but it has been upsetting and stressful for my friend to keep having these things crop up every time her kid goes in for a check up.

After telling me about the latest specialist A. in a bit of frustration says "so that pretty much puts a nail in the coffin of us ever having another kid".

After discussing it a bit further I wouldn't say the decision is quite as 'definitive' as her above comment would suggest, but her and her husband have seriously talked about having another child. They keep backing away from the idea because they are afraid of having a baby who has problems that are even worse than A.M.'s. They have a small reason to be concerned, as one of her daughter's doctors has mentioned that they might want to have an amnio if she gets pregnant again.

My heart hurts for my friend, because on the one hand, Brian and I know exactly that feeling of being terribly worried that something could go wrong if you have another baby. Hell, something DID go wrong when we went to have another baby. The worst part is, that I KNOW A. and her husband are looking at our experience and realizing that lightening does indeed strike twice...sometimes to people that you really care about. Worse is that if it could happen to them, it could happen to you. My friend, being a very cautious and conscientious person, would probably prefer not to risk it. I feel a little badly that our experience is serving as a cautionary tale for our friends.

On the other hand, it's nice to be able to have someone in real life that shares my "do we or don't we" concerns. As much as I enjoy discussing it with you bloggers, nothing can really beat that real life one on one interaction.

But as my friend and I were having this conversation and she's doing all the pro/cons in their situation, I'm thinking "Oh, I would totally go for it if I were you". Then I had to stop myself. I'm not her. I'm not A.M.'s mother. I don't know how stressful things have been with her daughter's health issues. I don't know how many nights she's laid awake worrying about them. I don't know anything at all. Plus as I've learned the last few years, it's much easier to be positive about someone else's situation than it is to be about your own. It's easy as pie to cheer your friend along from the sidelines because it's not your heart on the line.

It's HARD to throw your heart out there to possibly be hurt again (maybe even worse this time??!!) because who knows what could happen? It's almost harder if you're content with your current life status as is. My friend is very happy being mom to her single daughter. She would like another child, but doesn't know if she wants to risk upsetting the balance she currently has for a person she's never met. Even if that person is her own child. It is daunting.

Having a second child is never portrayed as having as much 'thought' put into it as having a first. The first is BIG NEWS! Hang the banners! Call the papers! We're having a BABY!!! The second is more like "oh, the way, just so you know, we're having another baby...oh, and did you see, there's a great sale on shoes at the mall!!" I find this interesting. Why is bringing one person into the world a cause for such fanfare and the second (or third etc) is sort of seen as 'less so'? Is it because the jump from no kids to one kid is seen as such a life changer, while adding the second is just more of the same? Is it because it's assumed that if you've successfully reproduced a healthy child once, it is almost guaranteed that you will so again?

Yet as I'm seeing now, the second (or third, or forth) will require the same amount of love, care, attention, affection and possibly cause the same (or more/less) stress and concerns as the first. Plus now you'll have to split your time at least two ways. It is perhaps an even bigger deal to consider having a second (or more) child because now you have to consider how an added person will affect not only you and your partner, but your other child(ren) as well.

It constantly amazes me how many of the moms on my July 2011 babyboard on babycenter (who all seemed to have healthy babies) are already pregnant again, some due as early as this July. It's equally amazing how many were 'surprises!' I'm not judging. I'm happy for those who are happy (and maybe mildly jealous of the easily fertile). It's just that having another baby so soon after having a healthy living one at home seems like a courageous leap of faith. Even if your first baby was an 'easy' one, your next one might not be. Might, in fact. be the exact opposite of easy. I'm sure it's just the dead baby mother in me talking but man, it just seems so SOON to throw yourself back into the unknown.

I guess to me that's what a new baby boils down to. A complete and utter unknown. A total crap shoot. You could have the best 'odds' in the world and things can go wrong. Or you could (like me and my friend) almost be expecting something terrible to happen...and it very well might be much easier than expected. In the end, as my friend and I are starting to come to terms with, no matter how much information you have about your own situation, or how well you prepare yourself, eventually you just have to make a decision. As the (very vulgar) old saying goes you just have to "shit or get off the pot". Unfortunately for my friend and I, I think we're both still a little constipated.

Monday, March 12, 2012

Baking Up A Storm

I've always liked to bake. Bake. Not cook. I hate cooking. Now some might ask, why would you like baking and not like cooking? You're basically doing the same things: adding ingredients together and putting it in the oven and then eating it. However, I think baking and cooking are very different. Cooking one does out of necessity. Whether it's tossing something in the microwave or a 5 course meal with the corresponding wine, one has to eat to survive.

But baking....ahhh....baking... It's not a necessity. I mean no one NEEDS Vanilla Almond Cupcakes or Raspberry Vanilla Bean Creme Brûlee. So if you do get to eat either of those delicious's a treat! Pure decadence. Plus I like the fact that desserts usually last a few days. You can make a cake one day, and still be eating it a day or two later. The ratio of effort to enjoyment seems more equal than the effort to enjoyment ratio of a main course, which if you eat like I tend to (*blush*), lasts less than 10 minutes.

I have fond memories of baking with my mom as a child. I got to measure and add the ingredients and my mom was the muscle and she stirred and dealt with the hot oven. I can't wait to introduce Kaia to the wonders of baking. Oh, and just a tip, a bit of baking flour in a plastic tub makes a wonderful toy. I use to drive my little cars and Legos through the 'snow' and it felt lovely to have flour run through my fingers. One of the wonderful delights of my childhood, truly.

Since things have sort of settled into an easier routine with Kaia after those first few sleep deprived months, I've felt as though I've needed a hobby. Something to plan and do during the day. My baking fetish was piqued when I found Pinterest. SO MANY RECIPES! So many lovely pictures of sugary goodness! Let's not kid ourselves. Pictures make all the difference. I don't care if something in a recipe book is called "Best Chocolate Cake in the World", if it doesn't have a mouth watering picture next to it I'm just not going to make it.

Since Christmas time, I've been indulging in my baking hobby. I've made Blueberry Breakfast Cake, Brown Sugar Carrot Bread, Red Velvet Cupcakes (EPIC FAIL...too much food colouring and you could taste it, YUCK!), Honey Cake with Honey Buttercream Icing, Billy's Vanilla Vanilla Cupcakes, The Best Vanilla Cupcakes in the World (with cream cheese frosting dyed delphinium blue in honour of my new nephew), Lemon Loaf, Strawberry Lemon Yogurt muffins, Strawberry Banana Loaf (currently defrosting on my counter), and Guinness Chocolate Cake with Vanilla Cream Cheese Frosting. All were pretty good if I do say so myself...

and fattening. :-(

Bursting my baking bubble, Brian is starting a diet today to lose his 'baby weight' (ie: the stress weight he gained from all the shit we've been through in the last year), so I've been told to quit making things with frosting. He says he can resist the loaves I make, or the muffins...but not the stuff with frosting. Boo. I love making frosting.

Really, it's probably a good idea in the long run. As much as I love baking, I will love fitting into a cute bikini come summer time even better. Pumping breast milk is currently keeping my weight in check, but once that's over I don't think my pants are going to fit if I don't quit it with the cupcakes.

As much as I don't like might be a better hobby for now. And hey, maybe I'll learn to love it as much as I love frosting (HA, fat chance!) Any healthy recipes, or recipe sites anyone can recommend? What's your favourite tasty healthy snack?

Monday, March 5, 2012

The Control of Birth

Since Kaia is now almost 8 months old, I'm technically 2 months past the point where I could be considered to be 'effectively' using the lactation amenorrhea method of birth control, since it's recommended only in the first 6 months postpartum. Although, I looked it up today and according to Wikipedia, I never really was doing it correctly since I pumped rather than breastfed and you technically have to have your boobs in your kid's mouth in order to be doing it right. Huh? Who knew? Oh well, since my period hasn't returned, it's hard to feel as though I really have to worry, although I know I could ovulate prior to having my period.

Although I really don't want another child right now (I'd like to sleep through the night again at least once and maybe have a few more dollars in my bank account before that happens), I'm finding it really difficult to contemplate taking 'control' of my fertility. I'm a little apathetic if you really want to know.

Both my family doctor and my cardiologist have asked if we're planning to have any more kids, prescription pads at the ready in case I want The Pill. When I sort of shrug my shoulders and say "we're not sure...", they both say "oh yes, given all the problems you experienced, it would be a big decision..." The problem is that I don't know if we'll ever be ready to MAKE that decision. Both Brian and I are so torn on this issue. Brian's exact words were "I'm leaning towards 'no', although I'd love another child". A wishy washy statement if I ever heard one. My feelings are so all over the place that I can only boil it down to monosyllabic *sighs* and *ughs* and shrugs of shoulders.

It's totally ostrich head in the sand of us, but starting some form of birth control seems a little ironic since it's hard to feel like we ever really had any control of our fertility in the first place. It took awhile to get pregnant both times, it took added progesterone both times to make our babies 'sticky', and it went totally off the rails both times with the same complication that is so rare as to have almost zero info about it on the internet. One baby died, the other survived. We had no control in either case.

Deciding to use birth control means then you have to pick a type. I'm not suppose to use any which have estrogen in them since that can up your chances of blood clots and my cardiologist has nixed that. So that basically leaves the 'mini' pill with progesterone only, Depo provera which I tried and hated, an IUD which looks like a teeny tiny torture device and kind of freaks me out, condoms which seem kind of 'casual partner' for people who've been married for almost 4 years, and sterilization which is a little too permanent.

What I would really love is a form of birth control that gradually 'fades out' over time. Like a pill that dissolves over a two-ish year period. So it would be super effective right now, but at some point, unbeknownst to us it would become less so, until around the two year mark it would be all gone and we'd be fertile again without even knowing it. Then if it happens, it happens. That way, I wouldn't have to make a decision along the lines of "Yes, we've 'decided' to have another child! Now we're going off birth control! Pregnancy soon to follow!" Ugh. Just the thought of deciding when and how and if we're ready makes me kind of nauseous...but not pregnant nauseous I swear.

I have also fantasized about being one of those moms on that ridiculous show "I didn't know I was pregnant?!" I would gradually just start to get fatter and we'd all think "gee, Emily's been digging into the sweets a bit too much lately hasn't she?" and then at some point after 'viability' I'd go in for a doctor's visit saying "I don't know what's going on Doc. I've gained a lot of weight lately and I'm tired all the time, and my feet are a bit swollen, and I think I have indigestion!" My doctor would look at me like I'm crazy and say "Emily, I think you're pregnant" and then I'd have an ultrasound and a perfectly healthy baby (with a perfectly healthy placenta and lots of amniotic fluid) would be found swimming around, content as can be. Gosh! I'm pregnant?! What a surprise! Boy...I have no idea how that happened! But we'll take him or her anyway!

*Snort* Yeah right.

I'm thinking about this more because last week I had J. and her daughter C. over for lunch. She told me she's pregnant. First try. Zipidee do da!

Friend me is happy for them. Dead baby mother/difficult pregnancy me is jealous as hell.

Then Saturday morning Brian wakes me up with, "I just got a text message from J.'s husband and J. is having some spotting. Could you call her?"

I immediately felt my stomach do that weird little flip flop, and my heart jumped into my throat. Oh yes, THAT feeling. How could I ever forget it? It's almost like an old friend. Panic, with an edge of despair. Like trying to hold tight to water. Nothing you can do.

As far as I know, things are fine with J. but it really smacked me upside the head: You're not ready.

Don't know if we'll ever be.

If you'd like to share, how did you 'decide' you were ready for a/nother child? If you got up the courage after a loss, how did you do it? What type of birth control do you use? Do you like it?

Friday, March 2, 2012

Friday Wrap

8 weeks in cast, 32 sleeps until freedom!

It's Friday! I took Kaia for a nice stroller ride today and part way I took off my hats, mitts and scarf it was so warm. Shades of spring to come! Exciting!

I'm feeling a little better about the whole head ventricle thing. I was anxiously trying to get a pediatrician appointment for Kaia this week, when I remembered that she had her RSV shot on Thursday at the local hospital. Kaia gets this shot once a month from November to April in order to prevent Respiratory Syncytial Virus. Most children under two get RSV at some point, which generally causes a bad cold. However, in preemies it can lead to hospitalization with bronchiolitis or pneumonia and can, in rare cases, be a killer. So I've been happy to lug her to her appointments (inevitably in bad weather) once a month.

On Thursday we arrive at the hospital clinic for her shot, the nurses check her out, weigh her, take her temperature and listen to her heart and lungs. Then the pediatrician comes in and chats and makes sure she's good to go for the shot. I was happy to see that it was one of the pediatricians we met while Kaia was in the NICU. I've seen him a few times and he's actually my friend's daughter's pediatrician. He's a nice guy and I trust his opinion. So when he asked if Kaia had been well I told him about her ultrasounds last week and about the recommendation from the neurosurgeon to go in for a head CT, and that I was a bit upset about the whole thing.

He checked online and was able to pull up the ultrasounds she'd had downtown last week. He looked over the reports and came back and told me that on the labia ultrasound they couldn't see a hernia, but because the cast covers part of the area they would have liked to image they are recommending that it be repeated once she's out of the cast. So, good-ish news, but not definitive yet. He also said that the head ultrasound states that she has mildly dilated ventricles, the left slightly more so than the right, but that it doesn't seem that serious to him. He asked me why the neurosurgeon was recommending a CT, and when I told him I wasn't totally sure considering she's ALWAYS had slightly dilated ventricles and we've just been following it with ultrasounds, the pediatrician suggested that we rethink the whole CT plan. One CT is basically like taking 300 x-rays all at once with all the radiation that involves. It would be worth it if something was obviously going on with Kaia, and it could definitively rule in or out certain conditions, but I agree with him that it does seem a little extreme a test to perform on a perfectly healthy baby.

So next week I'm hoping to get in touch with the nurse co-ordinator for the neurosurgery clinic. She might have a better idea as to what the neurosurgeon might be thinking (other than "hey, I'm a neurosurgeon, I like brains! I like picture of brains! I like scanning every kid I can get my hands on just to be *SURE* they don't need a shunt!"). She might be able to get him to change his mind so that we follow Kaia's brain with ultrasounds rather than a CT. I think I would be more comfortable with that at this point.

In other news, Brian and I are getting more and more excited to think of Kaia without her cast on! One of the big things we are looking forward to, is starting some solids. So far, I've put a few little finger tip sized amounts of things in her mouth, just to see if she'll like them, but I'm hoping to go more with the 'baby led weaning' approach and get Kaia set up with some easy to hold baby foods (bananas, avocado, yogurt, cooked noodles?) and let her decide what goes in her mouth and what doesn't. Another friend of mine spoon fed her kid every meal for over a YEAR (still does with her yogurt and she's TWO) and it just looks like WAY too much work. We don't yet have a high chair for Kaia, but I think we're going to buy her one as her 'out of cast' graduation present. I'd like a wooden one, so we might need to do some shopping around.

One of the things we have continued to be able to do while she's in the cast, is use the potty. On the advice of J. whose daughter is 20 months old and often wearing underwear, we got Kaia a potty for Christmas (the baby Bjorn one) and have been using it usually a couple of times a day. It's the perfect shape for her in her cast, and Kaia has become pretty good at peeing when she's on there. She still goes in her diaper all the time, but I'm hoping because she's already 'use to' the potty, it won't be such a big deal to get her on the potty more and more often as she gets older. We'll see how that goes.

Sleeping has been going a bit better around here, although we still have a ways to go. Kaia has been going to bed between 7 and 8pm generally and sleeps until about 11:30pm. This is usually right around the time I'm wrapping up with my last pump before bed, so I feed her and then go to sleep. She gets up again anywhere between 3:30am and 5am, eats again, and goes back to sleep. Then up again at 8am for another bottle. At this point, I need to pump, so I bring her into bed with me, she eats, I pump and then we usually have another nap together and get up for good around 10am. She might have a short cat nap anywhere between 11:30 and 12:30 that is about 20 minutes to half an hour, and then if I'm lucky she'll have a 2 hour plus nap in the afternoon. I think this is pretty good, although I would LOVE to cut out the middle of the night feed...but steps right?

My question is when will she not need to eat over night? I know this is probably different for different kids, but when she wakes up in the middle of the night, we've always given her a bottle and she always seems to eat quite a lot at this point (120-150mls). Knowing that she will eat so much, I'm reluctant to NOT give her a bottle at this time. How do you tell if she's waking up because she's hungry or because she just wants to 'suck' to sleep? I would assume she wouldn't eat a lot if she wasn't hungry...but maybe it's just become habit at this point? Hard to distinguish need vs. habit in a baby. This is another thing to tackle once she's out of the cast and I don't have to get her up anyway to change her diaper overnight.

Despite her cast challenges, Kaia really is a fairly happy baby. She still does that 'whine' thing that I mentioned a few posts ago, but it's more so now only when she's tired or bored. Since Brian made her a special chair that she can sit upright in, she's much happier sitting and watching us. Here's a picture so you can see what I mean:

And here:

I also try to 'play' with her on the floor. It's hard because she can't move anything but her arms, but we try. I can't wait until she can sit and I can roll a ball to her, or she can kick her legs and start to roll over to grab things. She does make the BEST faces though! I wish I could capture more of them on film.

As spring approaches, I am starting to think more and more about what we're going to do when I go back to work the second week of August. I've just heard that my contract job on the Medical Day Unit is extended again so I can go back to work for my 2pm to 10pm shift, 4 days a week (Monday-Thursday). I would need to leave for work about 12:45pm and Brian gets home about 5pm, so I really only need someone for the afternoon 4 days a week. Brian's parents are retired and keep saying they would love to look after Kaia, but I don't know exactly how much time they want to commit to. Once a week? Twice a week? All the time? I don't think so. Which means we will soon have to really start thinking about child care for at least part of the week. We've left Kaia a few times in the care of our parents, but it scares me a little to think about leaving her with a stranger!

Anyway this post is getting long, and I must be off to bed.

So that's a Friday wrap.

Any parenting tips you'd like to share? Who looks after your kids while you're at work? What age did your kids sleep through the night? How did you accomplish this? What age did your kids use the potty? Have you tried baby led weaning? And for all you photographers out there any tips about how to get good pictures of your kids when they WON'T HOLD STILL?