Friday, November 16, 2007

Second Time Around

Now that we've had a few days (two weeks to be exact) to settle in to our new "normal," I've been reflecting quite a bit on how different things are this time around. Talking to my friends who have more than one child (most who never struggled with infertility, granted), it seems like we all share the sense that things are much easier- and more relaxed- the second time around.

A friend of mine who has twin girls that just turned one is thinking of having a third and asked me if it's much easier with one. I told her that it is much easier, but I'm not sure if it's a function of having "just one" or if it is because I'm no longer a first time mother.

With the twins, everything seemed overwhelming at first, in particular my attempts to nurse them. I will never forget the endless days and nights where I felt like I did nothing but try to nurse one, then supplement that one with formula, then try to nurse the other and supplement that one with formula, THEN pump to try to get breast milk to feed by bottle later. By the time that whole cycle was done, it was time to feed again. Even though I gave up nursing after about a week at home, I kept up the pumping and pumped 7-8 times a day after feeding both babies. Not only was it time consuming, but I felt like such a failure for not being able to do what my body should do naturally. My mother-in-law is a pediatrician, so the pressure from her (subtle, but definitely there!) was unbearable. DH was wonderfully understanding, telling me to do whatever made me the happiest, but I still couldn't accept the fact that I had failed- yet again- at something I should be able to do.

This time around I decided to give nursing a try while I was in the hospital, but had pretty much resigned myself to formula feeding once we got home. In fact, I felt sort of proud of the fact that I wasn't going to let myself feel sorry for not nursing this time. I pictured myself telling my mother-in-law and the lactation consultants at the hospital, "Thanks for your advice, but we have chosen the best option for ourselves and our family, and it is a personal decision I hope you will respect." After all, I definitely don't feel that feeding a baby formula, even exclusively, is harmful. While breast milk may be "best" by certain standards, I really think that genetics and family health history also play a much more significant role in the health and development of a child. I always say that I was formula fed and DH was breast fed (albeit for only a few months, which I didn't find out until way after I felt guilty for letting my MIL down...) and I have far fewer health problems and allergies than DH does. So I'm a shining example that formula-fed babies don't have to be less healthy than those who are breast fed :)

So imagine my surprise when LS actually gained weight in the hospital before we left, and the pediatrician at the hospital told me that he hardly ever sees that happen, that nursing must be working really well for us. And imagine my further surprise at LS's two week pediatrician appointment yesterday when we found out she not only surpassed her birth weight but passed it significantly. Whereas babies should be gaining an ounce a day at this point, she gained two ounces a day. And she hasn't had a bottle yet- I've been nursing exclusively (now there are two words I never thought I'd use in a sentence when talking about me and one of my children).

I think a big part of our success this time is that I am much more laid-back than the first time around. Having the attitude that at any time I can stop and switch to formula if necessary, and that I won't be a failure because of it, really took the pressure off. I'm also not so worried that my baby will waste away if nursing doesn't work...I realized that if she was losing weight, I'd just simply supplement with formula and all would be well. With the twins, I got freaked out that they were losing too much weight- in part because the nurses at the hospital made me freak out- and immediately doubted my ability to nourish them with my own body. Of course, it doesn't hurt that this time around there was "just one" to feed, whereas last time there were two!

So I think that my whole experience with nursing mirrors my entire approach to parenting this time around- more laid-back, recognizing that there is no "right" or "wrong" way of doing things. It's OK if the baby cries for a few minutes while I get the twins settled in with their breakfast or snack. It's OK if I can't spend every moment doing productive activities with her in an effort to make sure her little brain develops correctly. It's OK if I take a few minutes for myself. I don't think that any of this has to do with having "just one" this time- although the extra sleep at night does help!- but I do think that it's a factor of having the perspective, and hindsight, that comes the second time around.

Saturday, November 10, 2007

Birth Story, Part 2

LS is napping now, but the twins are due to be up any second...let's see how much more of the birth story I can get down before they're awake.

So the first spinal didn't take. My doctor wisely advised me that as horrible as it sounded (and as I indicated by the tears rolling down my face as I realized the first one hadn't taken), it would be "better in the long run" if we "got it right" with a second try. I fully agreed- the last thing I wanted to do was feel anything related to the actual cutting! My hot-shot anaesthesiologist called in his colleague, who was scheduled to attend the next c-section, to give it a shot (no pun intended). In the meantime, he had tried again, which involved about 10 more shots of the topical numbing medication and at least two tries with the big needle going into my spine. All the while, I'm holding on to one of the nurses (I think she was a nurse) for dear life, shaking uncontrollably, either from fear or the large amount of anaesthesia I already had injected.

After what seemed like forever (turned out to be about 45 minutes after the ordeal started), the second doctor got the shot in the right spot and I was laid back down to let it take effect, hopefully. Luckily, when they tested me again I couldn't feel a thing. And from there on out, things went smoothly- and quickly. I did have a bit of nausea but the (new) anaesthesiologist put something in my IV that helped within a few minutes. DH was allowed back into the room as the surgical team prepared to cut, and within five minutes the doctor told DH to get his camera ready for the first shot of his daughter.

A few things I feel I should mention about the surgery itself- first, unlike the twins' birth (which was at a different hospital), DH was allowed to watch, and take still pictures, of anything he felt like watching. With the twins, he had to wait until the babies were born and then he could only take pictures of them- not of anything "behind the magic curtain" (i.e., my blood and guts). So whereas our first pictures of the twins are in an isolette as they were cleaned off, our first picture of this baby is her head emerging from the incision in my stomach. I'd share, but I'm not quite sure how many people want to see that image. The next shot is my first view of LS- and again, unlike the hospital where the twins were born, when I wasn't even able to see the twins until after they were checked out and cleaned up (in fact, my first image of them was not live but on the digital camera after DH took pictures of them and came back to show me as I was being stitched up), this time our wonderful doctor held LS up above the curtain so I could see her.

A second memorable fact about the surgery was that the doctors were all remarking about how little fat I have. I definitely don't mean to brag (and trust me- my stomach muscles and skin are so out of shape it doesn't really matter that I have little fat under it) but it was sort of gratifying, in a sick and twisted way, to hear someone actually looking at my insides that I have little fat, at least in my belly area.

Another interesting fact was how many people there were in the OR with me- I think DH counted at least 12 at one point, including my doctor, the anaesthesiologist, a neonatologist (a surprise since LS was term), and a host of nurses. I was surprised that there were so many people at a "normal" birth- I had expected it with the twins, but certainly not this time.

We had not found out the gender of this baby during my pregnancy, but as I've mentioned before, I felt strongly it was a boy. My official guess was a boy, 7 lbs. 2 oz. Well, so much for motherly instinct: obviously, it was a girl, and she was 7 lbs. 12.7 ounces. For the record, DH guessed girl, 7 lbs. 12 oz, so chalk one up for him!

Another surprise was the fact that LS has a full head of dark hair, unlike our twins who had very little hair and what they did have was light. I still remember the doctor saying, when he saw LS's head (but nothing else yet), "I'm not sure if it's a girl or a boy, but whatever it is has a head of dark hair!" My first reaction was "is he talking to me?" It's still a shock to see one of our children with dark hair, especially because DH is extremely fair and I was born with light hair. However, if anything, LS looks more like me than DH, which again is a surprise because our twins look so much like him. It also made me feel proud and particularly attached to LS right away, as I feel like I finally have a child who looks like me. And even though I didn't think I'd cry when LS was born, I bawled plenty of tears when I heard her cry and saw her face for the first time. For all my thinking it was a boy, and for all my worries about being able to love three children equally, there was no doubt that the moment I heard her voice, I was in total love with our new daughter.

As LS was weighed and cleaned, I was stitched up in what seemed like just a few minutes (I think it was more like a half hour, though). DH brought LS over to my side so that I could see her, and I remember one of the nurses telling me it was OK to touch her so I guess I was hesitant, or maybe feeling too constricted in the position I was in for surgery, to reach out to her. I just remember marveling at how surreal it felt to finally meet the little person who was inside me for so long, how we finally had a face (and a gender!) to put with the movements. I had said several times the night before and the morning of the surgery how I just couldn't picture how our family would look a few hours later- would we have two boys and a girl or two girls and a boy, and what would this baby look like? Now I had my answers, and everything seemed to fall into place.

After I was wheeled out of the OR, I was taken to a recovery area where I was told I'd stay for a couple of hours. I had some bad bouts of nausea, which were effectively treated with some meds in my IV. A nurse came in shortly thereafter to take LS for her first bath and to be checked out by the neonatologist. The neonatologist determined that LS was breathing rapidly, likely because of the fluid still in her lungs because she was born by c-section. She explained that they would monitor her for the few hours I was in recovery and if she did not improve by the time I was transferred to my room, she would go to the short-term (4 hour) NICU, and if she still didn't improve after that 4-hour stay, she would go to the NICU. I felt my first wave of panic- again, while I expected these sorts of issues to come up with the twins (none ever did, thankfully), I never expected them to come up with a full-term singleton.

Luckily, LS's breathing slowed down enough for her to go to my room with me when I was finally transferred. It was still rapid- in the 70's whereas normal range is 30-60, but over the next few hours it slowly came down to the 60's and then into the 40's. The only other issue the neonatologist spotted was some clicking in her hips, another issue that would seem to resolve itself by the time we left the hospital.

Our visitors arrived later in the afternoon, with my father coming first, followed by my sister and her husband, and then my father-in-law (our mothers were with the twins). I most anticipated having the twins come visit- I missed them a lot and just wanted to see their faces. After what seemed like forever (they had to take a nap and then eat lunch before leaving for the hospital), they finally arrived with our mothers and two "It's a Girl" balloons that they told me were for the baby. We spent the afternoon with our families, with me drifting in and out of sleep and and having a couple of episodes of nausea/vomiting from the anaesthesia.

Because of her rapid heartrate, the doctors and nurses asked me to hold off on trying to nurse LS until much later in the day. I was already apprehensive about trying to nurse- it wasn't quite smooth sailing with the twins (in fact, it was the most frustrating issue of the entire first few weeks of their existence) so I had already resigned myself to bottle feeding this new baby. Much to my surprise, however, she took to nursing pretty easily and although she lost weight at first, she actually gained a few ounces before we left the hospital. I have been taking it day by day, telling myself I can always go to formula if necessary, but so far I haven't even given her a bottle of expressed breast milk (ok, once I gave her a few sips just to see if she'd take a bottle). This has come as a complete surprise to me, as I really never expected to nurse this baby. We'll see how things go once DH goes back to work and I'm on my own with the twins, but for now I'm content with nursing and feeling rather confident that it's worked so well so far. After such a horrible experience with the twins, I've been pleasantly surprised to see myself able to make it work this time.

There are many other differences between the early days of LS's life and that of the twins (or at least my memory of it), but that post will have to wait for another day. For now I'm going to take advantage of the few hours of quiet I hope to have as the twins nap and LS sleeps after her last feed.

Thursday, November 8, 2007

Birth Story- Part 1

I only realized during LS's birth how much of the twins' birth story I had forgotten, so before any more time goes by (and while DH has the twins at their once-weekly Mommy- or Daddy- and Me nursery school program and LS sleeps), I want to get down as much of LS's birth story as I can remember.

The night before the birth was, of course, Halloween, my most loved and anticipated holiday. We spent much of the day as a family- DH came home early from work and we took the twins out to run some last minute errands as well as to a local Halloween festival for kids. On the way home, we picked up pizza for the four of us and my parents, who came by at dinner time to see the kids off and hand out candy while we trick-or-treated. We schlepped the kids out around our neighborhood, which gets VERY into the Halloween spirit. Our duaghter lapped it all up- she immediately got the hang of asking for candy (and saying thank you!) at every house, and laughed at even the scariest of decorations and costumes. Our son, on the other hand, already the more sensitive of the two kids, was a bit more skeptical. He was OK until the kid with the three-headed costume came out of a house, and then he clung to me like super glue. Needless to say, I probably carried more toddler than I should have, for longer than I should have. By the time we got home I had excruciating pain in my round ligament/groin area. Nothing I thought was labor (it was more muscular than contraction-like) but it made me realize that going into labor at that point would have actually been a good thing. First of all, I had been off of my blood thinner (in anticipation of the next morning's surgery) for the required 24 hours; secondly, if I went into labor, I could avoid a c-section.

In the end, it didn't matter because I was NOT in labor, just a lot of discomfort, which prevented me from sleeping a lot of the night. I fell asleep at about 11:00 p.m. and woke up at 3:00, unable (for a number of reasons) to fall back to sleep. I thought a lot that night and early morning about how much our lives were about to change, and was emotional at the thought of leaving our twins while I was in the hospital. Finally, at 3:30 I got up and showered to get ready for the day. We had planned to wake up at 4:30, anyway, so I was just about an hour ahead of schedule.

DH's mom arrived at our house at 5:15 in the morning (because my own parents, who live just a mile away, refuse to do anything before 8:30 or 9:00 a.m., but that's a whole different story...) She took some pictures- one of me as my "last picture before delivering" (she took the same picture before I delivered the twins) and one with me and DH. Looking at those pictures I realized how much smaller I really WAS (even if it didn't feel that way) then with the twins. After some last minute instructions, it was off to the hospital. I was sad leaving before I could say good morning to the twins, but also didn't want to risk waking them by going into their rooms before we left.

We arrived at the hospital about 15 minutes ahead of schedule at 6:00 a.m. There was no one at the admissions desk at the L&D unit, which made me wonder- what if someone had come in in active labor? We waited for at least 20 minutes before anyone came out to discover me waiting (DH had gone to the bathroom, of course, right as someone finally came out). I was admitted quickly and met my prep nurse, Paulette, who took me back to the pre-op preparation room before DH even came out of the restroom (he caught up to us while I was changing into my robe in the bathroom). Pre-op seemed to go by quickly- before I knew it, it was 7:00, just 45 minutes before my scheduled c-section. We went through all of the standard admission questions, which I seem to remember from the twins' birth. A few memorable interactions happened during pre-op: a nurse questioned Paulette's entry of "P2 G3" in the computer, indicating it was my second pregnancy but third child. Paulette explained (as did everyone else during my hospital stay any time they said "P2 G3") that I had twins at home...and of course added, for emphasis, that they were just 19 months old. This small fact seemed to make me a superstar at the hospital.

Another interesting incident that happened during pre-op was the fact that we had several "observers." The first was a student nurse who I would come to know well during my stay, and I didn't mind having her observe at all. In fact, I was her first c-section and she kept thanking me for letting her be a part of such an important part of our lives. The second, though, was a (seemingly) random guy who came into the pre-op room in scrubs. I think he got off on the wrong foot with me with one of his first questions- when he heard I had twins at home, and that they were boy/girl twins, he asked me if they were identical or fraternal. One of my pet peeve questions- when someone asks me that question, their perceived level of intelligence in my head goes WAY down. Now maybe that's unfair- if I didn't have boy/girl twins, maybe I'd fail to understand that to be identical, twins must be identical in ALL OF THEIR PARTS too, but I really didn't like this guy from the get-go. It turns out he was from the local fire department, where they send trainees to the hospital to watch operations so that they get used to seeing blood and guts. Now I'm all for supporting our local fire department, but I really didn't see the need for this guy (who was already making stupid comments) to watch MY blood and guts along with the 12+ other people who would be in the operating room. When Paulette asked me (in private) if I minded having him observe, I told her he could observe the pre-op procedures but that I would prefer he didn't come into the operating room. I felt a little badly, but it was also my prerogative to limit the number of "observers" in the OR, and if anything went wrong I wanted fewer people in the way.

While in the pre-op room, my doctor came to talk to me along with the anaesthesiologist. I really do love my doctor- this isn't' the one I had planned to have do my c-section, but he's one of my favorites in the practice anyway and just a really great guy. After the necessary preparations were taken, including inserting my IV (one of my biggest fears but Paulette did a great job) and shaving "down there," I was walked into the OR next door. The anaesthesiologist prepped me for my spinal, which unbeknown st to me at the time would become the most trying experience of my entire delivery.

To start out with, the idea of a needle going into my spine is NOT my idea of fun. However, when I had my c-section with the twins, it was a relatively easy and unpainful process. That time, however, I had an epidural with a spinal IN the epidural (in other words, a tube in my back that fed both the epidural meds and the spinal meds into my back). That was a different hospital, though, with different protocols, and at this hospital the protocol for c-sections is a spinal only, which means a shot into the spinal fluid (no tube inserted). I knew there was trouble when the anaesthesiologist seemed to have to try several times to get the needle in the right spot. Luckily this was after he had given me a few shots of local anaesthesia so I didn't feel it that much, but I was still uncomfortable. Finally, after what seemed like forever, he thought he got the meds in the right spot (and in fact told me that with spinals, you know for sure because some of the spinal fluid comes back in the syringe- nice image, thanks). However, when I laid down and was tested several minutes later for numbness, it was obvious the spinal had not taken.

LS is fussing...the rest of this story is going to have to wait until later...guess this is the story of my life from now on :)

Sunday, November 4, 2007

Quick Update

Just a quick update- first of all, thanks to Mel for the shout-out in her Friday Blog Round-Up. I feel like a celeb for even being mentioned :)

So we now have answers to a lot of the questions I had in my last post: first of all, it was a girl, a beautiful, 7 lb. 12.7 oz. girl who I'll call "Little Sister" (or LS) for purposes of this blog, at least until I come up with a more apt nickname. Unlike her older siblings, LS has a full head of dark hair, which was quite a shock. So far, she's amazingly easy- but then again, I think all babies are pretty easy at this stage (eat, sleep, excrete, repeat...)

The birth itself was pretty smooth and uncomplicated, except for the little issue of the spinal, which took one hour, two tries, and a second doctor to complete...not something I ever want to repeat in my life. However, the recovery so far has been much easier than I remember it being with the twins. I'll post the full birth story when I get a few minutes to reflect- hopefully sooner rather than later as I don't want to forget the small details like I seem to have done with our twins birth!

The hospital stay was wonderful- I really enjoyed bonding with LS and even though I missed our twins sorely, they did come to visit and I could still appreciate having the time to myself (and LS) at the hospital.

Most surprising, I am nursing LS exclusively so far and doing well, if I may say so myself. Nursing was my nightmare issue with the twins- by far the one issue that made me most miserable- so I am shocked (pleasantly) at the ability to do this- successfully it seems- so far. She lost a little weight the first two days in the hospital (nothing to be alarmed about, though) and then GAINED the last day we were there. Even the pediatrician said that was not routine, and must mean that she's thriving on my breast milk. I still have to stifle a laugh when I hear people say things like that- I can't believe they are talking to me. I'm taking it a day at a time- I know things can change, especially now that I'm home and real life (vs. life in the hospital, with all the time in the world) kicks in. But for now we're making it work, me and little LS.

The twins have been such troupers and seem to love their LS already. I'm SO proud of them. My heart was so filled with pride, love and joy tonight when we got home and the five of us were sitting around, enjoying life as a new family, that I almost started crying. What a different experience from when we got home from the hospital with the twins and my crying was more out of frustration and a feeling of ineptitude. Again, I know there will be frustrating times ahead, but for now I'm just basking in this beautiful feeling and appreciating the many blessings we've been given.