Paroneal Tendon Repair

Well, after a year and a half of living with a swollen, painful right ankle, my podiatrist finally figured out what was going on!  My paroneal tendon (the one that goes behind your ankle) was slipping out of place, causing it to tear lengthwise.  There was no injury that caused this to occur; it just started happening one day!  After a few months in a boot, the swelling decreased drastically, which allowed the tendon to slip out of place even easier!  So surgery was the only answer.

When the doctor got in there and took a look at my tendon, he was surprised just how long the tear was.  It was a beast!  He was surprised that I wasn't in more pain than I was.  He said it was like a hose sliced down the side and laid open like a hot dog bun.  So he stitched that up.  He also made the groove in my bone deeper where the tendon sits.  While he was at it, he noticed two separate spots where I had an extra (and unnecessary) muscle attached to my tendon, called a "muscle belly," and they were helping to pull my tendon out of place.  So he detached and cauterized those.  All in all the incision was about 5 inches long!  He said it was a mess in there, but he's happy with how it all turned out.  I hate hearing that things were worse than expected, but it is nice to have a confirmation that surgery really was the best choice.

The day of surgery 

One week post-op.  He was quite alarmed at the degree of swelling I had!

Normal, skinny toes vs. sausage toes.

Two weeks post-op.  Swelling was improved, but a bit of the incision looked like it might have opened up...most likely as a result of me trying to carry the baby while hopping on one foot.  I lost my balance and had to use my bad foot to catch myself.  That was my first time attempting to handle the baby's nap on my own, and I have since realized that I can't do it without help!  Thankfully I've had a lot of people offer to help, and I've humbled myself enough to accept their offers!

I'm now almost three weeks post-op and I had my stitches removed today.  In two weeks I'll go in for an ultrasound to see how well things are healing.  If everything looks good, I'll be able to start putting weight on my foot, walking with a boot!  Wouldn't that be exciting!

The pain was well-controlled for the first week, but after that it seemed like meds weren't making a difference.  There are times when the pain is pretty bad, but for the most part I can ignore it.  I've been told to expect that it will take a full six months before I feel completely healed, but it'll be worth it to not be in pain forevermore!  There's a super good chance that my ankles are symmetrical, so I just have to hope that the same thing doesn't ever happen to my left ankle!

Feeding Tube Awareness Week 2016

Happy Feeding Tube Awareness Week!

Let's jump right to the point of my blog post this year.

"A child won't starve himself."

LIES

You hear it everywhere.  In moms groups.  In parenting magazines.  In viral internet articles.  From your own mother.  And, as I can attest, from your own pediatrician.

I'm telling you, they're wrong!

What they SHOULD be saying is "A healthy child won't starve himself."  Unhealthy children do it more often than you would think, and in those cases, thank heaven for feeding tubes!

I'm not here to tell you what to do about your 75th percentile child who seems to live off of milk and quesadillas.  Sure, I have a lot of tips for picky eaters, but let's save that for another day.  The majority of those picky eaters will be fine.

Today let's talk about the many reasons why a child will legitimately starve, to the point of weight loss, or at least no (or very, very, dangerously slow) weight gain.

• First, the one that encompasses many, many reasons:  it's less painful to starve than it is to eat.  Let that sink in a little.  My baby would have rather died a slow and painful death than eat.  Eating just hurt too much.  There are many reasons why eating can hurt, and for Caleb and Russell it was because they were reacting to foods that caused tummy aches, nausea, bloating, etc.
• Then there's the cognitive cause.  Some babies are born unable to swallow, chew, etc. due to anomalies in the brain, such as cerebral palsy.  Some brains literally don't tell the body that it needs food.  
• Then there's the anatomical cause.  There may be strictures in the esophagus, making it hard to get food down.  A tongue-tie, making it hard to swallow.  An uncoordinated swallow, causing aspiration.  A loose hiatal sphincter, causing painful acid reflux.  A congenital heart defect, causing early fatigue while eating.
• Then there's the mental side of it all.  Things like tongue ties and reflux and an uncoordinated swallow and intense sensory processing problems can cause oral aversions so severe that children will starve themselves.  Most parents know how hard it can be to get their kid to take medicine, but imagine your kid having so much anxiety over putting medicine in their mouths that they actually throw up at the thought of it.  Now imagine that happening with water, or your baby's bottle, or food that looks or feels a certain way.  It can be pretty intense.
• Then there's the hundreds of other medical reasons, many of which go undiagnosed for many kids.  I know a kid with kidney disease who requires a huge amount of fluids to keep his kidney happy, and the only way to get the fluid in him was through a feeding tube.  Some kids have such extreme hypoglycemia that they can't go all night without food, so they get a tube for that.  There are so many reasons!  The biggest factor in Caleb needing a feeding tube was his poor GI motility.  His body just doesn't digest food fast enough, so he always has food in his stomach, making him always feel full, even when he's only had one snack all day.  His body was literally starving to death, but he absolutely would not eat because he couldn't fit anything else in his tummy.  When he got a feeding tube, he would throw up half of what we fed him, because he was always full of formula.  Now that we found the medication that works for him, throwing up is a thing of the past.  But he still can't eat enough on his own to grow.  We don't know why, but we do know that his feeding tube still keeps him alive.  And there are so many kids in the same boat as him.

Well, there are just a few reasons off of the top of my head that explain why some people need feeding tubes.  I'm sure there are plenty more.  But rest assured, if a child has a feeding tube, the parents have tried everything imaginable to get them to grow (yes, even putting butter on everything, or serving ice cream at every meal).  Doctors don't go handing out tubes to every kid who doesn't eat his veggies.  So instead of questioning the parents' diligence, or knowledge, or parenting skills, think again about the many underlying reasons why a kid really will starve himself.  Then give those parents a pat on the back.  Coming to the decision to tube feed your child isn't an easy thing to do, but at times it is necessary, and then it's an answer to those parents' prayers.  

If you'd like to learn more, you can visit http://www.feedingtubeawareness.org/

To see a video of how we gravity feed Caleb through his feeding tube, go here.

For pictures of many of the feeding tubes Caleb has had, go here.

Gall Bladder Woes

Once again, I woke up at 3:30AM.  Instead of bleeding, this time I was in intense pain.  For the first few seconds, if felt like an awful back ache.  It didn't take long to escalate and become unbearable.  It felt like labor cramps, but it engulfed my rib cage.  I woke Nate and told him I was in pain, then went downstairs to try to walk it off.  I thought maybe the baby had cozied up in my rib cage, and I tried to push him out.  I thought maybe I had a spinal infection caused by my weekly progesterone shots.  I thought maybe it was appendicitis, but I couldn't tell where my appendix might be since my anatomy is all squished together because of my growing belly.  The thought that I could be in labor at 26 weeks 2 days put me over the edge.  That is just way too early to be having a baby!  And besides, my belly didn't feel tight.  I tried rocking on my hands and knees.  I tried massaging my back against the door jam.  I tried breathing through the pain.  After about an hour, I sent Nate a text saying that I needed him to come downstairs to give me a blessing.  I don't remember what was said, but I do remember thinking that this wasn't going to go away on its own.

So we left our sleeping boys in their beds, called a neighbor to come sleep on our couch, and left for the emergency room.

I was in so much pain!!!!  They had to put me in a wheelchair (they wanted to send me straight to labor and delivery, which freaked me out) and Nate had to answer all of the questions because I couldn't talk or think through the pain.  There was no question my pain level was at a 10!  I never thought I'd be able to say that, because I am no wimp, but this was a 10, no doubt!

They ended up taking a urine sample, getting some blood, doing a non-stress test (monitoring the baby's heartbeat and my contractions), and starting an IV with morphine.  After the morphine kicked in, I felt like I could function like a semi-sane human again.  There was still no way I was going to go anywhere without a wheelchair, and by the time the morphine started to wear off I started writhing around on the bed again, but I had a few hours where I could think through the pain, which was nice.

Anyway, long story short, they were going to assume that it was kidney stones and we'd just have to control the pain while waiting for them to pass.  My blood, urine, and kidney ultrasounds showed nothing to lead them to believe that it was kidney stones, but it was their best guess since they couldn't do an MRI on a pregnant patient.  They were discussing admitting me for pain management (ie, giving me a morphine pump), because a few hours of morphine and some oral pain meds were clearly not going to do the trick.  When those meds were wearing off and the pain was coming back, it was easier to tell that the pain was originating from just under my rib cage on my right side.  The wonderful L&D nurse (seriously, I hope she delivers this baby in 3 months) had a "light bulb" moment and said, "Let's do an ultrasound of your gall bladder!"

So they did it, and it took a while to get the results back, so they admitted me on the Mother/Baby floor, set me up with a morphine pump (literal life-saver, there) and let me order lunch.  I took a few bites of food and couldn't keep it down.  I didn't exactly feel sick, but my stomach was just rejecting anything, even juice and crackers.

Eventually, in comes the surgeon, Dr. Patterson, to explain to me that I do, indeed have gall stones.  Two large ones and many small ones.  The small ones could travel through the duct and into my liver or pancreas and cause all sorts of serious problems there, and one of the large ones is currently blocking the gall bladder duct, causing the spasms and pain.  He said that the best course of action for me would be surgery to remove my gall bladder, and if I hadn't had lunch (even though I threw it up...) he could have done it then and there.  He also said that it's common for pregnant women to develop gall stones, and that they only feel safe removing gall bladders during the second trimester, before the growing uterus makes it too difficult to do it laproscopically.  Since I'm less than 2 weeks away from my third trimester, time was of the essence.

So I immediately start "fasting" and we plan to do the surgery in about four hours.  It's usually an outpatient surgery, but since I'm pregnant they wanted to keep me at least overnight so they could do a continual non-stress test to make sure the baby was alright and that the surgery wouldn't cause me to go into labor.  Then, on second thought, the nurse comes back in and says that they want to transfer me to Utah Valley Regional Medical Center, where they have neonatologists and an awesome NICU (the very same one that Caleb stayed at for his first 100 days of life) that could take care of us in the rare chance that this surgery caused the baby to come early.  And since I was on morphine, the only way they could send me was via ambulance.

(*Side note:  When Nate told the boys that I was going to ride in an ambulance, Caleb said, "NO WAY!" like he was jealous because it was so cool.  Russ said, "Oh no!" like he was concerned because I must be really hurt.  Those boys are so different!  And so funny!*)

Anyway, I end up in L&D at UVRMC.  We waited all night to see the on-call surgeon, who wasn't exactly on-call...they tried for hours to reach him, and he just never answered his phone.  They would have gone with another surgeon, but Dr. Patterson had already talked to him and gone over my test results and medical history with him, so he "knew" me and my situation.  They eventually realized that the surgery wouldn't happen that night, and let me eat a little jello and drink some apple juice.  I promptly threw it all up.  Nice.  The surgeon, Dr. Rasmussen, ended up coming in late that night and talked to me about the risks and benefits of doing the surgery.  He basically put the choice in my hands.  I felt a little like I would be crazy to opt for the surgery, but crazy not to.  It was dangerous either way.  If we chose not to do the surgery, it could cause serious problems for my liver and pancreas, or cause me to be in extreme pain for the rest of my pregnancy, and once we got into the third trimester they wouldn't be able to do anything about it without delivering the baby first.  If we chose to go with the surgery, it needed to be done ASAP to minimize the chance that they'd have to do a big incision (instead of laproscopic) which would require a longer hospitalization and a much harder recovery.  It could also cause me to go into labor and deliver a baby at 26 weeks, which is kind of a big deal!  That's even earlier than Caleb, who was born at 27 weeks 1 day!  We were to let him know in the morning.  So Nate and I talked and prayed about it, and I just felt strongly that I trusted the first doctor's opinion more, and he suggested the surgery right then and there.  I felt that the off chance of going into labor, or needing an open incision and longer recovery time, were worth the risk.  After all, if I went into labor, they could probably stop it, or at least hold it off for a few weeks.  Not to mention, I couldn't spend the rest of my pregnancy dependent on morphine, and there was no way I could handle the pain without it.  And then there's the fact that I was completely unable to eat or drink....So surgery was our decision.

Yes, this is my post-surgical belly.  All incisions were glued shut.  The lower one is the biggest one, and it's about a finger-length above my belly button, and maybe 1.5 inches long.  Baby Boy likes to kick it.  I don't like that so much.  It was pretty badly bruised coming out of surgery.   The two on the side are super easy to ignore, and the one on the top gets easily irritated just because of its location, but it's not so bad otherwise.

So they did surgery the next morning!  It went well.  Four laproscopic incisions.  The doctor said my gall bladder was starting to look inflamed.  Baby was going nuts afterwards, tons of movement with a good, strong heartbeat.  It was all very comforting.  Before going into the OR I was feeling like another "gall bladder attack" was coming on, which just confirmed that this surgery was the right choice.  And when I came out of the OR, that pain was completely gone.  It was replaced by a new pain, the kind you feel after you've been cut open and an internal organ was removed, but that kind of pain is more tolerable because you know that it will improve with time.

Yes, this is my gall bladder and those are the stones.  I have no idea if they're as bad as normal, or worse, but you can see two bigger ones and many smaller ones.

They let me order a late lunch, and I didn't throw up!  And I haven't thrown up since (although I've been eating really small portions)!

They monitored my little guy all through that night and until they discharged me around noon the next day.  He has a really steady heartbeat.  I felt like I got to know him better through this.  After all, he went through everything right there with me!  He's been through a lot for an unborn baby!  The heart monitor picked up and magnified his hiccups, and he hiccuped a lot!  He also would kick all day long against the monitor, which makes a really loud sound.  This kid is gonna have personality, I tell ya.  But after all of this, I feel more bonded to him.

Have you ever wondered what the outside of a uterus looks like from inside the abdominal cavity?  Wonder no more!  That's where my little guy is housed.  I'd guess he's just over two pounds right now, and safe and sound inside of his little womb.  Awww!

I was discharged after 2 nights and 2.5 days total.  Recovering at home has been hard...my lungs hurt, which is a normal part of recovering from an abdominal surgery.  I need to cough and breathe deeply, but it just hurts so much!  I've got a slight fever, and that first night at home my oxygen levels had me worried.  But today I woke up feeling half-way like a functioning human, and tomorrow will be just a little better, so I think I'll be ok.  :)  We'll see how living a gall bladder-less life effects me...good thing I never really jumped on that bacon bandwagon!  It's safe to say I'll be sad if I can never comfortably eat a donut again.  So far I haven't had any morning sickness or heartburn.  I can't say it has anything to do with the surgery, but hey, I'll take it!  There's a good chance that I can go on living without ever thinking of my lack of a gall bladder ever again, and that's the goal.

Feeding Tube Awareness Week

Parents of tube-fed kids usually have a love/hate relationship with their child's tube.  More love than hate from me, though.  We all wish our kids didn't need it (uh...how nice would it be to have a kid who can stay healthy without daily medical intervention???) but we're so glad the tube is an option!  It keeps them alive!

So for Feeding Tube Awareness Week this year, I'd like to share some of the things we love about that little piece of silicone that happens to save our kids on a daily basis!

*****

I can give him medicine without hearing him whine.  I can also give him medicine while he's asleep!  You know how when your kid has a high fever and you have to alternate tylenol and motrin every four hours?  Never mind what time he goes to bed, I can continue to give him medicine to keep his fever down without interrupting his slumber!

*****

I can keep him hydrated while sick.  You know when your kid can't keep anything down, and it's all you can do to make sure they eat popsicles, or a tiny bit of electrolyte drink every hour?  Well, I can just put Caleb on his feeding pump and set it to deliver gatorade or pedialyte at 20ml/hour, or whatever speed he's able to handle without throwing it up.  It's pretty darn handy.  In fact, at this very moment he's set to get 300ml at a rate of 80ml/hour because he has a cold and whenever he coughs with too much food in his tummy, he throws up.  He used to need IV fluids whenever he got sick, but in the almost 4 years that he's had his tube he has only needed an IV for sickness once!  And that was because his blood sugar was doing some wonky things after a day of puking, even though he was able to keep down 20ml/hour of gatorade for an entire night before going to the ER.

*****

I love that we can make sure he gets exactly the nutrients that he needs.  I've heard so many people lament that their kid will only eat hot dogs, pb&j, or quesadillas.  No veggies?  No problem.  I can rest easy knowing that he "eats" more healthy than pretty much any other kid his age.  Even though he is a veggie fan.  ;)

*****

Got a gassy baby?  No problem.  Just hook him up and burp him!  It's called "venting" and it's an easy way to get the air out of the tummy.

*****

You know how feeding a kid is a big production with all the mess involved?  You've got to do all sorts of dishes, wipe down the table, sweep the floor, wipe the kid's face, and sometimes even change the kid's clothes?  Not with a tube!  Unless the syringe disconnects unexpectedly and you spill formula all over (it happens), or the tubing disconnects while they're sleeping and instead of feeding the kid you feed the bed (it happens, and it's why Caleb's bed will always have a mattress protector)...but other than those instances, it's pretty mess-free!  All you have to clean afterwards is a tube and a syringe.  Not bad at all!

*****

When your kid is about to toss their cookies and they just look so uncomfortable...if you can work fast, instead of sending him to the bathroom to hurl, just hook up the tube and syringe and vent him.  You'll get his stomach contents out through his tube instead of letting them come up and out of his mouth.  It's so much more comfortable.  Just imagine needing to throw up, and not having to feel the discomfort of actually throwing up.  Amazing.

*****

Road trips are so much easier when you can tube feed your kid.  Imagine there's a long stretch where there aren't any fast food places (not that there are any fast food places where we can feed Caleb, anyway because of his food restrictions.  Only Chick-fil-a, which needs to expand across the country!).  Just hook him up on schedule and feed him.  Easy peasy.

*****

Well, right there is a pretty good list of reasons why it's awesome to have a kid with a feeding tube.  There are a million reasons why kids need feeding tubes--some aspirate food and drink into their lungs, causing recurrent pneumonia; some have severe oral aversions; some have low muscle tone; some have problems digesting; some have anatomical problems, like esophageal stricture or short gut syndrome; some are too weak to eat enough (like babies with congenital heart disease, or other organ failure); some need to go on a special formula and refuse to drink it by mouth because it's pretty yucky tasting (like Caleb); etc--and there's not a single parent alive who doesn't wish their kid didn't need a tube.  It's commonly believed that a kid won't starve himself.  To that I say, a healthy kid won't starve himself.  And we all want healthy kids.  For us, using a tube to feed Caleb is the best way to keep him healthy, despite his disease and special diet.  So instead of hating our circumstance, I choose to see the silver linings.  It's pretty awesome that we can use a tube to keep Caleb alive and thriving.  And it's pretty awesome that we can use it to help him burp, too.  ;)

Happy Feeding Tube Awareness Week!

This is Caleb with an OG (orogastric) feeding tube at a few days old.

This is Caleb with an NG (nasogastric) feeding tube at almost five months old.

This is Caleb during his year of being tube-free.  He was about 15 months at the time.

This is Caleb with an NG tube for the second separate time in his life, around 18 months old.

Caleb with his g-tube (gastrostomy) at about 22 months old.

Caleb today, at 5 years 3 months, getting fed lunch with his g-tube.

20 Weeks!

I'm so glad to be halfway!  This has not been an easy pregnancy.  From 6-14 weeks, I had pretty bad morning sickness and lost about 5 pounds from throwing up and being unable to eat much of anything.  Then at 13.5 weeks I woke in the night with bleeding, and was diagnosed with placental abruption.  I proceeded to bleed until I was about 18 weeks.  Now I haven't bled for over two weeks and it's been such a relief!

My routine 20-week anatomy ultrasound went well.  The baby is super active and measuring just right (two days big, actually).  My placenta is low-laying, but there is no placenta previa visible, which is good news.  There were two slight abnormalities, though.

First, the ultrasound showed what the doctor described as a "shadow" on the baby's heart.  It's called an echogenic focus, and it's basically nothing.  My doctor said it's the most common abnormality he sees on ultrasounds.  From my research, it sounds like it's a slight calcification in the baby's heart, between the ventricles or by the valve.  It sounds like it doesn't affect the function of the heart at all, which is good news.  They'll do a follow-up ultrasound later on (the doctor said 32-34 weeks) and if it hasn't resolved then we'll just have to notify the pediatrician when he's born and they may or may not want to do an EKG later on.  Thanks to Dr. Google, I found out that an echogenic focus is a marker for chromosomal anomalies, such as Down Syndrome.  There are many markers for DS that can be seen on an ultrasound, so having one marker shouldn't be significant, especially since I'm not of "advanced maternal age."  But having a perfectly clear ultrasound in no way guarantees that your baby will have healthy chromosomes anyhow.  So it's probably nothing, but now chromosome problems are on my mind and I probably won't rest entirely easy until the baby is born.

The other problem seen on the ultrasound is my amniotic fluid.  The fluid levels are fine, but it's very...dirty.  It looks like bleeding for five weeks straight leaves lots of "particles" floating around in the fluid.  If you've ever seen an ultrasound, you know that the black spaces around the baby are anmiotic fluid.  My black spaces looked like they were filled with layers of glitter floating around.  You could literally see them bouncing off of the walls.  It was honestly a little alarming to me.  The ultrasound tech said that we'd need an ultrasound in a month to follow up, but the doctor wants me to have another ultrasound to measure my cervical length at 26 weeks (you know, to make sure I'm not at risk of dilating early again) so they'll just check the amniotic fluid at that time.  The tech did say that she has no reason to believe that the dirty appearance is due to infection, so she would guess it's because of the bleeding...and while I agree with her, just hearing the word "infection" freaks me out.  We have reason to believe that Caleb was born 13 weeks early because my placenta was infected with strep and staph.  It would have killed him had he not been born when he was.  So naturally it scares me to think that there's even a slight possibility of an infection.  When Caleb started getting sick from the infection he stopped kicking (which was my only indication that anything was wrong, even though I was dilated to 4cm by that time and hadn't had a single contraction), so you can bet that I'm going to be hyper aware of this baby's level of activity.  So far he moves around more often than not--he's so active!  So that's very comforting.  If that doesn't keep up, I'm going to be calling my OB right away!

Those were the only concerns arising from the ultrasound.

Otherwise, I've been feeling much better.  I still throw up from time to time, first thing in the morning (it's always taking a sip of water with my medicine that puts me over the edge and sends me to bend over the porcelain throne, even when I eat a few bites of bland cereal before getting up).  The difference between the nausea and vomiting between the first trimester and now is that now the urge to throw up comes on super suddenly, and once I throw up I feel better immediately.  In the first trimester, I would feel on the verge of vomiting for 12 hours before throwing up, and throwing up never provided relief.  It was pretty bad.  Now I honestly can't complain.  It's not so bad at all.  I still take zofran maybe four times a week to control the nausea, but even that is perfectly fine with me.

My cramps have also decreased drastically.  They were awful the week of Christmas, when I was out and about more than usual at family gatherings.  Time spent in the car brought on cramps so awful that I ended up downloading a contraction timing app.  There were a few scary moments there!  But once Christmas was over the cramps went away almost entirely.  I credit the weekly progesterone shots, honestly.  They're designed to prevent preterm labor, and I think that's just what they're doing!  I started them the week before Christmas, so it seems that it took about a week and a half to get in my system and now they're doing their job!  Yay!  I'm still having plenty of braxton hicks contractions, but those don't worry me like the cramps did.

I feel much more stable now that I'm not bleeding or cramping.  I've even allowed myself to be more active (I actually walked through a few stores in the past week) and I haven't had any problems!  I can tell spending over 5 weeks laying low has weakened my muscles a lot, so it'll take a while to build up my stamina, but I'm glad that I'll be able to be mostly back to normal before long, with the main exception of heavy lifting.

I've also seen a decrease in heartburn recently (weird) and instead of my hair getting thicker, it's falling out more and more (I don't mind, because I have way too much hair as it is, but it's not "normal" for pregnancy, and I'm a little concerned about my thyroid levels, which have yet to be checked this trimester).  I don't have any overpowering food cravings, but I have aversions to ham and mints.  Yuck...just the though of mints...just no.  Since I'm able to eat pretty much anything these days, I've finally put on about 5 pounds in addition to gaining back the weight that I had lost.  And the best part of this pregnancy?  My mood is perfectly normal.  With my first two, I had awful and unpredictable mood swings.  I got mad at the littlest things.  I hated the sound of crying babies and whining children...I seriously hated kids during my first two pregnancies.  Now I feel like I actually have control of my moods, which is the most incredible thing!  I'm a functioning person (unlike before), and it feels great.  :)

17 weeks

18 weeks 2 days

1 day shy of 19 weeks

My little boy at 20 weeks 1 day.  Is that a smile I see?  <3 p="">

First Trimester Placental Abruption

This blog post will have lots of details that may gross you out.  It goes along with my policy of "if it's medical, it's not personal."  Be warned.

Thursday morning, December 4th, I was exactly 13 weeks 4 days.  It was around 3:30 AM when I awoke feeling like I was wetting my pants (see, personal details already).  I was a little embarrassed, thinking this is waaaay too early in my pregnancy for that to start, right?  I mean, it's not like I have 6+ pounds sitting on my bladder.  So I got out of bed and felt a gush.  I was like, seriously?  Can I not control my bladder?  So I went to use the toilet and was pretty darn alarmed at what I saw.  There was blood.  So much blood.  In my pants, turning the water red.  Blood everywhere.  It seemed kind of watery, too.  But then there was a blood clot, not huge, but certainly big enough to be alarming.  Oh crap, I think I may be having a miscarriage.

So I got cleaned up and woke Nate up.  I told him that if I start having cramps then I'm going in to the ER (after all, bleeding, blood clots, and cramps are symptoms that are pretty hard to ignore).  At that moment I felt a tiny cramp, so I was like, "I'm going."  Of course, it's 3:30 in the morning, so who would we call to watch our kids??  We decided that Nate would stay home and I'd drive myself to the hospital.

 

They were able to get me back for an ultrasound after not too long of a wait.  The ultrasound tech didn't let me see the ultrasound much at all, but after a minute of taking a look at things he said, "It's squirming around in there."  Whew!  What a relief!  He was also extremely surprised that I was only 13 weeks (and 3 days) because the baby was consistently measuring at 14 weeks.  He also informed me that I have a posterior placenta (it's implanted on the back of my uterus).  Good to know.

So after taking a look at a bunch of things, he brought me back to my ER room and they started an IV.  Or I should say, they tried to start an IV.  They were successful on their third try.  It turns out my forearms have deceptively nice-looking veins, but they blow extremely easily.  I'll be warning anyone else who ever tries to put an IV in my forearm.  

This is how it looked almost 9 days later.  I also recall how it took three tries to get an IV in my forearm when I had my tonsils out.  So after five total attempts in my lifetime, only one of those attempts was successful.  Yes, I think I'll have them stick to my elbow joints from now on.

To make a long story short, the doctor eventually came in and told me that I had a mild placental abruption.  My placenta is partially detached from the uterine wall, which shouldn't happen until after the baby is delivered.  He said it could bleed for a bit, then reattach itself and heal.  Or it could detach more and more until I miscarry.  He said to go home and stay on bed rest until I could follow up with my regular OBGYN within the next week.  He was very kind about it, but basically told me not to come back unless I was losing so much blood that I was dizzy.  There's really nothing the ER could do about a miscarriage, anyway.

So I made it home around 6:30 AM feeling very relieved that my baby was still alive and glad that there was something I could do to protect him/her.  

So I stayed on bed rest, with the bleeding getting better and worse and better and worse.  Literally every other day.  I could periodically feel my uterus contract and stay rock hard for a few minutes, but I never had any cramps.  Judging by my still-existent nausea and the fact that I could literally feel the top of my uterus growing higher and higher each day, I knew my baby was still ok in there.  All the while, Nate did a seriously amazing job taking care of the boys and me.  

I saw my regular OB on the next Tuesday.  Well, I saw the nurse anyway (the OB had just left for a delivery).  We located the heartbeat (always a relief) and she told me that there's a pretty good chance that the baby will be ok.  She gave me a 90 percent chance that the bleeding will stop on its own and the pregnancy will proceed as normal.  She wanted to wait for two weeks after the beginning of the bleeding before doing an ultrasound, to give my placenta a chance to fully heal.  She also said I didn't need to be on strict bed rest, but "modified bed rest," where I can be up and about and doing things, but don't do more than what's necessary and most importantly don't do any lifting (no more than about 6 pounds, she said).  Also pelvic rest.

Since going from strict bed rest to modified bed rest, I have been having loads of cramps.  As of today the bleeding still hasn't stopped, but it hasn't gotten worse, so I'm taking that as a good sign.  But the cramps are quite painful, and since my placenta is posterior, I get awful lower back cramps.  And then there's the overall soreness associated with placental abruption.  My abdomen is just plain sore.  Really sore.  And then there's the 10-minute-long contractions that I get when I do something as simple as bend over.  That was pretty "normal" for me when I was pregnant with Russell, so I was expecting it this time around.  But I sure hope that that doesn't harm my placenta any farther.

Also, oddly enough, the bleeding is always worst first thing in the morning.  I don't know if the baby likes to kick his/her placenta all night long or what, but after a day of milling around the house things always seem slightly better (except for those darn cramps).  

So now we wait.  There's a slight chance that the bleeding won't ever stop and then we'll just have to hope that it doesn't get any worse until I can deliver.  If that's the case, I'll be lucky if I can go full-term.  So let's just hope that it resolves!

I'll keep ya posted.

Quality of Life: It's the Little Things.

I have chronic dry eyes.  I've needed prescription steroid drops twice because of dry, scratched corneas.  I have had dry eyes for as long as I remember, and I remember thinking there was nothing I could do about it other than avoid wearing my contacts whenever possible and using eye drops.  But when I was pregnant with Russell my eyes got so much worse.  They were always red and painful.  At times they were even inflamed (it looks weird when your eyeballs swell!).  It was literally impacting my quality of life.  When you're stressed taking care of a medically fragile 2-year-old who pukes daily and a newborn baby with colic and undiagnosed food intolerances who won't sleep unless he's at the breast, sometimes little things like painfully dry eyes is enough to push you over the edge.  Same with needing a root canal (I've had four root canals on two teeth...yeah, that was miserable).  It's hard to be a good mom when you're in pain, even if it's minor.  Just the fact that there's always something gnawing at you.  Ugh.  I had to have it taken care of!

So my optometrist said that I was a good candidate for tear duct plugs.  I think most people think that those tear ducts on the inside of your eye, closest to your nose, on the bottom, are where tears are produced.  But that's not so!  It's where tears are absorbed.  So if you insert a little plug in them, you'll have more tears on your eyes.  I was concerned that my eyes would always be watery if my ducts were plugged (Russ had a plugged duct when he was born, and his eye was super goopy for a few months), but since everyone has coordinating tear ducts on the tops of their eyelids, you can still absorb some tears.

So last summer my doctor inserted temporary collagen plugs (they last about a week) to see if the permanent ones would be worth it.  Oh my gosh, the difference was amazing!!  So he inserted permanent ones a week later.  The procedure can be done in the office and only takes about five minutes.  It's pretty painless, except that your ducts will itch for the first few days and you have to resist the urge to rub them so that the plugs don't get dislodged.  But the itching goes away, and even though I'm more aware of when I rub my eyes, I haven't had any problems with them becoming dislodged.  

It has made such a difference in my quality of life that when my glasses broke a few weeks ago, I was actually able to wear my contacts all day every day for about three weeks, until my new glasses came in!  And when evening comes, thinking about taking my contacts out is no longer the first thing on my mind.  It may seem so simple, but it has literally changed my life.  And since something so simple was able to make my life so much better, I thought it would be worthwhile to share it with you.  If you're suffering from dry eyes, know that there is a solution that is much more simple than using over-the-counter eye drops multiple times a day for the rest of your life.  

Here is some more information about it (it's technically called punctal occlusion), including pictures.

Do you have dry eyes?  Have you ever heard of tear duct plugs?  Do you think it's for you?  

Potty Training Russ

For a few months now we've been letting Russell sit on the potty when he wants.  Seeing Big Brother do it makes it exciting for him.  He has often had successes on the potty, and when he does we give him a skittle.  Well, yesterday we ran out of skittles, so the boys and I went to the store and bought some more.  As soon as we got home, Russ was so very excited to sit on the potty and earn a skittle.  He had three successful potty encounters (all three with #2, too!) between noon and nap time at 3PM, and he kept his diaper dry that whole time!  But then we didn't bother to encourage too much potty time that evening.

Today, the boys had a bath right as soon as they woke up.  I let them play in the water (they play so well together!) for a long time while I cleaned the bathroom.  They were in there for almost an hour when Russell said, "Mommy, poo-poo!" with his little legs squeezed together as tight as could be.  I couldn't get him out until I was done cleaning the toilet, so he just sat there in mild distress while he held it.  Of course, when he was able to get on the potty, he had another potty success.  So I decided that today was as good as any to put him in underwear.  I really just asked him if he needed to go potty at any of the transitional times of the day (after finishing lunch, before going outside to play, after coming back inside, and before nap time), and he didn't have a single accident!  We even played outside for about an hour and he did great!  He's napping now, and tonight we'll be out and about, so I'm not sure how the rest of the day will go, but I'm pretty excited that it was such a successful and stress-free morning and afternoon!

I know that every child is different, but I always think of age 3 as being the magical potty training age for boys.  Just before Caleb's 3rd birthday is when we realized that he could pee on command, so we started potty training at that point and man.  It was stressful.  So many accidents and such a power struggle.  I remember it being so hard because he insisted on turning the bathroom light on by himself, but he couldn't reach it, so he had to get a stool (and wouldn't accept my help in getting a stool).  Then he was adamant about taking his shoes and pants all of the way off (not just putting them down around his ankles), and of course he wasn't able to put his pants back on by himself, but he always wanted to try.  Most of the time, he had already had an accident on the bathroom floor by this point.  Once we got him on the potty (he wouldn't sit on a big potty because he has awful balance and fell in once, so from then on he was terrified of big potties...and let's not even mention the fear he had for public potties, all because of how loud they are)...so once we got him on the potty, his attention span wouldn't allow for him to stay there long enough to let his pee-pee out.  So I had to sit there and sing "The Pee-Pee Song" for him (I made up a stupid song), and he wasn't allowed to get up until the song was over.  By then he absolutely did not want to wash his hands, because the whole process of going potty was already too long and drawn-out and he was tired of it.  And let's not forget, I couldn't motivate him with treats because a) he was on a diet of about 10 foods at the time and none of them made up anything remotely candy-like, and b) even if he could have had candy, he didn't enjoy eating at all and certainly wasn't motivated by anything that he could eat.  So we used a sticker chart and got him potty trained after a few weeks.  He was potty trained for a month or more when he suddenly started regressing.  I'm pretty sure it was to gain power again.  So we gave him a few months off (during the holidays and while I had my tonsils out) before trying it again.  When we tried potty training him the second time, everything clicked.  He could do everything by himself, never needed reminders to go potty, didn't need any stickers as motivation, and it all took less than two days.  He was about 3 years and 3 months old, and I thought that was a pretty good age for being potty trained!  However, using the potty for poo-poo was a different story.  He would hold it until he was in a diaper for nap time or bed time, and then go.  He was terrified of going poo on the potty.  He wasn't poo-potty trained until he was 3 years and 8 months old and we went on vacation and we were so busy being out and about that he didn't have any naps.  Boy was I glad when that finally happened!

Russell, though, is as different as could be.  He's excited to sit on the potty, could sit there all day, and can actually balance without a little potty seat insert.  There's nothing traumatizing about using the potty for him, and no power struggles.  But I wouldn't be surprised if he hit an independence stage (he's been saying "MY JOB!" a lot lately) and it turned into a power struggle.  If that happens, we'll just give it a break and revisit it later.  The only problem that I'm seeing now is that he's too small to get onto the potty by himself (I'm trying to avoid using the baby potty).  So even if he does get potty trained before long, he'll still be "high maintenance" potty trained.  And today is just day 1, so who really knows!  But I'm feeling optimistic.  :)

Also, in case you were wondering, the smallest size that you can get underwear in is 2T/3T.  Russell is 25 months old (a whole year younger than when Caleb potty trained), weighs 21 lbs, and wears size 12 months clothes, but the 2T/3T underwear still fits him alright.  It's loose, but it's not falling off.  And it's seriously cute to see him running around in his little super hero underwear and a t-shirt.  :)

So, wish us luck!  Maybe before long I won't have any kids in diapers!!  (knock on wood...)

Halloween 2013

When Caleb saw that I had picked out an elephant costume for Russell, he insisted on wearing the exact same costume.

They were pretty darn cute elephants, if I may say so.

In case you were wondering...

Here are some unexpected details regarding delivering a premature baby:

First off, you don't get to make a lot of decisions.  No one ever asked me if I wanted an epidural.  They just gave me one.  They don't ask if you want your water broken, or how you feel about pitocin.  If it's necessary, it happens.  They certainly weren't about to ask me how I felt about a c-section.  They were ready to do it, in case it was necessary to save my baby's life.

As soon as he was born, they took him away to put him on life support.  They said it was my husband's job to go with him, and leave me in the OR with just a doctor and a nurse or two.  That I'd see him when things settled down a bit.  I didn't question it.  I didn't even think about how it would feel to not see my baby, or to be left alone.  In that situation, feelings don't matter.  It's all survival mode.  Literal survival mode.  Please save my baby, and do it fast.

After I got to spend a few minutes with my new tiny baby (while he was getting his very first IV put in...aww!  I got to experience a "first" already!), the first thing I had to do was sign a paper saying that if I didn't pump enough milk for him then they could use human milk bank milk.  That was the very first matter of business.  That is how important breast milk was to his tiny, underdeveloped, immature digestive system.  I gladly signed it, even though I didn't know before that moment that there was such a thing as a human milk bank.

Then, a few hours later, a lactation consultant came to my room with a pump and asked if I wanted to pump and eventually try to breastfeed my baby.  Uh...of course...you mean I can breastfeed him?  But holy cow (no pun intended), I was not mentally prepared for that.  You mean...just how does this work?  Oh, so you're going to help me?  Great...let's just throw privacy and propriety out the window then.  But eventually I got to the point where half the medical professionals in Utah County had seen me try to breastfeed my baby and I hardly felt the need for a shirt when I was in the NICU.  Ok, that's a slight exaggeration, but still.  It was just a fact of NICU life.

Then, later that same day, there were two different people who came to my hospital room to request our participation in medical studies.  Who knew, right?  The very day I delivered a baby at 27 weeks.  He didn't even have a name yet!  One requested a whole vial of my saliva, and a swab of the inside of Caleb's cheek, to try to determine a genetic link behind prematurity.  The other wanted to pull a card out of an envelope to determine if Caleb would go on a "high flow nasal canula" or a "continuous positive airway pressure (CPAP)" machine when he was ready to be taken off of the ventilator, to determine if one showed better results overall.  He was chosen for the high flow nasal canula, in case you were wondering, but he eventually ended up using both at separate times.  I never heard of the results of either of those studies.  Nor the study that they did a month or so later, trialing a machine that monitors oxygen flow to the brain.  But of course I wasn't going to turn down the chance to participate in these studies.  Anything to help out babies to come.

And those were the unique experiences surrounding the delivery of a premature baby.  Those are all things that seemed so small, but absolutely did not happen when I delivered a healthy baby.

If you're interested in seeing the whole story behind Caleb's crazy entrance into the world, here it is.

It's always so weird to me that in our photo files, this picture:

 Is followed by this picture:

We were soooo unprepared for a baby!

My first time touching him...on the only extremity that wasn't occupied by a monitor, tube, or wire:

What a sweet, beautiful little surprise!