Happy Birthday!

I have a one-year-old.

My little 2lb 8oz baby turned one today. He now weighs 18.5 lbs, which puts him nearly on the growth chart for his actual age. He's grown from 15 inches long to about 27.5. Again, just starting to graze the bottom of the growth chart.

Whenever I describe his age to people, I always do the mental math by saying he was born 3 months early. It was actually a little more than that - 3 months and 5 days early. When I look at his ticker today for his adjusted age, it reads "8 months 3 weeks and 5 days."

Wow. Looking at it that way really highlights how early he really was.

As you'd imagine, today has been a crazy mix of emotions. Like all moms, I'm happy to be celebrating the first birthday of my son. I'm sad and nostalgic that he's growing up. I'm proud of how much he's grown.

There's so much more than that, though. All of my emotions just seem so much stronger than most parents' on their child's first birthday.

I feel like I'm turning a page. It's the same relieved feeling I had when we brought our son home from the NICU. We made it. We survived. HE survived. A whole year. And he's a thriving, happy ball of energy. What a relief. Now, we can concentrate on enjoying things more. It'll get easier from here...right?

And I'm so unbelievably proud of how hard my son fought to get here. I've heard people talk about their hearts swelling with love, but I never understood that until I became a mommy. It's like I can feel my heart grow. And it's magnified today. If we would have lost him in the beginning, I know we would have been devastated. Only now, after falling in love with my baby, do I truly understand what I would have missed out on if my son didn't make it. I didn't have enough capacity to love him enough until many month later, and it's only in hindsight that I'm able to grasp the all-encompassing love I would have missed if my son didn't come home with us. It physically hurts just to think about it that way. Luckily, my son was a fighter from the beginning. Rolled with the punches. "I'm showing up early? Cool. Have to live in a strange hospital in a strange city in a strange state? No problem." He's weathered the storm better than anyone, and we're so lucky to have an amazing son who likely won't have any long-term effects of his early birth.

I'm proud of us. My husband and I. We've been to hell and back in 2011, and we're closing the door on that. All three of us were admitted to the hospital at least once in 2011. We've had health scares and spent a dizzying amount of money, but we're here. And we'll be stronger for it. Better for it. I look back on who we were before our son was born, and I don't even recognize us. Everyone changes when they have a baby, but not like this. Not like this.

But not all the changes are good. All the memories came flooding back over the past few weeks, and they were especially strong today. Sometimes, it's images of labor & delivery or the NICU. They pop in out of nowhere, triggered by all sorts of things. The weather that takes me back to the snowy day of my son's birth. The Super Bowl advertisements that drag me back to that pumping room and the tiny individual TV where I stared at that game without knowing the score. My MacBook dictionary screen saver that has "gavage" as its word of the day. Really? Why today of all days? That stupid stupid wonderfully produced Pampers commercial about Every Little Miracle. It shows that tiny baby born 3 months early and it has that beeping. That NICU beeping. Beep...beep...beep... It took me months to not hear those beeps every time the microwave finished cooking or a truck backed up or my alarm clock went off, and that commercial takes me back. Every time. And it's been harder to push those images out as his birthday got closer.

It's not always memories, but sometimes it's feelings. I've been feeling anxious the past few weeks, and it got worse last night. I couldn't sleep. I was too lost in my thoughts until way past 2 am. I never had anxiety before the NICU, and now, every time I feel anxious, I think of the NICU. Or labor & delivery. Anxiety will forever be tied to those experiences, and I've been fighting against the flashbacks every time I've felt anxious over the past few weeks. Even when I get anxious about work or any other normal thing...BAM!...Back at the NICU. Or in labor & delivery. It's frustrating. I'm frustrated that I still struggle with these feelings. I know I'll never be the same, and I grieve the person I used to be. Sometimes, I wish I could be just a little more naive again.

On balance, I'm glad today is over. I'm terribly sad that my little baby is growing up, and I'm so happy to celebrate his birthday with him. But, mostly, I feel relief. Relief that this year is over, relief that my son is doing so well, and relief that we get to put some of the most difficult parts of this battle behind us.

I love you Captain Stinkerpants. Thank you for being the Best Baby Ever.

New year reflections

2011 was the worst year of my life. It was the best year of my life in that I got my son, but, in some ways, that's unfortunately overshadowed by how he got here. I will never be the same person I was before my son was born. Everyone changes when they have a child, but I'm scarred in a way that most people aren't.

It frustrates me when people say things like, "Oh, he's so healthy now!" The implication is that I should be over it. Yes, I'm incredibly fortunate that my son is doing so well. Yeah, but... I'm still not over it.

I feel like it's always "Yeah, but..."

It's been almost a year since he was born. Yeah, but I'm not over it.

He had a very easy NICU stay. Yeah, but I'm not over it.

He almost certainly won't have any long-term problems. Yeah, but I'm not over it.

I never will be. I still think about his birth or the NICU experience every single day.

Like, today, I remember that the labor & delivery nurse complimented me on my engagement ring. It's like so many things in my life get turned back to the NICU. Has it gotten better?

Yeah, but I'm not over it.

Maybe baby? Or maybe not

My husband and I have always wanted at least two kids. Maybe three. And, we wanted them to be 2-3 years apart. As my son approaches his first birthday, the reality that we'll have to start planning for our next baby relatively soon is starting to hit me, and I have a lot of mixed feelings on it.

On the one hand, I sometimes feel like I'm ready for another baby. My son is getting more and more active, and he's certainly not a tiny baby anymore.

On the other hand, I worry a lot that I'm just trying to have a "do over" of my first pregnancy. I never had a third trimester, and I worry that I'm just anxious to have another shot at pregnancy. We never had those exciting moments where we were wondering "is this really it?" with labor. Hell, my husband wasn't even there when my son was born. I was actually looking forward to my unmedicated birth with my doula. While I knew that not everything would go as planned, absolutely NOTHING went as planned.

And I missed out on having a newborn. I never got wheeled out of the hospital with balloons and a baby in my lap. I have no idea how to take care of an umbilical cord. We never had our baby sleeping in our room because he was getting up every two hours (our son slept in his own crib right from the beginning).

There's also no guarantee that we wouldn't have another preemie. No one knows why my son was born so early. While I'd be monitored closely and would get progesterone shots, I could still end up with another preemie. Or worse.

Beyond all that, I'm just not sure I'm mentally in the right place for another pregnancy. I've been wanting to watch "The Business of Being Born" for quite awhile. I was all set to download it tonight, but, after reading the online synopsis, I just couldn't do it. Just reading a little about the births that are in the movie was enough to set off my anxiety again. I never had anxiety until after my son's birth, and, now, I just can't quite seem to shake it.

I guess I still have a few more months before I need to worry about another baby. I mean, we'd probably want to get a HOUSE, so there are plenty of other challenges to overcome. Sometimes, I just don't feel that I have a path to get there, though. I've been seeing a counselor for months, but I'm not sure she can help.

How do I go from where I am now to someone who's ready to become a mom again?

Labor & Delivery memories

Labor and delivery for my son was traumatic. Scary. Awful. My husband wasn't there. I delivered him in a strange city, and I didn't know whether he was going to live. I had no idea whether I'd get a take-home baby out of the ordeal. I was diagnosed with PTSD following my son's birth, which is hardly surprising. I've been seeing a counselor for it, which has really helped. There are still lingering things, though, which is a big reason I've restarted this blog. I need a place to get my thoughts down.

One of the things that happened during the L&D experience is that I blocked out a lot of unpleasant memories. It wasn't until much later that many of them came back, and they often came back for random reasons. For example:

- I'd forgotten that I got oxygen during labor. The OB was concerned about my son's heart rate. I remember they were having trouble finding it, but I think that was because of his position and small size. I guess his heart rate must have been decelerating, because they gave me oxygen.

- The expression on the OB's face will always stick with me. She just felt so SAD for me. I can remember that. She said to me early on, "At 4cm dilated with a bulging bag of waters, you may not have this baby now. You'll be on bedrest for a long time, though." That obviously turned out not to happen. But I could tell that she just felt awful for me.

- I hadn't taken any birth classes yet, but I had read at one point that pushing was supposed to feel like going to the bathroom. When they told me I needed to get my baby out quickly, that thought came back to me, and he came out with only a few pushes.

- I will never forget thinking, "they're letting me hold my baby in case he dies." I knew that was why they gave him to me. I remember how warm he felt. And so tiny. So so tiny. And I remember thinking, "Why are we wasting time letting me hold him? He needs to be put in an incubator! I'm just being selfish holding him now!"

- I got a big bag of IV fluid after delivery. This memory just came back to me a couple of days ago when I started thinking about how many interventions I'd had during delivery. My OB broke my water and I had an episiotomy. I didn't have any pain medicine, though. Logically, I'm happy with the birth, given the circumstances. Even in the trauma of everything, I never felt pressured for anything. My son needed to be born quickly, given his small size. That was all explained to me. I consented to having my water broken and again to the episiotomy. Even my views on pain medication were respected, which is pretty remarkable given that I gave birth in a hospital I'd never been to with an OB I'd never met.

- I got pitocin following the birth of my son (but not during the birth). I may have been bleeding a lot, and that's why they gave it to me. I don't really remember, though. I remember the contractions with the pitocin after my son's birth were significantly more uncomfortable than the ones during labor. Weird, eh?

- I have no recollection of anything that happened after the first few minutes of my son's life. I remember they got him intubated on a warming bed, and I can still see the vision of the neonatologist working frantically on him. And I can remember the bed beeping. A long steady tone - like the kind you see on TV when someone dies and their heart monitor just shows that steady line. After the first few minutes of watching the doctor work on my son, I don't remember anything else until much later. I was in the recovery room the next time I have memories. I have no idea how I got there.

- I remember how alone I felt in the recovery room. I wanted someone to come in and talk to me. There was a nurse named Rachel (ironic, eh) who kept coming in to talk to me. I wanted her to stay the whole time, but she obviously couldn't. I just didn't want to be alone.

- I asked for a breast pump right away, and, at the time, I was proud of myself for having the foresight to ask for one. I felt so clumsy with it, though - I had no idea what I was doing. The nurse helped me, and I thought she was a bit condescending about it. Not necessarily mean, but she couldn't figure out how I couldn't figure out how to use the pump. It made me want to cry. I remember how happy the nurse was that I got colostrum the first time I pumped. I was surprised that she was surprised. It wasn't until much later that I learned that many many preemie moms have major issues with milk supply / pumping, etc.

- I walked from the recovery room to the NICU where my son was being stabilized (he was going to be transfered, but I got to see him before he left). Everyone kept asking if I wanted a wheelchair. I was genuinely confused as to why. What was supposed to hurt? I didn't hurt anywhere. Was it adrenaline? Maybe.

- The neonatologist who was there for my son's birth came and saw me a few hours later. She told me everything that was going on, and I said to her, "I have a friend who lost a 24 weeker after 8 days. I know I can expect a honeymoon period where everything goes well for a few days, and then things may start to go south." I was so pragmatic about it, but what other choice did I have?

I'm sure more memories will come to me, but that exhausts them for now. It's so hard going back to that time, but I feel like I need to. I'm still not right in the head, and I don't know if I ever will be. Going through the memories helps me to process things, though...

Baby's birth story

My pregnancy had been quite uneventful, and I'd considered myself to be quite lucky to have had a relatively easy time of it. Then, on January 25, 2011, while out to dinner on a business trip 300 miles from home, I started feeling sharp pain in my hips. I wrote it off as relatively common round ligament pain. When I got back to my hotel, I even filled up the bathtub, thinking that everything would be better after a warm bath. Then, I noticed that I had just a tiny bit of spotting. I decided to drive myself to the hospital to get things checked out. I called my OB back home and my husband – we all agreed that I’d probably be monitored for awhile and sent home with instructions to take it easy for awhile.

I got to the hospital at about 9:30 at night. By that point, I knew something was wrong. I told the admitting nurse, “I think I’m having contractions,” and they wheeled me over to L&D. At first, everyone in L&D seemed to think that what I was experiencing was no big deal. Probably just Braxton Hicks contractions. Then, at about 10pm, they did a cervical check. I was 4cm dilated and my bag of waters was bulging. I remember the OB saying, “at 4cm dilated with a bulging bag of waters, you could still hold out for awhile. You’ll be on bedrest for a long time though.” Unfortunately, that wasn’t going to happen.

A ferning test soon revealed that my water had broken, and, 15 minutes later, I was 6cm dilated. I barely had time to call my husband to tell him to start the 5 hour drive from our house to the hospital before I was wheeled into the delivery room. I remember asking, “Am I going to have a c-section?” and the OB replied, “No. If you were going to have a c-section, we’d be wheeling you into the operating room.” I remember thinking to myself at this point: WTF? I’ve never been to this hospital before! How am I supposed to know the difference between the ceiling of the delivery room and the ceiling of the operating room? That’s all I’m looking at at this point... It’s amazing the stuff that was going through my head during this whole process. I was extremely lucky that my son had been head down for weeks (he had been kicking me in my ribs for awhile). I didn’t automatically have to have a c-section.

It starts to get hazy at this point, but I can remember the OB asking me what my plan for pain was. I said, “I’d hoped to have an unmedicated birth,” and the L&D nurse said from somewhere behind my head, “At this point, I think she can handle it!” I had to be 8cm dilated or more by that point. I started shaking, and I asked the nurse if I was in transition, and she replied, “That could be it.”

I was at a smaller (but still very good) hospital, so there wasn’t a full-time neonatologist there. They had one on call, and I remember being told several times that she was “10 minutes away.” At the time, I remember thinking that they were lying to me. I knew they were trying to keep me calm. But, regardless, I had to hold out to deliver my son until the neonatologist arrived. I HAD TO.

I didn’t remember it until weeks later, but, at some point during this whole process, they started to get worried about my baby’s heartbeat. His heartbeat had always been hard to find, but it was dropping when I would have a contraction. They gave me an oxygen mask, and then there was talk of me needing to deliver him as quickly as possible.

It must have been after they gave me oxygen that the OB broke my water. The first time only resulted in a little gush of fluid, and then the second attempt ended up with amniotic fluid everywhere. I was surprised then how much fluid there was. After she broke my water, things slowed down. My contractions slowed way down during transition. Logically, I knew that was somewhat expected, but, at the time, I thought She just broke my water! Now I have to deliver! But my contractions are gone! What if this was all a false alarm and she could have stopped my labor? Now I have no choice! Nothing could have been done to stop the labor, but it certainly crossed my mind at that point.

I have no idea if I was 10cm dilated or not when I started pushing. I don’t ever remember having the “urge to push” that you hear about. It was never a physical thing – it was a mental thing. I NEEDED to get my baby out. The OB told me that we were in a rush to get him out, so that became my obsession. I pushed a couple of times. Then, the OB asked if it was okay to give me an episiotomy because it would help get him out faster, and I consented. I hadn’t wanted an episiotomy (it was even on my birth plan that I didn’t want one, as if that mattered at this point), but everything changed when I was having my son. Luckily, I never had any complications from it, and it healed fine.

After just a few pushes (I have no idea how many. 5?), my son (Z) was born. He let out a little wail before the medical team descended on him to stabilize his breathing and get him started on the ventilator. The neonatologist had arrived by this point, so she worked hard to stabilize him. He was on a warming bed, and I could see her working frantically from the other side of the room. The bed was beeping a loud solid tone, and the nurse kept saying to me, “It’s okay, that’s just the bed. It’s okay, that’s just the bed. That’s totally normal.” I vaguely remember delivering the placenta and the OB stitching me up.

They brought Z to me to hold briefly before they took him down to the NICU (the hospital where I delivered had a NICU where they could stabilize him, but it wasn’t equipped to have a 26-weeker stay there). I remember holding him and thinking to myself They’re letting me hold him in case he dies. What an awful thing to think, and that thought stuck with me for weeks. Still does. One of the L&D nurses had an iPhone, and she used it to take a bunch of pictures of everything – I obviously didn’t have a camera on my business trip. She took the very first pictures of my little guy. He was 2lb 8oz and 15 inches long at birth. Both of these were in the 97th percentile, and he was so big that there were some questions as to whether my due date was wrong. It wasn’t (it’d been confirmed with a dating ultrasound) - we were just very fortunate.

I have no idea how I got to the recovery room, but I got there somehow. Later, when my sister arrived (coincidentally, she lives about 2 hours from the hospital where I delivered), we were able to go to the hospitals NICU to see Z. There was a nurse holding IV lines in his umbilical cord, which seemed strange to me. I got to touch him for the very first time, but I was too numb to feel much emotion at that point. It wasn’t until MUCH MUCH later that I could say that I fell in love with my son.

While in recovery, the neonatologist came to see me. She had a little post-it note with Z's length, weight, and birth time (11:38pm). I still have it. I have no idea what she said to me, but I remember that she projected a sort of “wait and see” attitude. She wasn’t overly optimistic or pessimistic – she just said that we’d know more later. I said to her, “I have a friend who had a 24-weeker that didn’t make it. I know we’re in for a possible honeymoon period, and things might get worse after that.” She agreed. She was very caring and concerned, and I’ll never forget her.

I saw Z one more time that night. He was packed up in a transport isolette, and they wheeled him to my room so I could see him before he was transferred. I looked at him a bit, and then thought Why are they still here? They need to leave so they can get him to the good hospital. I think the transport team was surprised that I wasn’t more emotional. I was truly in shock. Later, I was diagnosed with PTSD, and the L&D experience were a big reason why.

My husband made it to the hospital at about 4am, and my parents arrived a few hours after that. My husband and I lived in a hotel for the 70 days our son was in the NICU, and we had a very uneventful all-day drive to bring him home on April 6, 2011. Our NICU stay was extremely easy for a baby born that early. He was only on the vent for a few days, then spent the rest of the time on the CPAP, high flow nasal canula, and regular canula. He had a grade 1 brain bleed that resolved on its own a few weeks later. No other issues. He had to coordinate his suck-swallow-breathe rhythm and learn to breathe on his own before we were discharged, and we never had any complications. He was sent home on oxygen with his feeds, and we discontinued that a few weeks after he got home.

Today, Z is a thriving 11-month-old. He’s learning to crawl and is an incredibly happy baby. He’s been followed closely by his pediatrician, the local NICU, and the local Early Intervention program. He’s never had any delays or required any therapy. While he isn’t completely caught up yet, he will be very soon. We’ve been incredibly fortunate.

Second appointment

We had our second appointment - everything looked great! They weren't able to find baby's heartbeat right away with the doppler, so they brought in a small ultrasound machine (this practice has several of them that they transport from room to room). It was crazy to see the little bugger flipping around in there! It really looked like a baby this time, instead of just like a gummy bear. We didn't get another picture, but we scheduled our anatomy scan for November 30th. That's when we'll find out the sex of the baby (hopefully)!

I think the midwife actually got enough of a glimpse today to guess what the sex was, but she wouldn't tell us. The small ultrasound doesn't produce the best images, and, since it's so early, there's no way she could have been sure. She did say something to the effect of, "Whoa! We got a really good shot there!" And she looked at us wide-eyed. When pressed, though, she wouldn't venture a guess. Not that I blame her. And, waiting another few weeks is no big deal.

So, now there really aren't any more excuses for me to tell everyone at work! That's going to be a little awkward, though. Telling people that you're pregnant is a little like saying, "Hey! Congratulate me!" I think it needs to be done, though, or people are just going to start gossiping at some point.

We also got some contact information for a local doula, which is exciting. For those that don't know what a doula is, it's essentially a labor coach. They attend the entire birth (unlike midwives or doctors who are generally in and out quite a bit), and they help you with things like pain management throughout the birth. I'm very interested in a non-medicated birth, and doulas definitely help with that. I hope I like her!

First appointment

We had our first appointment today. I know that I'm 8 weeks and 3 days pregnant, but, the OB thought I should be something like 11+ weeks pregnant. Luckily for me, that meant that the OB scheduled a dating ultrasound. Even luckier, we were able to get in to see the ultrasound tech today, too.

She found the baby right away (I still can't believe there's actually a baby in there), and she saw a heartbeat. I'd been a little worried about a miscarriage (as all pregnant women are), so I was very glad to see it. The heartbeat was 170 beats per minute. There's an old wives' tale that heartbeats over 140 beats per minute are indicative of girls, but we'll see if that's true. We'll get another ultrasound at about 20 weeks, and we'll find out the gender then - probably right before Christmas.

Everything else looks good. It was my husband's first time being at an OB / GYN-type appointment (obviously), and he was pretty horrified and uncomfortable by parts of the exam. He got over it, though, and he was so so so excited to see the baby on the ultrasound. He and I talked afterwards about the fact that we'd just started coming to terms with the fact that we're having a baby, and now it seems so unreal again.

I also found out today that the practice has midwives, which makes me really excited. I've wanted to deliver with a midwife for quite awhile, and this is exactly the type of delivery environment I want. The delivery will be at the best hospital in the area (the only area hospital with a NICU), and it will be done by a midwife as long as things progress normally. If things go awry, there is ALWAYS a doctor at the hospital to step in and assist as needed. We also got some information today about the hospital where I'll be delivering, and it sounds like exactly what I want. I'm very pleased.

Other than that, things are going well. I feel fine, mostly. Occasional mild nausea, but nothing really noteworthy. Some insomnia, some headaches, some moodiness - basically a little bit of a wide variety of symptoms. I know that I'm lucky to be feeling so good. While there's still time for things to turn south, I've been really lucky so far.

My next appointment is scheduled for the end of October. It's really starting to feel real now.