12 August 2013

Breastfeeding and Graves' Disease


Huffington Post published this article on Graves' Disease and breastfeeding - and it was like reading my own account of breastfeeding my first. I also was an exclusive pumper and hung in until 8 or 9 months. A good read for those interested.

20 March 2013

Life gets in the way

I've been threatening for awhile now to get back to regular posting.

As usual, life gets in the way.

When your boss is this sweet it's hard to do much else!



16 February 2013

6 months

Hard to believe my Sweet Cheeks is 6 months already. Where does the time go?


15 January 2013

Winning

Sweet potatoes are a yes!

Having fun starting solids with my little cupcake.

17 December 2012

Dairy Queen Wannabe


It was extremely important to me that I be able to nurse my child. Between the allergies coming down from my husband's side and the autoimmune disorders on mine, I knew one of the best things I could do for her was to breastfeed. Also, not to be overlooked, breastfeeding is much more cost-efficient than formula. I also knew it was possible I would encounter some challenges due to my thyroid. As it turns out more often than not, that thing I thought would be the biggest worry turned out to be the least.

In my idealist mind breastfeeding would be this wonderfully easy, natural thing: I imagined myself sitting in a beautiful field with a daisy chain in my hair while my newborn suckled and looked at me longingly with love in her tiny eyes. Birds would sing their delightful song, praising this act of instinct and we would never have a bottle in our home. After all, this was what my body was designed to do. Trust me when I say it is nothing like this in real life. Yes, there are moments where the hippie in you is affirmed and nursing brings on this amazing sensation of being bonded and beautiful, but these moments are brief...very brief...and fleeting. Especially in the beginning when you're both still learning. When Cartney latched for the first time after delivery we heard no angels singing, saw no glorious lights from above, and felt no magical closeness. It was all business and a third person was all up on my boob trying to make sure it happened. Not at all what I envisioned.
After her helpful assist on that first latch, the lactation consultant looked over my file and saw that I was hypOthyroid. She told me she'd rather me be getting too much hormone than not enough at this point to ensure my milk came in. Per my endocrinologists instruction, I would drop the levothyroxine to my pre-pregnancy dose the day of delivery. I felt great about our first latching attempt and my milk supply coming in. I was in good spirits about our learning to nurse...and then four hours post-delivery Cartney was sent to Neonatal Intensive Care.

I didn't realize it at the time, but the moment my child was sent to NICU I became an exclusive pumper. Let me reiterate: I BECAME AN EXCLUSIVE PUMPER. I didn't ask to be a part of this club, the thought of hooking my boobs up to a machine for 6-8 hours of my day was not the warm and fuzzy I wanted out of our nursing relationship, and I would never have volunteered myself for this task. (Reading that statement in all caps still makes me shudder.) Exclusively pumping is, in short, for the birds. But when she got sent to NICU she would need her intake monitored which would exile us to bottle feeding for the foreseeable future. So there I found myself - with the birds, flying around - listening to a machine say "whacko, whacko, whacko" while it removed my milk.

This was never explained to me and only seen in hindsight, but several things happened when I became an exclusive pumper: My supply was threatened because a pump will never be as efficient as the baby. Feedings once we got home would now take thrice (yes three times) as long because I would have to pump and feed a bottle. Not simply nurse, just pump, or easily fix a bottle, I had to essentially do all three (attempt to latch, feed, then pump - not necessarily in that order). When you are operating on 30 minutes of sleep in the last 24 hours and beginning the feeding triad for the umpteenth time, formula becomes an extremely attractive option. As in it calls you by name and whispers sweet things to you in between the 100db cries your baby is making.
But I'm stubborn. Incredibly rebellious and stubborn. I demonstrated by stubbornness in new ways when it came to breastfeeding. I refused to give up when she wouldn't latch, I refused to give up when I developed postpartum toxemia and had to be put on meds (it was a bit of a challenge to get the GP to understand I needed something safe for breastfeeding), and when I developed thrush...I continued to be stubborn. My nipples felt like they had athlete's foot and I still rebelled and said "NO! You will not decide when I will quit breastfeeding! I call the shots here!!!" If it could go wrong it did, and I continued to rebel. When my husband (who was truly trying to help) said maybe we should go to formula, I informed him that they were MY BOOBS and I would decide when I was done. I may have also peppered some postpartum hormone-induced rage in with it, but overall I was nice. Ish. In a Gandalf "You shall not pass!!!" kind of way.

"I am crazy," I thought. "I am officially stupid and crazy. Nobody keeps this up with all that's going on." But I couldn't back down then. See, the problem with stubborn is at some point you have to either back it up or back down. I had fought too hard to back down. So the Tom Petty song became my theme for my boobs. That and the "whacko, whacko, whacko" that I was now convinced my pump was calling ME instead of saying it in general. Come hail or high water, my kid was getting all the breast milk I could get my flanges on, even if that made me "whacko." I refused to be insulted.

Thus Cartney was primarily a bottle fed baby. I tried to nurse with a nipple shield as often as I could throughout the day, hoping one day she would latch again and we could nurse like nature intended. Six weeks postpartum I was only getting 10-15oz per day and the baby was drinking upwards of 20. No matter what I did, how many pumps I got in, how many cups of tea I drank, how many batches of lactation cookies I consumed, nothing upped my production enough. (Those lactation cookies certainly upped my waistline, though!) I came to terms with formula. As my baby grew and the supplementing went from 1/3 of her feedings to 1/2, I was at peace with it. I had done all I could do, I gave up trying to force myself awake for that essential "middle of the night" pump, and accepted defeat.
I exclusively pumped for 10 weeks, then one day, quite suddenly, something clicked. I went through our daily ritual of trying to latch; she kept knocking the shield off and otherwise doing her usual flailing around (my husband has said it looked like I was trying to suffocate her). I decided it was more trouble getting that darned shield to stay on than to just try to get her to latch without. I offered my bare breast to her and suddenly she opened wide and took it. She latched.

This moment, friends, I heard those angels singing. It was as if something miraculous had occurred - and honestly, it was pretty miraculous to me. This was the moment I thought we'd have when we nursed for the first time after meeting. Finally. She suckled and swallowed and had milk dribble out the corner of her mouth for a good hour. This made the past 2.5 months of ridiculous work worth it. Why did she suddenly latch? I suspect her mouth was bigger. And/or a miracle occurred. Either way there was singing.

I still pump some and nurse some. When we nurse it's less about nourishing and more about bonding. This allows me to quit worrying about how much milk she's getting and if it's enough. Now I simply enjoy the moment. There are no daisy chains, no field of grass, but there is this incredible feeling of closeness I can only describe as a warm hug. I will be the only person to ever share this experience with her in this way. It is a moment that is ours, no one can share, and when she is too old to be bothered with mommy I will remember the way she hugged on my breast like it was her BFF. It's so incredibly cute! (She'll kill me for this one day.)

I'm not defeated. Our success looks different from others. I haven't given up hope on exclusively breastfeeding the next one(s), but for my firstborn we are in our holding pattern of half and half. I choose my language carefully: it's not that we are unable to exclusively breastfeed, but that we are supplementing. (See how I took the negativity out?) The freedom is kind of nice and recognizing that is helpful.
That, my friends, is my nursing experience so far. Threatening-thyroid free. I am glad I chose to ablate my thyroid because hormone replacement is compatible with nursing while thyroid suppressing drugs are a contraindication. If you would like to nurse and are choosing a treatment option for Graves' Disease, this might factor in for you.

Sometimes I miss caffeine (okay, I miss it A LOT) but the things you must abstain from whilst nursing pale in comparison. It is the wonderful thing you believe it is. But some days it's just a lot of work. It's much like parenthood on a smaller scale: exhaustingly magnificent.

You should also know I am much less impressed (bothered?) by boobs now. They are much more about function now than entertainment, at least for me. I see them and think "baby food!" Heh...

04 December 2012

This time last year...

We were finding out some pretty big news.

21 November 2012

Our Cherub's Birth Story

If you've been reading along for some time you may remember we began our journey to parenthood in earnest last year. Our pregnancy was not without complications: I was miserably sick for the first trimester, an extra careful watch was kept on our girl to make sure my Graves' Disease antibodies didn't cross the placenta, and I had gestational diabetes. I thought for sure since I had such a difficult pregnancy I would have a breezy delivery. Surely I would catch a break for that! Not so...just fair warning that this post is a bit frenzied and all over the place, appropriately so, because that's what life has been like every since I began my labor journey. (You can see my first "birth announcement" post here.)

When my OB started my progress checks from 37 weeks on, I was only a fingertip dilated and my cervix soft but long. Each week when I went back at 38 and 39 weeks, there was no change and apparently no progress. I had been told earlier in the pregnancy that they wouldn't allow me to go past my due date because of the gestational diabetes. At my 39 week appointment my OB offered to induce me same day or allow me to go the full 40 in hopes that I would go into spontaneous labor. I opted for the latter. They were estimating baby girl at 8.5lbs at that point, but I remembered with my niece their estimates were about a pound over her birth weight so I felt good about erring on the side of caution and giving her that extra week. The OB wrote me a script for an induction and said if I hadn't gone into labor on my own in the next week to check in Sunday night to start the process.
We checked in at 8p.m. Sunday night for what we thought would be a routine induction. Two rounds of cytotec proved fruitless, however, and less than 12 hours later my OB was recommending a cesarean since I was not progressing (still only a fingertip and cervix long). By 8a.m. Monday I was being prepped for surgery and feeling in many ways my worst fears were being realized. I knew a vaginal birth was going to be best for my girl and me both, and my body was once again not doing what it was “supposed” to do. I was mad at my body for failing yet again at giving me a "normal" experience. But I resolved to accept the situation and trust that the doctors would take the best care of both of us (which they did) and spending my energy worrying about it wasn't going to help anyone. The husband and I didn't even have time to process this radical change in plans before we had to start calling in family for major surgery in 2 hours.
 
I was prepped in the L&D room and they wheeled us to the OR. Brian was given scrubs and instructed to get dressed and wait just outside the operating room; I was taken back and the anesthesia process started. As the anesthesiologist was administering the spinal block, he asked if I was swollen – I told him yes! I was swollen in places I didn't even know could be swollen! - and he informed me even my back was puffy. I hugged the nurse as he administered the spinal and within a few minutes was numb from my chest down. It was then they laid me back on the operating table which seemed impossibly small and was cross-like in that it had apparatus on either side for my arms to lay. I don't remember them strapping my arms down (I have heard of them doing that with sections before), but they did lay my arms out on the sides and when my face started itching the nurse was kind enough to get a tissue and scratch it for me. I probably was strapped down, now that I think about it... As they prepped me I began to feel a little nauseous and they put some Zofran in my IV which curbed it pretty quick. The sheet blocking mine and Brian's view was put up and he sat next to my head, stroking my hair and comforting me as the surgery began. The baby was delivered within minutes.
 
There was some tugging and pulling and pressure and they told Brian to stand up so he could see our sweet girl enter the world. At 8:37 I heard the most glorious crying of my life! They brought her around the sheet so I could get a look at her, and she was beautiful. She looked so big. She was 7lbs 9oz, 20.5 inches of perfection. I cried as much as I would allow myself – too scared to do the ugly cry for fear of shaking myself off the tiny OR table – and continued to listen as they let her cry to try and help the wet lungs that are a marker of section babies.

As the operation progressed, my OB finds that my pelvic inlet was too small to allow my baby to engage and get the labor process started. Amazing, considering I have a big ole buttand wide hips, that the inlet wasn't wide enough to let her drop. The doc said “We didn't know until we tried – and you tried!” And I laughed and said I did indeed try. Once they closed me up they took us to our recovery room, allowing Brian and me to carry our sweet Cartney as they wheeled me along.
 
Unbeknownst to me during surgery, my heart was skipping beats, missing back beats, and otherwise causing concern for the OR staff. In the next few days I would be visited by the anesthesiologist and a cardiologist to try and get to the root of what happened. When the cardiologist visited our room, he said “Do you remember what happened on the operating table?” And I innocently responded “I had a baby?” After a work-over it was determined it was a bit of a fluke (“We have a medical term for it, but essentially that's what it is.” per the cardiologist) and I would just need to make the appropriate medical personnel aware of it if/when I am put under anesthesia again. One of the nurses (our favorite nurse!) showed me the ticker-tape of my heartbeat they put in my file, and it was pretty impressive that I talked through this crazy stuff my heart was doing. My OB said that's why they went ahead with the surgery; I was apparently fine and alert despite what the machine was showing. I wish I could say that was the end of the odd occurrences, but they would continue.
 
Back to the birth story...once in the recovery room we got some skin to skin time and tried our hand at nursing. Cartney latched pretty well, or at least I thought she did great, and the lactation consultant was very helpful in facilitating that first attempt to breastfeed. After a few hours of us being stable, our family was allowed to come in and meet our sweet baby girl. It seemed as though there was some normalcy returning and it would all be downhill from there, and I could relax.
We had our baby for four hours before she was sent to NICU. She had some rapid breathing that didn't resolve itself in that time frame. When they told me they had to take her from us, I was devastated. Thankful that the drugs from surgery were still strong in my system so it would numb the pain a tiny bit... I kissed her and Brian walked down with the nurses to take our baby. I had told him several times over the course of the pregnancy that if at any point we got separated from the baby that he was to STAY WITH THE BABY. Thankfully, the nurses gave him no option and said he had to come with them. We would find out later she had an air pocket outside her lungs – pneumothorax – and it was so large it was pushing her other lung and heart to the side. They started antibiotics in expectation of having to put in a chest tube to get the air out.
I was helpless. I was still sedated and unable to leave my bed, I had just been through major surgery and had no baby (the thing that would make the last 10 months worth it all), and was sure my world was crashing down. I was asking every nurse and doctor that came my room “When can I go see my baby?” “When can I get up?” “When am I going to be able to go down to NICU?” As soon as they would allow me I was put in a wheelchair and Brian pushed me down to see the baby. I can't really describe the mixture of excitement and disappointment I was feeling as we navigated those long hallways...excited to see my firstborn but disappointed she was not in our room. I was lost.
 

We were buzzed in through the doors and went past “pods” of tiny, sick babies. The gravity of her being there started to sink in. I finally got to lay eyes on her again – there she was. My healthy, full term baby hooked up to IVs and monitors and all sorts of other things preventing me from holding her. My baby looked sick. She was frantic, her chest moving in an unnatural way when she was breathing, I wanted so badly to hold her and comfort her and couldn't. I can't describe the ache I felt in my heart, but it was in the pit of my stomach and the depth of my soul. I longed so badly to hold her, to cuddle with her, and I couldn't – we couldn't – I was desperate to bond with this child who we could do none of the “normal” stuff with.
It was two days before we got to hold her or feed her. During those days changing a diaper was the highlight of our time! She had a feeding tube for a day, but she gagged and pulled so much at it that they gave up trying to keep it in and went ahead and tried to feed her. (Her pediatrician said “She knew she could eat!”) When we finally got to hold our sweet girl, our world felt a little more complete.
During that week I was crippled in every sense of the word, but as soon as she was sent to NICU they brought a breast pump in the room.. This task helped tremendously for two reasons: it gave me something to focus on and it was one thing I could do for her to provide her with something no one else could. The nurses could care for my baby in every way I could – change diapers, bathe her, comfort her, etc. - but none of them could give her breast milk. Only mommy could do that. I was so proud when my milk came in on day 3 to march my “liquid gold” down to NICU. I was pushing myself to walk on that day too, even though it was a great distance from my room to Cartney, and I told the nurses as I passed by I felt like they should sing me the Rocky theme as I go! They laughed and obliged.
 

There were so many emotions during this time... I was mad at the moms who would leave their babies at the nurses station. When our L&D floor filled up I thought every time I saw a balloon I'll bet they have THEIR babies. When I would see a dad pushing a cart with a baby I was so jealous. I wanted to know why, to ask God why, to demand answers. Peace came when I accepted my responsibility was not in the knowing – only He is high enough to be privy to that information – and moved on from asking. My peace was not in knowing why; it was in accepting I may never know the reason my daughter's entrance into the world went down like it did. There, in that place of trust, I had rest.
It was Friday before I was discharged, and our favorite nurse removed my staples and was applying steristrips when she let out a gasp. My incision had come back open. I was so close to freedom and once again something goes wrong! After what seemed like an eternity waiting on my OB to come check the incision, he told the nurse to put a tincture on the wound and cover it with steristrips. I was given strict instructions to only care for baby until I came to see him the following week. We were hopeful the NICU pediatricians were correct in that the baby would be discharged Saturday, and at the urging of her nurses we went home for a few hours to eat and rest before spending the night in their family room with Cartney.
 
As we left, I was flooded with emotions. I wasn't prepared to leave the hospital without my child. Even though it was only a few hours, the overwhelming emptiness I had driving away from there without my baby was too much. I barely stepped foot in our home before I was ready to go back, desperate to get back to her. Those 3 or 4 hours felt like an eternity.
 

We spent the night in the family room – a wonderful transition for parents to have where you care for the baby but the nurses are there to take vitals and answer questions – and Cartney was discharged on Saturday morning. The pediatrician who gave us her discharge info said her pneumothorax had closed on it's own without intervention, which he called nothing short of miraculous considering they were convinced she would need a chest tube. I have no doubt someone in that NICU needed to see a miracle. I know we did.

The night we got home, all was right with the world. Life was so different. Every moment we had with her I wanted to protect for only me and Brian. I guess I was pretty stingy with her then and may still be now, but after having our time to be together delayed like it was I just wanted to savor every moment. I studied every yawn, celebrated every burp, and soaked in the warmth of her body when I held it close to mine. Perhaps now things could settle down and we could find our normal.
 
Just when I was starting to relax, another curve ball: one and a half weeks postpartum I woke up in the middle of the night from a dead sleep with a headache I thought was going to kill me. It felt like my brain was going to throb right out of my skull. Thinking it was part of postpartum recovery, I ignored it (if you can call writhing in pain and screaming ignoring it)...until it started happening every time I went to sleep. Someone suggested I keep an eye on my blood pressure, and sure enough it was running so high I was in stroke and seizure territory. Two weeks post partum I was put on labetalol (a blood pressure med that's safe for nursing) and although my doctors suspected it was a long-term issue developing, I was able to wean off 6 weeks postpartum when my blood pressure started running low. Praise be to God for that!

I finally had my last doctor appointment in October for the year - and am so thankful I don't have to see them for the rest of the year!!! Don't get me wrong - I love my doctors and they are wonderful people - but I have seen way too much of them this year.
This sweet cherub was worth every bump and surprise on our journey - and shockingly, even after all that seems to have “gone wrong,” I'm actually considering doing this again sometime!  

Call me crazy.

21 October 2012

Pump Up the Jam

So I spend a lot of time hooked up to this thing several times a day, but that means I'm still making milk! Now if I could only figure out what phrase my breast pump keeps repeating...

26 September 2012

Brevity

Sleep deprived, food deprived, freedom to go to the bathroom deprived...
So very worth it for moments like these.

14 September 2012

Missing

One month since my world changed forever...
I am missing the time I had before to accomplish the things I needed to handle and do stuff like update the blog.
But the greater offense would be missing moments like these:
So for now, I am content missing all the stuff I mentioned before. She'll only be this small for a brief moment before it's gone.
And I can't afford to be missing this.