One can only assume someone is writing a screenplay about parenting toddlers, right?
Jackson is three!
This is what three looks like:
Someone told me 2.5-3.5 is the hardest section of a human lifeline to parent. I am not sure it is the hardest, but I am positive it is the most tactical. I like to consider this timeline accurate because it would mean I am halfway done.
Don't get me wrong, this is also the most adorable age so far. Mother Nature is a sneaky gal. As Jackson's personality develops he becomes more and more difficult and affable at equal rates. I see what you are doing here, Mother Nature, and I accept your challenge.
One thing that is awesome is that it is so much easier to handle taking care of both of our boys now.
So.Much.Easier.
Mostly thanks to Jackson's ability to be somewhat independent, occasionally self-sufficient, and overall, nicer and less aggressive towards his brother.
Jackson had his third birthday party on Wednesday so more of his friends could come play in the bouncy house his Auntie Stacie & Uncle Eric so generously rented for his birthday. We had a wonderful time at Wildflower Park in our neighborhood.
Maybe a bouncy house at three is too much, too soon. In my opinion, the chaos in the bouncy house and wild rides down the bouncy slide are completely appropriate considering life often feels chaotic and wild right now.
Today, August 6th, 2016 it is official. Jackson is three.
Here we go.
Milk Chronicles
Just another mommy blog for your reading pleasure.
Saturday, August 6, 2016
Tuesday, December 29, 2015
Why you SHOULD travel with your toddler
I am sure you think I have lost my mind.
"Is she seriously suggesting that one should travel with a toddler?" you ask.
Well, yes. I think you should at least consider it. Especially if you get a family vacation out of it. At the risk of sounding pretentious, my toddler has been on trips that required plane rides four times and he has been out of the country three times so far. We have also traveled significant distances by car several times and have lived to tell the tales.
Was it easy? Hell no.
Was it worth it? Absolutely!
While there are many (many many many) reasons NOT to travel with a toddler, I will attempt put a spin on some of these reasons (excuses) and at least get you thinking you may reconsider.
1. I would travel with my toddler, but it will get them out of their routine.
You are correct. Your toddler is going to be all jacked up. The hard-earned and consistent (lucky!) nap times and possibly even bed times will go right out the window. The strict diet you have imposed on your little for the benefit of their health will be long-forgotten (that is, unless you pack all your food supplies, in which case you should just stay home - you may be insane).
Here's the deal. Perhaps your toddler needs to get out of the routine that you have worked so hard for. Toddlers who are too dependent on routine will not handle change very well. Maybe a little change every once in a while will help them grow into a healthy, well-adjusted kid who can go with the flow. So what if they did not get a nap and get a little cranky in the evening? Use that opportunity to put them to bed a little early and do some adulting. Who cares if they stay up past their bed time because you are out of town and out of sorts? Let them have a little fun since they are going to be a disaster anyway. So your toddler had gelato again for dinner? Well, we all indulge a little on vacation.
Just know this, your little terrorist is going to go back to their routine again once you are back home. Sure, it may take some work and a few days but if you are doing things right, your trip was worth it.
2. I would travel with my toddler, but our destination requires a plane ride.
In my experience, there are two types of people on airplanes:
1) Empathetic/sympathetic (do you know the difference?) people who will give you looks of encouragement and even try to engage and distract your toddler from their inevitable meltdown.
2) *Intolerant people who will shoot you death glares if they even hear a peep from your family and may even threaten the life of you and/or your child if they struggle to maintain silence (true story).
Either way, you can rest assured that you are the winner. Why? You are brave and refuse to let a possibly unpleasant ride deter you from your destination. To expect families to cease travel to accommodate the intolerant people in the world is unrealistic. Unfortunately, some people do not live in the same place as their grandchildren. Should they be deprived of visits from them because some people can't stand to hear a toddler get upset? Should families avoid vacations to spare others the high-pitch screeches of a toddler who refuses to wear a seat belt during take off? I think not.
The fact of the matter is, travel on commercial airlines is public transportation. You never know who you will end up sitting next to. To say toddlers should not be permitted to subject fellow passengers to their reign of terror would be the same thing as saying people who cannot take social cues and force others into unwanted conversation should not be permitted to purchase a ticket. From what I have seen, experienced travelers will put on noise cancelling headphones and go to their happy place when their hearing is assaulted by other passengers. Death glares tend to come from the asshats who paid $50 to upgrade to first class and think they are entitled to silence because of their monetary indulgence. Enjoy your free cocktails and marginal meal and try to keep your ridiculous expectations at bay. All you are managing to do with your judgmental comments and evil stares is look like a jerk.
I say, get on that plane! In fact, we even use miles to ride up front with the experienced travelers and asshats knowing that we are treading in dangerous waters simply because we need the extra room. If the sound of my angry and insolent toddler bothers you and you don't have ear plugs or headphones, sorry about your failure to travel intelligently. Have another drink on me. If you are that important, choose private transportation next time.
Finally, a special shout out to the kind travelers and flight attendants for all your sympathy and help. I will be forever grateful and will always pay it forward as my children grow older and become good travelers because I wasn't scared to let them learn how to behave.
*Note: Everyone should be intolerant of parents who make no attempt to soothe and subdue hysterical children. These people are also asshats and should not be permitted to travel. Unfortunately, the airlines have no way of screening for these people even though they are pretty much terrorists.
3. I would travel with my toddler, but I don't want to expose them to sickness.
People have looked at me like I am insane when I have mentioned that we have taken our boys to Mexico as infants and toddlers. Why do people think we are more likely to fall ill in other countries, particularly Mexico? Jackson has been to Mexico three times, starting at four months old. We took Carter when he was only five weeks old and not even vaccinated yet. Neither one got sick. At all.
I will tell you where my boys get sick:
4. I would travel with my toddler, but it will be too stressful.
Oh, for sure! If you go into a trip/vacation thinking it will include a toddler and be stress-free, you are a moron. (sorry - it's true)
Here's the deal. If you never get out of your comfort zone, you will never really appreciate how easy life is with the creature comforts of home.
First, the stress will start with packing. Once you have to pare your life down to what will fit in a suitcase or car, you will realize how much stuff you depend on to take care of your kid. Then, you have to get to your destination. Be it a plane or car, you will certainly encounter stressful situations that you have to deal with. Finally, few accommodations (hotel, condo, vacation home, etc.) will be as child-proof as your own home. The stress of keeping your curious and busy toddler safe and out of trouble will be exhausting. For example, maybe you have chosen an amazing vacation rental that has a water hazard on three out of the four levels of the home. In fact, one of the hazards may be a water fountain flush with the floor (you can literally step right in) right outside of your toddler's room. Just lock them in their room at night and call it a day (yes, true story).
All of that being said, until you experience these situations and get through them, you will never appreciate how easy you really have it in your comfortable little world at home. Also, this is a perfect chance to truly be a team with your husband/wife/partner. When you come together and deal with an excessive amount of vomit all over your toddler and in every nook and cranny of their car seat using only baby wipes on the side of a highway while being attacked by bees (again, true story), you can be confident that together you can deal with just about anything.
I can assure you, after a trip/vacation with your toddler, you will appreciate the space you have set up in the comfort of your own home. Suddenly, a day at home chasing your toddler around is not so bad.
These are just a few reasons you may think you should not travel with your toddler but why you really should. We just got back from ten days in Mexico and while it turns out ten days straight with your toddler is a bit much, (thank goodness for day care - another thing you can appreciate once you get home) the memories we made were certainly worth getting out of our routine, multiple plane rides, and the stress that comes with any travel. I would, and plan to do it again in a heartbeat. My hope is that my sons grow up to be great travelers as a result.
Memories from Sayulita 2015:
Family pic before boarding the long flight. Take off was awful for Jackson, but he was great for the rest of the flight. Colin wins Dad of the year for enduring that one.
Meanwhile, Carter was an angel.
Travel Suggestions: Wrap new toys, have plenty of snacks, and use iPad videos and games on your phone for toddler entertainment. Also, be prepared with more stuff for the flight home. Keep in mind you cannot find graham crackers or Tree Top Fruit Snacks during your stay in Mexico (so save some for the flight home!).
Chillin' in Casa Duende - vacation often looks like home
Nothing is better than watching your toddler relax and toddle around in their diaper. The gardens were beautiful at Casa Duende and a great place for exploring. Eventually I got over worrying about all the concrete stairs and drop offs!
Beach time!
Birthday breakfast at Choco Banana
Birthday girls on the beach!
Strict toddler diet = gone
Watching the parade at dinner.
Kid's area at Calypso - Mexico is actually very family-friendly!
Loving the humidity curls
Playground fun!
Golf cart afternoon adventure. Consider traveling with family and friends if you are lucky enough to have others who love your kids enough to travel with them. Extra hands and eyes are uber-helpful on vacation!
The travel bassinet is crucial for traveling with an infant.
Beach bums - this makes it all worth it!
Notice how non-childproof this place is - don't worry, everyone made it out unscathed!
Tons of concrete stairs - 4 level home
Jackson and MayMay in front of the infamous water hazard outside of Jackson's bedroom and Jackson enjoying the epic view on the one rainy day at home we had to endure.
Our boys love vacation!
Doughnut Doughnut - Jackson now pretends to sell doughnuts for pesos at home. Future beach vendor??
Napping at the same time!
Pretty little Sayulita
Jackson loves relaxing on vacation and even schedules his own naps - don't be afraid to let your toddler set their own routine!
Vacation selfies!
Loved the dipping pool - another water hazard we endured and survived!
A special moment and a gorgeous sunset - the epic view from this home was worth all the toddler hazards and travel stress.
"Is she seriously suggesting that one should travel with a toddler?" you ask.
Well, yes. I think you should at least consider it. Especially if you get a family vacation out of it. At the risk of sounding pretentious, my toddler has been on trips that required plane rides four times and he has been out of the country three times so far. We have also traveled significant distances by car several times and have lived to tell the tales.
Was it easy? Hell no.
Was it worth it? Absolutely!
While there are many (many many many) reasons NOT to travel with a toddler, I will attempt put a spin on some of these reasons (excuses) and at least get you thinking you may reconsider.
1. I would travel with my toddler, but it will get them out of their routine.
You are correct. Your toddler is going to be all jacked up. The hard-earned and consistent (lucky!) nap times and possibly even bed times will go right out the window. The strict diet you have imposed on your little for the benefit of their health will be long-forgotten (that is, unless you pack all your food supplies, in which case you should just stay home - you may be insane).
Here's the deal. Perhaps your toddler needs to get out of the routine that you have worked so hard for. Toddlers who are too dependent on routine will not handle change very well. Maybe a little change every once in a while will help them grow into a healthy, well-adjusted kid who can go with the flow. So what if they did not get a nap and get a little cranky in the evening? Use that opportunity to put them to bed a little early and do some adulting. Who cares if they stay up past their bed time because you are out of town and out of sorts? Let them have a little fun since they are going to be a disaster anyway. So your toddler had gelato again for dinner? Well, we all indulge a little on vacation.
Just know this, your little terrorist is going to go back to their routine again once you are back home. Sure, it may take some work and a few days but if you are doing things right, your trip was worth it.
2. I would travel with my toddler, but our destination requires a plane ride.
In my experience, there are two types of people on airplanes:
1) Empathetic/sympathetic (do you know the difference?) people who will give you looks of encouragement and even try to engage and distract your toddler from their inevitable meltdown.
2) *Intolerant people who will shoot you death glares if they even hear a peep from your family and may even threaten the life of you and/or your child if they struggle to maintain silence (true story).
Either way, you can rest assured that you are the winner. Why? You are brave and refuse to let a possibly unpleasant ride deter you from your destination. To expect families to cease travel to accommodate the intolerant people in the world is unrealistic. Unfortunately, some people do not live in the same place as their grandchildren. Should they be deprived of visits from them because some people can't stand to hear a toddler get upset? Should families avoid vacations to spare others the high-pitch screeches of a toddler who refuses to wear a seat belt during take off? I think not.
The fact of the matter is, travel on commercial airlines is public transportation. You never know who you will end up sitting next to. To say toddlers should not be permitted to subject fellow passengers to their reign of terror would be the same thing as saying people who cannot take social cues and force others into unwanted conversation should not be permitted to purchase a ticket. From what I have seen, experienced travelers will put on noise cancelling headphones and go to their happy place when their hearing is assaulted by other passengers. Death glares tend to come from the asshats who paid $50 to upgrade to first class and think they are entitled to silence because of their monetary indulgence. Enjoy your free cocktails and marginal meal and try to keep your ridiculous expectations at bay. All you are managing to do with your judgmental comments and evil stares is look like a jerk.
I say, get on that plane! In fact, we even use miles to ride up front with the experienced travelers and asshats knowing that we are treading in dangerous waters simply because we need the extra room. If the sound of my angry and insolent toddler bothers you and you don't have ear plugs or headphones, sorry about your failure to travel intelligently. Have another drink on me. If you are that important, choose private transportation next time.
Finally, a special shout out to the kind travelers and flight attendants for all your sympathy and help. I will be forever grateful and will always pay it forward as my children grow older and become good travelers because I wasn't scared to let them learn how to behave.
*Note: Everyone should be intolerant of parents who make no attempt to soothe and subdue hysterical children. These people are also asshats and should not be permitted to travel. Unfortunately, the airlines have no way of screening for these people even though they are pretty much terrorists.
3. I would travel with my toddler, but I don't want to expose them to sickness.
People have looked at me like I am insane when I have mentioned that we have taken our boys to Mexico as infants and toddlers. Why do people think we are more likely to fall ill in other countries, particularly Mexico? Jackson has been to Mexico three times, starting at four months old. We took Carter when he was only five weeks old and not even vaccinated yet. Neither one got sick. At all.
I will tell you where my boys get sick:
- Day care
- Local establishments where kids can play indoors (Bendites, you know where I am referring to - if you have been to either place I am talking about your kids have come home with the plague)
- Family gatherings with other kids
- Any place where they are around other kids
4. I would travel with my toddler, but it will be too stressful.
Oh, for sure! If you go into a trip/vacation thinking it will include a toddler and be stress-free, you are a moron. (sorry - it's true)
Here's the deal. If you never get out of your comfort zone, you will never really appreciate how easy life is with the creature comforts of home.
First, the stress will start with packing. Once you have to pare your life down to what will fit in a suitcase or car, you will realize how much stuff you depend on to take care of your kid. Then, you have to get to your destination. Be it a plane or car, you will certainly encounter stressful situations that you have to deal with. Finally, few accommodations (hotel, condo, vacation home, etc.) will be as child-proof as your own home. The stress of keeping your curious and busy toddler safe and out of trouble will be exhausting. For example, maybe you have chosen an amazing vacation rental that has a water hazard on three out of the four levels of the home. In fact, one of the hazards may be a water fountain flush with the floor (you can literally step right in) right outside of your toddler's room. Just lock them in their room at night and call it a day (yes, true story).
All of that being said, until you experience these situations and get through them, you will never appreciate how easy you really have it in your comfortable little world at home. Also, this is a perfect chance to truly be a team with your husband/wife/partner. When you come together and deal with an excessive amount of vomit all over your toddler and in every nook and cranny of their car seat using only baby wipes on the side of a highway while being attacked by bees (again, true story), you can be confident that together you can deal with just about anything.
I can assure you, after a trip/vacation with your toddler, you will appreciate the space you have set up in the comfort of your own home. Suddenly, a day at home chasing your toddler around is not so bad.
These are just a few reasons you may think you should not travel with your toddler but why you really should. We just got back from ten days in Mexico and while it turns out ten days straight with your toddler is a bit much, (thank goodness for day care - another thing you can appreciate once you get home) the memories we made were certainly worth getting out of our routine, multiple plane rides, and the stress that comes with any travel. I would, and plan to do it again in a heartbeat. My hope is that my sons grow up to be great travelers as a result.
Memories from Sayulita 2015:
Family pic before boarding the long flight. Take off was awful for Jackson, but he was great for the rest of the flight. Colin wins Dad of the year for enduring that one.
Meanwhile, Carter was an angel.
Travel Suggestions: Wrap new toys, have plenty of snacks, and use iPad videos and games on your phone for toddler entertainment. Also, be prepared with more stuff for the flight home. Keep in mind you cannot find graham crackers or Tree Top Fruit Snacks during your stay in Mexico (so save some for the flight home!).
Chillin' in Casa Duende - vacation often looks like home
Nothing is better than watching your toddler relax and toddle around in their diaper. The gardens were beautiful at Casa Duende and a great place for exploring. Eventually I got over worrying about all the concrete stairs and drop offs!
Beach time!
Birthday breakfast at Choco Banana
Birthday girls on the beach!
Strict toddler diet = gone
Watching the parade at dinner.
Kid's area at Calypso - Mexico is actually very family-friendly!
Loving the humidity curls
Playground fun!
Golf cart afternoon adventure. Consider traveling with family and friends if you are lucky enough to have others who love your kids enough to travel with them. Extra hands and eyes are uber-helpful on vacation!
The travel bassinet is crucial for traveling with an infant.
Beach bums - this makes it all worth it!
Notice how non-childproof this place is - don't worry, everyone made it out unscathed!
Tons of concrete stairs - 4 level home
Our boys love vacation!
Doughnut Doughnut - Jackson now pretends to sell doughnuts for pesos at home. Future beach vendor??
Napping at the same time!
Pretty little Sayulita
Jackson loves relaxing on vacation and even schedules his own naps - don't be afraid to let your toddler set their own routine!
Vacation selfies!
Loved the dipping pool - another water hazard we endured and survived!
Tuesday, November 24, 2015
One Plus One Equals Five
No, this is not a post about a tricky Common Core math problem.
To be fair, I was warned.
When Colin decided he was open to giving Jackson a sibling, he said since we have most of the baby gear we need and we kind of know what we are doing it should only be about 50% more work. "Totally!" was my response despite the fact I have plenty of friends with more than one kid and I knew better. I just didn't want to discourage the idea of having another kid.
I don't think the 2+ years difference in age is a mistake. Sure, Jackson can't really be reasoned with at this point. That is developmental and not his fault. I mean, it really isn't even his fault that he melts down after you put milk in his cereal even though he specifically requested milk. Just FYI: He knows what you are up to when you try to just pour the milk into the sink and give him the soggy remnants.
In my humble opinion, waiting another year to have another baby was not the answer. From my understanding, three is challenging as well. So what is the answer?
We expected a regression, but holy cow!
In his defense, Jackson was traumatized twice in the past three weeks. First, we left him for four days while we were in the hospital having Carter. Then, he was left again when Carter was admitted to the NICU and daddy left for a work trip. There was nothing we could do to prevent any of this, but we sure are paying the price now.
As you can probably imagine, separation anxiety has reared its ugly head. Our independent and flexible little guy is now a stage five clinger. He also has very little tolerance for baby Carter taking up mommy's time (and lap).
That being said, Jackson is trying so hard to be a good brother and mommy's helper. Poor Carter is already so tough. He can withstand a pacifier being forced into his mouth, kicks to his head and body, and even a little bit of smothering. Jackson just wants to engage with his brother. In the meantime, I am realizing the wild two year old boy behavior that used to be tolerable and understandable is now a major source of mommy stress.
It is super important for me to keep in mind that along with the clingy and wild behavior, Jackson is also such a sweetheart. For every behavior that makes me want to pull my hair out, he turns around and melts my heart. He is growing up so fast and I don't want to miss it because I am so wrapped up with trying to keep Carter alive and well in his presence.
I feel complete now that Carter is here. Having both of my sons by my side is the best feeling in the world. My heart feels like it is going to explode when Jackson holds his brother. It is the sweetest thing in the world to witness the blossoming love between siblings. I can't imagine Jackson as an only child and I don't regret a thing despite how hard these past few weeks have been.
All I can hope for is infinite patience and the ability to give my little boy some grace during this transition. Now, if only he would voluntarily go to bed at night and spare us the epic meltdowns. Some decent sleep would do us all some good.
Adding another person to the family does not double the work. It feels like way more than that right now. I am not a math teacher, so hopefully I am calculating this wrong. Perhaps time changes the equation.
To be fair, I was warned.
When Colin decided he was open to giving Jackson a sibling, he said since we have most of the baby gear we need and we kind of know what we are doing it should only be about 50% more work. "Totally!" was my response despite the fact I have plenty of friends with more than one kid and I knew better. I just didn't want to discourage the idea of having another kid.
I don't think the 2+ years difference in age is a mistake. Sure, Jackson can't really be reasoned with at this point. That is developmental and not his fault. I mean, it really isn't even his fault that he melts down after you put milk in his cereal even though he specifically requested milk. Just FYI: He knows what you are up to when you try to just pour the milk into the sink and give him the soggy remnants.
In my humble opinion, waiting another year to have another baby was not the answer. From my understanding, three is challenging as well. So what is the answer?
We expected a regression, but holy cow!
In his defense, Jackson was traumatized twice in the past three weeks. First, we left him for four days while we were in the hospital having Carter. Then, he was left again when Carter was admitted to the NICU and daddy left for a work trip. There was nothing we could do to prevent any of this, but we sure are paying the price now.
As you can probably imagine, separation anxiety has reared its ugly head. Our independent and flexible little guy is now a stage five clinger. He also has very little tolerance for baby Carter taking up mommy's time (and lap).
That being said, Jackson is trying so hard to be a good brother and mommy's helper. Poor Carter is already so tough. He can withstand a pacifier being forced into his mouth, kicks to his head and body, and even a little bit of smothering. Jackson just wants to engage with his brother. In the meantime, I am realizing the wild two year old boy behavior that used to be tolerable and understandable is now a major source of mommy stress.
It is super important for me to keep in mind that along with the clingy and wild behavior, Jackson is also such a sweetheart. For every behavior that makes me want to pull my hair out, he turns around and melts my heart. He is growing up so fast and I don't want to miss it because I am so wrapped up with trying to keep Carter alive and well in his presence.
I feel complete now that Carter is here. Having both of my sons by my side is the best feeling in the world. My heart feels like it is going to explode when Jackson holds his brother. It is the sweetest thing in the world to witness the blossoming love between siblings. I can't imagine Jackson as an only child and I don't regret a thing despite how hard these past few weeks have been.
All I can hope for is infinite patience and the ability to give my little boy some grace during this transition. Now, if only he would voluntarily go to bed at night and spare us the epic meltdowns. Some decent sleep would do us all some good.
Adding another person to the family does not double the work. It feels like way more than that right now. I am not a math teacher, so hopefully I am calculating this wrong. Perhaps time changes the equation.
Tuesday, November 17, 2015
Sometimes the answer is there is no answer.
This morning I was awoken by an angel.
I don't mean this one, although he is quite a little cherub:
Her name is Dr. Smith, and she is a neonatologist here in the St. Charles NICU.
She pulled up a chair next to me, introduced herself, and explained that she has very reassuring information to share with me in spite of the disappointing lab result we received. Carter's hemocrit (red blood cell count) level had continued to go down and we were now at 23, meaning we have reached transfusion territory.
Dr. Smith explained that in her 20 years at Dornbecher (the children's hospital in Portland where she practiced before coming to St. Charles), she has seen about ten other cases that look exactly like Carter's. Although there is no medical explanation for it and you won't read about it in any textbooks yet, other babies have also lysed their red blood cells at high enough rates that it caused a late bilirubin spike. The good news is, although there is no technical diagnosis, these babies have gone on to live normal, healthy lives with no issues.
At this point, we have ruled out everything scary. The rare G6PD liver enzyme deficiency that was suspected to be the culprit came back from the lab negative. After days of testing and monitoring, it looks like we have a freak, transient condition that is going to go away and leave us with a healthy baby.
I suppose the big question is: We have had access to Dr. Smith this whole time even though she was not the attending physician until today - why did we not have this information until now?
Trust me, I asked. The fact of the matter is, Carter's story had to play out so everyone could see the big picture. There were a lot of possible reasons why this is happening, so it has been medically imperative to rule out all of the more common causes before we could land here. In the end, it is a good thing is that we landed in the most benign place possible. I will take a transient condition that will stay in my rear view mirror as I drive away from the NICU (hopefully tomorrow).
As I sit here and write, Carter is having a blood transfusion. It sounds scary, but it is a simple procedure where he has to lie in his bed for four hours while red blood cells are pumped into his body via an IV. It is quite peaceful so long as we can hold him off that long without eating. His bilirubin finally fell off the plateau and went down another point, so we are on the downward slope. The hope is that the transfusion will "top off the tank" and give him the red blood cells needed to get his levels normal again. As a result, we expect to see his oxygen saturation levels to stabilize because he will have more hemoglobin in this blood for it to bind to. If all goes well, we get to go home soon and be a family again.
For now, I guess I will continue to binge-watch Mad Men on Netflix and read way to many parenting articles on Scary Mommy. I can't wait to get out of this recliner and into my Tempurpedic bed. My chiropractor is going to directly benefit from this experience.
Our brave little guy receiving extra gas for his tank:
The makeshift IV boot ensuring we only have to do this once. The blood cells are being pumped in from the tube at the top. Notice his battle wounds from all the heel pokes - they are all over his heels. Poor baby!
I don't mean this one, although he is quite a little cherub:
Her name is Dr. Smith, and she is a neonatologist here in the St. Charles NICU.
She pulled up a chair next to me, introduced herself, and explained that she has very reassuring information to share with me in spite of the disappointing lab result we received. Carter's hemocrit (red blood cell count) level had continued to go down and we were now at 23, meaning we have reached transfusion territory.
Dr. Smith explained that in her 20 years at Dornbecher (the children's hospital in Portland where she practiced before coming to St. Charles), she has seen about ten other cases that look exactly like Carter's. Although there is no medical explanation for it and you won't read about it in any textbooks yet, other babies have also lysed their red blood cells at high enough rates that it caused a late bilirubin spike. The good news is, although there is no technical diagnosis, these babies have gone on to live normal, healthy lives with no issues.
At this point, we have ruled out everything scary. The rare G6PD liver enzyme deficiency that was suspected to be the culprit came back from the lab negative. After days of testing and monitoring, it looks like we have a freak, transient condition that is going to go away and leave us with a healthy baby.
I suppose the big question is: We have had access to Dr. Smith this whole time even though she was not the attending physician until today - why did we not have this information until now?
Trust me, I asked. The fact of the matter is, Carter's story had to play out so everyone could see the big picture. There were a lot of possible reasons why this is happening, so it has been medically imperative to rule out all of the more common causes before we could land here. In the end, it is a good thing is that we landed in the most benign place possible. I will take a transient condition that will stay in my rear view mirror as I drive away from the NICU (hopefully tomorrow).
As I sit here and write, Carter is having a blood transfusion. It sounds scary, but it is a simple procedure where he has to lie in his bed for four hours while red blood cells are pumped into his body via an IV. It is quite peaceful so long as we can hold him off that long without eating. His bilirubin finally fell off the plateau and went down another point, so we are on the downward slope. The hope is that the transfusion will "top off the tank" and give him the red blood cells needed to get his levels normal again. As a result, we expect to see his oxygen saturation levels to stabilize because he will have more hemoglobin in this blood for it to bind to. If all goes well, we get to go home soon and be a family again.
For now, I guess I will continue to binge-watch Mad Men on Netflix and read way to many parenting articles on Scary Mommy. I can't wait to get out of this recliner and into my Tempurpedic bed. My chiropractor is going to directly benefit from this experience.
Our brave little guy receiving extra gas for his tank:
The makeshift IV boot ensuring we only have to do this once. The blood cells are being pumped in from the tube at the top. Notice his battle wounds from all the heel pokes - they are all over his heels. Poor baby!
Monday, November 16, 2015
Perspective
Although cliche, find these phrases helpful and meaningful right now:
- What doesn't kill you makes you stronger.
- Life is 5% what happens to you and 95% how you react to it.
- Every cloud has a silver lining.
- Its always darkest before the dawn.
- When the going gets tough, the tough gets going.
As I sit in the NICU with Carter, I am blessed with time to reflect and process this situation. As I rub my bleary, tired eyes and look at my beautiful baby boy, I realize that we have so much to be thankful for. The ability to do this really has nothing to do with being a strong person; it simply comes from putting things into perspective.
There are many definitions for perspective. In this situation, it means "a particular attitude toward or way of regarding something; a point of view".
For example: as I sit in the NICU with a relatively healthy, full-term baby boy, hundreds of people in Paris are dealing with losing a loved one at the hands of terrorists. Putting my family's situation in perspective, we actually have it pretty good right now.
It would be easy to spiral into a dark pit of despair and wallow in self-pity right now, but what good would that do? I think most people would excuse my selfishness and even give me a free postpartum depression pass. Don't get me wrong, I have my moments. This is just a short list of emotions and thoughts I have experienced over the past four days:
- Indignation - "This is not fair - haven't I put in my time here already?"
- Anger - "We made it to term and even ten days at home - this is B.S.!"
- Sadness - "My poor baby boys - one is constantly being poked and prodded and left alone by mommy and the other is being neglected by mommy because she is never home anymore."
- Coping sarcasm - "Cool, another reason to stay here another day. Any more tests we can perform to keep me here longer? I am getting the sleep of my life in this recliner."
- Anxiety - "I will keep you updated as I sit here and wait for another round of test results."
- Carter was full term - I did not get sick so I am capable of taking care of my boys. Also, the fact that he is a fully-cooked kid is helping us get out of the NICU so much faster.
- I got this - I can function in a NICU room standing on my head. Been here, done this.
- Support - We have amazing family and friends that are supporting us in a variety of ways. A special shout out to the grandparents who are taking care of Jackson in our absence. It really does take a village.
- NICU Staff - Colin and I once again stand in awe of the NICU nurses and doctors who are taking care of our son. So many people here recognize our family and have made us feel at home (reluctantly - no one wants anyone to be here) all over again. I find myself surrounded by personal cheerleaders, counselors, confidants, and friends all disguised cleverly as nurses and doctors.
- Carter's Overall Health - Yes, we are in the NICU. Yes, Carter is enduring many pokes, prods, and other uncomfortable tests. Yes, my heart breaks for my son multiple times a day as he cries through more pain. However, having all of these tests done confirms that other than the bilirubin issue, he is a healthy boy and we have no reason to worry once we get past this little bump in the road.
- Carter - This kid is tough. There is a part of me that believes that he is out to prove he can endure the NICU just like his brother did. Sure, he cries a little when he is poked. Otherwise, he is a mellow, sweet little guy and everyone here loves him. No one wants him to leave (it is fun for the nurses to have a well-done baby to play with - he can withstand contact and interaction that preemies cannot) but everyone wants him to go home and be with his family.
In other news, I realized today that I have way too much time on my hands when I found myself watching this video:
Saturday, November 14, 2015
NICU Part Deux
According to the Urban Dictionary, part deux is "a superficial, unnecessary, or overly bad sequel to a classic film".
This seems fitting for how I feel about blogging from the St. Charles NICU, again.
We thought we were in the clear. Carter had a tan that we knew was not a genetic blessing and it had a certain yellowish hue. However, he was checked twice during his first week of life and the numbers said he was fine and did not qualify for photo therapy.
Fast forward to Carter's tenth day of life. He was scheduled for his circumcision so it was already not going to be his greatest day ever. The nurse and his pediatrician agreed that he looked pretty yellow so we decided since he was getting messed with anyway we might as well go for another heel poke. He was an angel; he slept through the circumcision and did not make a peep until they poked his heel. The pediatrician said she has never sent an almost two week old baby back to the hospital to go under the lights so it was clearly just a preventative procedure.
Um, yea, not so much.
Four hours later I got a call from the doctor. She felt so bad because she had big news. Dr. Azimi and his nurses in the NICU had a bed prepared for Carter and we needed to go immediately. His bilirubin level was dangerously high and it was imperative to get him there ASAP to mitigate any further damage done.
As I drove Carter back to St. Charles, I did my best to keep my cool. Of course, I hit every light and got stuck behind every speed limit law abiding citizen on the road. Colin called as I was on my way (he was waiting for our personal life savers - aka: the Grandparents - to get to our house to stay with Jackson) and told me to leave my car right out front and he would take care of it. I pulled up and happily obliged and that is when the waterworks started.
Terrified of the neurological damage that can result from high amounts of bilirubin in a newborn's blood, I did my best to contain my tears as I realized I was living the nightmare again. Doing my best to answer questions and provide updated medical information, I struggled to not completely melt down. The idea of brain damage is enough to send any parent over the edge, so in hindsight I must cut myself some slack for not being more stoic in the moment.
Carter's bilirubin was 26 in the office during the afternoon. Another heel poke in the NICU showed 25.4, which confirmed that we were in the danger zone. Dr. Azimi had explained to us while we were waiting for the lab to confirm this number that we may have a tough decision to make. The reason we were in the NICU rather than the PICU is at a level of 25 or higher, a blood transfusion is protocol and only the NICU can do this on a newborn. There is a 5-10% chance of serious complications, so it would not be an easy decision for us to make.
Fortunately, at 25.4, we were just on the cusp of the danger zone and Carter was showing no signs of neurological damage. In fact, the NICU staff was very surprised at his vitals and responses considering the story the labs were telling. What we were looking at was an apparently healthy, yellow baby. When it came down to the decision to transfuse or not, Dr. Azimi told me he would not go into "if this were my kid I would...", which was nonsense. He was just recognized with a national NICU heros award and I wanted to know exactly what he would do if this were his kid. He said after conferring with a colleague, his recommendation would be to treat with photo therapy rather than risk a transfusion.
Done and done. Time to get in the tanning bed kiddo.
This may be a good time to mention the fact that Carter is following in Jackson's footsteps in one specific way. It is NICU protocol to monitor heart rate, breathing rate, and blood oxygen levels. Carter has been desating (blood oxygen dropping) during deep sleep and has been wearing a nasal cannula with the same slightest whiff of oxygen that Jackson had for weeks upon weeks. It is the tiniest amount of oxygen (we breathe 21%, he is getting 22%) but he can't keep his levels up while sleeping without it. Despite the fact this is too much information (many newborns are doing this at home without the parents knowing) and we are completely micromanaging him, it is not acceptable in the NICU world and should not be happening for no good reason.
Almost two days later, it feels like Carter has endured every test imaginable. Tons of blood has been drawn to rule out metabolic disorders, enzyme disorders and deficiencies, respiratory panels, (Jackson has been fighting a cold and in an effort to be a good big brother has likely shared some germs), and a total of three bilirubin checks so far. He has also had an echo cardiogram and lung x-rays for good measure. Everything has been coming back clear, normal, and healthy, which is awesome but makes you wonder what in the hell are we doing here again.
Dr. Azimi had a conversation with my mom yesterday and things may finally began making some sense. He had asked me every question you could think of, except if we had any family history of jaundice upon birth. In a caffeine-induced moment of clarity earlier that day it dawned on me that we have had jaundice upon birth on both sides of Carter's family. In addition to my week under the lights, my brother, mother, Colin, and Colin's nephew were all jaundiced when they were born. The doctor was most interested in my family and now suspects that this is a genetic thing - we are born with immature livers that need some extra time to process bilirubin.
Finally, a test came back early this morning showing something that is not normal. Carter is anemic today. His red blood cell count has gone down during his stay, which indicates that his red blood cells may be fragile and bursting more than normal. A blood sample was sent to Salt Lake City yesterday to screen him for a rare enzyme deficiency that may or may not be the root cause of all this drama. We will not get those results back for another four to five days and the implications of a positive result (other than an explanation/diagnosis) would be very minor and not really even treatable. In the case that this is his diagnosis, there is a chance that he would become slightly anemic when he gets sick in the future. For example, if Carter develops an upper respiratory infection we will have to keep an eye on him to make sure he is well-hydrated and perhaps give him some iron supplements to help him through the illness until his body fights it off. All things considered, easy peasy lemon squeezy.
So here I sit, two days later. Carter's bilirubin level has dropped 13 points (from 26 to 13) and we are so close to getting him out from under those lights. We will do another heel poke this evening to see if we are in the "no treatment necessary zone" again (12 or less) so we can start weaning him off the lights. Today he has gone from five lights to three, so we have already started the process. Next, we will have to make sure he does not rebound for a minimum of 12 hours after he is completely off the lights. Also, he had more blood drawn this morning as well as a sterile urine sample drawn from a catheter (poor guy!) to test for an unlikely case of a urinary tract infection, which can cause jaundice. Just another thing to rule out. Waiting for those results means we are here until at least Monday. Finally, why the hell won't this kid breathe when he is sleeping?! He has to stop desating or else we go home on oxygen.
I would love to tell you that once we realized a transfusion was not necessary and that no apparent damage has been done I became the pillar of strength that Carter needs. However, that is not really the case. There have been lots of tears and my mindset and emotions have been all over the board. Although we have so much to be grateful for and we know from our past and far more traumatic experience with Jackson that this will just be a blip on the radar, I have struggled this time around. How did I end up back on the NICU roller coaster again?
The bottom line is, I am not worried about Carter. He is apparently on a mission to prove that Jackson is not the only one who can tough out the NICU. I have watched this amazing little person endure so much these past few days and he is such a trooper. I am so proud and in awe of our handsome, full-term little guy. What I have worried most about is Jackson's well-being. I can't see him and leave him without crying and apologizing over and over for not being there for him these past weeks after having Carter. Now I have been ripped away again as I sit here all day waiting to nurse Carter and sleep in this hospital every night.
Come to find out, the person I should worry about the most is me. My lovely mother-in-law pointed out that I have two sons who have different needs right now, which can be hard on a mother. I pumped a bottle for Carter and went home this morning to spend time with Jackson. Colin left early for a work trip (which we decided as a family was the right decision) so Jackson is at home Gramma and Papaw. Although he was ecstatic to see me and sweeter to be around than ever, he was apparently not even bothered when I had to say goodbye again.
I don't know if it was the hot shower, fresh clothes, familiar smell of home, or the time I spent with my precious little boy, but now I know that this too shall pass and we will come out on the other side a stronger family, again. The postpartum element pretty much ensures I will still cry a little, but hopefully there will be more tears of joy and relief rather than sadness and frustration.
Like the story about the little engine that could that Jackson has made me read so many times, I think I can...I think I can...I think I can...I think I can.
Top: Jackson's tiny foot under the lights in the NICU; below: full-term Carter under the lights
Spending time with J today (the lack of a shirt is a long, typical story!):
Jackson was in the room just next door to us just two short years ago. It is amazing how many nurses here remember us, and of course we remember them!
We just want to go home and get back to this:
This seems fitting for how I feel about blogging from the St. Charles NICU, again.
We thought we were in the clear. Carter had a tan that we knew was not a genetic blessing and it had a certain yellowish hue. However, he was checked twice during his first week of life and the numbers said he was fine and did not qualify for photo therapy.
Fast forward to Carter's tenth day of life. He was scheduled for his circumcision so it was already not going to be his greatest day ever. The nurse and his pediatrician agreed that he looked pretty yellow so we decided since he was getting messed with anyway we might as well go for another heel poke. He was an angel; he slept through the circumcision and did not make a peep until they poked his heel. The pediatrician said she has never sent an almost two week old baby back to the hospital to go under the lights so it was clearly just a preventative procedure.
Um, yea, not so much.
Four hours later I got a call from the doctor. She felt so bad because she had big news. Dr. Azimi and his nurses in the NICU had a bed prepared for Carter and we needed to go immediately. His bilirubin level was dangerously high and it was imperative to get him there ASAP to mitigate any further damage done.
As I drove Carter back to St. Charles, I did my best to keep my cool. Of course, I hit every light and got stuck behind every speed limit law abiding citizen on the road. Colin called as I was on my way (he was waiting for our personal life savers - aka: the Grandparents - to get to our house to stay with Jackson) and told me to leave my car right out front and he would take care of it. I pulled up and happily obliged and that is when the waterworks started.
Terrified of the neurological damage that can result from high amounts of bilirubin in a newborn's blood, I did my best to contain my tears as I realized I was living the nightmare again. Doing my best to answer questions and provide updated medical information, I struggled to not completely melt down. The idea of brain damage is enough to send any parent over the edge, so in hindsight I must cut myself some slack for not being more stoic in the moment.
Carter's bilirubin was 26 in the office during the afternoon. Another heel poke in the NICU showed 25.4, which confirmed that we were in the danger zone. Dr. Azimi had explained to us while we were waiting for the lab to confirm this number that we may have a tough decision to make. The reason we were in the NICU rather than the PICU is at a level of 25 or higher, a blood transfusion is protocol and only the NICU can do this on a newborn. There is a 5-10% chance of serious complications, so it would not be an easy decision for us to make.
Fortunately, at 25.4, we were just on the cusp of the danger zone and Carter was showing no signs of neurological damage. In fact, the NICU staff was very surprised at his vitals and responses considering the story the labs were telling. What we were looking at was an apparently healthy, yellow baby. When it came down to the decision to transfuse or not, Dr. Azimi told me he would not go into "if this were my kid I would...", which was nonsense. He was just recognized with a national NICU heros award and I wanted to know exactly what he would do if this were his kid. He said after conferring with a colleague, his recommendation would be to treat with photo therapy rather than risk a transfusion.
Done and done. Time to get in the tanning bed kiddo.
This may be a good time to mention the fact that Carter is following in Jackson's footsteps in one specific way. It is NICU protocol to monitor heart rate, breathing rate, and blood oxygen levels. Carter has been desating (blood oxygen dropping) during deep sleep and has been wearing a nasal cannula with the same slightest whiff of oxygen that Jackson had for weeks upon weeks. It is the tiniest amount of oxygen (we breathe 21%, he is getting 22%) but he can't keep his levels up while sleeping without it. Despite the fact this is too much information (many newborns are doing this at home without the parents knowing) and we are completely micromanaging him, it is not acceptable in the NICU world and should not be happening for no good reason.
Almost two days later, it feels like Carter has endured every test imaginable. Tons of blood has been drawn to rule out metabolic disorders, enzyme disorders and deficiencies, respiratory panels, (Jackson has been fighting a cold and in an effort to be a good big brother has likely shared some germs), and a total of three bilirubin checks so far. He has also had an echo cardiogram and lung x-rays for good measure. Everything has been coming back clear, normal, and healthy, which is awesome but makes you wonder what in the hell are we doing here again.
Dr. Azimi had a conversation with my mom yesterday and things may finally began making some sense. He had asked me every question you could think of, except if we had any family history of jaundice upon birth. In a caffeine-induced moment of clarity earlier that day it dawned on me that we have had jaundice upon birth on both sides of Carter's family. In addition to my week under the lights, my brother, mother, Colin, and Colin's nephew were all jaundiced when they were born. The doctor was most interested in my family and now suspects that this is a genetic thing - we are born with immature livers that need some extra time to process bilirubin.
Finally, a test came back early this morning showing something that is not normal. Carter is anemic today. His red blood cell count has gone down during his stay, which indicates that his red blood cells may be fragile and bursting more than normal. A blood sample was sent to Salt Lake City yesterday to screen him for a rare enzyme deficiency that may or may not be the root cause of all this drama. We will not get those results back for another four to five days and the implications of a positive result (other than an explanation/diagnosis) would be very minor and not really even treatable. In the case that this is his diagnosis, there is a chance that he would become slightly anemic when he gets sick in the future. For example, if Carter develops an upper respiratory infection we will have to keep an eye on him to make sure he is well-hydrated and perhaps give him some iron supplements to help him through the illness until his body fights it off. All things considered, easy peasy lemon squeezy.
So here I sit, two days later. Carter's bilirubin level has dropped 13 points (from 26 to 13) and we are so close to getting him out from under those lights. We will do another heel poke this evening to see if we are in the "no treatment necessary zone" again (12 or less) so we can start weaning him off the lights. Today he has gone from five lights to three, so we have already started the process. Next, we will have to make sure he does not rebound for a minimum of 12 hours after he is completely off the lights. Also, he had more blood drawn this morning as well as a sterile urine sample drawn from a catheter (poor guy!) to test for an unlikely case of a urinary tract infection, which can cause jaundice. Just another thing to rule out. Waiting for those results means we are here until at least Monday. Finally, why the hell won't this kid breathe when he is sleeping?! He has to stop desating or else we go home on oxygen.
I would love to tell you that once we realized a transfusion was not necessary and that no apparent damage has been done I became the pillar of strength that Carter needs. However, that is not really the case. There have been lots of tears and my mindset and emotions have been all over the board. Although we have so much to be grateful for and we know from our past and far more traumatic experience with Jackson that this will just be a blip on the radar, I have struggled this time around. How did I end up back on the NICU roller coaster again?
The bottom line is, I am not worried about Carter. He is apparently on a mission to prove that Jackson is not the only one who can tough out the NICU. I have watched this amazing little person endure so much these past few days and he is such a trooper. I am so proud and in awe of our handsome, full-term little guy. What I have worried most about is Jackson's well-being. I can't see him and leave him without crying and apologizing over and over for not being there for him these past weeks after having Carter. Now I have been ripped away again as I sit here all day waiting to nurse Carter and sleep in this hospital every night.
Come to find out, the person I should worry about the most is me. My lovely mother-in-law pointed out that I have two sons who have different needs right now, which can be hard on a mother. I pumped a bottle for Carter and went home this morning to spend time with Jackson. Colin left early for a work trip (which we decided as a family was the right decision) so Jackson is at home Gramma and Papaw. Although he was ecstatic to see me and sweeter to be around than ever, he was apparently not even bothered when I had to say goodbye again.
I don't know if it was the hot shower, fresh clothes, familiar smell of home, or the time I spent with my precious little boy, but now I know that this too shall pass and we will come out on the other side a stronger family, again. The postpartum element pretty much ensures I will still cry a little, but hopefully there will be more tears of joy and relief rather than sadness and frustration.
Like the story about the little engine that could that Jackson has made me read so many times, I think I can...I think I can...I think I can...I think I can.
Spending time with J today (the lack of a shirt is a long, typical story!):
Jackson was in the room just next door to us just two short years ago. It is amazing how many nurses here remember us, and of course we remember them!
We just want to go home and get back to this:
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