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Thursday, October 8, 2015

Ward: The First Week

Well, I have blinked and my littlest man is almost one month old.  How is that even possible?!  I say it with every child, but I honestly cannot fathom how almost a month has already passed.  Time, please slow down!  

The week that we brought our sweet baby boy home from the hospital was an eventful one, to say the least.  We were discharged from Rex on Sunday afternoon, and I was so, so happy to be home and be with all of my babies under the same roof!  While I used my hospital stay to stock up on rest, I really missed my older two.


Naked eating is totally normal, right?

One of the grandmothers sent this to me - I can't remember where they were going but I thought the photo was hilarious!
Ward had a doctor appointment first thing Tuesday morning, and it came at a perfect time because I wanted to talk about his coloring - he looked a little yellow to me, and although I am no medical expert, I was concerned.  Lilly was a little jaundiced right after she was born - enough that they re-checked her bilirubin levels before they would discharge us, but she ended up being absolutely fine - and Craft never had any issues.  Ward looked a little yellow in the hospital, but they re-checked his levels and determined that he was fine and we were good to go home.  By Monday, however, when we'd been home for a day, the yellow coloring looked worse to me.  


On our way to the doctor on Tuesday, 9/15
When I discussed it with the pediatrician, she did not seem concerned at all.  She checked his records from the hospital and agreed that his levels had been fine when he was discharged.  He was eating really well and looked great.  She said that a little yellowing is normal in babies, especially those with olive coloring like Ward's, and she didn't think there was cause for concern.  I need to state for the record here that I trust our doctors implicitly.  I have not seen a single doctor at our practice that I dislike; they are all wonderful.  With that said, though, something about this just didn't feel right.  I explained to the doctor that the reason I was concerned about Ward's coloring was two-fold: First, when we came home from the hospital it was just his face that looked yellow in color, but over the course of the next day and a half it spread all the way down his body into his legs and feet.  Second, and this one turned out to be the kicker - Ward was a meconium MACHINE when we were in the hospital.  From midnight to 12pm on the day we were discharged, homeboy had 6 or 6 meconium poops. After we were discharged and got home, he had plenty of wet diapers, but no more poops.  

SO, taking all of that into consideration, the pediatrician decided that we should check his levels just to be safe and make everyone feel better.  She got out this hard-to-understand chart and explained that a normal bilirubin level for a baby of Ward's size and age was 12ish.  She said that she expected to hear that his levels were 13 or maybe 14, because other than the coloring he truly was perfect, and that if anything we MAY consider getting a blanket shipped to our house for some at-home therapy, but she didn't anticipate anything worse than that.  Off we went to Rex for my poor buddy to have some blood drawn.  

Fast forward a couple of hours.  Dan called me and said he had Dr. B on the line.  Yet again at a very important time, my phone had chosen not to ring.  Ugh!  Anyway, Dan conferenced me in and Dr. B very calmly said, "Okay I don't want you guys to panic, but I need you to pack a bag and get to the hospital as soon as you possibly can."  Talk about conflicting (and panic-inducing) statements.  Apparently, Ward's biliruben levels were much higher than anyone anticipated - almost 20!  I am so, so thankful that I trusted my instincts on this matter.  I know that with Lilly and even with Craft I would not have been confident enough to question not re-checking levels.

I had done some googling while I was waiting to hear from the doctor and so I knew that jaundice and baby's bilirubin levels can affect liver function.  What I did not read and was told later is that if the bilirubin gets to a certain level (I think they told me 21 or 22 and up, maybe?), they start to worry about other effects like brain function.  Thank the Lord I didn't know that at the time of our conversation with the pediatrician, or I might have had a breakdown.  He told us that we should anticipate to have to stay 2-3 nights.  I flew upstairs and for the second time in two weeks I packed a bag that I to this day have NO IDEA what was inside.  I was thankful when I arrived at the hospital to discover that I'd thought to put my yoga pants and a pair of slippers in there, and that I'd remembered my nursing pillow and an iPad.  Little buddy was admitted to WakeMed around 48 hours after we were discharged from Rex for some baby suntan therapy.


Not sure how it's possible that he still managed to look cute under those lights?!?!?!

The calm before the storm...he was relaxed before he was "over it" with the lights!
To make a long story short, Ward rocked it and we only ended up having to stay one night.  Thank the LORD, because it was torture on both of us!  He didn't seem to mind being under the lights for the first little bit, but after a couple of hours the poor guy had had enough.  I think he was hot and sweaty and just generally uncomfortable with all of the machines.  They were having me nurse him every 1.5-2 hours to try to get him pooping again in order to help get the extra bilirubin out of his system, and about the time I'd get him settled down and back on the machine the nurses would be back in to poke at him and take his temperature or stick his foot to draw blood.  It was pitiful, and we both got far less sleep in the hospital than we were getting at home - which made me extra thankful that our stay was short-lived.

I have to give my mother-in-law a shout-out here, because she was so helpful during this whole process.  She made plans to stay with us the first week that we were back at home, which ended up being a huge blessing because she was able to be with our older two when we had to rush back to the hospital.  Lillian and Craft (Craft especially) were VERY confused when they woke up from their naps and I was gone again after just getting back home, and that was eating at me just as much as my worry about Ward, so it was nice that Susan was able to be here with us and help.  Dan stayed with Ward and I at the hospital for a little while, but at the end of the day there was really nothing he could do to help since I'm the milk machine, and it was much more important to us to try to keep things as normal as possible at home, so he came home to be with the older two while Ward and I were at the baby tanning spa.  I was ecstatic when we were finally able to return home and I once again had all of my babies under one roof, hopefully for good this time!







Lills and Craft were ALMOST as excited to see mama as they were to see their baby brother...almost.
We went back to the doctor on Thursday morning, and they confirmed that Ward was indeed a rockstar.  His bilirubin levels had rebounded a little, but they assured me that this is totally normal.  The doctors said that it would take several weeks for it to get out of his system entirely, so not to be alarmed if he still looked a little yellow.  To further make us feel better, the doctor made us a chart of his levels from his birth through day #5 to demonstrate his huge improvement from our one-night hospital stay:

9/15/15 @ 1:28pm 19.8 
9/15/15 @ 6:33pm 18.8 
9/16/15 @ 12:10 am 17.8
9/16/15 @ 6:38 am 13.8 
9/17/15 @ 9:42 am 14.6

Apparently the bilirubin rebound is safe if it is rising <0.2mg/dL/hour, and in the previous 27 hours Ward's was 0.8 mg up total or 0.03mg/dL/hour, which meant he was in the clear.  Hallelujah!

SO, that was our eventful first week at home (and the hospital).  Luckily, we haven't had anything else quite that exciting happen since our (second) hospital visit.  We're so glad that little man is okay, and have spent the weeks since our hospital stay(s) adjusting to our new "normal," which happens to be total chaos all.the.time!  :-)


Tuesday, October 6, 2015

Ward's Birth Story

Two posts within a weeks after 8 months off?!  I'm on a roll, people.  Maybe I'll make good on my "two posts this year" quota/promise to Ward, after all!

I tried to keep notes on my phone throughout the day during Ward's "Labor Day(s)," but I fell off the wagon somewhere about halfway through and this all happened a little over three weeks ago now (?!?!?!), so I'll do my best here.  Side note: if you want to skip all of the reading of the longest post in history (maybe), there's a slideshow at the bottom that sums up the day perfectly thanks to my bestie.  :-)

As with my two previous pregnancies, I experienced some pregnancy-related hypertension with Ward that came on around week 32.  It wasn't as bad as it was with Lilly, but it was worse than with Craft.  I am very fortunate (and thankful!) that my doctors did everything in their power to keep me off of bed rest - I think my exact words to them were, "I honestly don't have time for that."  Ha!  Luckily, we were able to get by with 2-3 doctor visits each week (one ultrasound, and usually some combination of weight/urine check, bloodwork and NST at each of the others).  The decision was made at 36 weeks that unless something happened in the interim, we would induce at 37 weeks (Thursday, September 10).

I should make it known here that we did have a false alarm around the 36-week mark that really got my tail in gear, because even though I felt like an induction was probably in my future, I was NOT prepared for W to arrive yet (cutting it close, I know).  Warning: I'm about to divulge some semi-graphic detail, so skip to the next paragraph now if you're my Dad or have a week stomach.  We took the kids to the pool in the evening and were drying off/eating dinner when I felt some sort of liquid pooling down there.  I stood up and there was a small gush, then sat back down and it was  a trickle again.  I repeated that action with the same result three or four times and then said to Dan, "Um, do you think I would know if my water was breaking?"  To which he replied, "How the h*ll am I supposed to know the answer to that?!"  I had been having contractions (some Braxton Hicks but a lot of real contractions as well) for a few weeks at this point, and right around this time I was having some pretty intense contractions pretty consistently.  Dan and I decided that I should call the doctor just to check.  So I called, and when he called me back I said, "So I know this is going to sound totally idiotic seeing as how this is my third pregnancy, but I am not sure if my water is breaking?  I have been induced both previous times and I have a doctor appointment first thing in the morning so really I just want to know if there is anything I should be looking out for in the mean time."  I explained everything to him and he said, let's go ahead and get you into Labor & Delivery to check things out.  I cannot even tell you how much of a panic I was in at this point.  I packed a quick bag "just in case" and to this day have literally no idea what was in it.  I spent the entire ride to the hospital in hysterics after kissing my babies goodnight (Carney was a saint and came back to help with them while we went to the hospital).  The conversation went something like this:

Dan:  Why are you so upset?
Me (wailing):  I'm not readyyyyyyyyyy!  And neither are Lilly and Craft!  
Dan:  The kids are great, they will be fine.  How could you possibly not be ready?  You have boobs and the hospital will have diapers, everything is going to be fine.
Me:  I didn't get to dry my hair!  Or put on makeup!  And I have a hair appointment tomorrow after my doctor appointment.  And a mani/pedi on Sunday with my girlfriends.  And a brow wax on Tuesday.  I'LL NEVER GET TO DO THOSE THINGS AGAIN (wailing)!
Dan:  (Eye roll and heavy sigh)

Long story short, my water had not broken (and no, I did not pee myself, as my lovely sister suggested!).  They determined that it could potentially have been a slow leak but that baby moved and his head blocked any more from coming out, better safe than sorry, and then they sent me home with instructions to go to my appointment the next morning as usual.  My doctor told me not to feel like an idiot and said she would have told me to come in as well, again better safe than sorry, and to get my hiney in gear for the real deal a week later.  Point taken.

Fast forward a week to Thursday, September 10: Labor Day!  Or so I thought.  For my two previous inductions, I was told that the hospital would call on the scheduled date with instructions, and this time was no different; however, with the prior two the hospital called between 5:00 and 6:00 am and asked that I be there by 6:30 or 7:00 am.  We were super prepared this time around - we had taken the kids out to a "last supper" at IHOP the night before, I packed a bag and actually knew what was in it, childcare had been arranged, etc.  

C loves pancakes!  

So does L, although you'd never know it based on the 3-year-old 'dude.

"The Last Supper" (or so we thought) at IHOP (barf)

As with previous inductions, I did not sleep a wink the night before because I was so excited/nervous/anxious/you name it.  My bags were packed and all I had to do was jump in the shower quickly so that we could be off.  Since I wasn't sleeping anyway, I got up around 6:30 and did a few things around the house and turned on my computer to knock out some last-minute outstanding work items.  My parents had come in late Wednesday night in anticipation of an early call, so we were all playing with the kids and getting them ready for the day.  When Carney showed up at her usual arrival time of 8:30 and my phone still hadn't rang, I decided to hop in the shower so that I could be ready to go whenever.  I left my phone with Dan downstairs with instructions to answer if it rang.  I was out of the shower and ready to go in less than 30 minutes, but still no phone call.  Carney left with the kids to take Lilly to school around 9:15, and I sat down to continue working, when my phone vibrated and I noticed I had a random message from 8:15.  Of course it was the hospital and my phone never even rang.  They left a message asking me to call back, which I did, only for them to tell me that there were no beds currently but they hoped to get me in within the next couple of hours.  At this point I was just excited to talk to someone, but I also felt like time was working against me.  My doctor's office shares several on-call days per week with another practice, so I only had until lunch time on Friday, September 11th to get this baby out if I wanted one of my doctors to deliver me (which I desperately did).  

A "couple of hours" turned into literally an entire day of waiting.  When I hadn't heard from the hospital after lunch, I called back for a status update and they told me that there were still no beds but they were hoping to get me in soon.  They called again several hours later with the same update, so I asked at what point they would tell me "it's not going to be today" because my nerves couldn't take much more.  The nurse told me that it was really up to the doctor and that they'd continue to try to get me in when they could.  I called my doctor's office around 4 pm and talked to the nurse and asked her the same question.  She spoke with the doctor on call, who said that he was still planning to get me in whenever he could, even if it was the middle of the night, and it was really up to the hospital.

The benefit to all of the waiting was that I was able to get in an almost full day of work and finish up some things that I hadn't gotten to the day before (in addition to finishing up laundry, packing kids lunches for the following school day, etc.).  The down side to waiting around literally ALL DAY was that it made me even more anxious and crabby.  By 5:00 pm my in-laws had arrived as well and Dan and I were OVER it, so we decided to let all four grandparents play with the kids and go out to dinner just the two of us (at 5:30 pm with all of the old folks, ha!).  I just knew as soon as we sat down and ordered food that I'd get a call from the hospital.  Turns out I was right, except the call was just to tell me that there still weren't any beds, they were hoping one would open up shortly, and my doctor instructed them to still try to get me in (which I already knew).  We finished up dinner and headed back home, put the kids down and waited some more.

By 9pm I had had enough and was exhausted from all of the waiting and nerves.  I called the hospital one last time, apologized for calling so much that day and said, "I just want to know if it's looking like it will be tomorrow and if I should go to bed, because I'm exhausted."  To which the nurse replied, "Hey!  I was just about to call you, why don't you go ahead and come on in."  Seriously?  I honestly thought by 9 at night they would tell me to wait until the next day.  It had been such a long day of waiting already, and I was exhausted, and the thought of starting pitocin overnight was even more exhausting.  Also, though, as annoying as the whole ordeal had been up to this point, I was thankful, too.  I got to spend some extra time with my husband, and I got to put my babies to bed on their last night as a 2-sibling family.  We grabbed our bags, I put a call into Steph to hit the road and head to Raleigh, and by 10pm we were checked in and I was having blood drawn and getting fluids.

The next couple of hours were pretty uneventful.  We answered a lot of questions, got settled in our room and waited on the doctor.  Steph arrived around midnight and the doctor wasn't too far behind her.  I was not even 1 cm dilated and was only around 50% effaced, which the doctor explained meant that pitocin would do me no good.  We instead started with a foley bulb to "ripen the cervix."  I remember getting one of these with L - essentially they help you dilate to somewhere between 3-4 cm and then with the help of the pitocin things really get moving.  The doctor decided to let things get moving, so the foley bulb was inserted around 1:00 am with a plan to start pitocin around 4am.  They gave me an ambien so I could rest for a couple of hours and Stephanie went to a friend's house to get a few hours of sleep with a plan to return around 5:30am.  I have never taken a sleeping aid before but was so thankful for that ambien-induced two hours of sleep because I was still exhausted from the lack of sleep the night before.  Around 4am things started picking up a little and my contractions were 2-3 minutes apart on my own (no pitocin yet).  At 5am the nurse came in and re-attached my monitors (which they had detached so that I could try to sleep), and at 5:30 they started my pitocin.  Pitocin was started at a level 1 and increased every 20 minutes.  Not too long after I started the pit, my contractions were consistently 1 minute apart but not too awful yet.  By 7 am the contractions had spread to 3 minutes apart but were much stronger, and at my 8:45 am check I was around 4cm dilated and 60% effaced.  Progress.

Everyone told me that your body is primed with each labor, and that with two previous labors and a SUPER quick 9-lb-5-oz labor under my belt, this one would fly.  Everyone lied, because pretty much from that 8:45 am check until early afternoon nothing happened other than very frequent and very painful contractions.  I held out on the epidural for a little while, I think until around 10am (unfortunately my notes stopped at 8:45 am HA so that is my best guess)?  I just remember that my wonderful nurse Tiffany (whom I absolutely ADORED, and y'all know that is a compliment if you remember Nurse Rachel from my two previous labors!) asked if I wanted it and I said I thought I was okay, and then after some thought decided to go ahead and get it and by the time the anesthesiologist arrived I was in tears in the fetal position and thanking God she'd gone ahead and ordered it for me.  Around the time I got the epidural, we all were thinking things would start to fly because I seemed to be moving along pretty well, which made me happy because I didn't have long if I wanted my doctor to deliver.  Wrong again.

My doctor came to check on me one last time before she was done for the day, sometime around lunch time or maybe a little after.  After her check revealed that little progress had been made, she said, "you know, he seems to be in kind of a weird position, let's lay you on your side for a while and see what happens."  They brought in this hilarious looking thing called a peanut and had me turn and lay on my left side with this thing propped between my legs for 45ish minutes and then I flipped to the right.  I have no sense of time at this point, but I do know that once I flipped to my right side things really started moving and before I knew it, it was "go time."

I will try to spare you the super gory details, but the doctor was called and there was pushing and it was SO HOT and I needed a fan, and then after about an hour of pushing, sweet Ward (finally!) made his debut.  He was so warm and snug and cozy in the womb that even when I started pushing the doctor remarked that he was still pretty far up and I had a lot of work to do (By comparison, I pushed for 45 minutes with Lilly and about 30 with Craft.  I am not complaining about an hour because that isn't a bad labor at all, but it seriously felt like 10 years!).  I didn't know the doctor (she was from the other practice) and the epidural was no longer in full effect by the time it became time to push, but when it was all said and done I had the sweetest baby boy to show for it which of course made all of the waiting so worth it.  I am so, so thankful to the wonderful care that Nurse Tiffany provided to all of us - she was seriously fantastic and I will never be able to express what a comfort she was to me and how much I valued her excellent care during my delivery.  I also can't finish this post without bragging a little on how amazing my husband is in a delivery room.  He's a great cheerleader - encouraging without being annoying - and acts a fool all the time so he keeps things light and entertaining.  He is just generally a very calming presence for me.  I couldn't imagine doing this thing called life with anyone else.

Did I forget to mention that my BFF was with me to document the whole thing?  Steph had never photographed a birth, and although I enjoyed being with just Dan in the delivery room for my first two, my biggest regret was not having any good photos of us with each of our first two babies immediately after they were born.  I figured that Ward may not get a lot of things that are "just his," so this seemed like a win for everyone.  I cannot even begin to express what a wonderful decision that turned out to be.  Not only was Steph wonderful to have in the delivery room because she is my BFF and made me feel a lot calmer (I mean really we took BFF to a whole new level with this birth, ha!), but she captured the most incredible memories of for us.  She put together the below slideshow and I have watched it countless times and have yet to get through it without crying.  I will truly cherish these memories forever and can never begin to express my gratitude to her for being with me during this special time.




Longest post ever?  Probably.  I probably could have just written, "We waited.  And waited.  And waited some more.  And then there was pitocin and an epidural and laying on my side and then there was 8 lbs 9 oz of Ward."  But that wouldn't have been nearly as fun.  :-)

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