What We've Been Up To: Newbie3

I am very far behind on the baby updates! My brain has been so scattered lately, it's been hard to sit for an extended period and put thoughts together.

I am at 20 weeks--halfway there!

My last appointment with Dr. W was a few weeks ago, and here are the stats from it:
My bp: 120/68
Weight gain since last visit: 3 lbs
Baby's heart rate: 160

We discussed the Level 2 ultrasound I would be getting at 19 weeks, and she said we would not have the normal 20-week ultrasound in her office.

I asked about the pain in my tailbone, and she said it has to do with the position of the uterus, and the lax nature of the bony structure in my spine. Everything is stretching out for the baby!

That was pretty much the extent of the appointment. The fast heart rate started putting a little doubt in my "it has to be a boy" philosophy. Maybe...a girl?

Well, this past Thursday, we went to our Level 2 ultrasound. Of course, the main purpose was to find any medical problems that might indicate Down syndrome or other chromosomal syndromes. Within a couple of minutes, the sono tech said, "Well, I'm not looking at it closely, yet, but I can already tell you it's a boy!"

Haha! Another baby boy! What a blessing. Jon has his plate full in raising some good men! And my job isn't easy, either, trying to teach them how to treat ladies and look for godly women to be their helpmates in the future. What a responsibility, this parenting is!

But the more wonderful news of the ultrasound is that the doctor found no major health problems. All the "soft markers" that could indicate Down syndrome were non-existent, and all the major organs looked perfectly healthy. We were scheduled for a more detailed look at the baby's heart next week, because of James's medical history of a VSD, but the doctor said this baby had a "beautiful heart"--or maybe it was "beautiful ventrical septum,"--and there was no need for further study.

Prior to the ultrasound, we met with a "genetic counselor" whose main job was to explain what to expect in the ultrasound, and then to meet with us again afterward if any problems were found. He would explain the implications of what was found, the next steps or further testing recommended, and then also to handle the emotional stuff that could happen. We understand the possibility of what could happen, but God had taken care of us so far, and no reason to doubt that now, no matter what we found. Not that we would be bundles of smiles if we had found out some devastating news, but what a powerful peace we have knowing that God is in control--not my body, or the doctors, or anything else in all its imperfection. The perfect God is in control.

I have given up my pile of pillows that bolstered me up at night. They also kept me awake, and I fought with them any time I moved. So I'm going without, until I can't sleep without them.

Oh my goodness, I almost forgot! The name for little Newbie3!

Jackson Lee Norvell

We will call him Jack.

I'm not quite used to it, yet. I haven't said it enough times, I guess. But the boys can both say it, and that's good!

Jack is quite the mover and shaker! He was really wiggly during the ultrasound, and I feel him moving around all the time.

To Children's We Shall Go

Sorry for the photo hiatus...my computer is in the shop. I should have it back this time next week!

It is entirely too late to be blogging, so let me be brief.

James's cardiology appointment went great. He still has an ever-so-slight leak in his valve, but "nothing abnormal" the doctor says. We don't go back for another appointment for 18 months!

Caleb's appointment was in regards to the high fevers he's been getting like clockwork every month the last several months. I had done my own mama research online, and had diagnosed my son with something called PFAPA (pronounced "fappa"). Turns out, I was right! It's a handful of symptoms--high fever, red throat, swollen glands, mouth ulcers--that recur on a very regular schedule. For us, it's about the middle of every month, almost to the day. The cause is uncertain, it's not contagious, it doesn't impede his growth or development, and he will gradually outgrow it. Until then, there are a couple ways to minimize it. The first is to give him a small dose of steroid at the onset each month. His fever should respond within hours (the real test of whether he has PFAPA or not). If that works, we'll continue on that course. The dose is small enough, and infrequent enough, that there are no harmful side effects. A more invasive option is a tonsillectomy, which seems to have a good success rate. However, doctors aren't taking tonsils out like they used to, and are much more careful to ensure that it's absolutely necessary.

Caleb was a trooper! After having his blood drawn a week ago, he was pretty leery of this doctor. The doctor assured him that he didn't have any needles, so Mr. C relaxed and shared his litany of owies. That kid is a walking bruise...much like his mama as a kid! The doctor regarded each scrape and scab and deemed them to be healing nicely. But alas, they needed to draw more blood. After I showered him with stickers pulled from my bag, and the nurse brought him more stickers and bubbles, Caleb sweetly passed out stickers to everyone: the nurse, myself, James, Jon. We all got stickers! I wondered how often the nurses receive stickers from patients, and was thankful for a generous boy. (I repeat that prayer of thanks when he shares his Starbursts with me at the library story hour. We've raised him well.)

Anyway, if this is truly PFAPA, Caleb will have another episode mid-September, and we'll give it the true test of the steroid dose and see what happens!

James: 10-month Check-up

Yesterday, Caleb and I took James for his 9-month check-up that has been rescheduled so many times, it became his 10-month check-up. Caleb is very much a part of the process, as he feels that he is doing his part as the big brother to bring his little brother to the doctor. Since we have been going monthly for RSV shots, Caleb has gotten the routine down. But I was glad to tell him that James would not be getting a shot on this visit. (As a side note, the "RSV season" has ended, and we won't be getting the shots from now on. I don't know if they'll start back up next season or not.)

The visit was very productive, as Dr. R was more congenial than usual, and answered my many questions. But first, the stats!

Weight: 16 lbs, 6 oz  -  50%
Height: 28 in  -  75%
Head circ: 41.3 cm  -  45%

So my little man has gotten some length on him! I still haven't gotten around to moving him to 9-month clothes, but mostly because he's in shorts all the time. 6-month footies would probably not fit him very well.

Questions I asked:

1. Circumcision ok? James's circumcision doesn't look like a normal circumcision to me, and Dr. R said that he has adhesions, which my mom says is scar tissue that pulls skin together where it shouldn't. Dr. R said it should break up between ages 2 and 3 years, and if not, James will undergo another circumcision. Yikes. It doesn't seem uncomfortable to James, and it's not causing blockage or any other issues, so we'll just wait it out and make that decision when necessary.
2. Belly button ok? Ever since James's surgery, his innie belly button has been an outie. That's usually a sign of a hernia, but Dr. R said that if it was a hernia, it was a very small one, and that it should close up on its own. I have noticed the outie is not as much an outie as it used to be, so hopefully that's true.
3. Chest shape ok? Jame's rib cage is a bit of a mystery to me. It's concave at the top, flares at the bottom, and has a large bump over his heart. Dr. R says that the flare at the bottom is probably a result of his heavy breathing prior to surgery; his lungs pushed his ribs out. The bump over his heart is supposedly normal, and everyone's chest over their heart is larger than the rest of the area. I do not find this to be true in the rest of our family, but whatever. As with the other questions, James's chest shape is nothing to worry about, and should right itself with time.
4. Diet into his first year? Dr. R said it should be no problem to move James to cow's milk at his first birthday. We'll still thicken it, of course, but he should transition fine from formula. He also said that baby food would be fine, if James wasn't ready for table food. I guess I knew the answers to these questions, but I still wanted to ask to make sure I was on the right track. This is just one of those instances that shows how I feel like a new mom with James!



James and his therapist

5. Further therapies? I've asked our developmental therapist about starting other therapies with James--speech, physical, occupational--and he has been reticent to recommend it, feeling that what he was doing was sufficient. However, Dr. R feels there's no reason to delay, and I think I agree with him. A faith-based place for special needs children, called Hope Landing, is sending me a large packet of information and forms. Once I've gone through all that, James will be evaluated, and we'll be given a recommendation as to what therapies he currently needs. As a child with DS, he will probably qualify for all of the above therapies, and we could end up going to therapy every day of the week if we chose to. However, we have been cautioned by other families with special needs to not revolve the whole family around one child, and that we don't have to accept every therapy that is offered. Choose the ones that are important for James at the time. So that will take some prayer and wisdom from us when it comes time to make those choices. Hope Landing does not send therapists to the house (unlike the developmental therapist), but it is in town and not too far. It seems like a neat place that incorporates prayer and spiritual development into its plans, plus there are some programs that allow sibling involvement as well. So, I'll probably be writing more about them later.

Little Man loves his toes!

And that's it! That was the doctor's appointment. Very informative, and we don't go back until 12 months. Before that time, James has an appointment with the genetic clinic at Children's and a follow-up appointment with the cardiology department at Children's. I think his heart doctor will be happy to see how much he has grown, and how well he is doing!

3 Week Post-Op Checkup for James

This past Friday, I took James back to LR for his post-op checkup. We had the typical echocardiogram and x-ray, and I'm proud to report that James did great! His heart function is right where it should be, so we can take him off the meds for that. And there was no fluid on his lungs, so no more meds for that! He is now only taking the synthroid, which he will most likely take the rest of his life. The doctor said that his heart has no residual signs of leakage--it's just like any other healthy heart! (With the exception of a bit of gore-tex, of course.) So it was a great visit, and we don't have to go back for another 6 months.

Whew! I know we will encounter other health issues with James, but for now I kind of feel like we might get a little break for awhile. For the first time I feel like I can start planning things, seeing other people, and get back into the groove of things. Of course, it took a few months to get that feeling after Caleb was born, too.

And I've decided to go ahead and quit nursing. Well, "nursing" hasn't been the right term for over three months. Pumping has taken up a lot of my time in the day, and Jon has been pushed to the limit trying to keep up with things at work and things at home. In a normal situation, nursing is cheap (free!) with no bottles or hassle of keeping milk cold or warming it up. However, in a situation where thickener and formula is added in, nursing has become the most expensive option, with the most hassle. I've felt like I should keep going with it as long as my supply keeps up, but it seems to be keeping up just fine with no end in sight. James has gotten all the immunity benefits in his first weeks, and we know that he can handle formula since it's been added into his milk for several months. And, for the sake of myself and my family, I really can't conceive of keeping up the pumping for James's whole first year.  As you can tell from my paragraph of reasons, it's taken me quite an inner battle to make this decision. But it's made, and I'm glad for it. Now I just have to go through the painful process of weaning!

From these pics, you can tell that James's face has got a nice roundness to it these days. He's doing great and gaining weight just great. In the picture below, Caleb was ready to snuggle with James all night long (though I doubt he would have slept a wink!). It's good to see how much these boys love each other.

4 Month Checkup

James just had his four month checkup, and I'm happy to report that he has made it onto the growth charts!

He weighed in at 10lbs 8oz, which puts him at the 10th percentile. His length is 24inches, the 25th percentile. All the DermaBond has come off of his incision, and only a pink scar remains.

Everything looks good!

Here is our little man, pre-surgery, at 3 months and one week old.

As a comparison, here is little Caleb at six weeks old.

The swallow test

The swallow test was pretty neat. It was a continuous x-ray of James's throat as he swallowed liquids of different consistencies. We found out that he does aspirate some of his food (meaning it goes into his lungs) even though he doesn't cough or show other signs of it most of the time. The liquid just kind of swishes around his mouth and even a little into his nasal passages; it doesn't clear very well. It went much better with the thicker liquid, so we will start adding "honey" into his milk. It's not really honey, but looks like clear hair gel, and is about that same consistency. As he grows, we'll add the thickener to any other liquids (medicines, juice, etc.), and add extra rice cereal into his foods so they're nice and thick. The swallow test will be re-conducted at about a year of age to see how he's doing. Because he doesn't clear his passages very well when he eats, we have to be sure and feed him upright and then we give him a paci to encourage a few "dry swallows" during feeding, so he'll swallow it all down. We were also given some methods of massaging James's cheeks that should help improve his muscle tone there, which will improve his ability to keep a good suction on a bottle.

His feeding is getting more complicated, but hopefully it will encourage him to eat!

We're still on track for leaving on Tuesday, though the wait is mainly for the purpose of getting James off antibiotics and making sure there is no more fever. Hopefully that means that things will be a little slower. Jon and I both got to rest a little today, so that has been nice. Maybe I can finally get to that knitting....

And to All a Good Night...

OK, so James is doing extremely well.  He's free of nearly all his medicines, his fever is under control, and he is eating very well.  In fact, he is continuing to eat fast (for him).  You probably won't understand how excited this makes us - his normal feeding has been 45-60 minutes long for 3 or so ounces, but these feedings are 12-15 minutes for the same amount.  This translates into 3+ hours of time gained back in our day!

Otherwise, we are really getting excited about the possibility of heading home with him much earlier than we had expected.  It seems very possible that this will happen on Saturday!  That would be awesome!


In other news, as we've been in the waiting room here, we've been blessed to get to know several other families.  Many are facing far more difficult situations than we have with James.  Currently, we are sharing a room with baby Reagan.  Please pray for her and her family.  She has her arteries switched so that she has 2 vascular systems - one circulates blood to the lungs and back to the heart in a circle and another that does the same thing with her body.  The only thing that has allowed her to live at all is that she also has holes in her heart allowing a small amount of oxygenated blood to cross over to the body.  She has already been through 1 surgery and will have another next week.  Please remember these other families as you pray for James.

Well, we are about to settle in for our first night apart.  Lydia will be in the room with James, while I get to stay in the waiting room.  This is a blessing for Lydia (and not because she gets rid of me!).  Even so, we can't wait to get home with our little boy!

Good night!

Update on James and Hospital Life

James still has the ventilator on, which means he's still sedated. His oxygen level is 93.7% and it needs to be higher than that before they take him off the ventilator.

It's just the three of us here now: myself, Jon, and my mom. My mom will be headed to a motel for the night, since only 2 adults are allowed to stay in the waiting room thru the night. We'll use that motel as our resting place if one of us needs to get away and get some sleep or a nice shower. The waiting room is equipped with chairs that pull out into beds, and a shower, so Jon and I will be camping out here. There are snacks that people donate, toiletries, and even laundry detergent to use with the washing machines when it's time to do laundry.

The hospital has a "pumping room" for nursing moms. It's in the NICU and has curtains partitioning off four areas of a room. The hospital provides the pump and the accessories, and there is a bin of sterile bottles in every pumping area, as well as books and CDs. Once I'm finished pumping, I put the bottles in a box labeled with James's name, lock it with a padlock, and put it in a large glass-front fridge. There are bottles of water there for the moms to take. The nurses then will freeze the milk every day. When James is ready to take milk, the nurses will thaw out enough for a day's worth of feeding, and will provide it to the CVICU. At first they'll give James the milk thru a tube that goes directly to his intestines, and just enough to jump start his digestive system once again.

This is my first time since getting here this morning that I've just been sitting. Maybe it's time for me to bust out my knitting needles and see if I can make heads or tails of my new hobby!

We saw James!

Jon and I (and now the rest of the people who've been in the waiting room with us) have seen James! He's sedated, so he only gave an occasional twitch or tongue movement. He's covered in wires and tubes. The best news is that I got to hear the solid "thump thump" of his heart! Yesterday his heart was giving a "whoosh whoosh" that I will never hear again! Praise the Lord.

I'll have pictures up soon. Thanks for your prayers!

Surgeon just visited

Dr. I just stopped in to say that things are going well. James is all sewn up now. He'll be cleaned up and then headed to his room. We'll get to see him 20-30 minutes after that, once he's all settled in. Dr. I said the hole was very large, though it had mostly been covered by the valve. So we're excited to see what changes we see in him once he's recovered!

Update: As I was typing this, the nurse came back in and said James is in his room. He is doing well, and didn't need any transfusions. He's still on the ventilator, which means he will still be sedated when we go see him. I'm not looking forward to how pitiful he will be, but I'm ready to see my baby boy!

The hole is patched!

The nurse just came in...

This is my (Lydia's) first time to update since surgery started. Has anyone mentioned how huge the nurse is? His name is Mike, and he's a giant.

Back to business...

We just received the leftover bit of Gore-Tex that was used to patch up James's hole. There is a small circle cut out of the bit, about the size of a dime. Which, when you think about it, a dime-sized hole in an egg-sized heart...that's a pretty big hole.

The doctor also sutured up a small hole between the atriums. This hole had been mentioned at our very first visit, but the dr. then had said that it was common to most babies, and nothing to worry about. I guess the surgeon decided to just take care of it, and that's fine with me!

James's heart is now beating on it's own! The next stage is to add in lines for a temporary pacemaker, put in chest tubes (to get any drainage out of the chest cavity), and then sew him all back up. The nurse will be back in an hour for any other updates.

He's in

The nurse and anesthesiologist just came and picked up James. We've been set up in a private waiting room. The nurse said it will take an hour to an hour and a half to get all the lines and tubes in. At that point the nurse will come out and let us know, then he'll come out every hour to give us updates.

James did very well without food this morning. He only had a small breakdown toward the end of waiting, but he settled when we started walking. He's a trooper!

Surgery for my baby boy

I'm sorry I haven't updated this blog enough over the past few months. Besides the picture posts I am trying to catch up on, I have had so many thoughts and updates about the boys. However, some things just don't get done, and when things get crazy, the blog is one of those things.

James has Down Syndrome. I mentioned that once, and at that point I hardly thought we'd need to mention it much more. His doctor declared him a healthy baby with no problems other than this extra chromosome floating around. However, during the first few weeks of James's life, we struggled to get him to eat, and I believe we really fought for his life. Our doctor was still sure that things would work out just fine as long as we kept doing what we were doing, but we were struggling to get even a milliliter of milk in him, at a time when he should have been taking in hundreds of milliliters. I breastfed him almost exclusively for the first week, until a weigh-in before and after a feeding revealed that he wasn't taking in any milk. At all.

When I think back on that week and realize that he hadn't been getting any kind of food, I shudder. And I thank God for a friend, Kathy, who recognized that James was in trouble. She used to be a neonatal nurse at the hospital, and she supplied me with preemie bottles and nipples, a scale, a daily check-in, and a wealth of information about how to best help James conserve his energy. He slept most of the time, never cried, and was a very lethargic baby.

Slowly...slowly...James gained weight. Our doctor felt that all was going well, and even began to doubt that James had Down Syndrome. However, we finally received the chromosome test that confirmed he indeed had DS, and our doctor referred us to a pediatrician in town (there are very few pediatricians here, so most people take their kids to a family dr.).

Our new doctor, Dr. R, is known for being pretty brusque. Very thorough, but no bedside manner. He came into the room with confidence, and began to examine little James. In the silence, Jon remarked how grateful we were that James's heart was healthy, which is uncommon among Down Syndrome kids. Dr. R looked up sharply.

"Oh James has a heart murmur. A pretty loud one."

Those words confirmed our fears. James's sleepiness, his struggle to gain weight, his hard breathing--we didn't know if that was just a typical DS baby, or if there was something more wrong. A heart murmur made sense.

We were at the Children's Hospital in Little Rock the next day.

Children's confirmed a hole in James's heart, called VSD. The hole was causing some of the chambers of his heart to have high pressure, some to have low. One of his valves wasn't closing correctly because of the hole. There was fluid building in the tissues of his lungs. His heart was working as if he were running all the time. We were sent home with diuretics and formula to add into the breastmilk.

The change in James was dramatic. We began celebrating ounce after ounce of weight gain, and then half pound after half pound. He was awake more often, and then he began to kick his legs, notice his surroundings, and even start to cry a little when he got hungry. However, his breathing was still labored and he was well below the weight he should be. The day before Thanksgiving--our most recent visit--confirmed that the hole was not closing up. The high pressure on his lungs would eventually cause long-term damage, and the aortic valve was starting to show signs of distortion. The doctor gave us strict orders to keep James away from any possibility of contracting RSV (which could land him in the hospital and cause severe damage), and he suggested we come back for surgery within 4-6 weeks. The nurse called the next week with a surgery date in two weeks. The 14th of December.

The past two weeks have been stressful. We've kept James away from infection as much as possible, learned about the surgery and the procedures surrounding it, and come to terms that our tiny baby boy was going to have open heart surgery.

Tomorrow we leave for Little Rock. Monday is a day of pre-op tests and talks with the doctors. Tuesday is the surgery. I'll do my best to keep you updated on this blog. I know so many people are praying for us. God is good, and has shown His provision for us in so many ways these last few months.

Dr. Appt: 38 Weeks

The stats:
Weight: gained 2 lbs (35.5 total)
BP: 112/80
James' heart rate: good


And the big news: 1cm dilated and 50% effaced!


Woohoo! I didn't make it that far for another two weeks last time. It doesn't mean we're headed to the hospital by any stretch, but at least this ol' reproductive system of mine is remembering what it's supposed to be doing.


Our discussion was pretty short with Dr. W. My only question was if there was anything we hadn't discussed regarding the birth plan that she might still need to know from me. She said she wasn't worried and felt she had a pretty good idea of what I wanted. She said we'd have time as things came up for me to express my wishes. She reiterated that her only requests are that I wear the hospital gown and have a hep lock in case of the need for an IV.


I asked again about the procedure once the baby is born, and we confirmed that yes, James will be placed on a towel on my stomach right after he's born. The nurses will do their Apgar scoring from afar while we get to hold our newborn! The umbilical cord will be cut when it stops pulsating (meaning it's pumped all the necessary blood into the baby), and then the nurses will take James for weighing, measuring, eye goo and shots. They'll hand him back to us, and then he's ours! I suppose at some point he'll go off for a bath, but I remember that being quite awhile after the fact with Caleb. So this is when I'll get the chance to nurse for the first time, and then the family will all be banging on the door to see the new baby. Hooray!


And then James will cry and I'll understand the true meaning of sleep-deprivation for the next two months...but I'm not thinking about that part!


Back to our appointment.... Dr. W said that if we hit 41 weeks like we did with Caleb, we'll do a non-stress test on James. If he's A-okay, then we'll just keep waiting. She said she didn't see any reason to induce except for the baby being in distress.

After we finished discussing with Dr. W, I was trying to form in my mind how to thank her for her openness to a natural birth and letting things happen on their own, when she beat me to the punch and thanked me for the same thing! She said most women are ready to induce before their due date and just get it done, and she said it was refreshing for someone to be willing to let nature take its course. I hadn't really expected that!


So that was our appointment. As patient as I want to be (and know I need to be), I get excited knowing that we'll have James soon!

Dr. Appt: 37 Weeks

Stats:
Weight gain: .5 pound (33.5 total)
BP: 124/80
James's heart rate: good
Uterus measurement: 35 cm

The uterus has gone from 36 to 34 to 35 in the last three weeks, so Dr. W says he's just sort of floating up and down a little, but his head is firmly engaged where it should be, so that's good!

Questions we discussed:

• Sleep aids: High protein snack before bed, sleepytime tea, warm bath, heating pad on back. If at some point the early stages of labor begin but go very slowly (like they did with Caleb--two days of contractions for nothing), she'll prescribe Ambien, which she assures me will give me good sleep when I need it, but I will be awake and ready to go by the time contractions get serious.
• Nursing mechanics: I had some difficulty nursing Caleb for the first few months, so we discussed some ways to avoid that, but it sounds like it just might happen again. Dr. W said that wearing "shells" and other devices before the baby is born really doesn't help change anything, and using the shields during nursing are really my best bet.
• Tearing vs. epesiotomy: We brought this up again because when Dr. W asked me last time, I didn't really ask her opinion about it, and I wanted to know. She said that in fact the two heal just about the same way, so she didn't have a preference. There was one type of tearing that could cause some problems, but she said she could foresee if that was to happen and could avoid it with a small epesiotomy.
• Any recommendations for preparing for the Big Day? Dr. W didn't have any prep ideas, but she did say to bring a robe, slippers, and my own sanitary napkins, as most women don't like the huge ones the hospital provides.

We also talked about a couple of random things:

• Baby's equilibrium: The baby does not get dizzy in the womb because he doesn't have any muscle tone. Without muscle tone, he doesn't have the feeling of falling or being up or down.
• Placenta history: Dr. Apgar (the lady who developed the Apgar score) felt that there was too much intermingling of blood between the mother and baby, so she was the one who started cutting the cord immediately upon birth, instead of waiting until the placenta had been delivered. Doctors no longer believe Apgar's reasoning, but the tradition still remains. Dr. W will most likely allow me to hold the baby on my chest for the final stage of labor. Once the placenta is delivered, she'll let Jon cut the cord if he wants to.

Does anyone else think that "placenta" is just a grossie word? Couldn't they have named it something else? Or perhaps the object itself would mar any name. It is weird, though, how that whole part of labor is pretty much ignored by everyone...even the nuts and granola home birth people pan away at that point in the video.

In other news, James is officially full-term! If he were born today, his lungs would be developed enough to make it in the world. We made it! Whew!

We have been very blessed by two baby showers--one at our church and one by mail--so we've gotten our final baby needs put together. Our carseat is being shipped (yep, that's what you do when you live in the sticks) and should get here this next week. I've packed a bag for myself and James. Now I just need to get a "labor bag" together, though hopefully I can do most of my laboring at home this time!

There are a few more things on my "need to do" list, but if they don't happen, it's okay. Jon and I are getting more excited about holding our new tiny baby boy. We aren't as nervous as we were last time. We have a better idea of how stinking hard it is in the beginning, but we also have a very real reminder every day of how wonderful being a parent is, and we can't wait for James to join the family!

36 Weeks: Dr. Appt. and more!

Whew, these appointments are coming so close it's hard to keep up with them! Let's see if I can get you the highlights:


The stats:
Weight gain: 2.5 lbs
BP: 110/80
Baby's Heart Rate: "Just perfect"
Uterus: 34 cm

The uterus had measured in at 36 cm last week (so Dr. W tells me; I didn't get the measurement last week), which means the baby has dropped 2 cm! Hooray! I could tell something had changed based on my frequent trips to the bathroom, and sure enough, James is settled right on top of my bladder. His head is pretty set in the pelvis, so that's good! Hopefully he will stay there! Dr. W is estimating that he'll be about the same size as Caleb at birth, so around 7 lbs or so.

Questions we discussed:

• Further clarification on the "natural methods of induction." It turns out that these methods (mentioned in a previous post) will start contractions, but will most likely not start labor. The contractions will serve to start the effacement/dilation process, something that didn't happen 'til late in the game last time. So when labor does begin, we'd be ready!
• Birthing positions: It's common knowledge by now that trying to birth a baby flat on your back is not ideal. However, it's still pretty common practice. So when I asked Dr. W about different birthing positions, I was happy when she responded, "I'll use any position BUT flat on the back." She suggested a squatting position or even on all fours (I've read about it, but still not sure how that works). Something to note, though, is that an epidural effectively takes away the use of your legs, which means that an on-your-back position is almost required.
• Video and photography is allowed throughout the entire process...if I really want it....
• I found out that Dr. W will be attending the birth whether she's the doctor on call or not. This gave me a good bit of relief because I think she will be a big help, and by her admission, the other doctors in the group will probably only show up to catch the baby. She, on the other hand, will come around every 2 hours or so, day or night. She said the only time she won't come in is at the really tough part right before it's time to push (called the "transition phase"). While it seems a little odd, the reasoning is that at that moment, I will be begging her to do whatever she can to get. that. baby. out. Because I know she can. But if she's not hanging around (though she assures us she'll be close by at the nurse's station), I'm likely to be more patient and make it through that stage on my own. Interesting bit of psychology, eh?
• Dr. W said that the nurses are very open to natural deliveries and will be just as willing--if the time comes--to act quickly for an epidural or whatever is needed.

All in all I thought it was an exciting visit. Not only does James seem like he's getting ready to go, I'm looking forward to working with Dr. W...and getting to hold our tiny baby in just four short weeks!

On from there, Jon and I headed to the hospital to pre-register and get a little tour of the Women's Center. The pre-registration was long, boring and expensive. Nothing to report. I was thankful my mom was in town and keeping Caleb at home!

The labor and delivery room is huge! When Dr. W told us we could have as many people in there as we wanted, I think it's actually true! We could fit a tight 30 people in there, I'm sure.

I asked about food and the nurse said, "You mean for him (Jon)? Because you're only allowed ice chips." I left that alone. Dr. W had said, "I'll deal with the nurses" regarding that issue, so I'll let her deal with it. The nurse said they provide a birthing ball, but they only have 2, and both were in use while we were there, so if we really wanted one, to bring our own. Good to know, because I LOVED having mine last time.

And then I confirmed that I could carry James out in my arms, which I can. Some hospitals require the baby to be strapped into a baby carrier, which we're not planning on having. And that was the basic hospital visit.

Overall I'm still feeling good. I have slight swelling in my ankles if I've been on my feet all day, but it goes down with rest. Yesterday we went to an indoor/outdoor museum that wore me out. I've definitely slowed down, but I don't feel bad. I'm sleeping much worse lately (Jon says I'm snoring up a storm, which I did with the first pregnancy, as well!). I've been waking up every couple of hours with my mind buzzing about baby stuff, then I go to sleep and dream about baby stuff. I don't feel any less comfortable than I have in the last few weeks, so I think the change in my sleep patterns is more psychological than physiological. However, I might try the couch tonight and see if that helps anything. At least it'll help Jon get a better night's sleep!

Dr. Appt: 35 Weeks

Today was another doctor's appointment. I'll start going every week from here on out! It's getting exciting!

Here are the stats:
Weight gain: None this week. Holding steady at 30 pounds.
Blood pressure: 120/74
Baby's heart rate: 140 (The dr. checked it this time, so she actually gave me a number)
Uterus: Didn't take a measurement today

Though the Dr. didn't measure my uterus, she did check it out and confirm that James is in the head-down position! Hooray! She said it's very unlikely that he will move from that position, so that's good news! Babycenter says that James is about 18 inches long and 5.25 pounds. From here on out he'll just be packin' on the weight with not much more growth lengthwise.

I had a Strep test today, which is just a simple swab test of the vaginal area. If the test comes back positive, that means that James could contract strep as he passes through the birth canal, so they would put me on an antibiotic before delivery to avoid that.

My eczema is doing okay. The steroid cream is keeping the inflammation down for the most part, and the itching has become fairly minimal. My skin is starting to peel on the palms of my hands, but it's still minor right now, and hopefully it will stay that way! Dr. W said that if the eczema sticks around longer than 6 weeks after James is born, she'll send me to a dermatologist to make sure there's nothing more we can do.

We discussed labor options again today. I recently watched a documentary about hospital births vs. home births. It was very one-sided (leaning toward midwifery), but it showed me something I hadn't realized before: the Pitocin used to induce my labor with Caleb was probably what put him in distress, which resulted in a very harried (and hurried) delivery. Pitocin causes contractions to be stronger and longer, which is very hard on the baby. For some reason I hadn't put those two things together. So anyway, at today's appointment, I reiterated my desire to not be induced, and to avoid Pitocin if at all possible (many drs will prescribe pitocin to women whose labor began naturally but isn't progressing "fast enough" or whose contractions are erratic to regulate them a little more). Dr. W asked if that included using it after delivery (it's used to help the uterus contract back down and stop the flow of blood), and I said I thought that would be fine, since James would already be out.

Dr. W also asked me about the episiotomy, if I would rather the cut or to tear naturally. I had to pause about this one, because it sounds so much more in control to have a surgical cut. However, I know of several cases (including my own) where a cut has led to further tearing, excessive blood loss, or other complications. And recent studies seem to be indicating that a tear is actually faster to heal. So, I told her I'd rather the tear. Yikes! I'll have to do a little more research on the topic and make sure I'm certain about that decision.

My desire is the same as it was when I was pregnant with Caleb: I would like to stay at home as long as possible, and have as natural a birth as possible. That, of course, did not happen with Caleb, since we were induced and I checked into the hospital with barely a contraction in my belly. And it really seems that it was necessary to be induced (though I just spoke with a friend who self-induced with castor oil for all three of her kids, which worked like a charm and still allowed a natural delivery...wonder if I should have tried that). But Dr. W seems very fine with the fact that I want a natural delivery, and just emphasized that I need to be very clear about it to the hospital staff.

Perhaps because of our discussion about induction and Caleb's late arrival, Dr. W gave me a handout about "natural methods for induction" and suggested I start them at 37 weeks...starting slow and ramping up to 40 weeks. The handout included things like intercourse and using a breast pump. Well I gotta tell ya, I hadn't expected that! So I probably won't be keeping you apprised of that kind of stuff, but I thought it was interesting/funny that my dr. would pass on that helpful bit of information.

I won't get cervical exams until starting at 38 weeks, which somehow seems like a long way away! Not that I'm expecting anything, but it would be nice to know if there was any progress, and now I have to wait 3 weeks to find out. Oh, well! It'll all happen soon enough, I know!

Dr. Appt: 32 1/2 Weeks

So here we are, charging through this third trimester. Our 32-week appointment got bumped back a little, so we're almost to 33 weeks.

Here are the stats:
Weight: Gained 5 pounds in 2.5 weeks. Woohoo for goin' home to Momma's cookin! Total weight gain of 30 pounds.
Uterus: Measured in at 31 cm, a gain of 3 cm in the last 2.5 weeks
Blood pressure: 112/70
Baby's heart rate: just right

Today's visit was short and sweet. I didn't really have any questions but one, and it wasn't even baby-related. I've found out that my primary care physician won't see me while I'm pregnant; in essence, my OB becomes my PCP during those 9 months. So, my question was about my hands, which had gotten all itchy and bumpy over the last few weeks. At first it was nothing, just a little spot on my thumb, but then my skin started to dry and crack, and then the bumpiness and itchiness spread to my palm and then to my other hand. I'd kind of freaked out, thinking I had some sort of athlete's foot fungus on my hands, and I was a walking disease.

But the good ol' internet assured me that what I had was a sort of eczema, called dishydrotic eczema. As with anything, the internet was pretty broad in causes and treatments, so I spent the last few days using hydrocortizone cream and taking Benadryl--both prego-approved--which at least helped the itching, though it still spread to my fingers and threatens to show up on the soles of my feet, as well.

When I showed Dr. W my hands, she immediately confirmed my diagnosis. She commented that this type of eczema is one of only two dermatological issues that arise with pregnancy (the second--and more common--being acne). She said it was purely hormonal and would probably not go away until after the baby is born, or maybe even only after I stop nursing, but until then she prescribed a stronger steroid cream.

So it turns out that my non-pregnancy-related issue was really pregnancy-related after all. I still feel a little like a walking disease, but at least it's not contagious, and the worst of it on my thumb is healing up. Hopefully the cream will keep the rest in check. I just have to endure itchiness for the next...oh...year or so. I'm really looking forward to that.

In other, much more interesting, news, I've been belated in our baby name announcement! After much deliberation, we have chosen:

James Elliot Norvell

James (Jim) Elliot was a missionary in Ecuador and died serving the Lord there. Maybe Jon will write more about the meaning behind the name sometime. As for the James/Jim question, I'm sticking with James for now, though Jon's going with Jim. We're all for solidarity!

27 Weeks

It's been 27 weeks and I had an appointment on Wednesday. Here are the stats:

Weight: Total gain of 22 pounds
Blood pressure: Holding steady at 120/70
Uterus: Finally a concrete measurement at 27cm (she hadn't actually measured before)
Baby's heart rate: "good" was all I could get out of the nurse. Hmph. Doesn't she know I like numbers?

All of these things are "perfect" according to my doctor. "Perfect" is her favorite word. The nurse takes my blood pressure and listens to the baby's heart beat, so the first thing the doctor does when she comes in is have me lay back so she can measure my uterus. Every time I lay down, her eyes brighten and she smiles a beaming smile. "This looks just perfect. This is great!" Seriously, I feel like I've given her a great gift or something. Because I really have control over what my uterus looks like....

I got my Rhogam shot at this appointment. Because I'm Rh- and Jon's Rh+, I will have to get a Rhogam shot during every pregnancy, and after the delivery of every baby that is not negative. So that was this appointment. Bad news for me: unlike last pregnancy, the doctor does not provide the shot in the office. I have to pick it up at the pharmacy and take it to the doctor's office myself. Inconvenient, yes, but the really bad news is that prescription insurance doesn't cover it. Considering I have a high risk of miscarriage if I do not take the shot, this makes NO SENSE whatsoever. The nurse advised I check with my medical coverage and see if they would cover at least some of it.

I also had my glucose test, and the nurse did an awesome job taking the vials of blood she needed. Probably the best experience ever for me. I won't hear back from them about the test results unless I need to have further testing, so I'm going to assume everything's fine.

Questions I had:
Have I gained too much weight? Dr. W says I'm right where I should be (to quote: "perfect"). It's definitely more weight than I gained with Caleb, but who knows. I'm trying not to worry about it, but sometimes I still do.

Will I need to be monitored through the entire labor? Yes. But the good news is that the monitors are wireless. With Caleb, the monitors were attached to a printout machine with about a 10-ft cord, and I was confined to that area (bed or near the bed) except to go to the restroom or take a brief walk in the hallway. Because of the induction last time, the nurses wanted to monitor me constantly. Evidently this hospital requires constant monitoring of everyone, but at least I can move around some more. Dr. W said it was very important that I move as much as possible, and they would take the monitors off if they interfered.

Will there be a birthing ball available? Yes, as well as a large shower with a seat. Because of being hooked to the monitors last time, I didn't take advantage of the shower, and it intrigues me. I'm wondering if it'll be helpful or not.

When can I first feed my baby? What happens right after delivery is up to me. I have the option of holding my baby before the cord is even cut: the nurses would lay a towel over me, put the baby on top, then a towel on top of him. They would rub him down a little while I got to hold him.* He wouldn't nurse at this point, though. Whether I hold him before the cord is cut or not, the dr. always waits for the cord to quit pumping blood (which I read is a reaction it has when it hits the air...a water-birthed baby's cord won't stop until the baby is brought up from under the water...just a little trivia for ya). Anyway, I like this approach. Dr. K (my doctor with Caleb) had the policy of immediately cutting the cord unless the baby was a little listless, and then she would allow that last bit of blood to get pumped into the baby for an extra boost.

So back to the nursing question, Dr. W said I really needed to let my pediatrician know what I wanted, and while he wouldn't be there, he would send his instructions to the nurses. So I can choose to try to nurse before the baby gets his shots or his eye goop. The advantage to this is that the baby doesn't have all these different hands poking and prodding him, and he's not got stuff in his eyes to keep him from opening them (if you ever saw our first photos of Caleb, his eyes and eyelids are all shiny because of putting the eye goop in immediately). So waiting allows the baby a little extra measure of calm to try nursing for the first time before getting jostled around by the nurses. On the other hand, Caleb did fine with it. He didn't really nurse, but he was quiet and willing to try. So I guess I find out from the nurses if it's a big nuisance for them to have to wait to do all that. If it's not, I think I'd like them to wait while we try to nurse.

I don't remember any other questions, except that we got to talking about how most of Dr. W's responses lean to the more natural methods, and I found out that she trained under a physician who performed not only the basic medical births, but also births using natural methods: water births, etc. And while Dr. W was a fan of those things, she cautioned that she would always have a birth at a hospital instead of at home, just in case of an emergency. While I see some really great advantages to home births, I also have a much greater sense of peace knowing that we're where we need to be if something were to happen.

And that's it on my side of the tummy. How about little Newbie2?

Well, he's up to 2 pounds now! That means he's doubled in weight in the last month--no wonder I've been tired! As with every update lately, he is our little jitterbug, doin' a dance all the time inside Mama's belly. Today when I laid down for a nap, I felt a definite bump up by my ribcage. Whether it was a head or rear end, we couldn't tell, but Jon gave it a little kiss anyway. We love our little boy!

*Funny note: It was at this point in the discussion with my doctor that I started beaming. "I'm going to have a little baby! And I get to hold him! This is real!!" Wow, what a cool thought. However, it was also at this point in my relaying the discussion to Jon that he got very disinterested in what I was saying. I even stopped to ask if he wanted to talk about it later. "No," he said. "I just got really sick feeling all of the sudden." The day of labor and delivery was really hard on Jon last time, and he's not looking forward to it at all! It was pretty rotten for me, too, but I can't help but forget it and remember the sweet moments with my newborn!

19.5 Weeks

We're almost to the halfway point! I can't believe how quickly this first half has gone, yet Christmas (when we found out) seems so far away.

Newbie2 is about the size of a large heirloom tomato, so says my weekly update from BabyCenter. I think he must be sitting lower than Caleb, because I have to go to the bathroom all of the time, which I didn't have to do with Caleb, even at the very end! My belly is definitely growing, and I officially made the switch to maternity clothes yesterday. I've been wearing them for the past few weeks, but mostly just mixing maternity pants with non-maternity shirts. Now I'm all prego, all the time!

One thing I learned about myself during this switch is that I own 33 pairs of pants. What does that say about me? Granted, I've changed pants sizes since I've gotten married--sized up and then back down recently, and I have the pants I wear primarily when early pregnant or after delivery (an extra size larger), and then there's the pants that people have given me, and the pants that I've had since my college years and I love them. I'm a sentimental pants-owner. What can I say? But I do see a need to purge some pants once I've had Newbie2 and settled back to a normal weight. That's another year from now, or so. Maybe I can look at it more objectively by that time.

Newbie2 is still "Newbie2." No name, yet. We've got some good contenders, but I'm just not quite ready to decide, yet.

I guess I forgot to mention on here that we finally made it to our first appointment with our new doctor! Dr. W seems like a nice lady. She reminds me of Dr. K in a way, though without that "you brought my child into the world" bond. Waiting an hour in the waiting room was a little more of a challenge with a wiggly 1-yr-old, but Caleb did okay. Hopefully that wait isn't typical. The doctor didn't do a whole lot, though we did discuss my pregnancy and delivery of Caleb, and any specific thoughts and wishes I had. She seems pretty open to a natural delivery, though she insisted on a hospital gown and an IV. I asked if I could just have a hep lock, and she agreed, though she said she would require fluids once I'd been in the hospital for 12 hours. I'm okay with that. Last time they started my on fluids right off the bat (because of the induction, I think), and I was huge and swollen by the time all the cameras came out to take pictures of the brand new baby. Not that I cared at that moment, but I'd rather just drink a lot of water.

Speaking of drinking, I forgot to ask about eating during labor. Last time my nurse was set against it, but I snuck Gatorade and peanut butter crackers, anyway, something I'm thankful for since I had such a long labor time! So I'll ask about that next time, or rather inform her that I will be bringing sustenance for myself. We'll see how she takes that bit of information. :)

Otherwise, the visit was typical: blood pressure was great, uterus was where is was supposed to be, baby's heart rate was just right, and we set up an appointment for four weeks later (I think the first week of May...can't remember right now).

And that's about all I can think of right now. I've maintained about 10 pounds of total weight gain the last couple of weeks, but I've really noticed my belly growing this week, so that may be about to change! (Truth check: I weighed just now and it said I'd gained 5 pounds, so I'm discounting that one and I'll weigh again later and hopefully give a better report!)