Saturday, June 29, 2013

C-section recovery hints and tips

Towards the end of this week I will hit the 6 month mark. Wow. As it gets closer simple realizations like, oh, this baby has to find a way out, comes to mind. I know I will be having a C-section already with this baby due to past history and issues with my hips/spine.

I am by no means an expert in c-sections. I have only had one myself, so I decided to talk to some of my friends who have also had c-sections to see their take on the situation as well. I'm sure some of these you have heard or read of before but maybe not, so here goes.

Before your c-section (if you know your going to have one - if not, well, you're pretty SOL)
  • Shower now
    • Birth is messy and it will be a while before you can shower again.
  • Trim up your girly parts yourself
    • The staff will probably have to still do this, depending on where your incision is and how much is going on down there. So, your gonna have to get over that, but if you at least trim it down, it may reduce razor burn and itching.
  • Follow your doctors orders about eating and drinking
    • Remember, it's surgery.
  • Remind the staff of your c-section birth plan
    • Yes you should have one for a c-section!
  • Try to enjoy the last moment that you are pregnant
    • Whether your enjoying it for being done or enjoying it because it was pleasant, just take a breathe and try to relax.
  • Take photos
    • This is your last chance to take photos of yourself pregnant, just do it!
  • Prepare yourself for the surgery and ask questions about what's happening
    • Read a book or watch a movie if you have the stomach for it. As much time as I spent reading and preparing for a vaginal birth I was very underprepared for a C-section.
    • One thing I didn't know or didn't remember when the time came is that they will strap you down at your legs, your elbows and at your wrists. You won't be able to move. This was fairly bothersome for me. They did undo my arms after he was born so I could touch his face but I was very upset about being "tied down".
    • Be honest about the anesthesiology and if you can feel them during the tests. When they were testing to see if I could feel anything after the first dose I said I could still feel them poking me and was able to correctly tell them where they were poking me. They waited a bit longer and eventually gave me more which finally made it so I couldn't feel them poking at me. I shudder to think if I hadn't spoken up or they hadn't tested me by poking my belly.

In the hospital
  • Remember one thing
    • You just had massive abdominal surgery and now have a newborn to take care of on top of it. Normally no one in their right mind would expect you to even try to take care of yourself after being gutted like a deer, yet take care of another human being who depends on you for everything. Try to remember this and set realistic goals for the both of you.
  • You may shake like a crack addict in recovery and afterwards
    • You may shake so bad your teeth rattle and you cannot stop it. It's normal but very unsettling if you don't know to expect it. It's all the medication from surgery wearing off.
  • You maybe very itchy
    • One of my friends and I experienced this but not another friend. Our skin was extremely itchy and it happened around the same time as the shaking.
  • You may start coughing
    • This may be an adverse reaction to medication. Speak up! Coughing after surgery is very bad, not just because it hurts but because you can do actual damage (burst blood vessels and whatnot).
  • Ask for help
    • Ask for help with whatever you need. Getting out of bed. Picking up your newborn. Putting on socks. Just ask for help.
  • Grab a pillow and hold it against your stomach
    • Whenever you move at the beginning, hold a pillow to your stomach, it will help with the pain.
  • Never lay all the way down or flat
    • You probably won't even want to try anyways, stretching your stomach muscles hurts, but try to avoid laying flat. It will take a year and a half to get up. Use pillows to help prop you up and use the adjustable bed as much as possible.
  • Don't curl up in a fetal position
    • While you don't want to lie flat, try not to curl up tight either while sleeping. When you wake up it hurts just as much as laying flat. I found that if I slept on my side with a pillow against my stomach and a pillow between my knees it helped so much.
  • Roll
    • If you have to get out of bed by yourself and you are on your side or back, grab the pillow and roll yourself to whatever side you need.
  • Take your pain meds
    • Don't be stupid. If someone had gutted you under normal circumstances you would be hitting that pain button as often as you could. If you are nursing they will give you meds your OB approves of and they won't let you take more than is allowed. Don't skip doses either!
  • Take your stool softener
    • All of my friends and myself all underestimated this one. It didn't click with any of us the importance of stool softeners. But here's the deal, your OB just opened up your insides and moved them all around and your lower side is not happy. Just take them.
  • Ease slowly back into normal food
    • I was so sick before having my son that I had only kept soup down in the last few days. I was so starving but the first food they brought me was not digestion friendly and instead made me feel even more sick. I wish I would have thought to ask them to bring me things like soup, jell-o and yogurts.
  • Get moving
    • As horrible as the idea sounds, you really do have to get moving as soon as you can. It took me 20 minutes to get out of bed and walk 5 feet to the bathroom that first time. But the reason the nurses and doctors will harp on you is that the longer you stay in bed, the more your muscles will heal in a scrunched up position and long term that equals bad.
  • Don't be alarmed when you pee that first time
    • The best way I can describe it is weird. I got up a few hours after my c-section, after the meds had all worn out. I was still on IV fluids for an infection and other issues, so the first time I peed I felt like I had no control and instead it just came gushing out. It was gross and way more than I expected with a c-section; I guess I expected they would have sucked out a lot of it and if they did, wow, that was still a lot left. It freaked me out. It was all bloody. I felt bad for my nurse who had to measure it. Yuck all around.
  • Now's not the time to try out your pushing skills
    • More bathroom advice. If you have to go go, take your time. This isn't a race. Relax.
  • Don't look at your staples
    • My one friend didn't mind but the idea of metal in my skin grossed me out. Yuck. It still does.
  • Take a shower as soon as you can
    • I felt so incredibly gross, itchy and covered in sweat by the time I was unhooked from everything that I couldn't wait to take a shower. My hospital had a 24 hour wait from delivery time period which I wasn't expecting at all. Make sure to ask your hospital if they have a rule like this.
  • Keep your scar dry by using a pad
    • Seriously, it's got to stay dry or it will get all gross. Towel it gently or use your hair dryer on cool to dry it carefully after showers. After you dry it, stick a pad horizontally across and right up against it. It will help draw the moisture away from it.
  • Request more food if your hungry
    • By the 2nd day I was starving. I ate every single piece of food on my tray, food I would never eat normally. I could not seem to eat enough food. One of the nurses tipped us off that if I was still hungry I just had to let them know and they can add more food to your trays. One entrée only? Screw that, order two. Don't like any of the options, ask what other options are available, I was told that at my hospital things like chicken fingers, mac n cheese and pizza are usually available for lunch and dinner every day! Another tip I learned was that my hospital had a small kitchen on it's maternity floor stocked with cheeses, yogurts, juices, crackers and other small items. I cleared them out of cheese and crackers but they didn't seem to mind.
At Home
  • Get help
    • Whether you have to bribe, beg or pay someone, you will need help. Accept meals, baby sitting and any other wonderful things people are willing to do for you.
  • Have meals on hand you can eat with one hand
    • Whether you make them yourself before hand or you beg someone else to do it for you, having simple meals already on hand helps. Your brain is already so tired and standing up for long periods of time to make a meal just doesn't happen with a C-section scar.
  • Take the stairs sitting down and backwards
    • If you have stairs in your house, at some point you will have to tackle them. If you need to go up them and are carrying something important, like your baby, but are still shaky, you will need to take your time. Sit down on each step with your feet firmly planted on the step below you, then gently lift yourself up each step, making sure to rest on each step. You can do the same going down, sliding down each step on your rump like a toddler does.
  • Make a baby head quarters
    • Try and put all of the baby stuff in one area. Having to schlepp diapers from one floor to the next or even room to room is overrated.
  • Put your changing station at stomach level
    • While I later changed A.'s diapers on the floor with a changing pad, at first it was so much easier to change them with him laying on the pad that was secured on top of a dresser.

Any tips or hints I missed?

Thursday, June 27, 2013

Cold Shrimp and Veggie Pasta Salad

I hosted book club this week and it was long overdue for my turn! I love book club and not for the books, for the ladies I have book club with. They are the greatest bunch of woman I know and I love seeing them each month.

Last time I hosted I made a simple pineapple salsa and caprese salad on a stick. I also made mac n cheese cups that didn't turn out well, but moving on. This time I was going to host it outside (it was too muggy though) so originally I wanted the menu to be light enough for outdoors but enough that people didn't go away hungry.

The menu was a simple one starting with Tazo iced passion tea lemonade, fruit salad, cold shrimp and veggie pasta salad, pepperoni pizza dip and for dessert, s'mores layer bars.

Is it a sophisticated menu? Nope. Do the flavors go well together? Maybe? I don't know really, my only goal was to pick 2 sort-of-healthy options and two, very not healthy options.


Cold Shrimp Pasta and Veggie Salad
I made this the night before and it helps the noodles soak up the flavors. I just made sure not to overcook the noodles as they will soften overnight in the dressing. I didn't add the shrimp, avocado or parmesan though until about an hour before I served it. The shrimp and avocado might turn colors, it's still good but less appealing. If you're making it to serve that day, then just dump everything in.

Ingredients
8 oz uncooked pasta - I used tri-color Fusilli (short curly noodles)

16 oz deveined shrimp

1/4 cup thinly sliced red onion
1/2 cup sweet corn kernels
1/2 cup diced bell pepper
1 whole avocado, cubed
1 1/2 cups diced tomatoes
1/2 cup finely chopped cilantro

1/2 - 1 cup Italian dressing
1/2 cup freshly shredded parmesan
juice of one small lime

Directions
Boil noodles until they are al dente. Remove from heat, strain and rinse with cold water.

Remove any tails on shrimp and rinse well. Chop up shrimp or leave whole.

Combine noodles, shrimp, veggies, Italian dressing, lime juice and parmesan cheese.

Refrigerate pasta salad for at least an hour and then serve.

Tuesday, June 18, 2013

My breastfeeding journey & Why I don't want to do it again

When I was pregnant with A. I had no doubt that I would breastfeed. I read from cover to cover The Womanly Art of Breastfeeding, watched numerous videos about all aspects of breastfeeding, read forum after forum about hints and tips and spoke at length with My Mom who breastfed me until 15 months and My Brother until well past the age of two. I felt I was well prepared.

I knew breastfeeding was a skill, a difficult one, with a harsh learning curve. I knew it wouldn't be easy and prepared myself to be frustrated but I knew that there was no way I was ever letting my baby drink formula. Breast was best, period. I brought all the samples into work and left the coupons for formula on the shelves.

Then I had A. His birth was the exact opposite of what I had planned for - PROM followed by an induction due to it and pre-e, medicated, infection, fever and it all ended in a C-section after 18 hours of back labor and 45 minutes of pushing. I was exhausted and very sick from all the complications I had run into. A. was lethargic and had to have additional testing after birth due to his kidneys not functioning in utero (they checked out fine after all).

I did not see A. until at least 2.5 hours after his birth.  I could not get him to wake up until almost 4 hours after birth. My first attempt at breastfeeding was a blur. It didn't go well to say the least, A. was still sleepy and I was left with a bleeding nipple. A. quickly fell asleep and the rest of that day is blurry at best.

Over the next few days I tried to get A. to latch. Every time it was like electric needles and I knew it was wrong. My Mom helped to reposition me and A. several times, becoming frustrated herself at A.'s latch but reminding me we were both learning and to keep trying. The one LC at the hospital herself unlatched A. at least 10 times during one feeding I remember in particular, before she simply gave up and stated he must not want to nurse at that time. They checked his mouth and declared he wasn't tongue tied, just lazy, so I was to be extra diligent about his latch, breaking it every time it was wrong. I broke every latch.

The LC's seemed frustrated every time they came in, popping him off and changing my hold with him. When I asked why my breasts didn't feel full and I could still wear my same bra from before I was pregnant, or why I couldn't feel this sensation called let down, they said all mother's are different and not to worry about that kind of thing. I also asked why my nipples were flat. They stated simply some women have flatter nipples than others but it was nothing to be concerned about either. I persisted, stating that I couldn't seem to get A. to take the nipple correctly and one got me a nipple shield. A. seemed to latch a bit better with the shield but it still burned every time he latched. I asked why his top lip didn't flare out and why every time I flipped it out for him, it broke his latch. They stated he was learning too, give him time.

We ended up staying for 5 days in the hospital due to my complications. At the end of day 5, despite A. using me as a non-stop pacifier, my milk had still not come in. The LC, each of them, reassured me that I just needed to continue to let him suckle but under no circumstances should I supplement with formula and I should not introduce a bottle until at least 6 weeks. My milk would come in and we would be fine. So A. and I ended up heading home, nipple shield always by my side.

At A.'s check up at 8 days old he has lost over 12% of his body weight, his jaundice was not better and he had orange crystals in his urine. He was however having 6+ wet diapers a day and at least one bowel movement, yellow in color. His doctor recommended I just increase my water and calorie intake to ensure I had enough breast milk. At about a week and a half his bilirubin levels were fine and A. seemed to be getting enough milk, his output increased and his doctor assured me my milk was fine as A. had begun putting weight back on. He explained some babies are just slow and steady gainers but he wasn't concerned.

I continued breastfeeding A., stacks of pillows underneath him, nipple shield always in place and constant re-latching. I cried at the pain every session and found my days consisted of A. nursing on each side for 45 minutes each, to have a 20 minute break before he would want to nurse again. I knew babies liked to suckle at the beginning so I just kept going. I remember thinking things seemed okay until he turned 3.5 weeks and one day he just started screaming. He suddenly began pulling away at every nursing session, arching his back and screaming as I tried desperately to shove as much of my saucer cup sized areola and flat nipple into his mouth.

Soon our new routine started. I would put on the nipple shield, A. would latch, suck-suck-off. I would latch him again and we would repeat this, for 45 minutes on each side. He would fuss and I would cry. I called the LC at the hospital who assured me some babies were just fussy but that it might be something I was eating, so to cut out certain foods and add others in that would promote breast milk. I cut out almost all foods that have been known to cause problems and added in 4 cups of oatmeal a day, a 8oz glass of water during every feeding, the handful of fenugreek pills, mother's milk tea and extra fruits and veggies. I felt like I was starving all the time.

When I called back to report it didn't seem to be my diet, she suggested I might have low milk supply. At the suggestion of the LC, I began a new routine as well. I would nurse A. for a total of 1.5 hours and then pump both sides at the same time for 20 minutes. I never pumped a single ounce out. The LC said that was fine, it was just to stimulate my breasts to produce more milk.

I continued on these new routines, the nursing and pumping and the constant re-latching until A. was 3.5 months old. Then suddenly one day he simply wouldn't latch, no matter what I tried. He missed his morning nursing session, then the next two. Desperate, we brought him to prime care. He weighed 13.5 pounds, or between the 25-50% for weight. The doctor who saw us asked when he has last ate and how much. I explained I nursed so I couldn't tell her how much but at the 6AM feeding; it was now noon. She frowned and looked at his chart. She asked again why I didn't know how much my baby was eating in ounces and I remember looking at her puzzled.

She asked if his doctor was aware he was gaining weight very slowly. I shrugged and said he was regularly seen at his doctor and his doctor said his weight was slow but steady. She then stated that we should bring him home and try to nurse again. If he refused, feed him water from a spoon. When I expressed the concern that water was not recommended for infants that young she sighed and stated, "well you clearly do think your opinion is better, after all this baby is completely unvaccinated". I sat there stunned. It was true, but I hadn't come here looking to discuss his vaccinations. I went to open my mouth and The Husband broke in, telling her we hadn't come here for her bullshit and he picked up the diaper bag and we left rather suddenly. We went home and around 2PM A. finally, exhausted and crying, latched. This would be the 1st of at least a dozen nursing strikes. I never did figure them out.

The trip to prime care turned into a trip to his doctor the next day where they evaluated him for reflux. I asked about his weight gain and his doctor, who is actually a family doctor who has been practicing for 30+ years, said if he was worried, he would have said so. None the less, he patted my knee and told me if I wanted to stop nursing, formula was okay and sometimes breastfeeding just doesn't work, no matter the effort. I nodded, thinking he had lost his mind and asked for a referral to the children's hospital for reflux.

In the mean time, we began giving A. reflux medication and he seemed to fuss less at the breast. He still screamed almost every second of the day. By the time we saw the specialists he was 4.5 months old, which only happened because they called with a cancelation, his original appointment was for when he was nearly 8 months old! His weight gain had slowed down and his growth curve started to drop.

The specialist who saw us went over his birth and our breastfeeding till now. He jotted down notes and then asked how much milk A. was getting. I said I simply didn't know because I never could pump anything to put in a bottle, the most I had ever pumped was 1/2 an ounce. He frowned and jotted down another note. He warned me A. was close to the failure to thrive mark and I was sent home with a new routine and homework.

I was to begin supplementing immediately, that day, with double scooped formula after I nursed him, 2 ounces at a time to begin with. I went home and latched A. who arched, flared and screamed. I cried. I made My Mom feed that first bottle of formula to A. He gulped it down quickly and fell asleep. I bawled even more. I entered in the length of the nursing session, how many ounces and when,  and then stared at the sheet. At the bottom of the chart were helpful feeding tips at the bottom. All the hints I had already tried or were still doing.

I then sat down to begin my homework. I was to track how much I pumped in one day while A. received formula. I don't remember the actual number, but even without nursing A. for a day, I never pumped more than 1 ounce off each breast. They figured I was pumping less than a third of what he needed. I argued with the nurse, stating that pumping was not an adequate indicator of supply but they were more concerned now than before. I was then told to start weekly weight checks on him with my local doctor and call that information in as well while increasing the amount of formula he received. They told me I needed to drink more water, continue the pumping and let A. nurse anytime he wanted. I was told I just needed to nurse more often and my supply would increase.

So began our third new set of routines. I would nurse A. in the latch-suck-suck-off,  latch-suck-suck-off, repeat for the 45 minute pattern, for each side. Then I would feed him a 4 ounce bottle, double scooped with formula. I would put him in his bouncer or swing and pump both sides for 20 minutes. I would then have 10-30 minutes before I started again. I did this until A. was 7.5 months old and I finally gave up. By that point A. was drinking 8oz bottles of normal scooped formula every four hours and eating solids. I doubt he received any breast milk at all at that point. I just simply stopped one day.

I never once leaked. I never once felt encouraged, no matter how long I went between feedings or pumping. I never once felt the sensation of a let down. I burned through the motor on my first pump. I never had any milk to freeze.

I felt trapped and isolated. I resented my breasts and their clear failure to feed and keep my son alive. I hated breastfeeding. I cried every day over my failure to breastfeed my child and the poison I was sure I was feeding him. I became consumed with his weight, my output, diet and routines. I became mentally unstable over breastfeeding.

Now, four years later, I am sad that A. and I struggled for so long. I am mad because it was my fault for being so stubborn. I should have realized despite my efforts, providing my son's nutritional needs on my own just wasn't something I could do.

I won't ever know why, not truly, why we couldn't breastfeed successfully.
  • Was it A.'s colic and constant screaming?
  • Was it his reflux?
  • Was it because at the age of 2 we were told by his speech pathologist that the underside of his tongue was incorrect?
  • Or was it the fact that at 3 his dentist showed us that he has a frenum muscle that makes it hard for his upper lip to flare out?
  • Is it because at age 4 he was diagnosed with poor motor control planning in general?
  • Was it is because I was told by my RE just this past year I have PCOS?
  • Was it my flat nipples?
  • Was it my severe PPD?
I don't know, but I suspect all of the above. And now I'm left with the realization that I'm half way done with this pregnancy and in just a short few months I will have to feed this baby.

But... I don't want to breastfeed. Not really.

The very thought of trying to breastfeed this baby causes my breathing to quicken and my pulse to race. I have to close my eyes and mentally calm myself down. Trying to write this all down alone caused me to have to stop multiple times due to anxiety. I just don't want too again.

But I still feel guilty. Like I should give it a good college try and see. Maybe this baby will be a better nurser? Maybe I won't have supply issues? Maybe I'll love nursing this time?

But what if this baby isn't? And what if I still hate it? I can't be as insane as I was with A. I can't. I have a little boy who needs his mommy to function and not cry every day. I have a baby who needs not only food but a mother who doesn't dread having to feed her. The Husband deserve a wife who is mentally stable. I deserve to be mentally healthy.

That being said, I know that I will at least nurse in the hospital. I will try it again but I don't truly want to. I will try to nurse but my heart just isn't there this time.

I feel guilty that I'm not willing to put as much effort into nursing this baby as I did her brother.

I feel guilty I'm letting one bad experience influence my decision for this baby.

I feel guilty I don't want to breastfeed.

After all, isn't breast best?

Sunday, June 16, 2013

Our Gender Reveal Party

So last weekend was our big gender reveal party! I kept it super simple and just invited our parents and siblings to the party. I couldn't have asked for a better day for weather, so we had it in our back yard.

We still haven't figured out that family picture thing yet. Oh well.

It turned out great and I loved having our families with us to hear the news.

My Dad and his Wife even made it despite heavy traffic on the highway.

And of course My Brother and Sister-in-Law stopped after work.

I don't know what was up with my Sister-in-Law in this picture, but I promise she was having a good time!

Décor was simple, a few balloons My Mom picked up and blue and pink plates, napkins and silverware.

I served a simple menu of pizza, chips and watermelon. I also picked up a good amount of blue candy and pink candy. Finding candy with blue and pink wrappers was a bit easier than I actually expected. I ended up using Hersey's Bliss White Chocolate and Hersey's Cookies n Cream Kisses for the blue candy and Starburst FaveReds and mini boxes of Willy Wonka Grape and Strawberry Nerds for the pink.

And lots of drinks. Besides the usual pop choices, I also served Hawaiian Punch Berry Blue Typhoon which A. was so excited to pick out. I don't think he's ever had Hawaiian punch before so he was very excited to drink it. I also picked up Simply Lemonade Raspberry, I love that stuff!

After eating, we had A. bust open a piñata to reveal what we were having. I didn't want to spend a fortune on either the piñata or the candy for inside it (same as the candy above) so when I found this tiny baby carriage piñata for $8 it was perfect!

A. was really excited to be able to swing a big stick and bust something open.

I stepped in to help. Piñatas are tough!

I ended up being the one who knocked it down finally to reveal the... PINK candy!!!

Here's A. trying to get the candy out. He didn't seem to understand the fuss of pink candy, he just wanted to know if he could eat it.

To celebrate, The Husband had ordered two cakes from the place that made our wedding cake. In full disclosure, they mixed up the fillings but oh well. The first one was vanilla cake with a strawberry buttercream filling. So yummy!

The next was a chocolate cake with blue tinted butter cream. Their frosting is so, so full of sugar it makes your mouth buzz.

A. was so excited to eat cake he asked for a bit if both. I figured, hey, it's a great day, why not let him? He was still bouncing off the walls that night at 9. Oops!

So there you have it... we're having a GIRL!!!

Well 80% chance it's a girl... baby is in there, facing out and in the breech position with her legs folded up and underneath so the tech could only be 80% sure. I have another scan next month to check on the position and redo some measurements that they couldn't get because of the position, so we will check then too. Stay tuned!

Sunday, June 2, 2013

MIA action

So I went missing again. Besides growing a baby and raising a 4 year old, no good reason why.

I'll try and update better in the future... for example, this Friday we have the big ultra sound! Hopefully lots to update next weekend!