Sunday, November 30, 2014

Flu Vaccine and Family Dynamics

I am typing this as my sweet little girl sleeps next to me. It's hard not to just stare at her perfect features all day, but I will try to focus. 

C and I both work in healthcare, at the two major competing hospitals in our city. Both hospitals have required employees to receive the yearly flu vaccine for several seasons now. If you refuse the shot for certain allowable reasons (religious, allergies, etc.), you are required to wear a mask to work during the entire flu season. I remember the rule causing some controversy at first, but now it is just automatic. 

I agree with the mandate. We elect to work with sick people that are a) more likely to transmit germs to us and b) have compromised immune systems and are at greater risks of complications if we transmit germs to them. 

Our daughter is now just four weeks old and is in the category of greatest risk for complications from the flu, being under 6 months. Also being under six months, she is unable to get the vaccine. Her immune system is just too tiny and fragile now. Therefore, the CDC recommendation is that those around her be vaccinated and that we avoid anyone who is sick. The flu is contagious at least one day prior to the onset of symptoms and then at least five days after symptoms appear. 

Being overly cautious, first-time parents, C and I have requested that anyone who holds our daughter have received the vaccine and not be ill. 

My family was extremely agreeable to this. My sister's husband who has never had the vaccine in his life and lives two hours away got the shot. My two uncles, one without insurance and poor finances, got the shot. My single, male cousin got the shot within two days of his dad mentioning it and without any specific plans to see her. Everyone at our Thanksgiving dinner was vaccinated and took turns passing around the baby from relative to relative. 

C's family has been another story. Of his three sisters, only one got her family vaccinated. They normally get the flu shot, as both parents also work in healthcare, but made sure that it was received a little earlier this year. His one sister reported concerns about how it is is made and opposing most vaccines based on this principle and his other sister didn't give a reason. His mother "never gets it" due to concerns of potential allergens and his father "was going to get it" but ended up having a UTI that day. 

At their family Thanksgiving dinner, C brought hospital masks for people to wear if they wanted to hold Beuhla despite not being vaccinated. Only his mother opted to don a mask for the sake of holding the baby. Everyone else declined, giving the strong message that it wasn't worth it. We spent the entire time with Beuhla in our own arms, with what felt like minimal interest from his siblings or their families. (His sister's family who had received the vaccine were unable to make the trip, but I'm sure they would have been more enthused to see her.)

Needless to say, C was hurt by his family's lack of enthusiasm and for them not taking his request seriously. I think it was especially hurtful in comparison to my family. I let him take the lead of deciding how to handle the situation (i.e. sticking to our original plan or giving in) and I think he was comfortable with the decision. After all, it's not like we were asking for something that wasn't also to their own benefit and we also provided a second, non-invasive, option of the masks. Personally, I have not had a strong emotional reaction, instead observing the unfolding course of events with a sense of intellectual curiosity. 

I am curious about why our two families responded so differently to this request: if it is the difference between Beuhla being the first grandchild in my family compared with the 10th in C's family, or if his family doesn't take him seriously because he is the youngest child, or if my family is more open to vaccinations in general due to our strong presence in healthcare fields, or some other reason. 

It is also been interesting to me to observe this as one of the first controversial parenting decisions we have made - How our parenting can influence family dynamics so significantly. How others' can have such strong opinions and emotions when it comes the decisions we are making for our daughter. How much easier it would have been to allow family pressure to influence us away from our beliefs and ideals. Parenting is proving to be a fascinating social psychology experiment.

Thursday, November 27, 2014


I was cleaning up my drafts and noticed this post written on October 8th, 2014. I am not sure why I didn't hit "publish" back then... perhaps something about the curve ball I was afraid of and not wanting to jinx myself. I'm not afraid anymore, just grateful...

There have been times over the past few weeks that I have been filled with such an overwhelming sense of gratitude and good fortune. I am 35 weeks pregnant and everyone is seemingly healthy. C graduated nursing school and is being asked for interviews in jobs that he is excited for. Our finances are actually on an upswing and we are starting to return to discussions of home-ownership in our future. Could life really be working out this well?

Yes, this is definitely delayed. This is where I was hoping we'd be a few years ago, when we were planning our wedding.

But then life always had this way of throwing wrenches in our plans. C couldn't find a job and we had to downsize and then downsize again. I was in a horrible job that resulted in significant mood difficulties and destabilized us from moving forward on any future plans. C got kicked out of nursing school and then had to go through a huge process to be reinstated. And then there was the infertility. 

Now. Now it seems that we are so close to realizing our initial married goals, I can actually vividly imagine it. I can picture our life how I used to be able to picture our lives when we were first engaged and married. Before all of the uncertainty and wrenches and faulty plans. Now it feels so incredibly attainable...

...that part of me keeps waiting for the other shoe to drop. It seems almost too good to be true. That it can't possibly work out this well. I simultaneously feel so incredibly fortunate and then also still on edge, waiting for the next curve ball. 

Tuesday, November 25, 2014

Infant Personality

People have asked what Beuhla's personality is like, and I'm never quite sure how to answer that. I don't have anything to compare it to. Is she easy? Difficult? Serious? It all seems so subjective. Here is what I know:
  • Sometimes she loves to get her diaper changed and other times she screams as if we are killing her. 
  • She loves to look at lights. She also likes to look at our faces when we talk to her, but would prefer lights. 
  • She makes the cutest surprised face, with her tiny little mouth forming a small circle, after she has a large or noisy poop. 
  • Her smiles look mischievous and she often squints her eyes as if she doesn't trust whomever's arms she's in. However, most of the time her eyes are wide in constant amazement of her surroundings. 
  • She generally likes baths but hates getting her armpits cleaned. 
  • She has great neck control and doesn't mind tummy time like many babies. 
  • She prefers to be in the arms of someone rather than anywhere else, but is getting better about sleeping on her own. 
  • She will scream bloody murder when being put in her carrier, but them quickly becomes super content and loves car rides. 

Saturday, November 22, 2014

3 Weeks Old

Today my precious little girl is three weeks old. She was up to 7 pounds, 6 ounces at her pediatrician appointment yesterday and is healthy and generally happy.

We just concluded a three day period where she would not sleep for more than 20 minutes at a time without being in someone's arms and was generally inconsolable. I nearly broke down twice, but then she came out of it and has been sleeping in her crib for up to two hours at a time all last night and today. It's amazing how two consecutive hours of sleep can feel so amazing!

Sleep has been our issue from day one. She never liked to sleep in the basinet at the hospital, much preferring our arms, and we've worked daily at trying not to let this become a habit. It was common for us to put her down in the crib or cradle and her to be away and fussing again with 20 minutes. Luckily, she has generally been improving on this each day.

Eating is going well. She took to breastfeeding fairly easily and it wasn't nearly as painful or uncomfortable as I was afraid of. I often get stressed out that I am not producing enough milk, but there really isn't any good evidence to support this anxiety. I try to pump at least once or twice a day. Right now, this is used by C for one or two feedings at night, which allows a little longer consecutive sleep for each of us, but I hope to eventually start to build up a supply so that she's not always tied to me. It sometimes feels very restricting, like I have an anchor attached to me, to know that she is dependent on my breasts at such a high frequency.

C has been the most fantastic support and father that I could ask for. He has taken such an active role that, with the exclusion of the breastfeeding issue, I really feel like it's a 50/50 split of care-taking. He plans to take his nursing licensure exam this upcoming Monday, and I am so proud of him juggling the preparations and anxiety for this with these first few weeks of parenting.

Today, as I was breastfeeding, I looked down and unequivocally realized that I am a mother. This is very real and very permanent. It made me smile that it took three weeks to appreciate this, but I'll blame the sleep-depreciation on my lack of self-reflection.

Monday, November 10, 2014

Microblog Monday: first week of motherhood

Some random thoughts after my first week as a mother:

  • Many baby items are reminiscent of horror movies (eg. The creepy lullabies of the wind-up mobile, the night-vision mode of the baby monitor, etc.)
  • I haven't figured out yet how to simultaneously hold the breast pump nipple guards to my breasts and turn on/off the pump at the same time. So far, this has resulted in one dropped and spilled bag.
  • Babies have the best smell and the softest skin. I knew this before, but I am constantly amazed by it. 
  • I am also amazed at how my body has been changing shape daily, slowly beginning to resemble what I remember as normal.
  • Women's sanitary pads have come a long way since I last used them as a teenager.
  • Even more than any aspect of Beuhla herself, so far my favorite part of motherhood has been watching C be a fantastic, loving father. 

Saturday, November 8, 2014

Short but Dramatic: Beauhla's Birth Story

I was admitted for a scheduled induction at midnight on Saturday morning, November 1st, due to the worsening preeclampsia. The intake process took a while, and they finally inserted the Cervadil around 2:30am. The doctor at this point told us that this is usually kept in place for 12 hours, at which time they reassess if I need a second round to continue softening my cervix or if it would be ready to begin the Pitocin to initiate contractions. They warned that I might feel some mild cramping but that full contractions would probably not begin until the Pitocin was initiated. At this point, C and I were preparing for a very long night/day and bracing ourselves for the likely possibility that Beuhla** would not be born until Sunday.

I was not allowed to get out of bed for the first two hours of the Cervadil, which is why I remember that by 4:30am the pains were starting become very bothersome. It was impossible to get comfortable enough to sleep and I was mostly feeling a lot pain in my back.

Between 4:30 and 7:00am is when things started to get stressful. My blood pressure continued to rise, with the diastolic surpassing 100, and labs were coming back problematic. They decided that I needed IV medication to help with the blood pressure and ended up requiring at least a second dose to begin lowering it. Because of the high risk of seizures, I was also started on Magnesium Citrate via IV, which required complete bedrest, more frequent monitoring for the risk of respiratory problems, complete fluid and food restriction, and a foley.

The pains also began worsening. C asked if I was having contractions and I remember responding, "I sure hope so!" He attempted to time them and said that they never really achieved any regularity in terms of how often they occurred or how long they lasted. They started to get unbearable, but I felt like a real wimp because at the last check I was only 1cm dilated and kept remembering that the "real" contractions weren't even supposed to begin until after given the Pitocin. I started panicking a little in thinking I would have another 12-18 of this and then I made a deal with myself to make it until 7am before asking for the epidural. At 7am was the shift change and the CRNA that knew my mom was coming on. She came in by 7:10.

The epidural was in place by 7:30 and I felt pretty immediate relief. I could actually get comfortable in the bed and then started returning to mentally preparing for being bedridden and hooked up to IVs and the foley for a whole day.

This relief lasted for about an hour and then I started feeling pressure at the bottom of my cervix that was transient. The nurses determined that the pressure was associated with each contraction and I was  reminded again that the epidural can help with pain but not with the feeling of pressure. The intensity of pressure continued to worsen and increase in intensity fairly rapidly. I started feeling the distinct urge to push The nurse checked again and I was only 4cm dilated, which was very disheartening because the feeling to push was very distinct and growing.

Around the same time, the baby's heart rate decelerated and many more people starting hanging around the room to monitor her, with hushed voices about how to manage this situation. There were frequent calls in to my doctor and constant re-assessing of the situation.

The urge to push became unbearable pretty quickly. C and the nurse did a great job of coaching me to blow out air, which is incompatible to pushing, but each contraction was more and more difficult. I remember hearing the nurses talking, and then decided to check my cervix again even though it had only been 15 minutes from the last check at 4cm. "Stranger things have happened" said the one nurse. Turns out, in 15 minutes I went from 4cm to "8-9cm".

At this point, there was a much more frantic attempt to get my doctor in the room and a flurry of activity around me that I was only slightly aware of. My resolve to resist pushing was diminished but C stayed by my head and kept reassuring me.

My OB quickly arrived, finished getting set up, and finally I was allowed to give into the urge to push. Then the nurse went immediately from feverishly discouraging any pushing attempts to now being very adamant about the pushing. I recall being slightly annoyed by her change of pace, but more relieved that I could now listen to my body.

I likely pushed around 5 - 10 times. I distinctly remember two pushes being tied to her head and then one to get her shoulders out. I remember thinking that she must have broad shoulders, because this was most uncomfortable episode of pushing.

Our daughter was born at 9:26 am, approximately 7 hours from when labor was medically initiated. She was initially blue and took too long to cry for my comfort. I found out later that this was because she had the umbilical cord wrapped around her neck and that my placenta had begun abrupting. I did not know about this complication ahead of time, but learned that a placental abruption is a serious complication that can result in the mother bleeding out and the infant losing all sources of oxygen, which is likely the cause of her decelerated heart rate earlier in the morning. It was very good that she was born when she did.

Despite all of this, her APGAR at one minute was 7 and at five minutes was 8. She was was born weighing 7 pounds, 3.5 ounces and at a length of 19 1/2 inches. After a short and dramatic morning, we are now the proud parents of a generally healthy daughter.

**For the sake of anonymity, I have decided to retain her "place-holder" name of Beuhla for this blog. Rest assured, that she was given a more modern and fitting name in real life.