Saturday, November 28, 2015

Coming Out of the Infertility Closet.... Again

Yep. We're going through infertility. Again.

Ryan and I have been trying to conceive for the past 6 months without success. It's been difficult. Not as much as the first time, but still really hard. We've even looked into adoption, as in called a bunch of agencies asking tons of questions, but found out it's so astronomically expensive that it won't be an option for us right now.

I know you don't get to pick what your hardships are in life, but I so wish it could be something else. Something not so important to me. Birth and babies are my big passion. I think about Audrey's birth all the time. I think about my next pregnancy and birth, and what I want to do differently all.the.time. I even made a part-time career out of my obsession interest! It feels especially cruel to have to go through this struggle again. Infertility is a special kind of hell; it can be a repeating cycle of intense grieving and hopeful optimism, depending on where you are in your menstrual cycle.

Usually in the beginning of a cycle, when I got my period, I was extremely depressed and angry. Because that was when we knew the attempt failed and my womb was not filled with new life but was empty. After about a week I would start to feel better and look forward to the current cycle. After insemination I would typically feel really excited and hopeful, even if I didn't want to. I tried so hard not to think about it, but it was always lurking in the back of my mind. The last few days before my period was expected were excruciatingly slow. Every time I used the bathroom I would hold my breath until I saw there was no blood. Sometimes I broke down and took pregnancy tests, which were always negative. But I knew that it might be too early for a positive so I wavered between still hopeful and pessimistic. After the first cycle I stopped taking my temperature daily after I confirmed ovulation because any little dip or rise would set me off on a whirlwind of emotion, whether I tried my best to ignore it or not. And then I would get my period and the cycle would continue.

I generally don't handle emotionally pain well; give me physical pain over emotional anytime! And this process is especially hard emotionally. So far I've been able to stay off anti-depressants but I know the worst part of the year is coming up so we will see how it goes.

I've tried SO MANY natural supplements, vitamins, herbs, acupuncture, you name it. I even tried Clomid, a fertility drug, for two cycles. And those of you that know me well know I would have to be really super desperate to try a pharmaceutical option. The Clomid "worked" to improve my cycle but I still didn't get pregnant.

One of the reasons why I haven't been able to conceive yet may be because I'm still nursing Audrey. Most women can get pregnant while breastfeeding, especially an older toddler. I really really wanted her to self wean. I didn't think she was emotionally ready to wean. I wasn't emotionally ready to wean. I was even looking forward to giving tandem nursing a try! But breastfeeding can affect your cycle, usually by causing delayed ovulation and a short luteal phase (the time between ovulation and your period is the luteal phase and it's thought that if this phase is too short an embryo can't implant in the uterine wall). This is what happened to me and what Clomid "fixed." (Clomid is compatible with nursing an older toddler, by the way).

I thought about waiting longer to try for another baby and see if she would wean in the meantime. But I've wanted to have another baby for so long, and if I have to choose I want another baby more than I want to keep nursing her.

See, this whole thing feels so selfish too. Like I'm putting my needs above Audrey's. I *know* 99.9% of 3 year olds in America aren't nursing and I *know* she will be fine and won't "remember" but a part of this still feels wrong and selfish to me. I feel somewhat comforted by the fact that she stopped nursing during the day about two months ago, on her own accord. So maybe she is "ready." But this is still so hard for me!

We know that our insemination timing has been spot on, thanks to my cycle charting. We've been doing IUIs (intra-uterine inseminations) at home, which is how we conceived Audrey. Even though I've spent hours researching IUIs and donor sperm insemination at home I still wonder if maybe we're missing something. So I've also decided to go see a great, naturally minded OB who specializes in fertility in January. I hesitated to go in because A) we did this successfully on our own before, and B) it's very expensive. We've already spent about $5,000 on trying to conceive so far, which is A LOT of money for us. I thank God that I have my business because that is what has paid for most of it. I honestly don't know how we're going to pay the possibly very high bills that come with seeing an OB on a regular basis, which may include tests, ultrasounds, and even minor surgery. My insurance covers nothing infertility related.

Right now, we are taking a break from trying. I thought it would be hard to stop but it's actually been really nice to take a break from "living in the cycle!" I was able to enjoy our much needed vacation in Florida, Audrey's birthday, and look forward to the holidays.

But sometimes I still get angry, depressed, and jealous. I don't always 'like' or comment on friend's posts on Facebook if they are pregnant or have a new baby. I sometimes dread teaching my class or going to visit my doula clients, which normally brings me only joy. So the reason for this post is to let everyone know if I seem to act weird or if I've disappeared on Facebook: it's not you, it's me. But also because many people don't share when they're going through infertility. I chose not to tell most people we were trying because I really wanted to surprise everyone with the news that I was pregnant. Since that hasn't happened and I consider us to be going through infertility again, I'm tired of hiding this secret. I'm tired of pretending that everything is all right when it's not. And I shouldn't have to hide because infertility is real, it's not shameful, and more people go through it than you might think. We are 1 of 8.

Friday, August 28, 2015

Talking to a 2 Year Old About Her Donor Conception Origins

Recently we purchased a book for Audrey that discusses the origins of a sperm donor conceived child. I've done a lot of research on this topic (big surprise!) and what I found was that telling your children about their donor conceived origins was not only recommended, but that there are benefits to starting "that talk" early in their life. Before we decided to go the route of donor sperm I had read several books on the subject that included stories from donor conceived persons. Many said they remembered when they were told about their origins and that it was traumatic for them. I didn't want Audrey to remember a specific day where her belief that Ryan was her biological father was shattered when we told her the truth. We decided it would be best to start talking about it during the toddler years in a simple, easy way for her to understand and adding more age-appropriate details as she grew older. In this way we treat the issue like we would if she was adopted: these are the facts, they are not a shameful secret, and you have a right to know about your origins.

Of course this means we will have to have the "birds and bees" talk much sooner than most families do - but we would have done that anyways! At this point we aren't talking about sex at all, I explain more below.

Every time I think or write about this topic I feel a bit conflicted and worried about how she will feel in the future. There's a very real possibility that she will hate the decision we made to use a donor and prefer that she didn't exist; many persons of donor conceived origins feel this way. We are hopeful she can have contact with the donor in the future, but that's not a guarantee. We are in contact with many of her half-siblings at least, but there's still an entire "family" of blood relations she does not know. This is very similar to the situation many adopted persons and families are in, but of course adoption does not still carry the stigma that donor conception does. And there's the argument that adoption is morally acceptable because those children already existed, but with donor conception you are purposefully creating children who may never know their biological relatives. For now, we do the best we can for Audrey and only time will tell how she feels about her origins and our decision to conceive her from donor gametes.

So onto the main point of my post: how we are beginning this conversation with Audrey!

I was really excited about this book (you can read the whole book, and their other books, here. I didn't post pictures of the entire book, only the pages I read) but after reading it a few times I realized it was too complicated for her current level of understanding. So when I read it to her I basically read my own invented version, shown below:

I begin with talking about how "Mommy and Daddy met and fell in love. We had a lot of fun together!"

"Mommy and Daddy got married and became a family of two" (at which point Audrey usually says "TWO!!") But we wanted to have a family that included children."

"Mommy and Daddy tried really hard to have a baby, but it didn't work. We were very sad because we wanted you SO much!"

"We needed to get help, so we went to the doctor." 

"The doctor told us we needed two parts to have a baby. A part from Mommy and a part from Daddy." (I omit the 'nest' referral here for simplification) "Mommy had her parts, but Daddy didn't have his parts." (Not fully true, if you recall Ryan has a very low sperm count but IVF isn't an option for us for several reasons. But for her level of understanding, I currently omit that complicated detail.) "We needed help!"

"Since Daddy didn't have a part, we got the part from another man called a 'sperm donor.' Donors are people who help other people build families."

"The donor's part worked and you started to grow in Mommy's uterus in her belly! Mommy and Daddy were SO happy and excited that you were coming!"

"You grew for a very long time in Mommy's uterus and then you were born at home!" (I usually add a detail or two about "coming out of Mommy's vagina." She has watched many birth videos with me while I prepare for teaching class and seems to remember this is how [most] babies come out!). "Mommy and Daddy were so excited to hold you and meet you!" (Enter additional details about being born in the water and having 'nursies' for the first time - this usually results in her wanting to have some 'nursies' right now)

"Now we are a family of three" ("THREE!!" says Audrey) "Our family is Mommy, Daddy, and Audrey!"(And then she talks about the bikes - bikes are a big deal lately)

As Audrey gets older I will add in more details about her half-siblings, the IUI process (this book actually has a page about IVF so I will have to customize that somehow), the actual conception process, the cryobank, how most hetero couples get pregnant, other types of families, etc. And I'm sure she will have lots of questions. But I'm so glad we've at least started the process of "telling." And hopefully we will continue to have an open and honest dialogue about it.

Tuesday, July 7, 2015

20 Lies We Tell Women About Pregnancy, Birth, and Postpartum

Things women are taught by our culture that aren't necessarily true. 

1) Getting pregnant is very easy. If you can't get pregnant you probably just need to relax! And pray more.

2) Learning about your body's fertility signs and cycles in order to prevent or achieve pregnancy is ineffective and a waste of time.

Boring and pointless!

3) The best part of being pregnant is buying lots and lots of new things! Newborns need MANY material items and no nursery is complete without a: crib, bassinet, cradle, co-sleeper, swing, bouncy seat, jumperoo, activity center, rocking chair, changing table, dresser, high chair, bathtub, pack n' play, bumbo, sound machine, humidifier, lots of toys, lots of clothes, etc.

That's a lot of presents! But they probably only contain a fraction of the necessities for newborns.

4) Your OB is like a God. They are the absolute authority on your pregnancy and birth and you should always do what they tell you to. The health and safety of you and your baby is always their top priority (hospital policy, medical malpractice insurance, and their personal lives never affect their decisions). And all OBs practice evidence based care, so they're all pretty much the same!

5) Pregnancy is awful. The physical and emotional transformation your body and mind are going through aren't part of the process to prepare you for motherhood but are unnecessary and annoying. Thankfully there are lots of drugs that can mask any uncomfortable issues!

6) Pregnancy is a disease and birth is an emergency medical situation. Hospitals are always the safest place to have a baby and outcomes for hospital birth are vastly better than planned homebirths for low risk women.

7) Homebirth midwives are crazy, earth-worshiping hippies who have no real experience or training. Their birth supplies include a tambourine, flower wreath for your hair, and smudge sticks. They will respond to an emergency situation with chanting and lighting candles.

This is what a typical homebirth looks like: Birthing woman in the kiddie pool, lots of other people there staring at her, bright lights, screaming, and the token tambourine lady!

8) Natural childbirth is excruciating and worthless. It's better to be emotionally and physically separated from the birth process. Pain medications have no real risks for you or baby!

9) The only important outcome of birth is a healthy (alive) baby and mother. The birth experience itself is of no consequence. And no one wants to hear you talk about how your cesarean was medically unnecessary - who cares that you had major abdominal surgery for no reason??

10) After birth (and maybe a half hour of skin to skin, if you're lucky) your baby should go to the warmer for assessment, routine procedures, and to stay warm. But you'll get to hold him soon - he'll look so cute all swaddled up like a burrito with a hat!

Aww! Just how I want to meet my newborn! You can kind of see his face... Not any other part of his body, but that's ok - they all look the same anyways!

11) Your partner's wishes on how your son's genitals look are the most important aspect of making the circumcision decision. Since you don't have a penis you don't really have a say in this like he does. But he is an expert on both circumcised and intact penises! And he knows what kind of penis your son would want. He went into the future to ask him.

12) Circumcision doesn't hurt your baby. He's just screaming because he doesn't like to be held down in the circumstraint. Hey! I can't move! Oh you're slicing away at my genitals, I didn't even notice.

13) Learning how to breastfeed is super easy and natural! But if it doesn't instantaneously click for you, then you aren't meant to breastfeed - don't bother getting professional help. It's a good thing formula is available because otherwise your baby would starve!

14) Formula feeding is just as good as breastfeeding. And it may be better because breastfeeding "ties you down." There are way more important things you should be doing! Like folding your husband's boxers or scrubbing out the oven.

15) If you do manage to breastfeed - that's great and very healthy for you and baby! But don't do it in public. That shit is gross. There are MEN and CHILDREN here and they might glance over and see your BREAST!

Stop whipping your boob out of your shirt! Disgusting!

16) When your baby cries he's trying to manipulate you. Babies don't cry to communicate their needs - they have no clue what they need!

17) It's important to get back to your regular routine as soon as possible after you have a baby. You should be able to jump right back in: take care of your baby, keep up with any work from your job, maintain a spotlessly clean house, run any errands, and entertain all the guests who come to see your new baby!

18) Speaking of visitors, it's important that they get to hold your new baby as much as they want, so they can bond. They will be seeing your baby every Christmas and Easter after all! You can take advantage of this time to wash the windows or dust. And don't forget about offering your guests some refreshments while carrying on an interesting conversation - Hospitality first!

This is almost right! The new mom looks like she just stepped out of a salon, so that's a step in the right direction. Now she just needs to get off her lazy butt and offer her guests some delicious appetizers and cold drinks!

19) If your baby wakes up every 20 minutes despite establishing a bedtime routine, swaddling, using a pacifier, white noise, lullabies, waiting to put him down until he's deeply asleep. and using a fancy contraption like a rock n' play or hammock bed your baby needs to learn how to sleep: Time to start sleep training! (This problem has no relation whatsoever to your baby's biological need to be close to his mother. That's just a silly myth!)

20) Only the experts can tell you how to parent. Your instincts are nonexistent and wrong. But don't worry, all the experts are in agreement on these subjects and they all base their recommendations on the latest research!

Saturday, May 23, 2015

Audrey's Story Part 2

I've procrastinated writing this for a long time, partly because I feel like I've forgotten much of what happened a year ago. I've been rereading some of my earlier posts and WOW did we go through A LOT! But I really want a record of it, at least for Audrey to read when she's older.

So part one of her story left off with us getting home after two weeks in the hospital. At the time she was on a feeding tube that went through her nose and into her stomach and was being fed mostly Nestle Boost Kids Essentials. She was also on a daily multivitamin with iron, twice daily heparin injections because of the blood clot that developed from the PICC line, an antibiotic for her UTI, and possibly something else I can't remember.

Shortly before discharge

Soon after getting home, within a week or so, she started vomiting frequently during and after tube feedings. She was also starting to lose weight again. I was frantically trying to find a more holistic practitioner and so we tried going to Newbridge Clinic in Edina. They were very nice (although her problems were way beyond their scope and I wish they would have told us that) and suggested trying a hypo-allergenic formula. Well that was even worse! At that point I pretty much said "fuck it" and decided she was going completely on breastmilk, both mine and donor's, because that was the only thing she could keep down and I believed that was much better for her than any synthetic formulas with unwanted ingredients.

Our pediatrician at the time was very concerned about this plan because it was thought that Audrey would need such a large volume of breastmilk in order to gain weight that it wouldn't be feasible. But she was willing to try it and even said she would back up our decision to use donor breastmilk if the rest of Audrey's medical team questioned it. The nutritionist we were working with wasn't happy about it either but calculated that she would need about 45 ounces (about 900 calories) per day in order to gain weight.

So I asked in the local Attachment Parenting community I'm a part of as well as the two donor milk organizations that connect donors with recipients: Human Milk for Human Babies and Eats on Feets. We were blessed with a TON of milk - over 1000 ounces! Some was even newborn milk with a bit of colostrum! And magically, Audrey stopped vomiting so much and started gaining weight again!

Donor milk stash!

At this point we were doing weight check ups once a week plus seeing various specialists to try and figure out the root of the problem. She was also having blood draws done frequently to check levels of various things (iron, thiamine, etc.) and for further testing. This continued into the new year; basically our whole lives revolved around Audrey's appointments, trying to get her to eat solids, the daily tasks of caring for her plus her added special needs care, and me constantly researching online.

So now we were getting close to Christmas and we were really hoping to have a nice holiday where we could forget about everything for a day. But unfortunately, the second round of the stomach virus hit our household. On Christmas Day. Ryan was the first to feel sick and he laid on the couch while Audrey and I opened presents. Then she started vomiting and one session was so severe that her feeding tube came flying out! This meant a trip to the ER, because of course all the other clinics were closed. And I really didn't want to take her alone so poor Ryan came with. Lying on the bed meant for Audrey and vomiting in the garbage can. The nurses felt so bad for us and gave him a bunch of cans of sprite and crackers. The next day it was my turn to get sick, which was my second time with the virus already that winter.

Christmas tree fun before getting sick on Christmas Day

Audrey started going to feeding therapy (blergh!) and we started experimenting with her tube feeding schedule to try to get her to eat more on her own. Part of the problem with the tube feeding is that you need to give them enough so they gain, but then they don't feel hunger and so the little desire to eat that they already have is even more diminished. It can be a hard cycle to break. After researching I asked if we could try switching her tube feedings to night time in the hope that she would feel more hunger during the day. This can be tricky though since a toddler her age doesn't normally eat at night. With the pediatrician's support we offered food during the day (ALL.THE.TIME) along with sippy cups of my breastmilk and ran the tube feed continuously throughout the whole night making up for the calories she didn't eat during the day. This usually amounted to about 30 ounces of donor breastmilk. The first few weeks she did great and seemed to be eating more every day!

At this point the pediatrician suggested that we do the genetic testing that later found out Audrey is a carrier of a mild form of CF (you can read about that here), since we still didn't know the cause of her failure to thrive. Audrey was also having more trouble with vomiting again a few weeks after starting the night feedings, and was not as interested in solids anymore, often gagging. The Occupational Therapist at Gillette where we were going once a week suggested we do a scope test of her esophagus to see how it was working. I was skeptical of this as she had never had issues swallowing before, but decided to rule it out. Of course there was nothing wrong and the end result was a crying and screaming Audrey while the Amplatz therapist force fed her yogurt. I'm sure the therapist meant well but I still remember what she said that day "patient is unlikely to be off the feeding tube for at least a year" HA. Audrey was off it a few months later!

Although I didn't think Audrey had swallowing problems I was suspicious that she had another UTI. Just like the first time, she didn't have a fever but was fussy, had low energy, and bad smelling urine. Sure enough, a traumatic catheter insertion (which was unnecessary, I later found out they can use bagged urine just as well for the culture) revealed her second UTI.  I'm thankful Audrey isn't a boy so we didn't have to also fight against forced retraction of the foreskin or recommendations of circumcision to "fix" the UTI problem!

At the appointment confirming her second UTI Audrey was put on periactin for appetite and another med for reflux as she was still vomiting and gagging, although not nearly as much as when she was on the formulas. At this time I was also very concerned that she was going to wean, which was a very upsetting thought for me. She would latch on to nurse but kept gagging and then didn't want to keep nursing. It broke my heart because I knew she wasn't wanting to wean on her own accord! When I brought this up to the pediatrician she didn't even respond to my concerns, which isn't surprising because Audrey had passed the magical age of 1 after all, so at this point breastfeeding was "useless."

Shortly after she was diagnosed with the second UTI we went to a pediatric gastroenterologist which was the worst experience we had with a medical "professional." He was extremely condescending and hinted that he blamed out decision to use baby led solids as the reason for her failure to thrive! This is supposed to be an expert in the field of infant and child feeding and diseases of the digestive tract! And he claimed he had never heard about this feeding philosophy, which is becoming fairly common. This attitude of various practitioners thinking they don't need to keep on top of the research in their field just disgusts me. It's like they think they're done learning after they graduate. Ridiculous and ultimately their clients/patients are the ones that suffer for it.

He also wrote some very inappropriate things in her chart, such as "CPS was not involved" (implying, we felt, that they should have been), "parents did not feed purees and instead did 'baby led weaning' and fed toddler appropriate foods," and the worst one "maternal beliefs may impede patient's progress." We were livid and immediately requested that these statements be taken off her chart (which they were, thankfully!) and requested a new specialist.

Ironically, he was the one who scheduled her for a diagnostic ultrasound because upon examination of her abdomen he felt an abnormally large organ, when ended up being her right kidney. He also noted that her abdomen appeared swollen, which we kept asking the other practitioners about but they didn't see it as concerning.

The ultrasound found her right kidney to be enlarged, dilation of her right ureter, and the ureterocele on her bladder (an abnormal pouch where urine would collect and sit instead of being expelled). So now we had to do another test to further see what the problems were, called a VCUG (voiding cystourethrogram). This involved using a catheter to insert a dye into her urinary tract system and an ultrasound to see how the system expels the dye, etc. We were referred to our urologist, Dr. Jane Lewis, for further consultation.

Dr. Lewis scheduled the VCUG to take place at the Maple Grove medical center which I later found out was unable to provide any type of sedation or pain medication during the procedure. Audrey had reacted badly to the two previous, brief catheter insertions and I had serious concerns about her being held down for a catheter test that would take at least 20 minutes. So I switched the procedure to happen at Amplatz where she would be able to have some sedation in hopes that it would be less traumatic for her.

I'm so glad we did that because the test was rather long and she had to be fairly still for the entire 20 minutes! I don't think it would have worked very well if we had done it without any sedation. The test revealed a confirmation of an enlarged right kidney, enlarged right ureter, grade 5 reflux (worst level of reflux where the urine flows back towards the kidneys instead of to the bladder. This can cause recurrent UTI's), and a ureterocele (pouch) on her bladder. Her right kidney was only working at about 25% rather than 50% so the left kidney was working harder than it normally would. In our follow up consultation with Dr. Lewis we discussed the necessary surgery to fix the abnormalities and she said depending on how her organs looked during the surgery, she might need to remove her right kidney if it was too damaged to fix.

We scheduled her surgery for early March and in the meantime kept going to feeding therapy and check ups with the pediatrician. Feeding therapy was becoming increasingly frustrating, as the therapist was now wanting to to behavioral modification in the form of rewarding Audrey with a toy when she took a bite of food. I put my foot down at that because I strongly believe that appetite and eating isn't something that should be externally controlled by another person. I write more about that here.

Her surgery went great and the urologist was able to fix the abnormalities without removing her kidney! One thing that was funny while prepping for the surgery was the anesthetists wanted to use an epidural as part of her pain management and Ryan was initially very opposed to the idea because of everything he learned about them in the Bradley Classes we took during pregnancy. I knew that this was a great method of pain control with small risks and side effects, compared to the other methods available, and I convinced him that we should do it.

Dr. Lewis was able to remove the ureterocele on her bladder and taper her right ureter, which she hoped would reduce or eliminate the reflux as well as improve the functioning of the right kidney and reduce the size. The latest ultrasounds of her kidneys show that her kidney function has increased a little bit and her kidneys are growing well. The reflux is gone and swelling of the kidney is gone. She has not had any more UTI's to date either.

During her surgery both of our parents and Ryan's sister came to support us but I really didn't want to talk to anyone. I just wanted to be alone and absorbed in something. So I went to the computer lab where they provide free access to the internet and printer and I printed out tons of handouts for my Bradley Class. I figured I might as well take advantage of what they offered!

Although her surgery and recovery went very well, we still had to stay in the hospital for a couple days. And that really sucked. Ryan and I both hate the hospital with a fiery passion of a thousand suns. You can read more about that here.

Going for a wagon ride a few days after surgery.

The pediatrician advised that we should consider putting in a G tube while she was already under general anesthesia for the kidney surgery. A G tube is a portal directly into her stomach for food and medications, instead of relying on the NG tube which kept getting pulled out and replaced. Both the pediatrician and the feeding therapist had concerns that the NG tube may have been impeding her progress because it can cause gagging and it's supposed to be a more temporary solution. Neither of them thought she would be off the feeding tube for many months yet. Ryan and I were both very hesitant to go the G tube and as it turned out both couldn't be scheduled at the same time until months later so we decided not to do it. That was one of the best decisions we made because a few weeks later Audrey was off the feeding tube for good!

After the surgery we switched to day tube feedings and Audrey was on several medications and supplements. I also received my order of domperidone, which is a drug that increases breast milk production as a side effect. You can read more about that here.

A few weeks after her surgery we were all getting frustrated with how much Audrey was pulling out the NG tube, both accidentally and intentionally. Both Ryan and I thought she might actually do better with eating progress if we took away the tube feedings altogether. So when Audrey pulled it out on a Thursday night we decided to try leaving it out over the weekend to see how she did. More about that here.

Although it was a very slow process, and Audrey did lost some weight initially (some of that was excess - you can clearly see on her growth chart that her weight went above her 'normal' curve) and her weight plateaued for awhile, a few months later we could say that it had been a success and we were probably in the clear! She was slowly but surely starting to gain weight on her own! You can read about that journey herehereherehere, and here!

So that leads us to today. Where are we now? Well, Audrey is in speech therapy, which is going super well! She is a happy, energetic 2.5 year old who usually has a great appetite and no health problems! This past year she's had about 3 colds and no other illnesses. She's still nursing, mostly to fall asleep and during the night. She loves to read books, play outside, and build with blocks. Ryan went back to school last September to get his master's in Counseling Psychology and still works full time. I'm a mostly stay-at-home-mom while doing part time birth work: teaching Bradley Classes, attending births as a doula, and encapsulating placentas. In short, everything is back to 'normal,' aside from the once yearly kidney scans and the upcoming well child visit just to make sure Audrey is doing well. Although our journey was difficult and at times painful and traumatic, I can say that some good has come out of it. We are a stronger family. I really learned how to advocate for Audrey to get her what she needed despite the recommendations of the medical professionals (which are not always based on the best scientific evidence!) And we are really enjoying living a "normal" life and to see what the future brings!

Wednesday, April 29, 2015

What's In My Doula Bag?

I've had a couple non-birthy friends ask, "Hey, when you go to a birth as a doula (labor support person), what all do you bring? Is your car filled to the brim with gadgets?" Well I do bring quite a few things for both the client and myself, but luckily it all fits into a medium sized bag! The most important things I bring with me to births are things that cannot fit into a bag. My head, heart, and hands.

But for those of you that have asked, here's a less "hippie" answer:

 This is my doula bag! It's actually the bag for my electric breast pump but it works super great for fitting all my doula items in! It has 2 side pockets, one for my water bottle and the other I stuff my wallet and keys in because I don't want to drag my purse in to hospitals births. Especially if my clients need help carrying in their bags.

This front pouch is handy for:

Snacks and caffeinated tea! During births I need quick, easy to eat foods that will give me energy and fill me up. So I choose ones with lots of sugar (which I normally stay away from) and protein.
I also bring other food with me that doesn't stay stored in my bag, like sandwiches and fruit.

In the front pouch I also have gum and deodorant (laboring moms can be sensitive to smell), lip balm for me, comb with hair ties, and a tampon for me, just in case!

Lastly in the front pouch I bring drinking straws so she can easily stay hydrated and honey sticks in case she needs an easy boost of energy.

The main pocket of my bag contains:

A rebozo (Mexican hand woven shawl) for helping the baby reposition if needed (see here), as a comfort measure, or for use in pushing (see here). The green kneeling pad is for me, the mom, or the partner when kneeling on hard floors. The rice pack is heated and used on the lower back with counter pressure or other areas of the body. The tennis balls are also used for counter pressure on her lower back.

A ball pump in the left corner is great if the birthing balls at the birth place are too flat. My cell phone charger is a huge necessity, especially if I'm at a long birth. Tea light candles are great for giving enough light in a dim room (dim lights are preferable during birth as it helps the mom's hormones stay at an optimal level. We are mammals and mammals generally need privacy, darkness, and quiet when birthing!) The ziploc bags are for if the mom needs to vomit and there's nothing else on hand. I also use them as a cold pack with ice. Lastly here I have my essential oils that are usually used only as aromatherapy on the cotton balls and oil for massage.

This is one of the most important things I bring: my notebook and pen. I keep a list of events during the birth, such as when the client leaves for the birth place, vaginal exams, or what time she starts pushing. Then I type it up and give it to the client at our postpartum visit.

This awesome notebook also has folder pockets inside where I keep the notes from our prenatal visits, a copy of the birth plan, and my business cards.

A change of clothes for me in case I get wet from mom laboring in the water or from bodily fluids. Also very nice if I'm at a long birth and I want to just feel fresher. And a sweatshirt because hospitals can be very cold!

And lastly there is a handy pouch on the inside of the main section where I keep small items for the mom, such as:

A washcloth, comforting on her forehead or back of her neck during transition or pushing. New hair ties and hair clips for her as there's nothing more annoying than hair in your face when you're giving birth! New lip balm for mom, as women often get chapped lips when mouth breathing during labor. A "preggo pop" candy if she feels nauseated, and band aids because the last thing you want is an open wound in a hospital.

So there you have it! All my doula secrets and tools I bring with me to births! After a long winter of not attending births I have quite a few coming up and I'm looking forward to using my doula bag once again.

Thursday, April 16, 2015

Kidney Ultrasound Scan

Audrey recently had another ultrasound scan to check her kidney function and everything is looking great! This was also the first time she didn't scream and cry throughout the ultrasound, which was such a nice change! She was a little scared at first but then relaxed and watched the big screen showing the scan.

Her kidneys haven't grown since that last scan 6 months ago, but the urologist said that was fine because they are in proportion with her size. Since everything looks good we will wait a year for the next ultrasound and after that whether we do a yearly scan depends on if we can trust her to communicate if something isn't right or hurts. So we will see where she is on verbal communication next year.

We were also really excited to see that she had gained almost two pounds and has gone up from the 22nd percentile to the 27th percentile!

And that's about it :) We're still going to speech therapy twice a week and she's making good progress there. I'm also planning on requesting all the records and notes from her two hospital stays because I want to have a record just in case. And I'm also curious as to what they wrote about us!

Tuesday, March 10, 2015

Speech Therapy

Audrey has been going to speech therapy for about a month now. We've seen some progress but have only been going once a week because their schedule was full. This week we will start going twice a week and I hope that the higher frequency, along with being more comfortable with the therapist, will bring about more progress.

It was hard for me to finally get her in for an evaluation; I had been dragging my feet a bit. Partly because our past experiences with therapy, although it was feeding therapy and not speech, were pretty awful and partly because I just kept hoping she would start talking on her own. Now I'm really glad we've started to go though! She loves her therapist and the place we're going does all play based therapy at her age, not the rewards and consequences they were wanting to do at feeding therapy. And of course she's in a totally different situation now. We're not in the middle of a medical crisis where no one knows what's wrong and I'm not having to spend a bazillion hours on the phone fighting with insurance companies and clinics trying to get them to cover the astronomically high bills. Audrey is still on Minnesota Medical Assistance and I'm SO thankful because they will cover her therapy expenses 100%. Based on friends' experiences with school district provided therapy and our own experience with Gillette, I believe the private practice we're going to is the best fit for her.

Her first session was an evaluation which yielded interesting results! She was officially diagnosed with "Mixed Receptive and Expressive Language Disorder" which usually means both her understanding of language and her ability to communicate are low. But Audrey actually tested very high in receptive areas!

First the therapist asked me questions about her abilities and based on my answers she scored about 20 months in receptive language (what she understands) and 14 months in expressive language (how she communicates back). Apparently I vastly underestimated Audrey in both areas because after testing Audrey directly the therapist found she was actually at about 2 years and 8 months in Auditory Comprehension and 1 year and 7 months in Expressive Communication! (The tests given to me and Audrey were different, thus the different labels for the understanding and the expressing, but it's the same thing). So there is a significant discrepancy between what she understands and what she can verbalize.

I watched Audrey able to follow directions, identify clothing, body parts, and colors; and recognize the function of objects. She had trouble with analogies, following directions with negation (no, not), and following directions with spatial concepts (under, behind, over). Those are usually above a 2 year old's ability though.

The therapist also mentioned that Audrey uses 7 different phonemes (sounds) and heard a verbal approximation for "ball," "that,"  and "spoon." To me it just sounded like more of the nonsensical babbling she's been doing forever, but I think part of it is we're just so used to her not saying words that we don't recognize when she is. Today at therapy, for example, she said "duck," and tried to say "elephant" and "dolphin"!

Right now it's unclear if her inability to verbalize is because she has expressive language delays (slow to talk) or if she has something physically wrong and has speech production difficulties as well. The therapist said we will know more as time goes on. She put in an initial recommendation of therapy sessions twice a week for 30 minutes for one year, which can be adjusted accordingly as needed. We also get activities to work on at home. Right now we are working on teaching Audrey more signs and demonstrating different sounds (like oh, "hu" like in hot, and "b" in boat).

Thursday, February 19, 2015

A Day in The Life of The Infamous Pink Cup

Audrey has always gone through phases of being obsessed with certain small objects. When she was 9 months old it was a packet of buttons (she couldn't open it). When she was 12 months old it was a stuffed bear. 2 months ago it was my collapsible measuring cups. And there have been others that I can't remember now. Usually she latches onto the object and carries it everywhere for a few days before losing interest. But this time she has decided to hold onto her object for a bit longer. This pink cup has been everywhere with us the last few weeks. And I mean EVERYWHERE. To give you an idea of what this looks like, here's an example of "in the day of the life of Audrey's cup" (taken over several days, but you get the idea):

8am: Morning nursies, interrupted by the camera phone

8:30 am: Looking at Daddy's Valentine's Day gift (52 Reasons I Love You) while waiting for breakfast

9:20 am: Playing with the IKEA train

10 am: Walmart run (note: my ring sling is not being worn optimally; the rings should be much higher up towards my shoulder)

11 am: Fun with friends at an API playgroup

12 pm: Washing hands before lunch

12:10 pm: Daydreaming about chocolate instead of this awful yogurt and sandwich

12:30 pm Coloring with a pencil at my special table

1 pm: Nursing before nap while making Mommy bite the cup

3 pm: Directing Mommy how to dress up the potato head

3:30 pm: Fingerpainting

3:36: Handpainting?

4 pm: Afternoon meltdown because Mommy won't let me bang on the computer keyboard

4:01 pm: Mad at Mommy for taking pictures

4:30 pm: Relaxing on the toy-strewn floor

5 pm: Staring suspiciously at dinner

5:03 pm: Thinking about trying a bite of this "cheesy spaghetti" stuff

5:04 pm: Mmmm!!! I guess it's ok...

6:30 pm: Horsie ride on Mommy's back

7 pm: Bath with Mommy. Pink cup in the right hand, bath toy in the left

7:04 pm: Scooping and pouring water 500 times in a row

8 pm: My favorite way to fall asleep! In the toddler tula carrier

8:30 pm: Passed out in bed. Goodnight!