Wednesday, October 21, 2009

Parenting and Problem Solving

I've been thinking more about why I'm enjoying Petunia's newborn days more than I enjoyed Pumpkin's. This has been prompted in part by AskMoxie's recent post about having a new baby. I also just have a lot of time to think, since I'm nursing Petunia so often. I have tried reading while I nurse, but my neck is a bit tweaked*, and I can't find a comfortable way to read and nurse. So I sit and think instead.

I mentioned in my last post that I think part of the reason I'm enjoying things more this time is that I've already been turned into a mother. One reason I found that process so hard was that it forced me to change my approach to problems. Hubby and I are both planners and problem-solvers by nature. When we have a problem, or just something that needs to get done (like, for instance, grocery shopping or keeping the house clean), we tend to develop processes and try to optimize our solutions. We both like to have a plan for getting our chores done so that we can enjoy some chore-free time without guilt. Before we had Pumpkin, our household was humming along pretty smoothly. We knew when we'd do the grocery shopping (Sunday evening) and when we'd clean our house (every other weekend). We had processes for just about everything we needed to do to keep our lives chugging along, so we had a fair amount of chore free time, which we spent at our local pub or at the beach or out enjoying the many recreation options in San Diego. (I particularly miss kayaking....)

Then we had Pumpkin. This required changes to most of our household-running processes. It also presented us with a new set of problems- getting breastfeeding going, calming a fussy baby, dealing with her sleep issues, etc. I naturally approached these problems like I did any other- I tried to rationally analyze them and find solutions. If you're a parent, you're laughing now, because you know that children aren't really amenable to that approach. Babies certainly aren't! Pumpkin didn't care about my carefully researched and well-thought out plans for improving her sleep. She, in fact, didn't think there was a problem at all. She didn't have a sleep problem- I did.

Eventually, I learned a better way to approach the problems Pumpkin created in my life, such as sleep deprivation. I learned to look at the situation and figure out what problem could actually be solved. There is very little you can do to make a baby sleep. Once I'd tried all of the possible "solutions" that fit with our parenting philosophy and still had a baby who woke up in the middle of the night, I had to admit that the problem of Pumpkin waking up in the middle of the night was not really one that I could solve. I could, however, solve the problem of adults so sleep deprived that they could barely function. And that is what we eventually did.

For me, one of the hardest things about really becoming a mother (as opposed to just being a woman who had a baby) was learning that there are some problems that I can't solve. In fact, there are some "problems" that aren't really problems at all. My children have their own personalities and traits, and those aren't problems for me to fix, even when they create problems in my life. I need to learn how to focus on the problems in my life rather than in my child.

That process is ongoing, but at least I have learned the basic lesson. I think this is contributing to my greater happiness/lower stress this time around. Of course, as I type this, I'm sitting on the sofa, watching Petunia sleep and fretting about how she's sleeping past her usual "pre-bedtime" feeding, and wondering what I should do to "fix" that. Old habits die hard. At least I realize how insane that thought is, though! The real problem is the lack of good sleep for Hubby and me, not when Petunia nurses- she's not even three weeks old, and can't really be expected to have a schedule yet. We think having Hubby do the first post-bedtime feeding with a bottle will help solve our sleep problem. Petunia's just about old enough to get a bottle now, so I've started pumping and we'll try a bottle tomorrow night. I hope that this will work, and get us both a satisfactory amount of sleep, because having another little one in the house has certainly created havoc in our routines- we have lots of problems to solve!

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*Actually, my neck is really a mess. I'm not sure why (constrained sleep positions due to C-section? Craning my neck to see Petunia's latch?)- but the pain was so bad that on Saturday, I went back to the ER, fearing a return of the post-epidural problem. The doctor there thought it was more likely to be a muscle spasm, and prescribed a Valium as a muscle relaxant. When I got home and looked it up, I discovered that Valium is a very poor choice for a breastfeeding mother, so I didn't fill the prescription. Instead, I saw my regular doctor on Monday. She prescribed a muscle relaxant that I can take while breastfeeding. I finally got a chance to get that filled today, and will give it a try tonight. I am hoping that one or two nights will be enough to sort my neck out.

Monday, October 19, 2009

I've Seen My Future, and There is Not Enough Sleep

Hubby and I are settling into our new roles as parents-of-two. We're trying to figure out how our household is going to run with the new set of responsibilities that came with Petunia. Given our history, it is not surprising that we are trying to do this while in a state of sleep deprivation.

The funny thing is, if Petunia were the only child in the house, we'd be doing great on sleep- at least by our parenting-adjusted standards. Petunia already routinely sleeps one four hour stretch every night- something her older sister didn't do until she was several months old. Unfortunately for me, that four hour stretch is from 7 p.m. until about 11 p.m., and even on a good night, Pumpkin is unlikely to be asleep before 9. Lately, I've been in Pumpkin's room, laying next to her (OK, and maybe dozing a bit) until almost 10.

Petunia sleeps in, too- she gets up for the day at about 7 or 7:30 a.m. I am overjoyed by this. Pumpkin started her days at about 4:30 a.m. when she was a newborn. I remember celebrating when she started sleeping until 5:30 a.m. Pumpkin is still almost always the first one awake in our house, but she has been sleeping in a bit, too- this morning she got up at about 7:20. Her more usual wake up time is 6:30. This later wake up time is undoubtedly related to her later bedtime, and Hubby and I both agree we need to fix it. I want more sleep at night, and he is worried about the morning routine when he goes back to work.

So, between Pumpkin's schedule and Petunia's nighttime wakings, we aren't getting enough sleep. I know from my experience with Pumpkin that I need to get at least four hours of uninterrupted sleep on a fairly regular basis to feel OK. Hubby just needs more sleep, and would also prefer one decent chunk. We're both still getting up for all of the nighttime feedings- I feed Petunia and Hubby changes her diaper, burps her, and puts her back down. This will change soon. Petunia is almost old enough to be introduced to the bottle. Breastfeeding is going really well, so I'm optimistic that the bottle (and the pacifier that we'll probably introduce at about the same time) won't cause any problems. Our plan is to do the same thing we did with Pumpkin, which is to have Hubby give Petunia one bottle per night. He'll do that first middle of the night feeding, and then I'll take over. I am much more mobile now, and can get up in the middle of the night and change diapers. This should get us both the sleep we need.

I can see that we're going to struggle with our morning routines, too. Petunia is awake and wanting to be held at about the same time as we need to be getting Pumpkin ready for day care. The grown ups also want to shower and eat breakfast. I haven't figured out how this is all going to work yet, but I suspect it will involve wearing Petunia in her new Moby Wrap (which she seems to really like).

Other than the issues with setting up our routines, things are going well. I am never going to like the newborn phase as much as I like the older phases, but I am definitely enjoying it more this time around. I think this is partly because Petunia is a more laid back newborn (although she does have her fussy periods), partly because I'm a more laid back mother, and partly because I learned a lot the first time around. I have my breastfeeding "station" all set up. I know that if I start getting a headache, it is probably because I need to drink more. My Mom made me a nursing cover, and between that and my greater confidence with nursing and baby-calming, I am more willing to go places with Petunia than I was with Pumpkin.

I know that I have a lot more to learn. In a year, I expect to be looking back and thinking about how much Hubby and I have figured out and being amazed by it, much as I was at Pumpkin's one year birthday. However, the hardest part of Pumpkin's newborn period was the transition in me. I had to turn myself into a mother. I had to get used to the idea that my needs no longer came first, and accept the fact that there was a little baby who deserved as much of my time and energy as I could give- and who would demand that time and attention from me even when I felt least able to give it. That work has already been done this time around, which allows me to better appreciate the joys of having a newborn. My favorite part is holding her close to me, resting my cheek on her soft hair, and feeling the warmth of her as she cuddles into me. Until she gets a gas bubble and lets out one of her pteradactyl screams, right into my ear.

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Thank you all for your nice comments and good wishes on my last two posts. I did a little research about breech deliveries, and feel pretty good about our decision to have a C-section. This post about breech deliveries summarizes things well. I might have been able to have a successful vaginal delivery. However, the fact that Petunia was bigger than Pumpkin decreased my chances of doing so. I also found several papers that indicate a small but significant increase in risk to the baby from attempting a vaginal breech delivery. Since we are pretty sure that we're done having kids (and therefore won't have to face the decision about what to do next time), I suspect that even if we'd had time to research things and make a more careful decision, we would have had a C-section.

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For those who are interested: Pumpkin's Reading List has recently been updated.

Monday, October 12, 2009

Well, That Was Fun

Hubby, Petunia, and I spent 6 hours in the emergency room on Saturday night. Thankfully, my Mom was still here, so Pumpkin stayed home with her (and got some sleep).

We ended up at the ER because I had a headache. Yes, a headache. It was a very bad headache, and didn't respond to ibuprofen or Vicodin. It was bearable when I was sitting up, better if I got up and walked around, but unbearable if I tried to lay down- I essentially, couldn't lay down. It came on at about noon, and finally, after dinner, I called the nurse line to see if (1) this was something I should worry about and (2) if there was anything else I could do for the headache. The paged the doctor on call, who sent me to the ER.

Once I got to the ER and was seen by the triage nurses, it was obvious to me that we'd be waiting a while. I clearly wasn't having a true emergency- i.e., I wasn't having a stroke or an aneurysm. Everyone nodded knowingly when I told them I'd had an epidural.

When I finally saw a doctor, she confirmed that this was one of the infamous "epidural headaches". I was given an IV with sugar water, an NSAID that is a little stronger than ibuprofen, and caffeine. Within minutes, my headache was gone. We had to sit there for another hour until the IV was done and the doctor had a chance to come back and check me out. We finally got home a little after 2:30 in the morning. Petunia, bless her heart, was nice and woke up to feed almost as soon as we got home and slept the rest of the night through. We were tired, but not absolutely exhausted, the next morning.

I am trying not too be too annoyed about paying $100 (my ER copay) and wasting 6 hours to get the equivalent of a can of Coke pumped into me. Surely, someone could have just suggested I try drinking a can of Coke?

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In other news....

Pumpkin has a new cute phrase: Petunia, like most babies, gets frequent bouts of the hiccups. Pumpkin says she is "hiccing up".

Pumpkin is still loving having a baby sister. We know this can't possibly last, but it is super cute. Pumpkin likes to stroke Petunia's head, give her kisses on top of her head, and give her hugs (supervised carefully, of course).

My general recovery from the C-section is going pretty well. I'm still a bit sore, but am feeling much better. Last night, I even got to lay on my side from time to time! (I've been going crazy because I couldn't really change positions to try to get comfortable at night.) I have to put in a plug (unsolicited, of course) for Benefiber. I've been adding it to my oatmeal in the morning and my, er, system is finally getting back to normal. Yeah, I know- I should just eat more fruits and vegetables. But I'm a picky eater, and I don't feel up to forcing myself to eat things I don't really like right now.

Breastfeeding is still going well. Not surprisingly, given the antibiotics I got during and after the C-section, we developed a case of thrush. Culturelle has cured it beautifully (this is another unsolicited plug- I love this stuff). Once a day, after Petunia has eaten, I break open a capsule and empty the contents into a little bowl. I mix in a very little bit of water, and smear it inside Petunia's mouth and also on me. I put fresh breast pads on and let the little bacteria do their stuff. I also treat myself with some antifungal cream after my shower, and change my breast pads frequently. The thrush seems to be gone, and the damage it caused is healing. I'm hoping that nursing will be pain-free soon!

Wednesday, October 07, 2009

Unexpected Delivery

We had an unexpected delivery Friday night- our baby finally arrived! We have another little girl. Her blog name has yet to be finalized... I'm thinking that perhaps it will be Petunia. She was 8 lbs 9 oz, and is just perfect.

Since she was two days late, the actual arrival clearly wasn't unexpected. What was unexpected was the manner in which she came: via C-section.

I was sitting on the sofa after dinner when I felt a pop, and thought "gee, I wonder if my water just broke?" It had, and the contractions that had been intermittent and weak all day suddenly started getting a little stronger. So we packed up, kissed Pumpkin good-bye, and left for the hospital. By the time we got there, my contractions were 5 minutes apart, getting stronger, and lasting for over a minute. Thirty minutes later, I was checked into the labor triage area, and a nurse checked me and said I was at 6 cm. I was transferred to a wheelchair and taken up to the labor and delivery room. By the time I got there, my contractions were coming every couple of minutes, lasting what seemed like an eternity, and were quite strong. I was starting to swear at people and was in no doubt about my desire for an epidural. They had started the paperwork for me in triage, so the anesthesiologist was waiting for us in the labor and delivery room. My contractions were much stronger this time than they were when I asked for the epidural with Pumpkin. I have renewed respect for women who choose to deliver without any pain medication- I would not have wanted to do it!

I remembered the anesthesiologist from last time, but only because he has an unusual name- the epidural itself didn't make much of an impression. This time, it took him several tries to get my epidural in. I kept having contractions and couldn't hold still. I also had a hard time relaxing my back. He finally got the epidural in, and I was momentarily a very happy camper. He started talking to me about how I may or may not be able to feel the urge to push, since I was getting the epidural sort of late this time, but that if I didn't push my button for more medicine, my chances were good.

Then my doctor came in to check on me. I was lucky- my doctor was the delivery doctor that night. All the nurses said that he was a great labor and delivery doctor, and I was feeling pretty good... until he looked up and said "You're going to hate me. I feel a butt."

My baby was an undiagnosed breech baby. My doctor explained that I could still try for a vaginal delivery if I wanted, but that he'd recommend a C-section in this case. He said that overall, the statistics show that there is no difference in outcomes for vaginal vs. C-section deliveries for second births. However, he estimated my baby was at least a pound bigger than my previous baby (turns out, he was right on this), and that this could mean I'd have a hard delivery. Since the biggest part of the baby is the head, and that would be coming out last, it would be risky. I knew that Hubby and I were both already pretty exhausted from the many nights of false labor, including the night before, when we'd been up until after 2 a.m. timing contractions that never got closer than 7 minutes apart. Given all of this, we decided to go ahead and have a C-section.

My surgery was quick and uneventful- the baby was born just a little over 2 hours after my water broke (my water broke at 7:35, and the baby was born at 9:52). I never lost the ability to move my legs, so I didn't have to spend too much time in the recovery area. We were in our room before midnight. I was able to breastfeed Petunia for the first time in the recovery area, and she latched on with no problem.

I was still in a bit of shock at how things had turned out, but not feeling too bad until after we got settled into our recovery room. Then I threw up. I threw up several times over then next day- I didn't really feel better until almost dinner time on Saturday, and only started eating normally on Sunday. (The nausea is caused by the anesthesia.) The the long-acting pain medicine that I'd had for surgery began to wear off on Saturday, and I started to really feel the incision. I couldn't get up easily to get Petunia when she cried, so Hubby had to bring her to me. I had a hard time finding a good position for breastfeeding that didn't hurt my incision, so I ended up not positioning Petunia well. I'm still working through the issues that caused. I can't imagine how overwhelmed I'd have felt if Petunia had been my first baby and I didn't know that breastfeeding gets much, much easier.

I'm doing much better now. I can almost walk at my normal pace, and can pick up Petunia without trouble. We did have to switch sides of the bed, though, and put Hubby next to the co-sleeper. We'll switch back as soon as I can lay on my side and turn over easily in bed. Breastfeeding is going really well- Petunia is having am much easier time with it that Pumpkin did.

Without a doubt, I preferred the vaginal delivery- even with the four hours of pushing. I cannot believe that some women actually opt for a C-section. I'd definitely take the pain of labor and the work of pushing over this longer, more difficult recovery!

Monday, September 28, 2009

Health Care- Personal and Universal

So, I'm still pregnant. My due date is Wednesday. I've been having "pre-labor" symptoms for almost two weeks now, including four nights during which I actually started timing the contractions. So, a lot of lost sleep (why do the contractions always come at night?) but no baby. At my last doctor's appointment (last Friday), I had made progress and was told birth could come any day now. Saturday night, I had almost three hours of moderate contractions at roughly 10-15 minutes apart. I got all excited, and ruined Hubby's sleep, too. Then they just stopped, and I went to sleep for a few hours. Then they started again, and then they stopped again.

Anyway, I don't really want to talk about it. I'm tired of starting all my phone calls/emails with "I'm still pregnant!" or "No, I'm not in labor." I want to talk about health care instead. (Here is my earlier rant on the subject).

One of the things I've been doing to help pass the time while I wait for this baby to be born is read magazines. Somehow, concentrating on a magazine article is easier than concentrating on a book. My parents brought over some old magazines for me to read. One of them was a Newsweek with an article called "No Country for Sick Men", by T.R. Reid. It makes an interesting point- a nation's health care system says something about its character. The American mythology includes the rugged individualist and the self-made rags-to-riches man, so perhaps it is not surprising that we emphasis personal choice and responsibility so much in our health care system.

It also gave me a little more understanding into one of the aspects of the debate that has been most difficult for me to grasp. To me, and many other left-leaning types, health care is a universal right. I consider the large number of un- and underinsured people a symptom of a moral failing in our country.

As I read and try to understand the point of view of people opposed to the proposed reforms, I have been puzzled by the belief of many more conservative people that health care is not a right, but a privilege. (One good, and non-combative place, to get a feel for this point of view is this guest post from Loralee's husband on her blog.) I could not figure this out. Isn't the right to life one of the most fundamental rights? Doesn't lack of access to adequate health care impinge upon this right? I've posted these questions on a couple of the more thoughtful conservative posts opposing health care reform, and never really gotten an answer. I also have never received a satisfactory answer to the question of what to do about emergency care- currently, emergency rooms have to provide care to anyone who needs it, whether they can pay or not. We all pay for the care for those who are unable to pay for it themselves. This is an expensive way to pay for care, some of which could be handled in a doctor's office if the patient had access to one, and some of which could be avoided altogether with good treatment of chronic diseases like asthma and diabetes.

But perhaps the Newsweek article explains it, at least partially. To me, providing health care to everyone is a moral imperative. To opponents of universal health care, it is a moral hazard, creating a system in which people can shirk their responsibility for their own health- and if you won't take care of your own health, what does that say about your approach to other responsibilities? I guess that forcing someone to go to emergency rooms, with their long waits and stressful conditions, for all his care does send a message that he has somehow failed in his responsibilities.

I don't agree at all with this viewpoint, and I am hoping that my country decides that providing health care to all is a moral imperative, not a moral hazard. But perhaps I can understand one of the opposing viewpoints a bit better now. I still can't really reconcile the moral hazard idea with the rabid opposition from the same people to a mandate requiring people to take responsibility for their health care and purchase insurance. This is usually painted as an attack on personal freedom- but why should someone be free to force me to pay for his/her emergency room treatment? As far as I know, no one has argued that we should turn people away from emergency rooms if they cannot pay.

So I guess I still cannot understand the viewpoint of the opponents of health care reform. I suspect they are just as baffled by my viewpoint. What a shame that we have not taken this opportunity to have a thoughtful debate on real issues, and instead are shouting at each other. Maybe if we all tried a little harder to understand the concerns of the other side, we could find a solution that really would reflect our nation's character.