Monthly Archives: September 2016

Lactation Consultant – Two Hour Class – The 411

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Image result for breastfeeding

Because no one properly taught me to latch my baby while I was in the hospital for FIVE NIGHTS and I have been exclusively pumping, I researched and found a top lactation consulting firm, Premier Lactation Services , and called and hired them to help me with my breastfeeding woes.

The company has only RN-BSNs who come out to your home and start with a two hour class and assessment.

My nurse, Jennifer, came today and we started with an assessment of my breasts, medical history, current meds etc.  She said my breasts look great for making milk and they will work with me to increase my supply and get the baby latched.  I am currently making enough milk to exclusively feed the baby breast milk instead of having to supplement with formula.  If I can stay at home long enough to get my eight pumps in per day !

I have had to go to the ER daily for wound care. Now that my incision has pretty much healed to the point that it does not have to be packed any longer, my health insurance is almost done with processing my out of network request for home health care !  Go figure !!

Today, we got the baby latched right away, as she knows exactly what to do and goes for it and we have discovered that the baby wants immediate flow like with the bottle.  I was given a 1 ounce syringe with a long tube on it that slides under my nipple shield and the baby can suck the milk out and it mimics nursing, until the baby is able to cause let down.  She has a great suction, but she, like most preemies, tucker out and will not work for the milk.  By using the SNS method, the baby will have to suck and I control the milk flow, which encourages her to latch the nipple and not be bottle dependent.

The nurse gave me Lecithin to help thin out my colostrum so that the baby has an easier time getting the milk to flow quicker so she doesn’t get discouraged.  I was also given Fenugreek to take as well to increase milk production.  My goal is to pump 25 ounces a day and continue to build from there.  The baby needs 15 ounces per day to grow properly and she should be eating eight times a day at minimum.  I was given a list of meds that my OB can prescribe if need be, but we are going to start here and see if I can get my supply where it needs to be.

In other news:  My mother is still in the hospital and has a staph infection.  The infection was found in the fluid that pooled in her abdomen that collected when the drains were removed.  They now have her hooked up to some kind of machine that drains the fluid and they discard it.  The machine is attached some kinda way up under her skin and the hoses have to be removed and the machine and area has to be cleaned every so many days.  When she is allowed to come home they will send her home with a skilled nurse.

13 Days Post Partum – The 411

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It has been a whirlwind these past thirteen days !  I had a planned / unplanned cesarean and emergency hysterectomy,  my mother took ill the day we were released from the hospital and the same day she arrived in NYC.  I have been in the emergency room five times since my release from Lenox Hill Hospital on 9/14 !

My Mother has developed a staph infection due to fluid pooling near surgical sites from her reconstructive surgery on 9/2; fluid that didn’t find a way out until two weeks later.  Thank goodness, the infection is not bloodborne.   She has been in the hospital for a week and we are not sure which day she will be able to come home.  She is currently hooked up to a machine which drains the fluid out of her body.  Skilled nursing will have to come to my sister’s house to clean and replace the drain under her skin.

My incision which opened in two places is healing.  I have to go to the ER for woundcare until my slow behind insurance gets home health in place for me.  

My baby is doing well.  We had a slight hiccup when I changed her formula we are using for supplementing from Enfamil NB to Holle Goat Milk formula.   The baby’s poop became very hard little balls so I called the nurses line and was told to put her back on Enfamil NB since she is not tolerating the Holle- supposedly the best stuff on the market !  

In other news, I am still struggling with peripheral edema and pain in my legs and feet. Yesterday, the ER doc gave me Lasix to drain some of the fluid and give some relief.  I am currently down 27 pounds since giving birth.   

I have to say, having this gorgeous girl seems so surreal.  I feel like I am in the middle of a dream and I will awaken to find it all just a dream.  She is beyond perfect and so very chill !  She is also bossy and picky. She let’s you know right away what she likes and doesn’t like ! 

I am so blessed to be her Mommy !

ER visit #4

On our way to the hotel from the hospital in Uber Black Car Service
My nieces welcome baby girl home !

Basket of baby girl’s clothing my nieces set up for our arrival

She’s Here !!!!

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I had to deliver her today due to a subchorianic hemotoma near the placenta, IGUR, and placenta abruption. I had to also have an emergency hysterectomy because of placenta increata.  The placenta had fused itself to the uterus, grown up into it and into the muscle.  It had developed it’s own highways of arterial vessels.

How the day started: I went to NYC for my MFM and OB appointments; the 36 week check up.  The MFM doc says she was very concerned about the Sch beside the placenta and the rate of growth over the past few weeks of the baby and asked how I felt about delivering this weekend.   I told her I would prefer to wait until Dr. Karamitsos returned from vacation on Sunday so he could do the procedure and she said she would confer with my OB’s office and call me on my cell if she feels I need to deliver.

I went to the OB appointment next and saw Dr.P, whom I had never met and he explained that Dr. Minor had called and he agrees with her that the baby needs to be delivered to reduce risk to my life and baby’s.  He felt the placenta was no longer functioning as it should and if I had another bleed like I had the week before that landed me in Labor and Delivery for two days, the abruption could be so bad that they could potentially lose me and the baby.  By delivering today, the baby would be fine and could grow properly outside the womb.

Luckily I didn’t eat anything so I was in the OR within three hours.

I called my mom and sisters and let them know what was going on and my mom freaked out.  She was ready to walk to NYC if she had to lol.  She was a week out from major surgery. I assured my mom that I was fine and that I was not afraid at all.  My pastor called me before I went into surgery at 4 pm and I felt this calm.  I am surprised that I was not freaking out, going through a birth, and a surgery at that with no family or anyone by my side…. so NOT the way I envisioned this day, but this is what it is.

I walked down the hall to the OR with my two nurses ,Dr. P, her attending, and the Anesthesiologist.  When we got to the OR, there were two Perionatologist, two Urologist, and two NICU nurses.  I thought, quite a few people for a simple procedure!

The Anesthesiologist got me to sit on the cold metal table and told me to arch my back like a cat. He took two tries but got the spinal in and my legs got heavy quickly.  They had me lie on the table that they undressed me, positioned me, and washed me down.  The curtain went up and then they explained things to me as we went along.We went in at 4 pm and at 4:18 pm., my daughter was out and screeching with powerful lungs !   They wiped her down and then brought her to me to see and I looked at this tiny 4 lb 10 oz being and said ” Hi Momma !” With that, the baby opened her eyes !  She looked at me as if she recognized my voice.  They let me kiss her and then they whisked her off to the NICU to get her in the warmer.

I started getting cold and feeling queasy so they gave me something for the shaking and nausea and placed an alcohol soaked pad under my nose to help ward off nausea and it worked.  They had some contraption with sleeves on me that they turned on and it was a heater !  That thing felt sooo good !

Next, I felt like I was on a boat rocking back and forth.  Dr. P tells me that my placenta is not budging !  She said she was going to try one more time.  In the mean time, the other doc ordered three units of blood and they put another IV in my other arm.  The blood arrived and they quickly gave me two bags and then started the third on a slower drip.  Dr. P then comes to my head to tell me the placenta has grown up into the uterus and has fused itself into the uterine muscle and she has to remove the uterus to save my life.  She said I had lost blood.  I told her to do what she has to do !  I have four babies on ice, two sisters and female friends AND a healthy baby, so I was not worried about not having a uterus.

Some time later, they were all done and I was being wheeled to recovery.  When I go to recovery, the nurse, Lisa, who served as my photographer since my film crew could not be there on such short notice, handed me my phone and my friend Crystal, another SMBC, was there waiting for me and congratulating me !  My pastor called shortly thereafter to see how things went and to call my baby’s name aloud.  Only two people, my mom and sister friend in Canada, knew my baby’s name and I would not say her name nor tell anyone until she was here and Pastor Hicks said her name aloud into the Universe.

I named my daughter Chandler (which means she who brings light) Grier (watchful and alert).  It is so crazy to me that my baby came out the spitting image of the most important person in my life; My Mother !   She is the spitting image of my mom’s baby pictures and she has my grandfather’s gray/blue eyes for now anyway.

Crystal sat with me for a while and then left to let me get some rest and then my best friend, Janus and my godson Shai came and stayed with me until I was sent to the ICU.  Once in the ICU, they gave me more morphine in my drip and I remember sleeping for quite a while.  Later that night, I kept asking for my catheter to be taken out so that I could get up and walk.  They told me they would take it out later that morning.  I did not get the catheter out until the afternoon and then I got up and walked up the hall and back.  It was not bad !  I slept a lot in the ICU. Later that afternoon I walked down the hall to the NICU to see my baby.  I had never been so glad to see a little person before in my life !  I knew exactly which baby was mine as soon as I saw her. I was able to feed her a bottle of donated breast milk.

(My OB, Dr. P)

My baby girl only spent one and half days in the NICU before being transferred to the regular nursery.  I was sent to the maternity floor two days after my cesarean.  Medication management is a lot better in the ICU because it is all IV meds.  On the floor, they try to make you pop pills.  I refused and demanded that they dope me up.  I was sore and was not having it !  They gave me IV pain meds for a while and then we switched to Percocet every four hours and Motrin every six hours.


I spoke with my family and my sister informed me that our mom was still a bit weak and sleeping a lot.  I told her to make our mom stay put until I found out when I could go home. I spoke with my docs and they planned to release me on Tuesday afternoon, which was the normal four night stay, but since I had to come back to get staples out and the fact that I had an emergency hysterectomy, they were not rushing me out the door.  I asked to stay once more night so that I would not have to come back to the office for staple removal the next day and to give my mom and sister time to get to NY with my car seat and baby / mommy hospital bags.


Wednesday morning, after my shower, the doctor came in to remove the staples and it did not hurt. My sister called to say that our mom was feeling tired and a bit weak so I told her to leave her at the hotel and my driver would be there to get her and bring her to the hospital.  My sister and driver, who is a good friend of mine, came about 10 am and I was really glad that the hospital had done the car seat test on the baby the night before since it took a whole hour.  Because my baby was under five pounds, they had to place her in a car seat for an hour and then check her vitals and breathing.  My sweet little baby had been blowing the tops out of all her tests thus far.  She scored 9.9 on the APGAR and passed all the tests with flying colors.  She did well on her car seat test too.

I got my release papers and had to go down to the financial office to settle up and get a receipt and then bring it back to the nurses station for release.  I had to wait a while for the nurse to come to release the baby.  She FINALLY came and we got released and we went straight to Walmart to fill my scripts and grab a few things I needed and then to the hotel.  My mom was sitting up in the bed waiting in tiptoe anticipation for our arrival and she took the baby and I became persona non grata instantly !  lol

My sister said that Dr. P called her after my procedure and told her what went on but she was short and to the point. My sister did not tell my mom much for fear of upsetting her and then not being able to talk her into staying in VA until I was released.

The day after we got released, the baby had a Pediatrician appointment.  I noticed when I got to the car that my pants felt damp across the front and it was blood !  My incision has opened a little. Thank goodness my OB’s office is down the hall from the Peds office.  I checked the baby in and left her with my sister and then walked down to see the OB on call and they looked at the incision and determined that indeed it did open and that it was not infected and is only the outer layer that opened.  They put gauze over it and ordered Visiting Nurses to come out to redress it.

Later that night, I had counted a total of FIVE soaked thru maxi pads that I taped to my incision area and I called Labor and Delivery and asked for the OB on call from my practice and they had me come in.  Dr. Moisa was the same OB I saw earlier.  She said it was just draining built up fluid and would continue to drain for a few weeks and will close back up on its own.

Saturday morning, my sister and I took our mom back to Northern VA to be near her doc and surgeon and we called the surgeon and left her a message informing her how weak our mom was and that some coffee colored substance was leaking out of her side.  She called us back and gave us her cell number and said to bring my mom into the hospital.  She said my mom was severely anemic and that she has seen the drainage in other patients and that is was not alarming. During one of our stops, the left side of my incision opened and was bleeding like it had done about 2am before we left. Long story short, my sister ended up taking both my mom and I to the ER.   I was given wound care and told to redress the wound daily. It was not infected and was already healing from the inside out.

My mother was given a blood transfusion after the CBC showed a low blood count.   Infectious Disease was called in to consult regarding the fluid draining  from mom’s drain port.

Fast forward a few days and I have been to the ER every other day to have my incision looked at and treated.  I was placed on antibiotics four times a day as a precaution and on 9/21, I was given Lasix to help bring down the horrible edema in my legs.  


The lab results came in for my mom and she has a localized staff infection.  Mom has to stay in the hospital for several more days.

 

Thirty-Six Weeks & Counting – The 411

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Two heads of romaine lettuce with dark background

How my baby’s growing

Your baby is still packing on the pounds – at the rate of about an ounce a day. She now weighs almost 6 pounds and is more than 18 1/2 inches long (about the length of a head of romaine lettuce). She’s shedding most of the downy covering of hair that covered her body, as well as the vernix caseosa, the waxy substance that covered and protected her skin during her nine-month amniotic bath. Your baby swallows both of these substances, along with other secretions, resulting in a blackish mixture called meconium that will form the contents of her first bowel movements.

At the end of this week, your baby will be considered “early term.” (Full term is 39 to 40 weeks. Babies born before 37 weeks are preterm, 41 weeks is late term, and those born after 42 are post-term.) Most likely your baby is already head-down. But if not, your doctor or midwife may suggest scheduling an external cephalic version. That’s a fancy way of saying that your healthcare provider will apply pressure to your abdomen to try to manipulate your baby into a head-down position.

How Mommy’s life’s changing

Now that your baby is taking up so much room, you may have trouble eating a normal-size meal. Smaller, more frequent meals are often easier to handle at this point. On the other hand, you may have less heartburn and have an easier time breathing when your baby starts to “drop” down into your pelvis. This process – called lightening – often happens a few weeks before labor if this is your first baby. (If you’ve given birth before, it probably won’t happen before labor starts.) If your baby drops, you may also feel increased pressure in your lower abdomen, which may make walking increasingly uncomfortable, and you’ll probably find that you have to pee even more frequently. If your baby is very low, you may feel lots of vaginal pressure and discomfort as well. Some women say it feels as though they’re carrying a bowling ball between their legs!

You might also notice that your Braxton Hicks contractions are more frequent now. Be sure to review the signs of labor with your doctor or midwife and find out when she wants to hear from you. As a general rule, if you’re full-term, your pregnancy is uncomplicated, and your water hasn’t broken, she’ll probably have you wait to come in until you’ve been having contractions that last for about a minute each, coming every five minutes for an hour. Of course, you’ll want to call right away if you notice a decrease in your baby’s activity or think you’re leaking amniotic fluid, or if you have any vaginal bleeding, fever, a severe or persistent headache, constant abdominal pain, or vision changes.

Even if you’re enjoying an uncomplicated pregnancy, it’s best to avoid flying (or any travel far from home) during your final month because you can go into labor at any time. In fact, some airlines won’t let women on board who are due to deliver within 30 days of the flight.

BABY STATS:

How Far Along?

36 weeks !

How Big Is The Little One?

The baby is the size of a head of romaine lettuce or a spaghetti squash.

Total Weight Gain / Loss?

Eeeeek !   I gained TEN pounds of fluid weight since my hospitalization last week !  I freaked OUT !    That is a total weight gain of 23 pounds !  I had only gained 13 pounds until last week.   I lost 27 pounds my first trimester so I am still under the weight I started at but I do NOT like this weight gain AT ALL !  I am certain that it will fall off after I deliver the baby and also with breast feeding.

Maternity Clothes?

I spend most of my day in either pjs or a body con dress.  I have absolutely NO desire to do anything but shower and put on fresh pjs since I can not really leave the house due to bed rest.  I have gone out a few times to pick up breakfast and just put a dress on on top of my pjs.

Sleep?

Because I am tending to my mom at night, I am not sleeping well.  I wake up because she is talking out of her head , she gets up, or if it is time for her medications.  I have been napping during the day somewhat. My baby is pretty active around 1 am too.

Best Moment of the Week?

I have had a pretty boring week !  My mom had surgery on Friday and I am on total bed rest so I have pretty much been on the sofa or in the bed watching tv, drinking fluids and chilling. I have a biophysical exam and sono in the morning in NYC.  I see the OB after that.  My OB is in Greece until Sunday so I am praying my baby does not try to come out before he is back !  I do the second hospital tour on Sunday in preparation for the birth.  I just pray they do not try to keep me after my appt tomorrow !  I am NOT ready and my mother can not travel four hours to NYC right now. She has her post op appointment tomorrow and gets her drains out.  There is very little drainage now, which is good.

Symptoms?

My legs and feet are so swollen that I look like Miss Piggy !  My toes in the left foot are numb most of the time.  I have an external hemorrhoid that has not gone down. My baby feels super heavy and I am having sharp pains shooting down into the vaginal area and I have problems getting comfy.  I have a definitive waddle when I walk and walking has become uncomfortable due to pressure.  I try to stay on the sofa with my feet up.

Food Cravings?

I have no cravings and really no appetite.  I have more room now for food now that the baby has dropped down a bit but I still am not hungry most of the time.  I have random periods where I am starving.  I will start to eat and get uber full quickly, thus I had eating out !

Food Aversions?

I just have no desire for food at all right now.  I am sitting here drinking lemonade and a protein shake.  I will likely eat apple cinnamon oatmeal for an afternoon snack.

Gender?

baby girl !

Labor Signs?

I hope not !  I have a lot of pressure, but that is just a 5 – 6 pound baby and tons of fluid.  I had contractions in the hospital after the transvaginal exam and a cervix check and I can say without a doubt, SHOOT ME !  Do NOT let me have ANY contractions at all.  That ish is for the BIRDS !

What I Miss?

Having normal size legs and feet !

What I Am Looking Forward To?

Giving birth to a healthy baby girl in short while !   The doctors have scheduled me cesarean and I am just hoping this baby stays put until then.  They have moved our time table up a whole two weeks ! EEEEEEEEk !

Bump?

I have a low basketball !

Navel In/Out?

In

Baby / Mommy Purchases?

The only think I bought this week other than receiving the Milk Snob car seat cover, was a foot bath and Dr. Teal’s foot soak with lavender.  I am sending my sister out to get the baby a preemie outfit to wear home in the event that she is as small as they say she is and her other clothing will not fit.

Mom’s Surgery – The 411

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My mom’s reconstructive surgery that was basically a revision of the breast reconstruction she had done in December, went well. 

Because of the massive scar tissue due to radiation, one breast was super tight and small and the other was a lot larger and lower in placement.   The skin where they did radiation was akin to cutting through concrete according to her surgeon.  They removed all that scar tissue, did a tummy tuck to get new skin and muscle and reconstructed her boobs.   

Her tummy is so flat now I am jealous !  Lol

Her blood pressure remained stable this time and she was under for a little over 4 hours.

She stayed in the hospital all day and overnight and was able to be released to come home this afternoon.   I ordered a lift chair for her comfort from a local medical supply house and this chair is a godsend !!

Thanks for all the well wishes and prayers !!

Thirty Five Weeks – The 411

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Whole honeydew melon with stem in green bowl on green table

How my baby’s growing

The baby doesn’t have much room to maneuver now that she’s over 18 inches long and tips the scales at 5 1/4 pounds (about the size of a honeydew melon). Because it’s so snug in your womb, she isn’t likely to be doing somersaults anymore, but the number of times she kicks should remain about the same. Her kidneys are fully developed now, and her liver can process some waste products. Most of her basic physical development is now complete. She’ll spend the next few weeks putting on weight.

How Mommy’s life’s changing

Your uterus – which was entirely tucked away inside your pelvis when you conceived – now reaches up under your rib cage. If you could peek inside your womb, you’d see that there’s more baby than amniotic fluid in there now. Your ballooning uterus is crowding your other internal organs, too, which is why you probably have to pee more often and may be dealing with heartburn and other gastrointestinal distress. If you’re not grappling with these annoyances, you’re one of the lucky few.

From here on out, you’ll start seeing your doctor or midwife every week. Sometime between now and 37 weeks, she’ll do a vaginal and rectal culture to check for bacterium called group B streptococcum (GBS). (Don’t worry – the swab is the size of a regular cotton swab, and it won’t hurt.) GBS is usually harmless in adults, but if you have it and pass it on to your baby during birth, it can cause serious complications, such as pneumonia, meningitis, or a blood infection. Because 10 to 30 percent of pregnant women have the bacteria and don’t know it, it’s vital to be screened. (The bacteria come and go on their own – that’s why you weren’t screened earlier in pregnancy.) If you’re a GBS carrier, you’ll get IV antibiotics during labor, which will greatly reduce your baby’s risk of infection.

This is also a good time to create a birth plan. Using our form will help you focus on specifics – like who’ll be present, what pain management techniques you want to try, and where you want your baby to stay after you deliver. It will give you a starting point to discuss your preferences with your medical team. Childbirth is unpredictable, and chances are you won’t follow your plan to the letter, but thinking about your choices ahead of time – and sharing your preferences with your doctor or midwife – should take some of the anxiety out of the process.

Learn about: Arriving at the hospital

How can I prepare for my arrival at the hospital?

Long before you go into labor, you and your partner should map out the most direct route to the hospital or birth center. Find out where to park, keeping in mind that you’ll be leaving your car for at least 24 hours. Ask the hospital staff where you should enter if you arrive after-hours. Most hospitals offer tours of the obstetrical floor at designated times. Taking advantage of these tours will give you a chance to do a dry run before the big day.

BABY STATS:

How Far Along?

35 weeks !

How Big Is The Little One?

My baby is the size of a honeydew melon and she weighs 4lb 3 oz

Total Weight Gain / Loss?

Although I lost 27 pounds my first trimester, I have only gained a total of 13 pounds. Since I was in the hospital for two days and given 3-4 bags of fluids, I can not do an accurate weight reading this week.

Maternity Clothes?

I am wearing the same maternity clothing:  jeans, capris, oversized tees, maternity tees, body con dresses, sundresses, and a few of my baggy dresses from pre-pregnancy.

Sleep?

I have been sleeping well.  It was hard to sleep the two days I was in the hospital because of the monitors and the unfamiliar noises.

Best Moment of the Week?

The best moment I had this week was the relief of knowing the bleeding was not an issue of my baby and that the baby and I both were fine and also hearing of the excitement of the little gifts I sent to my sister-friend’s children.  One child has been sick and the older toddler helped to care for the other.  I was so tickled to hear how much they enjoyed the little tokens.   Now I am gearing up for my mother’s reconstructive surgery tomorrow.  She will be in the hospital for a few days.  I am just praying all remains stable with me and my little munchkin and that my mom’s surgery goes smoothly.

Symptoms?

I have an external hemorrhoid which has not gone back down.  Some mornings, I awake a bit queasy and my skin is often overly sensitive and itchy. I take children’s liquid Benedryl and it helps tremendously.  This week, I seem to be burping a lot.

Food Cravings?

I still have no appetite so I do not crave anything in particular.

Food Aversions?

None

Gender?

Girl !,

Labor Signs?

I experienced contractions after a vaginal exam in the hospital.  They discovered that I was very dehydrated and after 2 bags of fluids, the contractions stopped.

What I Miss?

Nothing at the moment except being at the beach.

What I Am Looking Forward To?

Seeing my baby and holding her.

Bump?

My little soccer ball is still nice and round.

Navel In/Out?

In

Baby Purchases?

This week, my baby’s 4Moms Breeze Play yard in Grey arrived at Target.  I had giftcards from my shower and Sunday was Run Target day with 10% off, coupled with my 15% off completion coupon, I ordered the play yard so that I could maximize the discounts on the $300 large ticket item. I ended up getting $90 off ! I also ordered a Milk Snob carseat cover to match the baby’s Kate Spade baby bag.