Max's first month

Time has certainly flown by and I can't believe that Max is now 8 weeks old (yes, this post is a little late, but better late than never!  I still need to write about his birth day too)!  I wanted to write a bit about our first month with Max.

Our first month started out a little rough, not because Max was a bad baby or poor sleeper, but because we got a call from the on call resident at Mayo with a positive newborn screen result.  I will say that being on the other end of that phone was a lot more difficult than I ever imagined.  I was able to keep myself together while on the phone, but then fell apart once I hung up.  I kept telling myself, "Margaret this isn't all that bad."  I kept thinking to myself about all the kids I'd taken care of who had much worse inherited conditions and needed things like liver transplants, but nonetheless the mom hat overpowered the doctor hat and I was emotional about it for days.  I didn't even want to talk to my parents about it just because it made me so upset.   During that phone call it didn't help that the resident said to take him to the ED immediately if he didn't eat or started throwing up and told me that they'd already arranged for me to see the geneticist at Mayo the next morning at 8:00.  All of that just added to my anxiety.   Our pediatrician was so nice and called us at 8:00 that night to be sure we knew about the results and knew we had options on where to take Max.

 Turns out, the diagnosis remains unclear as Max doesn't have a full blown genetic mutation, but regardless they want us to treat him like he does.  Basically he doesn't metabolize short chain fats at 100% so he has to eat more frequently to ensure that everything gets all of the energy it needs (in simple terms, for my medically inclined friends, it is SCAD deficiency [short chain acyl Co-A dehydrogenase deficiency]).  The frustrating thing is that only 31 states test for it and they still don't know the clinical significance and even stated that he would likely never develop any symptoms.  Right now, it means that he can't "fast" so for at least one more month I have to wake him up every 4 hours to eat and take him to the ED if he ever gets a GI bug and can't hold anything down.  The feeding schedules spreads out as he gets a bit older, thank goodness, but I just know that Max would have been sleeping through the night within his first 6 weeks if it weren't for us needing to feed him on this schedule!

All this newborn screen experience has really taught me a lot as a physician, as has just being a mom.  I will be sure to be as informed as possible when trying to explain things to parents over the phone and reassure them that it is in fact only a screening, not a diagnosis, and needs further work-up.  Many of these diseases tested for on newborn screen are complex and go all the way back to biochemistry, but I will try to do my best! We are just grateful that Max's mutation isn't as serious as it could be and for right now I will continue to sacrifice sleep even though we don't know if he really needs to eat as scheduled.  I get to spread out his feeding schedule to 6 hours maximum fasting at 3 months, so hopefully I will be able to get at least 5 hours of continuous sleep at night before starting back to work.

Other great things about Max's first month were all the visitors and just getting to know his personality and watch him grow.  He did have a follow-up with the geneticist at almost 1 month (26 days) and he weighed 4.4 kg or 9.7 pounds up from about 3.5 kg at birth.  He was 20.7 inches long up from 20 inches at birth, so our little guy did a lot of growing his first month (probably due to having to eat every 3 hours, which is what the feeding schedule was before the follow-up appointment).

We are exclusively breastfeeding, which is going well and for which I am grateful. At his weight check at about 9 days of life he had already exceeded his birth weight and weighed in at 7#13oz.  For the first 2 weeks, we just let Max sleep when he wanted and were sure to feed him every 2 hours during the day (once we got the results of the screen) and every 3 hours at night.  We were able to spread this out to every 3 hours during day and night once we saw the geneticist for the initial visit.  When my older sister came to town, she got Max on a schedule, which was so nice!  He had been taking all of his naps in his newborn sleeper (thanks Hannah) and sleeping in his crib at night, but Mary E. had us put him in his crib for all of his naps.  This was hard to do, but I was really grateful because it allowed me to be productive during the day.  We started eat-play-sleep cycles at 1,4,7,10 am and pm.  All of this continued until Max was 26 days old and we had a follow-up visit with the geneticist who said Max could "fast" for a Max of 4 hours, so then we switched to a 2am and 6 am feeding schedule.

Other notable things in Max's first month:  We switched from newborn diapers to Size 1 at about 2.5 weeks.  He was able to wear newborn clothes, but quickly grew out of those around the end of month one (although I still squeezed him into a few afterward, but you could tell that he was stretching them out).  He has always been a strong fella and has good head control for a baby his age.  Two of my favorite things he did during the first month were 1) nuzzle into my neck when he was working so hard to hold his head up and 2) how he ALWAYS straightened his legs out with each diaper change--it made it a little easier.  I loved holding him up with just one hand supporting his bottom and loved how tiny he seemed, although he really wasn't ever THAT small!

I need to come up with a better "template" to mark these month milestones--maybe I will get the hang of it soon.  Here are some pics of Max's first month.  Month 2 post coming soon!

First bath at home.

He loved his newborn sleeper!

This was one of my favorite newborn outfits.  Max made a lot of his doctor visits in this outfit. haha!  thanks Mary E. for letting us borrow it!

Max's first bottle.  We waited probably until he was just over 3 weeks old to introduce a bottle.  Marc gave him his first bottle and he took it really well, however we now somewhat struggle with bottles.  We are working on it though! It just went downhill after the first 3, but now is getting better!

Construction Day 1

Today is the first real day of construction for our home renovation.  I think we must be crazy for STARTING a huge (5 month long) renovation with a) a 5 week old boy and b) at the start of a Minnesota winter (started snowing this afternoon) but we are going through with it!

We started this process really and truly around Thanksgiving 2011 meeting with a design-build company, and I guess started actually developing architectural plans around February or so of 2011.  The process was long, made even more lengthy by our indecisiveness and by the departure of the 2 architects to a different company, but we ended up with a design and an architect that we loved!

The project will entail a COMPLETE demolition of our family room and "master" bedroom.  In exchange, we will lengthen the house, have a brand new kitchen, family room, mud room and "master suite" with a walk in closet and new bathroom.  We will also be getting a 1/2 bath downstairs to replace our closet of a 1/2 bath and a butler's pantry to transition from the more formal part of the house (dining room and living room) to the more lived in part of the house.  I am so excited about the finished product, but it will be a long journey there!

It has been stressful already.  We had to move all of our things out of our family room and bedroom and much of our kitchen.  Since I am still not supposed to lift anything more than 15 pounds, it made it tough to move our things and I definitely broke the rules several times I am sure!

Today, they came to board up our family room and bedroom and start cutting the house in half for the demo on Monday.  Here are some pictures . . .

Our "master" bedroom once we moved all of our furniture out.  Don't you love the pink carpet?

Another view of our bedroom.  The closet did not work for the two of us!

Construction site in the morning.  Backyard fence is down, port-a-potty is here! haha!

Family room with all of our stuff moved out

Construction site this afternoon, just a few more additions

Boarded up hallway to family room

We now have less than 1/2 of our original kitchen and our pantry is now in the middle of the kitchen....Obviously we will have to move the table and lamp!

Here's to 5 months of crazy living!!!

Family Visits

It is amazing how quickly this first month with Max has gone by and I feel like they will only go by more quickly.  I will eventually blog about Max's birth.  He was born on a Wednesday evening and Marc and I got to go home the following Friday.  My parents made it up for the birth and my mom was able to stay for several days afterward to help us get settled in.

Max's crib had not yet come in so as soon as we got home Marc had to make an emergency trip to Target to get a pack n play, baby monitors, sheet, etc.  Max spent his first night in his nursery, but in the crib.  I can't remember all the details of his first night, but he seemed to sleep pretty well.  The following morning the crib and dresser were delivered and we were able to get his nursery all put together.

We had lots of visitors in Max's first month.  After my mom left, Scott (Marc's twin brother), Jessica and Dean all came up and Max had his first cousin meeting.  It was SOOO nice to see them.  We just did a lot of hanging out around the house and it was fantastic to spend some good quality time together.  We miss the luxury of just being able to pop over to their house in Little Rock.

They brought a Mickey's cake (our very favorite) for baby Max and it was eaten rather quickly.  Here are some pictures from their visit.

Max getting to meet Auntie J and cousin Dean

Dean wanted to help push baby Max

On a stroll in our neighborhood

Max is already ready to get into his first Mickey's cake!

After Scott, Jessica and Dean drove back to Arkansas it was only a few days until my mom came back and my older sister came for their visit.  Mary E. (my sister) was fantastic and came up here to get Max on a schedule and help me figure things out with my new boy.  She also brought up her newest boy, Tull, who is just 5 months older than Mr. Max.  We had fun with our two boys and Mary E. helped me learn tricks on how to soothe Max and many, many other things.  She even stayed up with me when he was fussy and came to hang out with me at the 1am and 4 am feedings!  I still call her ALL the time with questions.  We had a great time with everyone and I was so thrilled to meet my newest nephew.  He looked so big compared to Max!

Our next visitors were Marc's parents who came for Thanksgiving.  We got most of our meal catered from Whole Foods (thank goodness).  It turned out really well and was much easier.  We made macaroni and cheese and pumpkin pie, but everything else we picked up and heated up!  

Max with his Thanksgiving turkey.

The vegetarian Thanksgiving meal (there was turkey, just not on my plate!)

Our most recent visitor was my mom--her third trip up since Max's birth.  I am SO grateful that my mom can come up so frequently.  There is nothing better than having your mom around! :)  While she was up she kept Max so I could go meet with my assistant program director for my 6 month review and she kept Max so Marc and I could go out to eat for our 4th wedding anniversary.  Poor mom was sick while she was here, so she walked around with a bottle of hand sanitizer and a mask and didn't get to hold Max at all!  She will get lots of time later though!

So Max had a very busy month of visitors, not including friends who have stopped by, which we are also grateful for!  

More to come later

Bed Rest

I am trying to catch up a bit on blogging, and although there aren't many readers, I think it will be a good way for me to try to remember things!

From my last post, it is pretty evident that my pregnancy always fell into the "high risk" category, therefore I knew bed rest was always a possibility, but it came somewhat unexpectantly.  I went to my normally scheduled OB appointment (32 weeks, but was just at 33 weeks)--was a little bit late as far as weeks go because I had been on an inpatient peds month and just couldn't go to the doctor.  I was so excited to get a peak at our little guy on ultrasound since I had growth ultrasounds at every single appointment due to my high risk for growth restriction in our little guy.  It was always so reassuring to see our little man and to see how big he was getting. He was always measuring 2 weeks ahead of my due date with weight in the 80th percentile and HC > 97th percentile, so we figured the risk for growth restriction was long past us.  Ultrasound looked fantastic which was always a relief.  Then it came time to be seen by the doctor. . . I go in and have my blood pressure checked and it was 162/98--certainly on the high side.  My doctor came in, of course concerned about me, and started talking about the possibility of preeclampsia and what I might need to have done as far as testing goes. We didn't want to make any decisions until BP was rechecked...came back and BP was 158/102.  A call was made to triage to get a bed ready for me and I was briskly rushed to triage which was just down the hall with Dr. Rose carrying my purse and coat.  He helped get me settled and introduced me to the nurses and then went to talk to the staff on call.

I wasn't every SUPER worried about things, probably because I had just seen Max on ultrasound and knew he looked great and I hadn't had any symptoms at all of preeclampsia.  Marc couldn't come to my appointment with me so I tried to remain calm for him knowing that he couldn't get down to the hospital for a bit.  I underwent further work-up and everything continued to look okay, lab work and everything.  My blood pressure came down slightly to the 140s and in came the staff physician with my new plan.  It was bed rest immediately and I had to start betamethasone (injectable steroids to help with the baby's lung development in the case of a pre-term delivery).  After I was "cleared" I had to go complete the MRIs I was scheduled to have that day.  It was not pleasant to lie flat and still at 33 weeks pregnant, but I was grateful that the staff still did all of my imaging despite my being late due to my adventures in triage!

  I had to go back to Mayo the next day for a 2nd injection and again my BP was high in the 150s, so it was back on monitors again and again things looked okay.  I had to go back for a follow-up appointment just 2 days later to see how the BP was and to see if bed rest was still needed.  BP was still on higher end of normal, but was a bit better and labs still checked out okay, so I had medication changes and remained on bed rest.

I was on bed rest from 33 weeks until Max arrived at 38 weeks 4/7 days.  I had to drive to Rochester twice a week for ultrasounds and non-stress testing (monitoring baby's heart rate) along with doctor's appointments.  It was not pleasant. . . I had a lot that I needed to get done and finally had the time to do it, but was unable to do it.  Days were long for sure.  I am just grateful to my co-residents and program staff for taking so much of the stress away for being gone from work.  I can't even begin to tell you wonderful everyone has been!  I am also so appreciative of Marc for all the chores, grocery trips, and just generally putting up with me and for my mom who came up while Marc was traveling for work.

Thank goodness bed rest is over!

Pregnancy

As some of you might have noticed, I was, throughout my entire pregnancy, a bit hesitant to talk too much about things and certainly waited to make the news public.  I worried every single day about our baby boy until the day he arrived--I still worry, but it's a different kind of worrying!  When I was young (probably 10 or 11), I remember my doctors saying that adolescence and pregnancy would be the most difficult times for my health.  In fact, there were many times when I even wondered if I'd be safely able to carry a pregnancy.  I remember being upset about this even as a little girl because I was the girl who packed a diaper bag for her dolls and brought them to our church nursery where Oma would "watch" my babies.  I remember making "bottles" for my babies by mixing water and baby powder and positioning all of my Magic Nursery babies in the living room floor and watching them all.  I even had a magic nursery pouch that had 3 babies in it that was designed to wear on your belly.  It even had a button you could hit to make the babies "kick."  I don't really know what Mattel toys was trying to promote with that, but I had one and I thought it was super cool.  All this to say, that even at a young age I realized what this potential "difficult time" meant.

Soon after Marc and I got married, we decided to go see a Maternal Fetal Medicine Specialist to discuss if pregnancy was even an option for me.  We weren't interested in having kids at that time, but we knew that if pregnancy wasn't possible that adoption and/or surrogacy were paths that would take a lot of time and we wanted to prepare appropriately if needed. (We still may adopt some day too!) Fortunately the doctor told us that it was certainly possible, but remained risky.  I was a third year med student when I went to see him and remember him specifically saying that I needed to be in a place in my career where I could go on bed rest if need be at 20 weeks.  He even told me that if I were a lawyer he wouldn't even worry about me so much.  I repeat that only because my older sister is an attorney and my little sister will graduate from law school in the fall.

There were a variety of procedures and tests that were recommended to me to have done prior to thinking about having children.  Some more invasive than others and most that I didn't want to do!  Still without thinking about kids yet, once we found out we were moving to Minnesota, I started establishing specialty care up here at the Mayo Clinic, which was the only place my providers at ACH (Arkansas Children's Hospital) knew about to best manage my medical care.  I traveled up to Mayo in May 2011 just after med school graduation to see a cardiologist in the Vascular Center at Mayo.  He, again not being an OB, gave me much more reassurance that I could carry a pregnancy and even said that the procedures recommended to me were not necessary in my case, which relieved me!  He dictated my clinic note while I was still in the room and kept referring to me as "Dr. Whipple (hadn't changed my name yet), which sounded so weird to me!

Once I found out I was pregnant, it was easy then to decide to go back to Mayo for care.  So once we found out that we were expecting, back to the cardiologist I went and same day met our OB.  We got 2 pieces of great news that day.  The first of course, seeing our little peanut on ultrasound and knowing that I was in fact pregnant.  The second being that I didn't need Lovenox, an injectable blood thinner, during my pregnancy.  Our OB was fantastic and so knowledgeable.  He even emailed me several articles about Klippel-Trenaunay in pregnancy.  There were few case reports and limited literature, but nonetheless all good information.  Maybe one day, my case will be written up.

Although we had some good news, we realized the potential speed bumps in the road ahead and kept the news to ourselves for quite some time.  I was able to avoid bed rest for about 13 weeks longer than originally anticipated at the very first MFM consult several years prior and continued to avoid the injections (until post-partum). Although there were some complications, Marc, my family and I all feel blessed that the pregnancy went as smoothly as it did and now we have our sweet, sweet Max!

Thanks for reading this and now maybe understanding a bit of why we kept things to ourselves for a while.  I am sure all of the daily anxiety didn't help my blood pressure, but now we have our little one who makes it all worth it!

More to come later, and as Max and I establish a routine, I hope to be blogging more!

As some of you know, Marc and I attempted to refinish some of our hardwood floors ourselves.  This was quite the task and took over a year for us to work on, mostly due to my work schedule and Marc's travel schedule.  Now we can say that the floor is finished, however it took a different turn that we expected.  Just as a reminder, this is what the room looked like BEFORE...

Don't you love the light fixture, carpet color and drapes?  We HAD to fix this!  So we started with carpet....

There was not only a layer of carpet and carpet pad but also this HORRIBLE plastic (linoleum-like) layer with felt backing that was GLUED to the hardwoods!  We finally got the carpet up (it was gross) and were left with this below:

It took use a long time to figure out how to remove this horrible layer.  We tried glue removers, strippers, and NOTHING worked, so we were left to scrape it off.  Of note, we did have the felt and glue tested for asbestos before we got too into the job.  Fortunately, they were both negative!

It took WEEKS to get this stuff off.  It was a great way to let off steam after a long day; however, it did result in some floor damage, which we attempted to cover up or sand out.

We had to sand and sand the floors to get all of the glue off and to get down to a stainable layer of wood.  We just used a belt sander, which is tough to use.  I can't even remember how many different grit types we had to use, but it was quite a bit.  Marc did all the sanding, I did all the vacuuming.  Then I got to do all the staining because Marc was in London by the time we finally got to the staining point (yes, it took from about August 2011 to January 2012 to get to this point).

This was after 2 coats of stain, which we had to do to cover up all the imperfections in the floor.  It looked pretty good and then the polyurethane came.  First coat of polyurethane looked great, then we had to sand that. That's when things started to not look so good.  In the daylight there was this white film that was pretty inconsistent.  We didn't know what to do about it.  Reading some about it, maybe it was too humid when we did the application?  Who knows.  We did decide to have the floor in what is to be the nursery refinished too before that furniture came in, and given that I am not much help in my bed rest state (not that I would want to do any floor staining in pregnancy anyway), we decided to hire professionals.  Best decision we could have made!  They did 3 bedrooms and they now look fantastic and took 1 full day + 2 days of maybe 2 hours of work (polyurethane application that had to dry between coats).

These guys got all the imperfections out of the floor and it now looks wonderful.  We were so impressed with their work.  Below is a picture after the first application of polyurethane, which isn't dry, so it looks very shiny!

We (meaning Marc) still has to get the quarter round back down and then we will be ready to hang curtains and move into this room with our new bedding to prepare for renovations to the back of the house!  Will post with completed pics soon!

UPDATES

As many of you know, Marc and I are expecting our very first little one this November.  We were a little bit late to announce it, just because we were extra cautious, and as a result, I never blogged about it due to the late announcement and because we've been so busy.  Now, however, I am on bed rest so I do have a little bit more time than I did while I was in the NICU and on inpatient peds!  :)

We do know that we are having a BOY!  No official name yet, but we are working on it and certainly need to decide soon.  I am 35 weeks 4 days today and he is a big fella (consistently measuring over 2 weeks ahead of schedule)!  Due to some of my health problems and risk for baby being growth restricted because of them, I had very regular ultrasounds to be sure he is growing normally.  Here is one of my favorite pictures from our 20 week ultrasound (sucking his thumb):

Since our 20 week ultrasound, he hasn't been super cooperative and won't let us get a good profile picture!  

They put me on bed rest on Sept 26th, which was about 33 weeks and 3 days for me.  It hasn't been very fun.  It's hard to go from working really long (sometimes 80 hour weeks and a few 28 hour shifts), to sitting or lying on the couch all day.  It also bought me twice weekly doctors appointments and 2 injections of steroids for baby's lung development.  Although going to the doctor (and driving 70 miles to Mayo) is not fun to do twice a week, it does give me SOMETHING to break up the long days!  My mom was here for most of the week last week since Marc was out of town for work.  It was so nice to have her here and she really got a lot done and ready for our little guy's arrival.

Because we were so late with things, the crib and bedding still aren't in, and probably won't arrive until close to our due date, but I will try to make a post about the nursery soon.  We do have a chair for the nursery and have gotten the rug, curtains and changing table.  Lots to do still, which makes bed rest all the more tough--knowing I can't work on things but yet having all the time in the world to do it.

Now that I have more time (at least until the baby comes), I will try to blog a bit more.  We will have more baby stuff I am sure along with home renovation updates!

Thanks for reading!