Thursday, March 29, 2012

Keep Your Pants Up, Maternity Edition

I've been having trouble this whole pregnancy with keeping my pants up.  Doesn't matter if they are low-rider maternity, larger normal pants, pants with elastic, pants with buttons or even the over belly pants, I've been in near constant need of suspenders.  My solution had been to walk while holding onto them.  Which both looks awesome and doesn't really work that well.

Then I was in Pea in the Pod because I needed to grab some additional clothes as I needed to be a little nicer than business casual for four days at a conference.  I ended up deciding that I would get cut enough slack that I didn't need suits, but I did need some additional non-worn out business clothing.  And while I was there I remembered the secret!

Here's the secret.  You know Spanx?  Holds your fat in and reshapes your lines normally?  Well, there's a product called Mama Spanx and that is not really what it does.  What it does is give your pants something to adhere to!  When I saw it on the rack I immediately remembered that this is the magic trick!

So I grabbed some.  And it was brilliant.  Pants stayed where pants should be!

However, I was struck one day by the amount of layers that were over my belly and so I took a series of shots to document the semi-absurdity of it.

Image 1: this is fully covered.

Image 2: this is with the top sheer shirt pulled up
Image 3: this is with the pants that had stretched over the belly pulled all the way down
Image 4: this is with the fitted tank that I wore under the sheer shirt pulled up. (Note to self: I should probably stop wearing my nice theory suit tanks before the growing belly ruins them for future wear)

Image 5: this is the Mama Spanx pulled down as well.  Yes, four full layers with two going each direction over the belly is what we just saw there.

So, it might seem a bit absurd, but it's brilliant and makes you able to walk, talk, laugh, dance, jiggle, and climb an aircraft carrier all without having to hike your pants!

And yes, I literally mean hiking and climbing all over a low-rider.  Did all the tours of the USS Lexington in this, including the 4-inch heels and the pants stayed up!


I tested it the last day with a pair of low-riders (I'd broken down and just accepted the over the belly all the previous days) and it worked!


Apparently having the hotel full-length mirror inspires me to examine how my clothes stay up!  These are all at just before, exactly and just after 21 weeks.

And for fun, here's one of my feet after I forgot about the hiking part of dinner on an aircraft cruiser when I got dressed:

And for more random biological shots:
As I have a very deep belly button normally, this is a bit freaky.  And on occasion, you can catch a dancing baby here.  Not sure if you can tell if you don't know when to watch, but this is definitely the earliest I've seen motion from the outside.

And last, just to round out with cuteness and awesomeness, here is Trajan this morning at the dentist.  Trajan loves him and so do I.  Except he said we should talk to our pedi about having him seen by the ENT again and possibly pulling out his tonsils as part of a strategy to help his overbite which does not excite me.

Wednesday, March 21, 2012

20 weeks - Them Edition

So, as Karen pointed out there were no pictures in my 20 week ramble. In fact, other than saying all was good, I really didn't talk about the girls.  Because you know, it's all about me!  Duh ;-)

I'll make that deficiency up now with "their side". I went to the perinatologist on Monday morning and then the OB Monday afternoon, so they got lots of opportunities to show off.  The perinatologist puts the pictures and videos on a CD for the 20-week appointment only and so we have some short videos.  Unfortunately, I have pretty much no clue who is who in these pictures and videos, so I just dub them one of the girls.  In some I can figure it out since Righty is lower and she was showing more of a profile while Lefty was showing more of a face-forward view, but I haven't really even tried to work this out.

video
Paul combined all the clips into one for me, so this is all of the clips in one clip. You see heartbeats (super yeah), hiccups, hands moving around and some kicking.  Seeing the dividing membrane is always fun too!

Both babies are growing right on track and the measurements of the different parts of each of their bodies produce the same gestational ages, which is good.  They are still very similar in size with a 4% size discrepancy now (it was under 1% at 20 weeks), but this is still an EXCELLENT value.  Righty is measuring at 10 ounces and Lefty at 11 ounces.
Righty's placenta has moved up so it's not even a low-lying, much less a previa which is happy, good news.  Both girls are still girls and appropriately active.  It's fun to watch kicking/shoving go on between them.

They will have another growth scan at 24 weeks.

Righty gave us a great profile shot during the OB appointment and so she printed it.
And wanting to be fair, she then went and tried to get a similar shot of Lefty.  However, she was still lying with her face out, so we got more of an alien shot, but hey eyes are still cute!

Both of their fluid levels are great, all of the organs checked out exactly on track and I don't think there is anything that could have been improved from an evaluation of their anatomies perspective!  And that's the 20 week story from "their" perspective with pictures as promised.  Though, I'm not convinced ultrasound pictures should really count as "pictures" ;-).

Tuesday, March 20, 2012

Reflection @ 20 Weeks

I don't know when exactly it happened, but my mindset has changed at some point.

Not only am I not thinking that these two girls are dead, I'm acting based on an underlying assumption that they will be here, alive and relatively close to when we expect. I'm employing a whole person based on this belief. Changing rooms and schedules and things like that.

Not only that, but I realized this week with my 20-week OB and perinatologist appointments that I am not expecting bad news. I am not ramping up my blood pressure for appointments.

I know that bad things can and do happen, but I'm not EXPECTING them.

Everything I've read and heard from professionals makes me think this is weird. I'm supposed to be getting more worked up as we near the point in the pregnancy that Aurelia died. But I'm not. At all.

Maybe in part it's because I know she died at a really unusual point in the pregnancy. If you look at the fetal mortality curves, her dying at 24 weeks was just odd. So, maybe that's part of why I'm not worried?

Or maybe it's just the nature of the human spirit to be naive almost and expect a good outcome?

I still looked for their heartbeats and was glad to see them, but I had zero of the feeling of desperation as I waited. I had zero feeling of they are going to be dead. Appointments involved some jokes and calmness.

Maybe part of the early nervousness came from the fact that these two girls are such a surprise and so I wasn't mentally already worked up to be pregnant? And so I had to process that?

Maybe I'm just a stupid naive fool?

But I don't think so.

And what's interesting is the doctors seem to have arrived at this place at the same time. I scheduled FOUR-week appointments with both of them. I've been doing weekly or biweekly, so this is a huge jump. No longer worried about cervix, placenta location, implications of the iud being there at conception... I know they are still going to be doing more BPPs and monitoring the placentas and some stuff like that, but the language is starting to sound like these actions are to be cautious and to take the conservative approach more than because something bad is expected.

The next appointments are at 24-weeks. Last time, that was the perinatologist appointment where they both labelled perfect and viable and the obstetrician appointment of the word catastrophic. I imagine I will have some anxiety at this point, but I completely know that it is not rational fear and I think that will help me. And I will have the perinatologist that I like and the OB who is truly probably the best practicing doctor of any specialty that I have ever known. That and a little faith and I'm expecting even my blood pressure will be ok.

One last thought I had today. I was leaving work when I realized that these two will count as people rather than medical waste now even if they do not stay alive. This may sound dark to you, but this was a very happy and peaceful thought to me.

Life is good, I am very blessed and that's really pretty much it.


- Posted using BlogPress from my iPhone

Rant and RSV

I wrote last week about Chiron's trip to the ER due to bronchiolitis and a fever on March 6.  What I haven't written about is the aftermath of this trip in the week and a half after.

Quick context: I took him into the ER Tuesday evening of that week due to wheezing that was accompanied by a fever.  We were seen, he was given some breathing treatments, some Zofran for his vomiting from the cough and was started on prednisone.  Easy, right?  Continue albuterol as it helps, give prednisone to help him beat this cold, keep fever down to keep respiratory rate down and all is well.

He was tested for RSV and flu in the ER.  In fact, he was actually checked for RSV TWICE because we agreed he could be used in a trial for an even more rapid RSV test.  This was actually one of the reasons that our primary pediatrician asked that I take him in that night rather than just managing his symptoms at home.  However, when I asked the doctor caring for him in the ER what the results of the tests were, I was told "since we treat the same, I don't disclose RSV or flu results to parents as they do not know how to appropriate use this information."  When I pushed her on this further, she told me that this was an "evidence-based medicine approach."

I probably should have pushed more and at least asked to see the attending, but in my head I decided that this most likely meant that his results were negative and she was worried about a parent putting too much credence in a possibly false negative result and that's why she wasn't telling me.  I argued with her for a couple of minutes, but in retrospect, should definitely have pressed harder as I truly believe that as a parent I am the most constant factor in Chiron's care and really am the final arbiter of his continuity of care.  That's where I messed up.

That said, I shouldn't have HAD to push to get this information.

He did all right over the next few days, but did continue with some fevers that spiked high (105 level) at the beginning of the next week and so we saw his primary care pediatrician on March 14 (a week after the ER essentially).  She asked about his ER visit and acted utterly shocked when I told her that I did not know the results of his flu and RSV tests despite having asked and had in fact been told that it was policy that I COULDN'T know his test results as a "parent".  She moved past shock towards anger/irritation and told me that she would call and work to get the results as not giving them to me was nonsensical to her in general and definitely inappropriate towards a parent who was discussing H&H values with the clinician and was very familiar with her child's medical record.

She called me within half an hour of our leaving.  He did have RSV.  The doctor KNEW this at the time, but not only did not tell me of her own accord, but actually REFUSED to give this information when I made a direct request for it.

I was a little agitated about this and posted the scenario to Facebook.  In discourse with a number of friends, I realized that I was more than a little agitated.  I really felt that this unwillingness to provide me with this information represented a serious issue.  I have a friend who works at the hospital and she actually provided me with the contact information for the right person to address a letter to the hospital to and so I wrote a letter.  I mailed it yesterday and will be interested to hear if I get a response.

To be clear, I am not concerned about the quality of medical care that he received there.  Between his time on floor and in the ER, I have nothing but positive things to say about the medical care provided by this hospital.  However, I feel that this communication failure is significant as it both communicates an attitude that parents are assumed to be incompetent and purposefully withholds information from the parents that could be used in decision making!

While the majority of parents are not medical professionals, they do represent the individuals who spend the most time with the child and are ultimately responsible for the child's continuity of care.  If information is withheld from me, I can not effectively do this for him.  And this unwillingness to communicate makes me feel, rightly or not, like she did not have the time to effectively communicate with me.

And last part of my rant: I really do believe that withholding this information from me represented a public health risk.  RSV can be a very serious illness and particularly if transmitted to a very young baby or one who is immunocompromised can easily have lifelong health complications or even result in death.  Luckily, we recognized that he wasn't feeling great with just the bronchiolitis and did not expose him to any newborns, but we were not given this critical information by the hospital.  I acted on my gut and had Paul stay home with him rather than dragging him to Dallas and back, but I shouldn't have had to act on my gut.  I should have KNOWN he had RSV.

It's a teaching hospital and so I'm going to take a positive attitude and hope that this can serve as a teachable moment.  We were lucky and there were no serious repercussions from this incident, but there is no guarantee that this will be the case next time.

And as promised, a bloody ear picture.  When I took him into the doctor because his fever had spiked back up, she started trying to scope his ear, but it was so inflamed that it started bleeding.  It was obvious from that much that he had an infection there and thus a clear cause of his fever.
Last reflection: his fever actually was the highest in the two week period the night after we saw the pedi and the next day or so.  He was on every 3 hour doses of Motrin alternating with Tylenol both at the weight specific higher dose rather than the general window.  That night when he was still at 104.8 after a dose, I had two reflections.  First, he is a MUCH better sport than I am with that high a fever.  When I had mastitis a year ago January and was running in the 104s to 105s, I didn't want to do anything.  He was still playing on.  And the second reflection is that I had no desire to take him back to Dell and negotiated with the on-call nurse to keep waking him up and checking throughout the night rather than go back in.  I think I would have wanted to take this course anyway, but it scares me that my feelings about the attitude of a resident might make me reticent to take my child in.

So, do you think I'm crazy to be bothered by the withholding of this information, or would you be upset too?  I know it's a bit of a rant, but I really think it is based on a very real issue. 

A friend who I work with who is competent at you know mailing things sent it for me yesterday.  Since it's in town, they should have it today or tomorrow.  I know that they have a written policy that they must reply, but I don't know what the time frame is.  I feel like hearing something by middle of next week will help me feel as if they are taking the issue seriously.  I expect that I'll update here regardless.

And I promise I'll revert back to normal cute pictures :-)

Wednesday, March 14, 2012

Grumble grumble Captchas

So, I'm mostly asleep from the grand total of five hours I've slept the last three nights and the like, so I'm not going to write a post about the irritation of ER residents not releasing information that is important, RSV or anything like that.  Instead, I am going to use the word "so" repeatedly and go on a short rant.

What the heck is up with the blogspot based captchas these days?  It changed sometime in the last few weeks and it's just an unnecessary and annoying hassle.  And why even have these things on?  And am I the only one who gets so irrationally annoyed when one pops up?

I'll save my bloody toddler ear pictures for tomorrow as well, but for now, let's take a moment to judge captchas.  Come on, please?

Monday, March 12, 2012

Officially walking

I dub this officially walking, agreed?

YouTube Video


YouTube Video

So maybe the time change is good for something!

- Posted using BlogPress from my iPhone

Unscheduled Fun with Doctors!

The theme of the last week or so was definitely unscheduled fun with doctors.  First, I had a cold that led to some asthma type symptoms that landed me at the allergist and on steroids and albuterol.  Doing much better now though and nicely recovered. 

Then, Chiron picked up the cold.  He went from fine when we dropped him off on Tuesday morning to not looking great when I picked him up at 5:15.  They said he'd been coughing and seemed a little under the weather, but weren't alarmed.  I figured it was a cold and we headed to pick up Trajan.  As we were waiting for Trajan, Chiron seemed to get worse by the minute, so I hurried him up and we headed home.  Decided to skip dinner for him and just head upstairs, get a temp, give him milk and put him to bed.  The temperature was 102.4, so I put in a call to the pediatrician to get them to call in some Albuterol preventatively.  Started feeding him and he started wheezing and coughing more.  He was deteriorating as I watched and so headed back downstairs to start packing to go to the ER.  While doing so, the pediatrician called and said to definitely take him in.

At this point he was wheezing loud enough that it sounded like a musical instrument.  Driving to the ER with the stereo all the way off listening to him to make sure he kept wheezing was one of the most terrifying experiences of my life.

He continued his life-long achievement of not having to triage in the ER by wheezing pretty severely at the checkin assessment.  His pulse ox wasn't bad at 96, but since I'm not above dropping the phrase "29-weeker" there, we got taken straight back.  They tested him for RSV and flu, but the doctor we saw says she refuses to give this information as it doesn't impact what they do and can get parents worked up.  I think I got a nurse to say both were negative, but I'm not 100% sure.  Things like that just annoy me.  If I am quoting you his H&H, I obviously have a bit more knowledge than average running around there and I promise not to overreact either way.  I just like information.

However, I still like this doctor because she said that she sees very little improvement with kids this young with albeterol because they don't have sufficient smooth muscle or something like that.  Since he had wheezing in the lower part of the lungs and crackling in the upper, she had an RT administer two nebs of albuterol over the time we were there and they both confirmed that it didn't seem to improve things.  As a result, she said that we definitely don't have to wake him up to do albuterol and can really think about not doing it at all.  As he screams and struggles throughout, this made me love her.


Isn't he the happiest looking fella (with the exception of the first picture)?  And this is hours after his bedtime.  I got him a 40-minute nap in the Ergo at one point, but that was it. 

He was having problems with his cough causing him to vomit, but I got very good at catching it in the emesis basin.  They got some Zofran into him though and that helped a lot and so we were able to get him started on oral steroids.  His fever came down with Motrin to 101 and so they discharged us with a prescription for four days of prednisone, a just in case albuterol prescription refill and instructions to monitor.

He stayed home with Paul the next day, but really was doing better by Thursday, so we sent him to the majority of a day of school.  And he's looking much better now.

Trajan's explanation of his medicine to one of his after-school counselors was kind of awesome.  He touched a bug and so his soldiers have to fight it and we are giving him medicine that gives his soldiers armor so they can kill the bugs easier!

Chiron stayed home this weekend while I ran Trajan up to my parents for spring break just to give him a little more time to recuperate, but I'm happy to say that he's looking great and has no fever nor any wheezing at all.

However, to continue the fun of unscheduled medical appointments, I had one of my own this morning.  Yesterday, I got back into town and walked down to the mailbox with Chiron.  Our mailbox is at the entry to the street in a cluster.  This was actually an auto-eliminate when we first started looking at houses, but our standards dropped and we live with it.  There was a package and so I carried it, the mail and Chiron back.  Within a few minutes of getting back I felt a gush type wet and I had had some sort of bleed.  I laid down while he napped and it completely stopped and there wasn't even the old blood within two hours, so I waited until this morning to call.  They had me come in just to check things.

The answer is it was almost certainly a placenta bleed from Righty.  Her placenta started as a partial previa and I think is now a marginal that we are hoping might make it all the way to no Type of previa at all by the end.  It was self-correcting and hasn't continued to bleed, so nothing too alarming.  Because of the bleed, she went ahead and did an internal exam and my cervix is not only long, but is still closed, which is definitely a very good thing.

Both babies looked good at this twelfth ultrasound, but Right had a much lower heartrate than Lefty when we looked on the ultrasound so she checked them on the Doppler.  Righty was easy to find and was in the 150s.  Lefty is harder since she has the anterior placenta, but we were able to get a reading through the placenta and it was in the 130s, so also a perfectly acceptable value.

She said to go ahead and add a 25-pound weight limit to my life as the only modification for now.  She also said she wanted me to keep my appointment for next week so she can do a one-week recheck.  I also see the perinatologist that day, so will definitely be checked!

And just for giggles, the dog who thinks she's a cat:

Tuesday, March 6, 2012

Random Tidbits VII

I am unclear if this one was a maniacal or a genius move, but I took off work a couple hours early on the afternoon Poppins was bringing her son and husband over to meet us to take the dogs to the dog park.  They are good fun guys, but they are definitely terriers and have some energy and so I figured that having them a bit tired would be wise as I didn't know what her son thought about dogs.  It turned out that I probably didn't need to worry at all as he loved them, but I had a great time and so did they. 

The dog park we normally go to is pretty busy normally, but at 3 on a Wednesday afternoon it was almost dead.  A good part of the time we were there, there was no one!  Since I'm not supposed to be taking them for long walks right now, I might should try to find more times like this when I can take them without taking either boy and let them run some;
I just realized I've never actually written any blogs giving these two stories and so I should definitely work on doing that. 

And, since it was calm, I was able to sit back in a chair with my feet up in another chair.  So nice for everyone!
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We had noticed that Chiron was getting paler.  While we were aware it was February, I figured I should call the pediatrician to confirm that we didn't need to worry.  I told her that she wasn't exhibiting any other signs of anemia, but she decided that since he had been off of his vitamin supplementation for about two months, it probably made sense to go ahead and draw blood.  His H&H was 39.2 and 13.4!  That's the best he's had since the week he was BORN.  His iron reserve (ferretin level or something like that) was significantly lower than she'd like to see (17 maybe?), but since his H&H was so good, we aren't concerned at this time.  We didn't do a retic, so don't know what that is.

Whle the results were great, getting the blood draw drawn was a comedy of errors with the order not being found, needing three sticks and lots of wiggling around, and the like turning a thirty minute trip into 2.5 hours.  However, Chiron wasn't bothered by the wait at all:


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Trajan has been dressing himself entirely on his own on the weekends for around a year now, so I decided it was time he started doing it on the weekdays as well.  He had been dressing himself, but he required someone in the room.  He objected at first, but I think we've got it down.  However, he occasionally puts things on backwards and the like. 
Shirt AND shorts backwards, mismatching socks and unbrushed hair.  But his teeth are brushed and that's all that I actually require.
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I am continually impressed by how great a brother Trajan is.  Chiron really likes to be pretty much on top of him a lot of the time and Trajan not only tolerates this, but enjoys it.  We do make sure and manage Chiron so that he isn't on him when Trajan is working on something Chiron is likely to mess up though and I think this helps to keep Trajan's attitude so fantastic and loving towards Chiron.  I'm hoping that they will stay as close with these new two rather than Trajan retreating for self-preservation.  The little two being girls seems like it may help!

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At some point I received a coupon to try the MyHabit thing from Amazon.  I bought a shirt that ended up costing about a dollar after using the code.  This is my favorite one dollar shirt of all time:

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The story I wrote for the Preemie Power fundraising contest is now up on the Hand to Hold website as a family story.  It's interesting to see their story there for others to read.  Chiron and Aurelia's due date (the 40-week FYI one) was this Saturday, it's kind of crazy to think so much time has passed.

Monday, March 5, 2012

Cervical Length

I made it through the entire pregnancy with Trajan without ever even considering the length of my cervix.  Crazy, huh?

Last time, they checked my cervical length based on standard twin procedures at 24 weeks and it was 4.38 cm.   Then at 28 weeks, while on hospital bed rest, it was still actually 3.7 cm.

Despite these good cervical length values, the fact that I delivered at 29&6 takes precedence in deciding the risk management in this pregnancy.  We think that the cervical change was a result of the demise, but since we can't know that with absolute certainty, they are managing conservatively.  I had it measured early on at 8 weeks, but the value was so inaccurate that we are ignoring.  Since then, I have been measured at 12, 16 and 18 weeks.  I dropped from 4.5 cm to 3.8 cm between 12 and 16 weeks and while this was still a more than acceptable value, the shortening was a little concerning.  They didn't add any restrictions, but did recommend that I listen to my body and assume that any contracting is bad contracting so try to prevent contracting from happening by doing less and definitely lie down and hydrate any time I feel contracting.

I actually kind of like having this to worry about.  Preterm labor is definitely not good, but it is something you can take action on and DO something about.  So, I figure it's a much healthier worry than worrying about fetal demise or anything like that. 

I have been acting on this worry in a healthy manner following the advice about adding rest periods, not overdoing stairs, upping my hydration even a little more and just generally listening to my body for the last two weeks since the previous cervical length. 

Cervical length today?  5.0 cm. 

Yup, you read that right, not only did it lengthen, but it is longer than it has ever been previously measured at any point in a pregnancy!  And she said the shape was great as well.  I actually received PRAISE from a perinatologist today.  I didn't know they ever did that!

Based on the lengthening, I was cleared to go another two weeks until my next cervical length which will be at the same time as my next anatomy scan at 20 weeks.

And as a bonus, they confirmed cardiac activity and movement in both babies as long as I was in as well as their fluid levels and they both looked great! I declare ultrasound number 11 a great success.  Though, perhaps they should give keepsake printouts of the cervical length like they do the babies with scans :-). 

And here's evidence of my continued work in good eating:

Friday, March 2, 2012

Trajanism - Babies Pee in Your Stomach!

Last night, Paul, Trajan and I were sitting around the table drinking smoothies (they are supportive of operation get more protein into me) and Trajan finished his and stuck his belly out and said it was so big.  Then he declared that Daddy's belly was the biggest, but mine was getting close, but that was just "because of your babies."  (Note: my stomach is bigger than Paul's, Trajan may not be the best judge.)

Then he paused and asked how babies poop before they are born.  I replied that they don't poop until after they are born, but that they do pee.  I've always thought it's kind of cool how they swallow amniotic fluid and pee, so thought I was passing on an interesting trivia fact.  He paused for a minute and then burst out laughing and declared, "babies pee in your stomach!"  And proceeded to laugh for about ten minutes.

Then I took the opportunity to point out that HE had peed in my "stomach" (decided to skip the anatomy lesson for the night) and then he had another round of laughing.

Thursday, March 1, 2012

Massive Leaps of Faith

This week has included two leaps of faith that dwarf the previous $30 leap of faith.  Not only did we make these leaps of faith, but I actually didn't stress over them too much, which I perhaps think is more impressive.  [There's a question at the end of this that I'd love you to read if you have household employee experience! I'll stick it in big font too since this is such a long post. Pretty, pretty please ;-)]

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First off, we have a nanny in place!  I had previously decided that getting a nanny in place for June 1 would simplify things a fair bit and wouldn't increase our costs too much and would definitely provide a greater chance for the situation to work.  Wanting someone to start June 1, we had been told that we should probably plan to start looking around April 1.  Great plan, right? 

Well, I am still on the forums for my local mothers of multiples (MoMs) group from last time and I get a digest a couple of times a day.  A week ago there was a message titled "Nanny Available in March".  The description was really positive, was specific to our area and seemed to fit what we were looking for.  I had had a friend recommend that talking to a couple nannies in the area could help us finetune our job description, so I decided to go ahead and contact the current employer to get information.  I gave her a little information about what we were looking for and she replied that she thought the nanny would be a great fit as she had previously cared for infant triplets along with a toddler sibling.

I talked to the current employer the next morning and the nanny really did sound like a great fit.  Her current employer thought that she would be good with an April 1 start date and she passed on my information to the nanny, who I am going to call Poppins since I'm not sure about the etiquette here.  The current employer also let me know what she was currently paying which was well below the price point we had expected.  Poppins called me and we talked during nap time of her current job and she sounded fantastic.  We arranged to meet at our hour the next afternoon to talk in more detail and have an initial interview.  Poppins and I discussed that as a compromise since we were shooting for June 1, we would employ her at her current rate until August 1 and then would give her a 20% raise.  Poppins left me with her resume and references.

Here's a brief summary of reasons that I was excited about her and willing to consider moving forward with an earlier start date.  She lives within three miles of us, has experience carrying for infant triplets plus a two-year-old, is organized by nature, I enjoy talking to her, has communication identified as her most important job characteristic, has availability for the hours we want, is within our price point, has great professional and personal recommendations and is already CPR and first aid certified.  In addition, she not only is ok with us doing things by the book, she prefers it!  She went to a year of culinary school and likes to do meal prep for the families she has worked for.  She is willing to do the meal planning for the meals during the day definitely and even dinners if we prefer.  She prefers to have responsibility for the children's clothing and laundry.  She grew up here and definitely has English as her first language, but is also fluent in Spanish.  And she liked the dogs!

Phrases in her reference letters include: ‎"remarkably caring and responsible", "household manager", "effortlessly holds their attention and with more patience than I can and I am their mother", "responsible and reliable", "universally punctual and flexible", "active with them", "initiates own crafts projects"

She didn't blink an eye when I told her that we didn't even have broadcast television either.  And her cell phone number?  The 7 digits that aren't the area code consist of six of the same number and the seventh being a multiple of that digit.  I had it memorized from the first time I dialed it!

Based on this first interview, we decided we did want to try to go ahead and hire her at the earlier April 1 date.  Then I spoke with her current employer and found out that in the week she had been on the market, she had NINE offers on the table.  Poppins had apparently liked us, but it definitely wasn't a shoo-in.  We decided that we didn't want to lose her, so we made two changes to our contract.  First, we made it so she starts on March 19 and second, we have the 20% increased pay beginning from day one.  After these changes, we moved to the top of her list and she was willing to move forward with a contract with us after a meeting of both entire families.  Apparently the fact that we seem like nice and good people and that she likes to be considered more an extension of the family than just an employee is what pushed us to the top.

Last night, we met with her along with her son and her husband at dinner time.  Her son is in kindergarten and a little over a year older than Trajan.  Those two boy shad the best time and really hit it off.  We all got off really well and so we are moving forward!

We decided that since Chiron is paid in daycare through the end of March, we will go ahead and leave him there for this month.  She will therefore be working at the house for two weeks with no kids.  Our plan is that she will use this time to work on the general organization of the house and some of the chaos that has grown since I went in the hospital (yes, a year and a half ago, don't judge).  It will also allow her to meet the maids that we have who come for a few hours every Friday morning without having the kids there.  And she is going to do some counting and measuring to help set us up to move towards babyproofing (wasn't necessary with Trajan, but is so necessary with Chiron).

Then, we will add Chiron at April 1.  We are thinking that we won't add Trajan even for after-school until he gets out for the year at the beginning of June, so her first day with both boys will be June 4.  Then, when the girls get here (see the leap of faith!), we will work them in some as well while both of us are in the house more in the months after they are born and then when Trajan goes back to school and we go back to work full-time in the offices, she will watch the three littles.

All seems great to me, but you can see that pulling Chiron out of daycare, giving an employment contract in which we require at least four weeks notice to terminate and committing to pay a full-time household employee is a very significant leap of faith.
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Second leap of faith is a friend posted the following picture to Facebook on Tuesday:
 Along with the caption "Liz & Chiron at the registration table. (BEAUTIFUL belly).

It was tagged with my name and so it received very quick comments and feedback.  Up until now, I haven't really been discussing the fact that I was pregnant with people that I don't see.  I decided to just go with it and embrace the disclosure/sharing rather than censor or anything.  So, I posted a status that I was pregnant with the twins and soliciting more name thoughts.

Leap of faith!
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And the question:

Since we are starting with a nanny in a little over two weeks, I have to get my household employer stuff in line.  I definitely have worked out the details of FICA, unemployment insurance (state and federal), withholding and the like in terms of the theory.  What I haven't figured out is the best way to implement.  As far as I can tell the options are: do it myself with spreadsheets and tracking, use a software product (nannypay.com and Intuit seem to have one each) or use Breedlove.  It's a tradeoff of confidence, time and money... So, what do you do?  What do you suggest?  And ahhh!!!
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I just realized that working on names counts as a leap of faith too!  While I have also thought in my head that they need names whether living or dead at this point, I really am thinking of them in terms of living, breathing babies as we discuss names!