Trajan on Growing Up

Growing up is possible. And it takes a long time to grow up.  And when I do, I can go to En-gland.


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Dagnabit and Decisions

This is the trend of my total milk production (I lost the first two weeks of data so this is 1/5/11 to now.  Also, the dip at the beginning is dual mastitis that earned me my six-day readmit):

I thought it was because of the passage of time since he was born plus the evidence from this graph of my total daily pumping time:

(odd trivia fact: I always subtract three minutes from my pumping time... originally I think I had some theory about it being letdown time, but now I just do it to seem consistent with other weeks.  Well, and the real reason is to probably make it seem like less time.)

I should have been suspicious that the drop was too much to be explained by just the pumping time because after an initial drop, the number of times I have pumped a day has stayed pretty even:

Today I finally figured out what is going on.  I use two pumps: a Medela Symphony at the house and a pump in style at the office.  The pump in style seems to have reached it's last leg.  I had thought this a few times in the last months, but I convinced myself I was crazy.  Today it was obvious that it just ain't cutting it.  Pumped twice so far today and under 50 mL total each time.  And after the second time I experimented with hand expressing.  With a good pump with the Symphony, I can then remove maybe 5 mL per breast.  I got over 30 mL from each breast working less than three minutes per side.

I think I should have been suspicious based on the change in the ratio between the two sides (this is right divided by left):

When I was falling off more naturally, it seemed like the right deteriorated my quickly, but despite the serious decrease in each breast over the last two months, the ratio stayed pretty constant.

So Decisions....

• Do I cart the symphony back and forth?  This is one I bought myself, so it doesn't have a hard case, so I worry about damage to it.  Also it would be huge, I really don't want to do that.
• Do I try just pumping once or twice during the work day and running home?
• Do I rent a second symphony and leave it here?
• Do I just buy a new pump in style as it's handy... Also, I have a trip to Canada coming up that I was considering taking the pump in style instead of the symphony just due to size anyway.
• Do I declare myself done/incompetent and just quit?

Seriously, how did I not notice earlier?  Despite an average of less pumps on the weekends, the production is better... Argh.

I'm leaning towards just buying another pump in style.  If I remember right, that's around $300?  I feel like I've tried everything.  Replacing all the membranes has seemed to improve the performance of the Symphony, but the PIS is just getting worse and worse.

I went home and pumped (just finished) and got more than double what I had gotten from the two pumps I had done at work today!

For the sake of visual completeness, here's total broken down by left and right to make the problem a bit more obvious (yes, I know I should make more useful graphics given the data, but these are fast to autogenerate):

I really do need to take some sort of action, like today.  Thoughts?

Where's the Other Shoe?

This little guy is doing so well, but I find myself looking for another shoe to drop.

Even before he was born, from the first conversation with a neonatal nurse practitioner while they were stopping labor at 24 weeks, we were told to expect a roller coaster. Ups and downs. Rises and falls. Two steps forward and one step back. With the possible exception of going on a ventilator for six to eight hours when he was 12 hours old, he hasn't. And really, can you call a 6-8 break on an ET tube a step back at that point?

At his six-month-old appointment, his pediatrician said he was on track for his actual age, not adjusted. I was tempted to argue that he still had six more months before we drop adjusted. The only thing he wasn't doing was showing signs of readiness for food, but given his reflux, we would be waiting a bit anyway probably.

The reflux isn't the other shoe, at least not for me, because his full-term brother had the same issues plus protein intolerances in his case.

I found myself hunting for things wrong with him in the first few months home. We actually ended up at a physical therapist because I noticed him turning his head to the right more than to the left. The physical therapist said that yes this was true, but I had caught it so absurdly early that with just a few stretching exercises we were able to nip it in the bud.

When he had been home a bit we saw the other pediatician at our practice and she thought the grade of his murmur had increased (comparing versus written notes since she hadn't seen it before), so we got referred to a cardiologist with an immediate appointment. The murmur was shown to be a benign increased flow outside the aorta. Not only that, but as of about two months ago, they can't even hear that.

He hasn't had an eye appointment in months, and so I wonder if the shoe is going to be at his appointment in October. But when I think honestly, I don't think that would be a shoe. Based on what they said at his last appointment, the worst we are looking at is glasses. Not a shoe in my book.

From talking to other parents of preemies, it seems that there is always a shoe. Some either short-term high-magnitude event or some life-long issue that has to be dealt with. Maybe it's eating issues and problems with textures. Maybe it's cerebral palsy. Maybe it's poor muscle tone. Maybe it's cardiac issues. But I haven't found anyone without another "shoe".

Is it possible that there's not a shoe? What age should I really stop looking for a shoe because most of them will have landed? Is it an age? Is it meeting milestones like walking and talking? Is it possible that developing the last ten weeks in change out of the uterus and six weeks before that in a still status without really working the vestibular system could really not matter?

In case it isn't clear, the first shoe was the event of the premature birth.

Last thought, I don't want to credit a shoe improperly. Like the reflux, that's not a product of his premature birth. I do know from friends and acquaintances that there can be a tendency to attribute anything that turns up to the premature birth. So, while I may be looking for a shoe, I'm going to continue doing my dangedest to know Chiron for Chiron and not for his premature birth, because it seems the most likely shoe would be me handicapping him by continuing to see him for his prematurity and crediting him for his survival rather than demanding things of him that I would otherwise.

I'm not sure that made sense...



Gratuitous Nursemaid Puppy Picture One - Chiron



Gratuitous Nursemaid Puppy Picture Two - Trajan

Gratuitous Nursemaid Puppy Picture Three

Etsy for Dummies

Is there such a thing?  A good tutorial in how to dig through and use it? 

I have seen blog posts that show getting birthday packs and things from Etsy to create a theme and this sounded like a great idea to me, but when I go and search, there's no real way I'm seeing to dig into the thousands of results well.

We are having Trajan's 4th birthday party at the Austin Children's Museum and he has said he wants a pirate party.  We are having the party after hours on a Saturday, so we can decorate the party room as well as some minor entry stuff. 

I'm thinking a pirate themed happy birthday banner, maybe some stickers for water bottles, pirate-themed gift sacks... In my mind I was open to seeing great things and finding perhaps even more when I searched Etsy, but instead I'm feeling lost.

Any thoughts on how to more competently find stuff or should I resort to my more natural state of barely getting an evite out (still going to evite regardless) and getting a basic birthday cake?

Chess

Trajan had his first introduction to chess this weekend by our friend Scott. I feel his opening move of h4 was a portend for how the game would end, but he seemed to like it.



Scott used a whole board setup, but I was thinking teaching him the movements of pieces individually might work better. Now that I've said that, I think a more rational thought would be to start with checkers!


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Wow...

We made it to the theater about 3:20 and I was really amazed by how many people were ahead of us. We have awesome seats though because there were two seats left in the middle and people assumed they were reserved or something and I asked!

We are taking bets on how much our tab will be at the end of the day.

1,178 minutes of Harry Potter to start in three minutes.




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Chiron's thoughts on morning

"Our Whole Story"

The prompt was tell your whole story.

How can I write a whole story?  Because a story of a person, or a family, doesn’t have a beginning and it doesn’t have an end.  If you think about it, we existed in our parents who existed in their parents.  We have no beginning.  And while we are alive, we definitely don’t have an end.  And I think even when we’re dead, we don’t really have an end, because we still impact people.  So, how do I write “our whole story”?



Five Week Ultrasound



Do I begin at meeting my spouse, or do I begin at marrying him?  Do I begin with the birth of our first son?  In this case, I think “our whole story” is confined to one pregnancy and its aftermath.  In the spring of 2009, we decided we were ready to have another child.  Went to the OB, started trying and luckily were very quickly pregnant.  Five weeks into that pregnancy, had an ultrasound and it looked like it was probably twins. 



Seven weeks, definitely twins.  And I guess that’s the beginning of our story.

Seven Week Ultrasound - "Heart" & "Eggplant"

I have about as easy a pregnancy and birth story with our older son as it is possible to have.  37 weeks without even a cold, working full-time happily and both happy and healthy.  Blood pressure started to go up then, so he was induced at 38 weeks.  Watched TV for 12 hours, put in three minutes of work and got a kid and a large pizza.  He was 8 pounds, 1 ounce and healthy except for some jaundice issues.

This second pregnancy?  Nothing like that.  I had a pretty bad sinus infection early in the first trimester followed by bronchitis later in the first trimester with an extra cold in the middle. 

Aurelia @ 12 Weeks

Chiron @ 12 Weeks



Then I had two separate back-to-back GI bugs in the second trimester that caused me to lose 16 pounds over two weeks.  By week 20 things were looking good and easy. 

Aurelia @ 20 weeks

Chiron @ 20 Weeks

 Both babies checked out beautifully at their 20 and 24 week anatomical scans and my cervix was praised as gorgeous at 24 weeks.  I was definitely growing and at 24 weeks was about the size when my older son was born!

Together at 20 Weeks

Then it all changed

I experienced some weird sensations at 23.5 weeks and so the perinatologist moved my appointment up one day to check me the next day and perform the 24 week scans.  Both babies were fantastic and he labeled them viable.  Unfortunately, I don't know who is who in these last 4 ultrasound pictures that I have from the 24 week ultrasound.

A day and a half later, I went in for a routine OB appointment.  My OB was actually out on maternity leave, but was only supposed to be missing one appointment, so I had been scheduled with a random OB that had an appointment.  She came in, with a resident or whatever you call the student doctors, following her.  I impressed them with my ability to sit up on my own and they started passing out the glucose tolerance drink.  The resident was chatting about her twins while the OB grabbed the ultrasound.  Since there were two babies, they always checked the heartbeats with an ultrasound.  She started with baby A and asked if we knew the genders. 

She grumbled something to the effect of “it’s not cooperating” and moved up to baby B.  I thought she meant to see the genders.  Baby B checked out great.  Something in the attitude of the room had changed though and I looked closer and somehow I knew that A, our girl, our daughter Aurelia, was dead.  I was by myself at the OB’s office for the first time ever with a doctor I had never met before and a resident.  She went back to A, but there was no heartbeat.  “I’m afraid something catastrophic has happened.” 

I still don’t like the word catastrophic.

I was sent over to the perinatologist’s office.  The wonderful nurse of my normal doctor actually drove me over.  My husband met us there and we were taken back.  They confirmed a fetal demise in baby A.  Sometime in the day and a half between checking out as perfect and viable, she had died.

We were sent home with instructions to follow strict bedrest and to call if anything unusual was felt.  I had gone from a Facebook status of “can’t decide if she has a gyro problem or if the guy at Pars Deli is just that friendly” to “is processing.  Sometime after Wednesday morning and before this morning, the girl twin died.  No abnormalities or infections to give an idea of why, so focusing now on giving the boy twin as long as possible to grow and develop.  This was just past 24 weeks.  No guarantees obviously, but hopeful thoughts.”  It had all changed.

By the next morning, I was feeling regular contractions.  We were sent to the hospital and I was put on magnesium to try to stop the contractions.  One of the neonatal nurse practitioners from the NICU came down to talk to us about what would happen if we delivered them at 24 weeks and change.

The mag worked.  I stopped dilating.  I was moved over to the stable antepartum side where I stayed for the next six weeks with some trips back and forth to L&D.

I would like to claim that I handled everything well.  I did on some levels.  I actually worked full-time while in the hospital and did a good job of it.  I communicated with friends and family and honestly enjoyed the very frequent visits.  But I was also a little crazy.  My OB was on call early in my stay (despite being on maternity leave!) and I did not recognize her, that’s how disoriented I was.  For the first probably four weeks, I on some level expected my son, Baby B, to be dead whenever they hooked me up for a nonstress test of fetal heart tones.  For some reason I didn’t tell anyone this though.  Like I said, I was crazy.

Then three days before Christmas, I started feeling some odd contractions.  They weren’t like what I had been having on and off.  They were confined to my back.  L&D was full, but they started terbutaline protocol in my stable room.  The contractions stopped.  Then a couple hours later, they started again.  At this point one of the doctor’s actually checked me and I was five centimeters.  Her statement, “Happy Birthday.” 

While I liked this doctor, it was close enough to the start of a normal day that she texted my normal OB (who was back from maternity leave) who came in to deliver them.  May seem like a small thing, but this meant the world to us.   The doctor who was on call and the nurses worked to get us all prepped and said we would wait for my doctor as long as I didn’t rupture.  Despite a “poop event”, which I never got defined, my doctor made it and we went back for the c-section.

My memories of the c-section are very vague.  I know I got a spinal at some point, but I can’t remember it sticking.  Just being rolled on my side.  I remember being very, VERY bothered by the drape.  In my mind, it was going to be a vertical curtain.  It wasn’t.  It was on an angle, billowing in my mouth and nose.  Gave Paul, my husband, something to do though in keeping it out of my mouth.  I hated that drape.  Hated.

My clear memory is the OB calling out, “Good grief!” and seeming to jump.  Turned out when his water broke, it did it rather violently.  Our daughter was born at 08:15 and her brother followed quickly at 08:16.  No one mentioned her.  We heard him and were glad to hear his protests.  He was spirited off to get into the warmed transport unit.  We asked if they were going to deliver her now and that’s when we found out they already had.  I wish I had known at the time.  It just made her seem like more of a footnote that we weren’t told.

Chiron got APGARs of 7 and then 9.  We saw him briefly in the transport unit on his way out and up to the NICU and I even got to touch his hand.  He was a scrappy 3 pounds, 1.4 ounces or 1402 grams.

Paul went up with him as soon as I was moved to the recovery room.  I was given a diaper that was Chiron’s size to hold.

I really didn’t know what to do with myself as bored might be the best descriptor.  Paul had luckily left my phone, so I busied myself updating Facebook and even took a call from work and talked a coworker through how to do something for about ten minutes before telling her what had happened.  This motivated me to follow up with my boss. 

My doctor had told me that I could go up as soon as I could transfer to a wheelchair, so from the time I hit the recovery room I was working on moving my legs.  At the time I was moved to a real room two hours later, I knew I could do it.  But I met a roadblock.  The nurse I had was one I didn’t know and I for some reason didn’t have my thoughts together enough to ask her to send one of the others or call down to the nurse’s station and talk to one of the ones I knew.  And she said no.  She said I couldn’t go for like 24 hours.  I should have protested, but I didn’t.  I knew my doctor had said she would be over at lunch and so I waited.

I really almost killed this nurse because despite the OB having said I could eat as I desired, she wouldn’t let me eat ANYTHING.  And she wouldn’t get me a breast pump.  It wasn’t until I was going to send my husband down the street to rent a pump that she got one!

My OB rocks and when she got there she said not only could I go up, but I could eat whatever I wanted.  Our streak of being blessed continued as not two minutes after this declaration a friend walked in.  This friend actually is a NICU nurse who works at another NICU in town.  She went up with us to meet the man.

I really only feared for Chiron once the entire time he was in the NICU and that was late that first night, but they intubated him for about eight hours after his second dose of surfactant and this allowed him to get enough rest in that he did great.  They warn you about a rollercoaster, but we never experienced this.  Chiron was a glider.  Slow and steady, he progressed until after 53 days, he was discharged.

The flipside of the story was Aurelia.  She was brought to me in the recovery room and then again when I got to a real room (another reason I threw less of a fit about going to the NICU).  She was just wrapped in a blanket originally and then dressed in the smallest knit gown ever when they brought her again.  I regret that we took no pictures.  We just have the six pictures that were taken by my recovery nurse of her.  I regret that I have no images other than my mind of holding her.  I regret not having her brought back one time.  But I don’t mourn these decisions.  They were fine, just that I would do them again if I had it to do over.

They were born on December 23, so coordinating getting her to the funeral home was oddly complicated.  She qualified by six grams for group burial, but we decided to go ahead with our plan to have her cremated.  And she was.  One funny memory is that when we were taken in to look at the urns, both Paul and I instantly knew what one was right.  It’s a brushed nickel looking one and like all infant urns, is tiny.

Her cremation and his discharge aren’t the end of story though really.  The story is still going on.

What does XXX mean

Well, no, not xxx. I mean blank by XXX!  This is the current theme of the majority of our conversations with Trajan these days.  No matter what you are talking about, there is going to be a word that he wants defined.  I love this because it shows he is becoming conscious in his word choice.  I also loves that he seems to have really grasped the concept of which words are in English, which are in Spanish and which are in French.

That said, occasionally I just want to scream ARGH rather than define another word.

Those with older kids, is this one of those things that will pass or is this what we will be doing between now and say 16?  I bought dictionaries for the kids I tutored pretty regularly, so I know definitions continue to be useful, but do they stay so verbal?


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Harry Potter

Harry Potter 7.1 was in the theaters during the time I was in the hospital.  While a friend volunteered to bring a bootleg copy, Paul declared that instead we would just wait because surely the Alamo would have showings of 7.1 before 7.2.  His theory was that it was much better on the big screen and we should do it together.  Collective awwww.

Well, they aren't. Instead, they are doing this. Yes, 21-some-odd hours of back-to-back Harry Potter.  While they have said they didn't sell the whole theater, I still think it makes sense to get there early to get good seats as long as we're going to be there all day, what's another hour?  So going to shoot to be at the South Lamar theater about 3:30. 

You ask, what about the boys, you crazy woman?  Well, Paul is such a super hero that he is getting his dad to come in and watch the boys so he can follow through on my promised, admittedly now much enhanced, Deathly Hallows experience.  I feel pretty and loved and all that.

So, now is the time for scheming.  What to bring?

• Wear into the theater comfortable clothing: perhaps athletic type pants, tshirt and flip flops?  Yes, a Harry Potter costume might be more appropriate, but less comfortable and who really is going to be caring at 3:30 am?
• Socks (for cold moments in theater)
• Sweatshirt
• Small blanket?
• Pillow (i thought this was crazy, but they sent out an email explicitly telling people they could) - we are at the location where the arm rests can be lifted up, so hopefully can work with this
• Medela symphony in car (need to see if it's easiest to run it off the power plug in back or just bring an invertor)
• Bottles and flanges
• Cooler?  I'm wondering if I can keep it cool enough in a cooler with ice packs for 24 hours or if I should just throw away the expressed milk
• Possibly a manual pump and a breastfeeding cover?  I've experimented with them and they seem loud in a quiet room, but maybe in a theater it would be fine?  Not sure if I could do this, but if so it would be much easier.
• Tennis ball?  Labor never bothered me, so I've never tried them for that, but they do seem like they would be useful to work the kinks out.

I'm going to be sure and do a good solid pump before we leave (so say 2:30 to 3:00 am?) and then hope to only do it every 4-6 hours after that?  I have off work the next day as well, so hopefully can do some intense pumping to make up.  I've had to only pump three times a day for a couple days at a time for work conferences, so I think it will work, but I don't want to do anything stupid.

Anything else I should bring?  I'm assuming I can get enough charge on my phone during the times I'll be pumping given I won't be using it in the movie theater.

Definitely need to write out information for Paul's dad the superhero who is allowing this event to take place.

(I'm actually really excited!)

Master of His Universe

Scrappy Doo was his NICU nickname and it still seems appropriate.  Under thirteen pounds, but can totally work an exersaucer.  Under thirteen pounds, but can take four people to hold still once they put the rubber around his arm for a blood draw (I know I've heard they can't have traumatic memories, but based on Chiron, yes they can).

And he sleeps now!

Intense ball spinning.

It's you, milk lady!

Ahhh, to be young and milk drunk.

And a bonus picture of big brother (who typically does NOT want his picture taken when he's awake, except for the occasional picture he picks.  He does ask to see his sleeping picture most mornings though, so I have a lot of these (actually two facebook albums):

Labels II - An Achievement

I've noticed labels seem to be a theme in lots of blogs.  Stillbirth blogs, NICU blogs, autism blogs.... This concept just seems to plague people across the spectrum of existence.

While I still get bothered by labels, I believe I took a big step the other day.  Ever since Aurelia died, I haven't liked the phrase we lost her.  As in, we lost her to a cord accident at 24 weeks.  We NEVER lost her.  We knew exactly where she was.  When we ultrasounded Chiron, she was there.  When he was born, she was removed first.  I can't really say she was born first since born implies life (see, the dang labels), and I still haven't seen any official sheet of paper showing it, but she was removed from my body at 08:15 and he was at 08:16.

Losing her somehow makes it sound to me like it was an act of negligence.  Like we didn't care enough to keep track of her.  Like I didn't love her enough to keep sending her oxygen through her cord.  Like there is action I could have taken that would have kept her alive.  Similar to how hostile interuterine environment bothered me because hostile sounds like it is the product of intent.

Despite this, I've kept using the phrase.  It seems to roll over people well and not upset them.  Losing her somehow makes her less real.  Real things die.

At Trajan's first play therapy session, I departed from this practice.  I said, "his sister died due to a cord accident at 24 weeks."  I want to add in likely cord accident, but I think it's cleaner this way.

I've tried it a couple of times now and I would say that saying your child died is a little harder on others than saying you lost them, but I just don't think it's about them, so I'm going to stick wtih it.

Next step would be for me to use her name.  I still have trouble doing that.  As a final funny thought, my main problem with the name Aurelia was I wasn't sure about the pronunciation.  Turns out that was a total non-issue. ..  So, for practice: Aurelia died in utero at 24 weeks gestation.  I think I've got this! :-)

Random Shots (and a Sophie Ramble)

I had never heard of Sophie when Trajan was a baby.  A couple of months ago, I read a blog post implying that Sophie was actually BETTER than sliced bread and just kind of went "hmmm."  Then I read another.  And another.  Geez, I got the hint, universe!  So, we got a Sophie a couple weeks ago.

Baby crack. 

This is a kid without teeth.  And as his brother didn't get his first tooth until 14.5 months, not a kid we are expecting to have a tooth anytime soon.  But he loves Sophie.  He will stretch his motor skills to their limits to move her between hands, rotate her, love her, suck on her, sniff her and just generally embrace her in his love. 

So, I don't know why, but yes Sophie is all that.  And no, $17.27 is not too much for such happiness (http://www.amazon.com/Vulli-Sophie-the-Giraffe-Teether/dp/B000IDSLOG/ref=sr_1_1?ie=UTF8&qid=1309963864&sr=8-1).  I'm debating ordering a second now that I have the page pulled up.

There's something about this expression that I just love.

Pragmatic or Impulsive

Apparently I don't know the meaning of moderation.  I've always suspected this.  What's funny is this is just in my thoughts, I actually end up walking the moderation line pretty well in the real world.

Why am I thinking so much about moderation that I wrote a blog post?  Well, because I'm having trouble seeing the middle ground for reproduction.  I have a 4-year-old and a 0.5-year-old.  I should not be thinking about reproducing right now, but I am.

I made a table that shows everyone's age at different conception dates and at probable due date.  I keep thinking of would it be so bad to have them tight?

Intellectually, I think we are best waiting until at least October 2012 to conceive and really this starting June 2013 would be best. 

I didn't have this bug with our older son.  Didn't even think about getting pregnant again beyond a hypothetical most likely until he was over 2.5. 

So, pragmatic?  That would be to wait.  To completely wait.  I mean even to make the decision about having more kids until lets say at least 2013?

Impulsive?  Rip out this birth control and see what will be.  Knowing that ye olde breastfeeding would buy us some months, but would probably be pretty quick.

I will not do the impulsive.  Flat out guaranteed.  One, it's irresponsible.  To my body, to my spouse, to my children.  Two, it's dangerous to the kid if uterus isn't lined well due to birth control. 

Honestly, I am so far from impulsive I have reasonable doubt that we will EVER have another.  But I hate that idea.  It just feels wrong.  It's like the picture needs something else.

So, here's the goal.  Work on improving competency.  Be a better wife, mother, employee and friend.  Cook, clean and organize better.  Make a world that will be better for another child.  Keep at it.  Don't worry about the another kid until it's all I can think of.  Then deal with it.

Genetic Gift or DUH!

Trajan earned a double parent-teacher conference for the last trimester of the year.  In my mind it was two because it was split into half-he's doing awesome academically and half-behavior is more of an issue.  His report card had a similar theme with mostly E's (excellent) with the occasional S (satisfactory) in the academic things with a mix of S's and P's (in progress) for behavior.  He was promoted to the next grade, but we were left wanting to help him to make it easier anyway we could.

While the school didn't make any sort of treatment necessary, we were of the opinion that if there was anything we could do to make life easier on him, we should look into doing it.  Yes, it is highly likely that he would work through most of these issues in the next few months on his own anyway.  Yes, they are all within the realm of normal development.  But no, I don't like my kid being hurt.  He's sensitive.  He knows that there are some kids who won't sit next to him because they say he's a fighter.  He knows he exasperates his teachers and parents and relatives at times.  He's smart, he knows these things.

So, we saw the pediatrician who referred us to a psychologist (i think that's the right one) for some play therapy.  Get this, the doctor's name? Dr. Suess. Can't make that up! 

We went in for the first discussion/evaluation session yesterday. 

Trajan seemed to like her and enjoyed talking to her (hanging on the side of her chair when he came to talk to her like he'd known her for ages).  She had legos and scissors, so he's pretty convinced she's good. 

45 minutes into the discussion she'd tied together the things we were saying to conclude that while we were seeing his problems as impulse control, they were really more based on language/communication or lack thereof.  When she said this, it made complete sense.  He really doesn't verbalize emotions very often.  In fact, I can only think of one time.  We were talking about that and some possible approaches to take when I happened to say something in passing about how I'm not medicated right now because of the whole breastfeeding. 

You could almost see her mind race across her face and she declared, "oh, you have ADHD.  Everything clicks! This isn't a developmental problem or anything more than some early signs of ADHD." 

She laughed and commented on how this made my understanding of Trajan more than Paul does make complete sense and also cleared up why some events had happened.  He's not even four yet, so it's not really a diagnosis of ADD, with or without the H, but it does give some insight into thinking about how to handle him.

We are going back next week and she's going to do more of a session with him and then we are going to discuss whether we want to continue doing sessions to work on improving coping mechanisms or if we are going to take more of a hands-off approach for now but with an open mind towards ADD kind of things.

She recommended that we add more rewards-based things into his life and we started this last night with bed time.  He goes to bed pretty well, but there's some yelling or crying that normally goes down.  For this first week, each day he can earn a truck if he's good with bedtime ritual and going to sleep. He pulled it off last night.  Then we can either drop the reward frequency or add more behaviors (like getting himself dressed in the morning). 

So, duh!

Happy Fourth!

We went up to Dallas for the 4th of July.  Impressively, we succeeded in leaving Friday right after work/school.  This may not sound impressive to you, but having both boys packed and everything organized so we could leave straight from pickups was impressive for me!

We made it to my parents a little before nine on Friday night.  Only hiccup is we were moving which room Trajan was sleeping in and he wasn't going for that two hours after bedtime, so I ended up sleeping in one room with both boys and Paul got a room to himself.

Saturday morning, Paul and I went to meet some friends for brunch with Chiron while Trajan went to swim at my aunts.  Chiron started his patriotic look off:

These activities resulted in two sleepy boys:

We ate some fantastic fajitas my dad made that night and then the boys went to bed.  I went and visited a friend in town that night.

On Sunday, we took both boys to meet up with two friends for brunch.  No pictures taken there, but it was fun.  So was the swimming and fireworks show we hit up that night that I also took no pictures at.

We went to a parade Monday morning.  This was the second year we met up with my first friend (I've known her since I was four months and a week old) and her  kids and family.  I as always didn't take pictures, but I did receive two:

You can tell Paul was really enjoying my picture taking (it was hot by then and he was taking Chiron back to my parents' house).  There was an Apache helicopter there, but Trajan wouldn't let me take his picture with.

So the only 4th of July picture I have of Trajan is with the Hulk after we got back to Austin.  We stopped in at the comic book store on our way to pick up Jack and Gretchen.

Last impressive accomplishment?  Last night I had Trajan asleep by 7:30, just the second night after we got back!  He always stays up later when we are in Dallas because his cousins do and it just doesn't seem worth it to make him go to bed and miss out on two hours of fun.

Round Three?

I've repeatedly read that when you're done having kids, you just know.  Is the opposite case as clear?  If you're not done, is it obvious?  Or is feeling that you are definitely not done just a sign of some other psychological condition?

Oddly, I didn't feel complete after Trajan was born, but I also didn't feel this strong imperative to have more either.  I just kind of was.  We actually started discussing one more pregnancy before Chiron was born, before I even went into the hospital and whenever I'm near that overpass, it always runs across my mind.

Paul has gone from yes to no during the length of Chiron's life.  I've gone from yes to I can't contemplate it to I want to, but I think the best thing to do right now is say that I don't need an answer for now.  And we don't.  We do not have to decide.  If we were going to, I imagine we'd want to wait another two years from now anyway. 

I feel comfortable enough that I got a Mirena implanted when the mini-pill caused my body to go horror movie on me.  It's good for five years, but they can pull it before.

If Paul stays at his current no, it won't matter.  Even if it breaks me or leaves a hole that I can't even explain, I know I wouldn't be comfortable talking him into it.  The problem for him with another baby is that means another preschooler.  The problem for me is that means another lump-a-baby.  Lets see how we do with this one first, I guess.

Also, I know intellectually I can't predict where we will be in two years as to whether we can expand our homes, our hearts and our minds for another.  Right now, I know we could, but I have to see what happens in the next couple years.

And now for confessions:

One reason I think of for another is something one of my friend's husbands told me about what it was like going through the death of a sibling by himself and how much he wished there had been another sibling.  I know babies and children can die.  Three gives you more of a support system for their loss and also the possible loss of parents/grandparents.

I love families with three and four kids.  However, maybe they have a competency that led them to having more.  I love the dynamics of multiple siblings.  My dad and his brothers are now in the 50-60 range and I still love the relationship that is between the three of them. 

I know one reason I have for considering another pregnancy is to leave a different taste of pregnancy in my mouth.  I'm good with babies, but I have some anger towards pregnant women.  It's selfish to want to change this, to experience birth based on something other than avoiding negatives.  I know that, but I wonder if it's selfish to want to change my mentality because of how it will impact relationships.  The boys have a reasonable chance to have kids someday and I want myself to be as positive and healthy about that as possible (and yes, I'm worrying about a 3-year-old and a six-month-old).

I worry that a third would make us make decisions based on there being three rather than what is best (like public versus private school). 

I know that there are no guarantees.  There's no guarantee against a miscarriage, a stillbirth, a neonatal death, a death from old age ;-).  I know there's no guarantees that I won't find a new problem this time, gestational diabetes or one of those liver conditions or something. 

I do know that there are great positives about either a boy or a girl, so we wouldn't have to deal with that anxiety.  I do know we have the love.  I do know Trajan would do well with another sibling.  I don't know whether Chiron's birth will require a c-section (the OB has said it is likely it wouldn't).  I do know that both the perinatologist and the OB have said that I would be very unlikely to have problems with preterm labor and that I have a fantastic cervix for how well it stood up.

I know that while I don't need an answer right now and honestly can't even generate one, I still think about it every day.

I know I don't like the term rainbow baby.  Maybe it's because I had a loss with a live birth, but I don't think so.  I think I don't like the term for the same reason I don't like calling Chiron a miracle, it debases all the effort that went into him (see 160 Medical Professsionals) and I think somehow casts those babies who weren't as lucky in a negative light.  If we do have another, it will be for him or her as his or her own self.

2013, we will look at it with you.

Adding one last thought: in case anyone reading this is debating a pregnancy after a loss or a NICU stay, here's a fantastic article: http://handtohold.org/resources/helpful-articles/pregnancy-after-preterm-birth-or-loss/. I just tried to add that using safari on the phone since blockades kept catching, so hopefully the link works. Otherwise, I'll fix it tomorrow. It's written by my OB, whom I think is wonderful, and published by a fantastic group in Austin called Hand to Hold.

Pumping

Pumping as guilt.


Pumping to prove something.


Pumping as a karmic payment to the universe.


So many reasons, but it comes down to I pump. And pump.

I wrote down this quick thought as a note the other day and while it's short, I'm impressed with the "trueness" of it.  I pump to assuage guilt for an early birth, I pumped to prove that I produce enough for two babies and could have fed them (in progress, I've let go of feeling the need to do this), I pump as some sort of payment in my mind for Chiron being so lucky in the NICU.  Who would have thought that one action could be rooted in so many different psychological explanations.

I've now logged over 64 gallons of milk (8199 ounces and 242482 mL) with the first week and a half of my pumping missing from my log.  I've got 1137 recorded puming sessions and since I was pumping 10-12 times a day those first days, I have definitely pumped over 1200 times.

I haven't gotten an update from the milk bank recently of how much I've donated, but it was right around 3000 ounces the last time they called me.

Moo. 

I honestly have considered stopping some in the last few days, but I don't think that I'm there yet.  Chiron has issues with reflux (Zegerid and Bethanochol improve it though) and the gastroenterologist said that it's likely to be best with breast milk.  He doesn't seem to require that I do the diet elimination that his brother did, so I think it's best that I keep on carrying on. 

To help motivate myself, a list of reasons to keep it up:
1. best for X-man's stomach
2. address all those psychological explanations
3. the excess really can mean the difference between life and death for preemies
4. can't really start up again if I change my mind and while the pumping exists only in the now, the decision is forever
5. I think he may be supposed to take special caloric formula if we move him to formula and that looks expensive
6. don't have to deal with formula diapers!

Anybody else have any other items I can add to my list when I feel whiney/when I'm up in the middle of the night/when I'm figuring out where to pump at a conference/when I'm exploding because I got caught up in meetings/when I'm working out a plugged duct/when my work shirts don't fit because of said lactation?


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Laughter

I have a tendency to not want to do things or make plans that are just fun for me, thinking it's selfish, but whenever I do I'm amazed. By things as little as how good laughter makes me feel. By how much I really do value these days in my existence which really are paradise, even if they're not beautiful.

So, my recommendation is go ahead and do some things just because you like them.

Plus, a bonus picture of Chiron because he fell asleep on the way to daycare dropoff and so I left him in his bucket instead of carrying him and I thought he was cute.

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Bittersweet sentiments

Death mingled with life. Nursery mingled with morgue. Carseat mingled with urn.  Death in multiples definitely creates some bittersweet moments.

Yesterday was Chiron's half-year mark.  Woot.  But while I thought about it at least a half-dozen times, I somehow couldn't bring myself to write anything, not even a quick picture (I cheated with Facebook and did it the day before).

When I think of things that should be happy as events in Chiron's existence I get this tightness in my jaws. It's like the muscles at the hinges of my jaws contract all at once. Why? I think I feel guilt at my bittersweet sentiments.

So, intellectually I think Chiron earns his own six month post, but I just couldn't bring myself to write one, so instead I'll lump in stats here.

Big news is with the exception of showing signs of readiness for food, he hit all of the unadjusted six-month milestones.  Woot!  Big woot!  Also, his length is now on the chart for unadjusted age at the 5% mark at 24.25 inches.  His head continues to be huge at 46 centimeters (75% for unadjusted).  Actually, it's so huge that we are doing an extra measurement appointment in six weeks.  My head is huge and Trajan's is pretty big, so it's probably fine, but just to be sure.  His weight is up to 12 pounds, 12 ounces of 5.755 kilograms and while this isn't on the chart, it's good progress for him and over 4 times his birth weight!

I'm resolving to do better for your birthday, little man.

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