Pumping

So, I finally broke down and asked the question of what am I supposed to feed Chiron if I stop pumping.  Doesn't mean that I've stopped or have identified a time to stop, but does mean that I'm closer.

Here's a crazy graphic that shows a positive.  I am not pumping as much or as often.  I am not pumping during the night.  Each line is a day with the most recent at the top.  See the big gap on the left?  That's sleep!  It's updated through the morning of 7/29/2011.  I mainly put this graphic together because I knew it would help give me a push towards more pumping, and I think it has.

So, I did this a couple weeks ago and it has had two effects.  One, it has made me have a better attitude towards pumping and two, it has motivated me to pump during the night if I do happen to wake up.  I'm not seeking to wake up, but if I do, I'm sucking it up and taking a little time and pumping.  And it's had a DRAMATIC effect on supply.  The week of July 29 I was at a 1036.3 daily average and this week I'm at 1231.8 and still going up a little.

I really should write a post some day of my tips for pumping.  I wrote a word document with Trajan that I gave a couple friends, but I can't find it and I wasn't as much of a pro then.  But, for now, I will go with my short three most important tips.

1. Get hands-free.  Seriously.  Chiron was hours old and I sent someone to buy a hands-free strip of cloth (normally sticking them in a bra works)

2. USE your hands.  You don't have to the whole time (I find doing something else with them keeps me pumping longer), but for at least part of the pump, provide pressure to the breast and help express.  Also, particularly if you are establishing supply or worried about it, take a little time to hand express without the pump at the end as well.  Good motivating video for upping your production with a pump.

3. Hydrate.

And a bonus because I'm not sure this applies to most people, but is huge for me, document.  I use Trixie Tracker.  You can use a log book, google docs, or whatever, but keeping these stats has really helped me.  In particular, it has helped me get comfortable with pumping less often which is great for the sanity.  Trixie Tracker is nice because it is phone friendly, produces some useful graphics and also exports to excel great.

Speaking of which: here's the same visual but for the time since July 29:

See the four middle of the night pumps!

Oh yeah, for the sake of disclosure, Trixie Tracker does charge.  For me, it is well worth it for the pumping data.  We actually have stopped keeping stats on everything else in the last couple weeks, but our original six-month subscription after the free trial is about to expire and I'm definitely going to be renewing and I think probably even the six month version...

Shellac, why didn't anyone tell me?!?

Being a consultant, I have to be presentable on the occasions that we interact with clients.  However, I tear fingernail polish up.  Like, I can't get through a one-day meeting typically, much less a multi-day conference wtih nails done.  So, traditionally I've just gotten a pedicure and then had my hands either just cleaned up or possibly buffed.

Enter Shellac.  Last weekend, we went to Dallas for my niece's birthday party and then Paul and the boys headed back to Dallas while I stayed in the metroplex for a conference.  Right after they left, I ran to a nail salon to get a pedicure and my fingernails cleaned up.  Part way through they asked if I wanted polish on my nails as well.  I explained that I tear them up too much and so I just wanted them cleaned.  So they offered Shellac. 

Here's immediately after:

I went and tried on jeans immediately after, unpacked into a hotel room and did eveything without trying to protect them at all and got only one little chip:

And you have to look to find that!

Now, ten days later, the only chip is still on that finger and I think it's still looking pretty good:

My full report will have to be after I get it removed.  Apparently you have to either get it off at a nail salon or buy pure acetone to remove it.  But, with it lasting this long, maybe I'll just replace it. 

But seriously, this stuff has been out for almost a year and a half, how come no one had told me?!?

Grumpiness

I generally say my life is good and embrace what I have and accept what I don't. But there's the occasion when you just wake up and you're grumpy. No good specific reason why, just grumpy.

Today is one of those days. I really can't come up with a reason. It's possible it's a reaction to my realization early in the morning that I have to take Chiron to the ENT today, but I don't come off well with that, so we will go with no good reason :-).

But I am combating it. I ate breakfast (left over dinner that was awesome tastiness that Paul and Greenling united their powers to make), I'm indulging in a Dr. Pepper and I'm enjoying friends and life.

It's actually going well enough that I'm thinking maybe I should appreciate the occasional grumpiness as it forces me to go out and seek positive things and happiness.

And, in another positive, my big brother rocks. One of our cousins is getting married about an hour and a half south of where I live. It's a no kids wedding though and rather than try to coordinate babysitters in another town, Paul's parents are going to come into town to stay with the boys. Yeah!!!

Only negative? They can't be here Friday. So, I am going down for the rehearsal and Paul will come down the next day. This means two cars though, so eww. Here's where the awesome big brother comes in. He and his family are going to pick me up on their way through!

Weddings plus my big brother:



 

Big brothers are the best and I've been thankful for him as long as I can remember. I swam almost two miles starting when I was six to see him at the boys summer camp on the other side of the lake, that is how awesome we are talking.




This one is a little brother, but he's pretty awesome too. And needs to watch The Incredibles to learn about the perils of turning a bib into a cape.

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Random Tidbits III

Chiron, I love you very, very outerspace until it gets to infinity.  - Trajan


We are in some sort of honeymoon period where Trajan has the language skills and the memory to tell me about his day as well as the desire and willingness to do so.  And I like this.


Chiron's head is more than six centimeters more around now than all of Chiron was long when he was born.


Discussing cremation with an almost four-year-old definitely makes a drive more interesting.  Turns out I don't really know many of the details.  Cremation was the longest topic, but a lot of other questions as well.  Why didn't you help her or tell a doctor so they could heal her before she died in your tummy?  The doctor took her out so you could have more babies in your tummy?  Why can't we name another sister Aurelia? Plus one more reflection which really impressed me at how old Trajan is and how much his mind works:  when Chiron was playing with Aurelia in your tummy, he thought they would be grownups together.


Is it normal for a pretty-much-four-year-old to switch to referring to himself in the third person at this age?  Including both saying Trajan and he in reference to himself?

I was at a conference the last few days and I gained a new life experience and determined that I may be too competitive.  One of the things they had brought in for one of the dinner/receptions was a guy rolling cigars.  One of our clients asked if I'd ever smoked one and I explained that no, despite having gone to Cuba in college with a license from the Treasury Department, I'd never actually figured out how to smoke one.  Then he said something to the effect of he wasn't surprised that I couldn't.  So, I decided I could. 

It was an interesting experience.  I choked, coughed and sputtered on the first inhale, but then I pretty much figured it out.  It lead to a light-headed feeling and a bit of tingling in my face.  However, I don't understand the habit and don't anticipate I will be adopting it soon.  While a shower when I got up to my room took care of the smell on my body including my hair, I woke up at least three more times during the night to go brush my teeth again and rinse with mouthwash because the taste was just so disgusting.  It was still there part of the way through the next day!

I was an intense smoker.

Baby Planking!

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Preemie Clothing

I had another thought from my exercise in rotating the clothing in Chiron's room from 0-6 to 6-12 months:

Preemie clothing is inconceivably small. 

Even having seen him wear them and having them swamp him, my brain just can not grasp the idea of him being that little.  Chiron was born on December 23 and a friend, who is a NICU nurse at a different hospital, came that day to help us go up for my first time.  She brought us a number of preemie sleepers including a Christmas one, because she knew that while he wasn't wearing clothes yet, we would appreciate having them when he could.  He couldn't wear it yet, but we went ahead and took his picture with it stretched out beside him Christmas night:

This same sleeper today with the same boy:

This was actually not one of the smallest preemie things, but since we had the early picture, I thought it was best for comparison purposes!

Resilience.

I think this is a phenomenal word and concept.

Bad things may happen.  It's what we do with them and how we manage ourselves that matters.  You can not judge or structure yourself by the things that happen to you, they mean nothing.  It's the conscious decisions and actions that you choose that matter.

I even remember reading an NPR story about how the trait of resiliency is one of the things most closely associated with a life expectancy.  Sadly, a quick search couldn't find it, but I found this and it was interesting.

Parenting Treatises

I stumbled across something in the notes section of my phone I wrote when Trajan was about 2.5 that I think is worthy of review:

Don't sweat the little things, know and stick to your big things, be willing to discuss and explain anything, including the big ones, even if it's the nth time.

To be completely honest, I've never really sat down and tried to think out or write out my parenting philosophy.  I know a lot of people who have and it seems like a really useful thing, but just never have and not getting there today.

I have however, identified a few basic elements that would compose my parenting treatises if I wrote them.  First is seek moderation.  In almost everything.  I really find that extremes just don't work for our family, so I really do consciously seek out the moderate path.

Second is own your choices.  It doesn't matter what they are, I think that as a parent I should be comfortable with them.  Even if they aren't something that I think most people will agree with or like.  While small children might force you to do this some since they present their reality honestly, I think it's important to make a conscious effort to be conscious of your decisions.  This also means you need to make decisions instead of just letting them happen by default.

Similar to owning your choices, I think it's important to consciously choose your battles rather than let them happen by default or through frustration.

Take these three ideas and roll them up with a conscious effort to not sweat the little stuff and choose to breathe rather than react and you've got my basic ideas.

I probably will never get around to writing a parenting treatise, but I think I'm on the right path to identifying what the key parts of it would be.  Probably plus some thoughts about how I recognize that my actions probably teach my children more than my words.  It may not be formal, but it works for us and I own it.

Breastfeeding doesn't follow the Laws of Thermodynamics

Something has bothered me since the NICU and I'm wondering if someone has an answer.  In the NICU, they said the typical breastmilk contained 2/3s of a calorie per milliliter or 20 calories per ounce.  They also said the average woman makes around 30 ounces a day.  All seems reasonable, right?  Add in a third factoid that it is important to get an extra caloric load of 200 to 500 calories. 

This would seem to say that the average woman produces about 600 calories of breastmilk a day.  And that is 600 calories contained within the milk without accounting for any calories used in the creation of the milk.  This is HIGHER than the 500 calories they give as the high end of the caloric load.

I recognize they were just trying to get some basic facts in with a pumping log, but this seems to clearly violate the laws of thermodynamics.  Breastfeeding mothers as perpetual motion machines? 

My guess is that these amounts are due to an assumption that lactating mothers will also draw upon their maternal stores.

Other interesting trivia fact: based on this, I've produced 190,000 calories worth of breastmilk just counting the amounts that have been pumped and logged, excluding direct breastfeeding and the first two weeks that I don't have my pump log for.

I clothed my boys for $120 for four years of clothes

I'm not typically a talented bargainer buyer or frugal type.  However, I believe my own Craigslist purchase in my whole life was sufficiently awesome to give me some thrift credit for all time.  Over 48 months of clothing a kid for $120. 

When I was pregnant with Trajan, I for some reason decided to post a listing on Craigslist saying I was looking to buy a kid's entire wardrobe from birth through whenever they had.  I got a response of a woman who had five large rubbermaid tubs of clothes and wanted $105 for them, with the tubs.  We went out to pick them up and it turned out they were fantastic (clean, many new items, variety of sizes and weight of materials).  We however got to her house with only twenties.  The woman was willing to take $100, but having seen the stuff, we went ahead and paid $120.

We did not buy Trajan any clothes until he was two other than one outfit one day when we were out and he needed warmer clothes than he was wearing.  With Chiron, we had to get some preemie and newborn things, but most of these were given to us, so I would say we have still spent less than $50 total on top of that original $120.

Why am I bringing this up now? This weekend, I decided to rotate Chiron's clothes.  We originally set up the stuff from zero to six months for him and he's now outgrown all of the sub-three month stuff and some of the smaller three to six month stuff.  While he is still fitting in some 3-6 month, I am going to be out of town a significant amount of time in the next two months, so I decided to take advantage of my last free weekend for awhile and rotate his clothes.

This is about 60% of the stuff from 6 to 12 months:

I brought everything in from the garage where it was stored in plastic bins, washed it and sorted it downstairs before taking it upstairs.  I wish I'd taken an intentional picture of it all.  This was just something I sent to a friend who asked what I was doing.

I waxed nostalgically about a future time when he will  be big enough that I will just gradually change out his clothes rather than all in one fell swoop while I emptied his drawers of 0-6 month stuff, organized them and stored them.

I took the 6-12 month stuff and I divided it between 6-9 warm weather, 9-12 warm weather, 6-12 cool weather and then put stuff for actual cold into plastic bins in his room to be considered if and when we need it.  I made a strategic change this round and decided to put everything up as outfits rather than organize by type (short-sleeve onesies, t-shirts, shorts, etc.).  I'm pretty sure this is what we did with Trajan and I remember it working really well.

I even sucked it up and organized socks.  As children's socks are my archnemesis, this was pretty hard core.  I sorted shoes as well and determined that he is still not big enough to wear a size 2 shoe yet!

You would think I wouldn't be able to dress a kid born 4 months later in the year than his brother with his brother's clothes (the kid we bought them from was a July baby), but there is so much clothing that it is absolutely not going to be a problem. 

Perhaps the most disturbing thing is despite the original kid wearing these, Trajan, a friend's kid, my nephew and Chiron, there are still things in there that have never been worn.

I wonder if I've never gone back to Craigslist because I know there's no way to ever beat my original transaction.

What KIND of Twins are they?? II

One of the posts I wrote in the early days of the blog (barely pregnant) was What KIND of Twins are they? I thought this was a kind of amusing question at the time.  Jokes about telling people they were a boy and a girl and still being asked if they were identical.  Things like that.

Now, I feel it's still a valid question, but one with more gravity than hilarity.  What kind of twins are they?  They were in-utero together for 30 weeks.  They spent 24 of those weeks interacting with each other.  In every ultrasound, the appearance was that Aurelia was just pounding on Chiron.  She often looked to not just be kicking or moving her arms at him, but even actively pushing him.  The joke was that he was wedged transverse across the top because she acted like a singleton and took up all the real estate.  They were delivered in the same surgery, Chiron following just one minute after Aurelia.  08:15 on December 23, 2010 was the last time they were together though.

Another light thought I had during that early period, before it all changed, was that I never referred to Trajan as a singleton before being pregnant with twins.  There's a similar thought in the after-period and that is that I never really thought of the term single twin until Aurelia died.

In the NICU, Chiron was always referred to as a twin.  All of his paperwork referred to him first as "B" and then gave his name.  As we've gotten farther and farther from the time of their birth, it seems he's getting further and further from his status as a twin.  I have trouble imagining a medical scenario in which the fact that he was a twin would matter.

Is he really a twin, even a single twin, given they never existed as twins as independent entities?  Perhaps the right grammar is to say that he was a twin.  But what does that make him now?  Singleton seems categorically wrong.  Maybe that's where that odd term of "single twin" must come in.

I find myself with rationale arguments for why we really shouldn't think of him as a twin, but I have a strong emotional feeling that he is which is best summed up by an image:

They were heart and eggplant.  Or the fact that their stomachs were developing side by side:

I should give up on labels perhaps, but I doubt I will.

I do know one thing for sure and that is that he is wonderful and we are lucky to have him in our lives.  Because when it comes down to it, labels are not what determine what we feel, they are what we try to use to try to affect our feelings.

100 Posts

I know 100 posts is almost nothing for most people, but I think this means I may have achieved a habit of some sort. So now I need to think more seriously about how I should proceed.  I think I should go ahead and move it to a domain (we own quite a few, so what's one more anyway?).  Then it's a question of should I just use blogger on there or make the move to wordpress?  Most of the people I know in real life seem to use wordpress, so I'm kind of leaning that way.  But, I'm about to start on a six week period of a whole lot of travel and a bunch of work that needs to get done too, so instead of even starting my research, I'm going to put an action item on my calendar in October to start the research.

Questions I want to find out include is how would posting from my phone work.  It looks like blogpress works for wordpress as well, so I think that the pictures and video directly from my phone would still work.

Wileydise.com?

If I'm going to make the move, I think I will have to consider aesthetics as well.  And as someone who is completely non-visual, this makes me say ugh.



That's the ramble, now here's the part where I ask questions of those who might be reading this:

• Is the change worth it?
• Is there a helpful service to pay someone to move old content from blogger to wordpress to avoid the insane frustrations I've read about from other people with fixing links?
• Am I right that it's a good idea to make a change earlier rather than later?
• Can you still easily embed objects from Picasa Web Albums?
• Would I be better off just keeping on keeping on doing the same rather than adding changes like trying to make a banner and layout or moving to wordpress?
• Any books or tutorials or the like you recommend I consider during my research phase?

While I'm at it, I think I will ask the comment that has been plaguing me for years:

Why do people set blogs up to require me to click though to see the content? 
My typical response is to normally just click on them and move on down the line in Reader.  For the ones that show the first part of the post (like at least a paragraph), I can almost understand, but the ones who show nothing or just a few words or couple of lines, I just do not get you.  Am I unusual and most people routinely click through and so you get more reads that way? 

This choice just effects those using Reader or another RSS feed, so it seems like a really odd decision to me.

That said, is there any product or service to go through and cheet and get the feed through them and they will send me the whole post instead of just the oddly truncated part?

Random Tidbits II

• I live with Alf.  And she has a hard life.

• I love the fact that our boys seem to really enjoy each other.  It's becoming more of a two-way street as Chiron has developed and it just makes me happy.  Yes, I know they will hate each other at times too, but I feel no need to think about that!

• I have no idea how we would actually do it, but I just had the idea of someday having a birthday party for Trajan themed around Trajan (the typeface) and this made me giggle.

• I will miss the day that my son wants to hold my hand in the movie theater.

• Is there such a concept as "rationally paranoid"?

• I've thought more on the argument of having three or more kids allowing them to support each other in the case of the loss of one and I think it's more than that.  I think it's more lines of support in almost everything, throughout life.

• Before going out and buying a new pump-in-style, I luckily remembered that our local nursing store will test pumps.  So I took it in and she said it tested perfectly.  It is just not a Symphony.  So, I've made a concentrated effort to pay attention to it and experiment to find what conditions will get me the best results.  First step was I went ahead and changed out the membranes on all of my flanges (doing this every 4-6 months is just generally a good idea and as Chiron is 7 months, I was well overdue).  Second, I have found that for some reason I have more luck with the Pumpin Pals flanges than the Medela ones (I don't find this with the Symphony for some reason).  And third and probably most importantly, I take the time to make sure all connections are tight and the membranes start firmly depressed.  It's still not as good as the Symphony, but I think it is good enough to keep using.

• I got a call this morning from the pediatricians that Chiron's brain CT was fine, but that one of the pediatricians would be calling me Monday to talk about it and what future monitoring they want to do.  Why Monday?  Well, his normal pediatrician is now almost two weeks overdue, so they are inducing her tomorrow and the other pediatrician in the office is out sick herself.  I'm guessing they are having a bad day today!

• I love the things we learn through our kids.  I've always hated the fact that if I choose to take a bath, I still have to take a shower after to clean my hair.  Well, after almost four years of washing a child, I suddenly had to the idea to use a cup in the bathtub.  Tada!

• We are proceeding on a multi-disciplinary front with Trajan re: Mr. Hyde.  He has an appointment with a neurologist on November 2nd, but the pediatrician called and got him on their urgent fill-in list, so hopefully he will get in there earlier.  He has an appointment with the psychologist we had been seeing for play therapy on Tuesday to continue giving her opportunities to work with him and particular in hopes that she can ferret out whether or not he actually has any awareness/memory of the episodes.  Then we are probably taking him to a psychiatrist as well for some other evaluation.  Seems like a lot to me for something that only happens about once a month, but they are of pretty severe intensity and we want to help him to make life as easy as possible, so I think it makes sense.

• I still haven't written an actual submission for the "whole story" prompt for Hand to Hold as they requested, but I have had one more thought:  

Is this the end of our story?  No.  It's not even the end of Chiron's birth story for how and when we are born impacts all of our lives.  Is there another shoe that will drop?  I don't know, but we never know.  Life is fragile.

No "something"

Well, not officially no "something" yet, but I'm willing to call it.

Chiron and I successfully dropped Trajan off and headed to the hospital (I brilliantly dressed him in clothes to sleep in that he could also wear to school since he doesn't have a dress code right now).  We made it with plenty of time to wait. 

And wait.  And wait.  But, I really shouldn't complain since they did schedule all three procedures for the same day.  On the other hand, I had a baby who likes to eat regularly who wasn't allowed to eat, so maybe I can complain.  Between the wait before the brain CT and the wait between it and the stomach procedures, I walked miles with him in the pouch because that produces happier baby.

Here's evidence of that huge head we were checking for.  We went back for the brain CT first.  It was quick and easy.  Strapped him in and some combination of the swaddling, secure straps and just the new setup resulted in him not complaining at all.

I'm definitely not a brain expert, but looking at the picture in the viewing room, there was no obvious area of color change or big pool between brain and skull or anything like that.  Between that non-expert viewing and the fact that they didn't stop us right then and no one has called yet, I'm saying there was no "something" there.

Then it was back to the waiting room.  By this point he really wanted to eat, but I did successfully walk him to sleep:

And then it was back to the room where they did both the swallow study and his repeat upper GI.  Luckily, I was able to keep him asleep through the first half-hour discussion of what they would do and how to set it up, because when he did wake up, he really did want to eat.

They started with a swallow study which he was fine with as it meant eating something.  This time they mixed the barium with expressed breast milk instead of just doing the barium drink.  He seemed to like it:

Unfortunately, they only let him drink about 15 milliliters and then took the milk away to flip things to shoot the upper GI.  He was NOT amused:

He did get to eat some while he was flat for the upper GI and this improved his mood dramatically.  Then they finished and he got to go back in the eating chair to finish his bottle while they took more shots:

I also haven't gotten any official results on these digestive procedures, but did get some basic info from the speech pathologist. 

1. Still definitely has reflux, oh lots of reflux
2. He swallows later than is typical, so this is likely the explanation of some of his coughing/choking.  He does do a good job of protecting his airway though, so we should just support him through these episodes
3. He is not aspirating (woot)
4. He performs better with non-thickened milk, so we are not going to try the trial of nectar thickness expressed breast milk we were going to do this weekend

He did have one of his choking episodes after we left, so I was able to call the gastroenterologist with information on how long it had been after eating, the nature of the choking and the duration as he had wanted this information.

I'm unclear when or if I will hear anything official from either doctor, but I don't think we got any real newsflashs either positive or negative from these studies.  Slow and steady, tortoise, gradual progression from status quo, that's our boy.  And he's always been that way and it totally works.

Where do we stand now?  We are keeping him on both of medicines, Zegerid and Bethanachol.  He has an appointment August 5 to get a head measurement.  He has an appointment August 11 with the ENT.  The gastroenterologist said that the ENT will likely schedule him for some more visualization/scoping that will likely require sedation.  If she does and his head grows percentilewise again, we apparently may schedule a second MRI at the same time as the ENT imaging stuff.  And he goes back to the gastroenterologist September 6.

If he increases in frequency or severity of his choking episodes, the gastroenterologist says to call him and he will likely admit him to the hospital for more workup.  As this may end in a fundoplication, we vote to avoid that.  That said, if either of us starts to feel uncomfortable with the episodes, we will do it.

I did remember to warn daycare about the barium poops, so I haven't received a paniced call on that front!

Baby's Got a Big 'Ole Head

Chiron and I get to have a fun day of imaging tomorrow.  He's still having pretty severe reflux episodes with some choking, so the gastroenterologist wants us to repeat the upper GI to make sure and rule out any anatomical abnormalities as well as do a swallow study with a speech pathologist present.  The gastroenterologist also referred us to an ENT who we will be seeing the beginning of August who apparently will also want to do some scoping/studying. 

In addition, he's also getting a brain CT.  Why?  Because he's got a big 'ole head.  And more specifically, he has a big 'ole head that is getting relatively larger.

These are his head sizes and the percentile rankings (I couldn't find a preterm head chart, so I only have adjusted for when his adjusted age is after zero).

In case you're curious, here's what the values look like:

The likely answer is just that he has a big head.  That was the theory at his six-month appointment.  But given the growth in the month between his six-month appointment and his appointment yesterday at the gastroenterologist, they want to go ahead and look at it.

Both doctors, gastro and general pediatrician, wanted to look at it once they saw yesterday's value.  The only question was would we do an MRI or a CT.  The argument in favor of a CT is that it doesn't take as long and doesn't require sedation.  The argument in favor of an MRI is less radiation exposure and much more information.  The final decision was since he has previously had an MRI, we know most of the structural information and so a CT should be fine to look for fluid on the brain.  And he hasn't had an CTs of anything yet, so they are less worried about radiation.

Image from his last Upper GI

Image from his last brain scan

Honestly, I'm not really sure what we are hoping for.  My instinct is to hope for nothing turning up on any of three imaging studies and a continued uncertainty as to why he has such severe reflux and choking episodes.  But maybe it would be useful to turn something up?  I just generally don't like "somethings", so I think I am rooting for three clear scans showing nothing other than reflux with the upper GI.

I am in love with our local hospital, Dell Childrens, because they shuffled schedules to get him in for all three of them back-to-back even with different doctors ordering different components.  Also, they are doing the brain scan first, so we only have to cut him off from food four hours before the expected start of the first stomach imaging procedure.  Since that's at 10, he can eat until 6 and since he normally eats at 5:45, this should work great.

Trajan is currently going to Chiron's daycare for four weeks because his school is completely closed right now for four weeks (no camp, no nothing).  It's going well so far (based on his experience yesterday, his first day), so hoping today went well and we have an easy time getting him going and there in the morning because the only negative of the great scheduling is we have to have Chiron in the building at outpatient registration by 8:30.

I will update the world.  Think good thoughts our way!

Bad guys

Trajan has this odd obsession wtih bad guys.  Example comments from the other day:

Are there any places besides Mexico that have bad guys?

I know about bad guys in Mexico, on tv, commercials and movies.

They're people who decided to do bad things.

I don't want to go Mexico until all the bad guys change their minds.

Now, you may be asking yourself, why the obsession with Mexico?  Well, it happened like this.  Trajan wanted to know how all the dinosaurs died, so we started talking about the extinction and the Chicxulub crater came up. He said he wanted to go see this and my mom said she didn't want to go to Mexico currently and so somehow we were on the subject of corruption, drugs and crime in Mexico. 

I'm a little worried we've forever warped his mind by this absolute association of bad guys and Mexico.

That's my antecdote.  My real question is what should I do with this obsession?  Should I buy in and discuss it with him and ways in which people can be bad, how we make decisions and the like?  Should I try to deflect him away from the topic?  Should I just go with no attention, positive or negative, on the topic?

Bad guys. 
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Seven months old

And he celebrated by laughing at his brother for about fifteen minutes straight. He's laughed before, but not so much!

And yes, he still doesn't like sitting. Doesn't practice it and actively goes against you, but he stands like a pro.

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Best Trajanism to Date!

"can you eat a lot of chocolate so Chiron can get chocolate milk?"




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Validation

We recently have been having some behavior problems with Trajan. Called the pediatrician to ask about it and maybe a referral for play therapy or something and they said it was developmentally normal. Called the pediatrician again after a couple months and said no, we really need to do something and they had us in for an appointment. She said she wasn't seeing any red flags, but almost begrudgingly gave us a referral to play therapy. Went to play therapy and after a few sessions she said we might be seeing some developing ADHD behavior, but he really didn't need more play therapy. She would write a letter at the start of the school year with some tips for helping him.

Called the pediatrician to see if we should see anyone else for some guidance on the possible ADHD front (the play therapist had recommended a psychologist for evaluation and since I was more familiar with behavioral pediatricians, thought I would ask his normal pediatrician). They scheduled us for an appointment.

So, so far, everyone has been pretty much indulging us, but have seemed to think we were just seeing a problem where there wasn't one (despite reporting issues in multiple settings: home, school, gymnastics).  Not quite patronizing, but the attitude seemed to be we were just expecting too much.

Is validation the right word? I don't know, but the appointment was yesterday and we didn't get any recommendations for a path or even get past his infant history (his doctor is on maternity leave and so were catching the other doctor up since she's only ever seen Chiron. And yes, the theme of the year is doctors on maternity leave.). Why did we not get past this?

My arm immediately after

My arm this morning

He had an episode. Went from this funny, sweet boy explaining the blood pressure cuff and where his heart was to the nurse to this non-verbal, grunting, hitting overwrought thing. 

The pediatrician was great about it. Talked some as I tried to work him though it, took notes and tried to help. We stopped trying to talk about anything and instead said she would call me. He didn't want to leave the room. He didn't want to get in the car. He didn't want to go for a walk. He indicated with his head that he was not mad. That he was not sad. I asked him if he wanted to go see TK (one of the front office staff). I don't know why, but this worked. Likely was just timing. He stood up, walked out and by the time he walked the twenty yards to the water jug was perfectly fine. Smiling and laughing with a nurse while going back to restock the sticker basket.

He was fine. I took him to run an errand with me to have a pump tested (it tests fine, but still isn't working for me, but that's anther story.) Helped pick up his brother. Ate dinner. Got ready for bed. Went to sleep. All while being a sweet, communicative helpful boy.

The pediatrician said she would call me so we could discuss more of what he is doing, what the path is and really what is going on.  She did ask that we try to catch one on video if it is at all possible (recognizing that they aren't that frequent, but saying a cell phone video would be fine), because it is really hard to convey the extent of what was going on.  Similarly, she was really glad that she got to see it.  She said that she actually thought the first step might be the neurologist rather than either a psychologist or behavioral/developmental pediatrician.  We are supposed to pay particular attention to the correlation of nose bleeds with any of these behaviors.  She said she would write up a note and send it to the play therapist and the neurologist as well.

She hasn't called me yet, but I do feel like we are on a path to help him.  And that is good, because this has to be hardest on him.

I just realized I never really wrote a description of what he was doing.  This is hard for several reasons.  First off, some deficits in me.  I am not a very visual person and don't store information about how things looked.  Second, my memory seems to be short for negative events (Paul says this is a feature!).  Third, I was trying to help him and deal with it while still communicating with the pediatrician.  But here's my best attempt.  With no trigger, he started yelling.  Not words, but sounds.  Short, staccato-type noises without language in them.  Flailing and hitting and perhaps best described as a look of intent as he appears to set out with the goal of causing harm.  Of scratching, hitting, slamming, headbutting, whatever necessary to lash out in what appears to be rage.  There is crying throughout and blood running out of what I think was his left nostril.  Wrapping arms around him to hold him against the rage just makes him appear to add frustration to the rage.  Ignoring repeated hitting doesn't seem to be noticed by him.  He doesn't seem to have awareness or respond to his surroundings or the doctor or anything I say.  He seems to calm down.  I crouch in front of him as he seems like he may be able to communicate.  He doesn't lash out.  He doesn't attempt to hit or kick.  He just sits there befuddled, crying.  He doesn't want to leave the room.  Then suddenly he nods to the idea of going and seeing TK.  He reaches out and takes me hand, picks up his water cup (which had gotten knocked over, the doctor tells me to not worry about the spilled water and just leave it) and we walk into the hall.  He looks up, smiles and walks to the water jug and refills his cup.  Then he's the laughing, fun boy.

I didn't get a picture of it, but he also raked his own arm with what I assume was a nail.  And while we were standing at the front desk, I noticed red up and down my arm.

On the question of trigger, I say there was no trigger because we really couldn't identify one.  The best I could come up with is we were talking about him, but as the pediatrician pointed out, we were talking about his jaundice as a baby, not really something that should upset him.  The only behavior we had gotten into was to praise him for having stayed in the green (behavior system at school) for both of the last two days and getting a special note the day before complementing his behavior!

I'm not sure why I'm writing this, except perhaps to document it.  I can not imagine what it must be like to be inside his mind at the time.  The pediatrician mentioned the idea of prefrontal cortex seizures.  Whether it's medical, psychological, behavioral or even produced by us as parents, I really hope this is a good step towards us finding a path where we can help him so he doesn't have to experience this.

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Philosophy

I was talking to a friend yesterday morning on google talk.  She's in Africa, so was around for an early morning chat.  She asked something to the effect of how am I and said she had been thinking about me and my family.  My response was:

I've got a good life.. things happen and while I don't have to like them, I've gotta accept 'em

It didn't really strike me at the time, but I noticed later that she had changed her status to this line.  That made me think about it and I think it's true and I think I like it.

I've been bothered recently by something that might seem odd, I've been bothered that I'm not too upset, that I am able to laugh, love, enjoy and even do the day to day banalities of keeping life moving.  But as I think about it, I don't think this is a problem.  I don't think there is anything lacking in me.  It's that rather than being the plot of the movie of my life, Aurelia forms part of the soundtrack.  She's there and will always be there, but as something that has helped to shape me rather than something that has in anyway broken me.  I am more than I was before her.

In the last week or so, four friends have independently either talked about her, written me a note about her or just asked me about her.  I like this.  I think it means that I am strong enough that others can tell that I have her as a part of my life and acknowledging her doesn't hurt me, it just is a part of me.

This is a ramble, so I think I need a conclusion.  She wasn't created and then died to be my angel, to absolve for my sins or in any other way rise above the plane of existence.  She did exist though and she did impact not just myself and my family, but others that connect to us in rings like the currents that spread out from a tsunami.  She mattered and like our family, her story isn't complete, even if she never breathed a breath.

I do have a good life.  I am blessed.  It's not just a question of resiliency, I think it's taking the effort to really appreciate.

Toes are evidence that the world is a wonderful place

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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