As of Wednesday afternoon, we're home. We're enjoying Grandma time while my mom is here in town. As I have explained to those who have asked, having my mom here means that the dishes get done while I stare in awe at the baby, dinner gets cooked while I coo at the baby, floors get swept while I feed the baby, and the baby is tended while I try to grab a few winks of sleep. In other words, we're exceptionally grateful for the help.
Ian is doing well. We've had some significant challenges with the whole feeding routine, but we're learning together and are finding ways to overcome our problems. Ian had lost a great deal of weight over the first few days of his life due to latch problems, but with the help of some changes in our feeding routine, flexibility and a bit of formula, we've brought him back up to what promises to be a healthier weight and he's back on breast milk alone, most of it from a bottle. That was not my ideal. However, I'm quickly learning that parenthood requires one to let go of expectations in favor of realities, using what is helpful by way of freely-proffered advice... and lumping the rest. I am also learning that I need to be gracious with myself. Not living up to my own expectations or that of others is not a failure -- carrying the disappointment of unfulfilled expectations is, because the main thing is overcoming the challenges, not failing to have them in the first place.
Ian has been a very sweet baby so far. He has been very mellow the vast majority of the time, and his Daddy and I are in love with him (and each other)! We think his grandma is quite fond of him, too. I love nothing more than gazing at him (when I can stay awake to do it) and reveling in the wonder that he belongs to us. Daddy has been helping a great deal with feeding and diapering, and he's also beginning Ian's cultural education by reading poetry to him and playing classical music for him. It's fun to watch Daniel settle right in to fatherhood.
I've taken more pictures over the last few days, but I am not quite ready to post them yet... so, with that teaser of good things to come, it is almost certainly time to feed a certain sweet little boy again...!
Saturday, August 8, 2009
Tuesday, August 4, 2009
Eye on Ian
Ian is going on one day old, and his first 24-hour period outside the womb has been a busy one! His health continues to look good, he passed his hearing screening, he had a visit from Fr. Thomas for a special blessing, and spent time with his grandma. After a very alert night, he has spent a lot of the second half of his first day sleeping. Mommy and Daddy only wish they could have done the same! Mommy is doing well, aside from a very sore back and medicine that makes her very drowsy, and Daddy is getting to be a diaper-changing and baby cuddling pro. Here are a few moments from Ian's first full day.
Monday, August 3, 2009
Introducing Ian Gordon
Date: August 3, 2009
Time: 7:45 PM
Weight: 7 lbs, 9 oz
Length: 21 inches
Apgar: 9 and 9
About Ian’s name
Ian is the Scottish form of “John” which is of Hebrew origin and means "the Lord is gracious". We chose a variant of John in honor of St. John the Merciful (also known as St. John the Almsgiver), who is commemorated by the Orthodox on November 12.
St. John the Merciful was the Patriarch of Alexandria in the early 7th century, and earned his name because of his reputation for unfailing compassion for others, humility and generosity in his work for Christ through the church. Where his contemporaries saw trickery and abuse of generosity by a man who came in disguise seeking alms, John saw Christ and gave over and over again. With all of the riches of the church at his disposal, he lived simply and gave generously from the church coffers in faith that God would supply what was given away — with interest. When a conflict with a brother priest who had erred and had been disciplined for his shortcoming kept that man from repentance, John left the gifts at the altar, in obedience to Matthew 5:24, and prostrated himself before his brother to beg forgiveness, even though he had not been in the wrong. John’s humble action moved the man to repentance and reconciliation and a restoration of his ministry. John lived mindful of his mortality, and had his own grave partially dug prematurely, asking to be reminded on every great occasion that his grave awaited him and that he knew not the hour of his death (Matthew 25). St. John dedicated himself to Christian education, to the freeing of those in slavery, and to service of the sick and needy. Under his leadership, the number of churches in Alexandria swelled from 7 to 70. (http://en.wikipedia.org/wiki/John_the_Merciful, http://orthodoxwiki.org/John_the_Merciful)
Needless to say, we would love for Ian to follow in the footsteps of this godly man, as he followed Christ.
Gordon is a family name. Gordon is from Gaelic origins, among others, and one of its meanings is “beloved.”
Ian’s paternal grandfather, who passed away while we were pregnant with Ian, was named Gordon. Ian’s maternal grandfather, Ronald, also bears the name Gordon, but as a middle name. We wished to honor our fathers, both of whom have also dedicated their lives to Christ, by giving Ian their shared name.
Indeed, this child is beloved, and he is an example of the graciousness of God in our lives. We are incredibly blessed.
Time: 7:45 PM
Weight: 7 lbs, 9 oz
Length: 21 inches
Apgar: 9 and 9
About Ian’s name
Ian is the Scottish form of “John” which is of Hebrew origin and means "the Lord is gracious". We chose a variant of John in honor of St. John the Merciful (also known as St. John the Almsgiver), who is commemorated by the Orthodox on November 12.
St. John the Merciful was the Patriarch of Alexandria in the early 7th century, and earned his name because of his reputation for unfailing compassion for others, humility and generosity in his work for Christ through the church. Where his contemporaries saw trickery and abuse of generosity by a man who came in disguise seeking alms, John saw Christ and gave over and over again. With all of the riches of the church at his disposal, he lived simply and gave generously from the church coffers in faith that God would supply what was given away — with interest. When a conflict with a brother priest who had erred and had been disciplined for his shortcoming kept that man from repentance, John left the gifts at the altar, in obedience to Matthew 5:24, and prostrated himself before his brother to beg forgiveness, even though he had not been in the wrong. John’s humble action moved the man to repentance and reconciliation and a restoration of his ministry. John lived mindful of his mortality, and had his own grave partially dug prematurely, asking to be reminded on every great occasion that his grave awaited him and that he knew not the hour of his death (Matthew 25). St. John dedicated himself to Christian education, to the freeing of those in slavery, and to service of the sick and needy. Under his leadership, the number of churches in Alexandria swelled from 7 to 70. (http://en.wikipedia.org/wiki/John_the_Merciful, http://orthodoxwiki.org/John_the_Merciful)
Needless to say, we would love for Ian to follow in the footsteps of this godly man, as he followed Christ.
Gordon is a family name. Gordon is from Gaelic origins, among others, and one of its meanings is “beloved.”
Ian’s paternal grandfather, who passed away while we were pregnant with Ian, was named Gordon. Ian’s maternal grandfather, Ronald, also bears the name Gordon, but as a middle name. We wished to honor our fathers, both of whom have also dedicated their lives to Christ, by giving Ian their shared name.
Indeed, this child is beloved, and he is an example of the graciousness of God in our lives. We are incredibly blessed.
Friday, July 31, 2009
Reconsidering the considerations
So, we're about 57 hours or so from our induction appointment, and, as I tend to do before any big life event, I "decided" to melt down emotionally last night and today. As I recall, we got married on Sunday nearly 7 years ago, and on the Friday night previous to the ceremony I flipped out under the pressure. By the day of the wedding I was ready to go, and I hope that by Monday I will be the same! So, while unpleasant, this development wasn't unexpected.
I didn't sleep last night worrying that the induction of labor was the wrong choice. However, what I didn't realize at the time was that the worries I was experiencing were a result of accepting the wrong presuppositions. Basically, I had assumed that the "reasons" we had been discussing as justification for induction were limited to the two on my mind, which were not, on their own, reasons to induce, which made it boil down to an elective procedure. I made this mistake because in talking to the doctor, we had agreed with the course of action he proposed without having heard his reasons for it, which meant he hadn't actually spelled out the case for us, so we just operated on what was in our minds until those reasons failed to justify the action.
Some elective procedures I'm okay with, but not those that take two lives into the balance when nature has been doing a pretty good job of accomplishing the same thing since the advent of humanity. So, I fretted and read and worried and cried off and on for 12 hours until finally, mercifully, had an appointment with our OB just before office closing time.
We left the office with a completely different perspective, because what we got in this visit was his professional opinion: that I am at substantially above average risk for adverse outcomes as pregnancy progresses, which means that there is more risk inherent in leaving the baby where he is than there is in urging him out while we know he's healthy now that he has reached a very favorable point in development.
He gave me three medical reasons having to do with my own personal status and health:
1. I am right on the cusp of "advanced maternal age" and the risks that attend it, and there is nothing magical that happens on my quickly-advancing 35th birthday that might not be an issue now.
2. My blood pressure is borderline high, which increases risk to the baby.
3. My gestational diabetes - which can cause premature aging of the placenta, such that it fails to provide adequate oxygen and nutrition to the baby as pregnancy progresses, and which also places me at higher risk of developing pre-eclampsia - is an ongoing concern.
He proviced one reason that is his own selfish motive and not a real reason for us:
4. He would get to attend the delivery.
And one reason that is evidence-based statistical data about fetal outcomes at various gestational ages:
5. Fetal morbidity based on gestational age at delivery decreases from an already low rate at 36 weeks to its lowest at 39 weeks before increasing again at 40 weeks and beyond. This is without regard to particular maternal risk factors - babies born at 39 weeks, for reasons that are not entirely intuitive or clear, just do better.
To these 5 reasons we can add two more:
6. We're both exhausted, physically and mentally, by the pregnancy and its complications.
7. There would be an advantage to getting antibiotics in a timely manner, which is more likely with an induction than with spontaneous labor, given how far advanced I am already at this stage.
None of these reasons is compelling on its own, and even a combination of 2 or 3 is not enough to make it wise; they are "soft" concerns. However, when we add them all up, they spell higher risk that it makes sense to more actively manage, which means there is a medical case for induction, making this a choice, yes, but not a purely elective procedure.
We have heard nothing but good things about our doctor from the nursing staff at the hospital, people in his office, other doctors at the hospital, and even the guy that sold Daniel his suits (his own kids were delivered by him 2 decades ago) at Men's Warehouse, and so when our judgment is wanting direction, it seems like his opinion is worth trusting.
Our choices, he said, are two:
1. Proceed with the induction on Monday
2. Choose not to proceed with the induction - which is fine as long as the baby looks healthy now - but, if I do, I will need to begin twice-weekly non-stress tests immediately to make sure that the baby's health is not deteriorating as he and the placenta age, and if the baby is not born by week 41 due to an emergency or spontaneous labor, induction would become extremely strongly advised.
He explained his professional opinion but he also stressed, quite honestly and supportively, that it is our pregnancy and that the choice is absolutely up to us and that he won't force the issue aside from ordering more tests if we refuse. He then answered my specific questions about the risks and benefits of both approaches for about 40 minutes. He was very straight-talking, which I really appreciate. He also said that if he felt like an induction was absolutely necessary, he would not mince words about that. We have a choice, essentially, as long as the baby looks okay and my health holds up, but we also have and the benefit of his opinions as to why he feels strongly that induction at the gestational age the baby will have reached on Monday is the safer course.
After he did the usual exam, which didn't show any growth of the uterus for the last 2 weeks and showed a lower-than-usual fetal heart rate (still acceptable, but on the slow end of the scale), I was sent to have a decidedly more scientific examination: a non-stress test done at the hospital, which was performed tonight. I had instructions that if it did not look good, the doctor from the practice that is on-call this weekend would order more tests or even deliver us immediately. If we passed the test, on the other hand, then we should be fine until Monday's planned induction, or non-stress test, if I refuse the induction.
Thankfully, we passed, which means we still have the choice, and the opportunity for spontaneous labor in the meantime.
So, after the test, lots of talking and taking into consideration the factors that were presented to us, I'm again feeling more peaceful about the possibility of induction. Hopefully I will now be able to just chill out and accept what may come. I would love to have labor begin spontaneously between now and then (the doctor on call this weekend is my second favorite in the practice, and I would much prefer a more natural process if that is possible), but I also feel like it can be the wise and loving thing to proceed with induction on Monday if it does not. So... it looks like we'll most likely have a baby on his way out sooner than later, and it is a fun thing to contemplate... if also the scariest thing I have faced in a LONG time!
I didn't sleep last night worrying that the induction of labor was the wrong choice. However, what I didn't realize at the time was that the worries I was experiencing were a result of accepting the wrong presuppositions. Basically, I had assumed that the "reasons" we had been discussing as justification for induction were limited to the two on my mind, which were not, on their own, reasons to induce, which made it boil down to an elective procedure. I made this mistake because in talking to the doctor, we had agreed with the course of action he proposed without having heard his reasons for it, which meant he hadn't actually spelled out the case for us, so we just operated on what was in our minds until those reasons failed to justify the action.
Some elective procedures I'm okay with, but not those that take two lives into the balance when nature has been doing a pretty good job of accomplishing the same thing since the advent of humanity. So, I fretted and read and worried and cried off and on for 12 hours until finally, mercifully, had an appointment with our OB just before office closing time.
We left the office with a completely different perspective, because what we got in this visit was his professional opinion: that I am at substantially above average risk for adverse outcomes as pregnancy progresses, which means that there is more risk inherent in leaving the baby where he is than there is in urging him out while we know he's healthy now that he has reached a very favorable point in development.
He gave me three medical reasons having to do with my own personal status and health:
1. I am right on the cusp of "advanced maternal age" and the risks that attend it, and there is nothing magical that happens on my quickly-advancing 35th birthday that might not be an issue now.
2. My blood pressure is borderline high, which increases risk to the baby.
3. My gestational diabetes - which can cause premature aging of the placenta, such that it fails to provide adequate oxygen and nutrition to the baby as pregnancy progresses, and which also places me at higher risk of developing pre-eclampsia - is an ongoing concern.
He proviced one reason that is his own selfish motive and not a real reason for us:
4. He would get to attend the delivery.
And one reason that is evidence-based statistical data about fetal outcomes at various gestational ages:
5. Fetal morbidity based on gestational age at delivery decreases from an already low rate at 36 weeks to its lowest at 39 weeks before increasing again at 40 weeks and beyond. This is without regard to particular maternal risk factors - babies born at 39 weeks, for reasons that are not entirely intuitive or clear, just do better.
To these 5 reasons we can add two more:
6. We're both exhausted, physically and mentally, by the pregnancy and its complications.
7. There would be an advantage to getting antibiotics in a timely manner, which is more likely with an induction than with spontaneous labor, given how far advanced I am already at this stage.
None of these reasons is compelling on its own, and even a combination of 2 or 3 is not enough to make it wise; they are "soft" concerns. However, when we add them all up, they spell higher risk that it makes sense to more actively manage, which means there is a medical case for induction, making this a choice, yes, but not a purely elective procedure.
We have heard nothing but good things about our doctor from the nursing staff at the hospital, people in his office, other doctors at the hospital, and even the guy that sold Daniel his suits (his own kids were delivered by him 2 decades ago) at Men's Warehouse, and so when our judgment is wanting direction, it seems like his opinion is worth trusting.
Our choices, he said, are two:
1. Proceed with the induction on Monday
2. Choose not to proceed with the induction - which is fine as long as the baby looks healthy now - but, if I do, I will need to begin twice-weekly non-stress tests immediately to make sure that the baby's health is not deteriorating as he and the placenta age, and if the baby is not born by week 41 due to an emergency or spontaneous labor, induction would become extremely strongly advised.
He explained his professional opinion but he also stressed, quite honestly and supportively, that it is our pregnancy and that the choice is absolutely up to us and that he won't force the issue aside from ordering more tests if we refuse. He then answered my specific questions about the risks and benefits of both approaches for about 40 minutes. He was very straight-talking, which I really appreciate. He also said that if he felt like an induction was absolutely necessary, he would not mince words about that. We have a choice, essentially, as long as the baby looks okay and my health holds up, but we also have and the benefit of his opinions as to why he feels strongly that induction at the gestational age the baby will have reached on Monday is the safer course.
After he did the usual exam, which didn't show any growth of the uterus for the last 2 weeks and showed a lower-than-usual fetal heart rate (still acceptable, but on the slow end of the scale), I was sent to have a decidedly more scientific examination: a non-stress test done at the hospital, which was performed tonight. I had instructions that if it did not look good, the doctor from the practice that is on-call this weekend would order more tests or even deliver us immediately. If we passed the test, on the other hand, then we should be fine until Monday's planned induction, or non-stress test, if I refuse the induction.
Thankfully, we passed, which means we still have the choice, and the opportunity for spontaneous labor in the meantime.
So, after the test, lots of talking and taking into consideration the factors that were presented to us, I'm again feeling more peaceful about the possibility of induction. Hopefully I will now be able to just chill out and accept what may come. I would love to have labor begin spontaneously between now and then (the doctor on call this weekend is my second favorite in the practice, and I would much prefer a more natural process if that is possible), but I also feel like it can be the wise and loving thing to proceed with induction on Monday if it does not. So... it looks like we'll most likely have a baby on his way out sooner than later, and it is a fun thing to contemplate... if also the scariest thing I have faced in a LONG time!
Wednesday, July 29, 2009
Aside... CA legislation I REALLY hope passes!
I have read quite a lot about lately about the risks/benefits of fire retardants in baby items. I have come to believe that the benefits do not justify the risks. There is proposed legislation in CA that would change the requirements in CA, which would, in effect, change them for the rest of the US, since manufacturers tend to manufacture to the most stringent codes, which, in this case, would be the codes in CA. I would LOVE to be able to buy products that have not been treated with flame retardants, so I hope this legislation or similar manages to pass. Click on the title of this post to read the LA Times piece that spurred these comments.
Monday, July 27, 2009
The more things change...
...the more they stay the same.
So, the doctor says, giggling through much of the appointment, that I am at 3-4cm "I can see someone calling it 4cm" and 80% effaced. I think he was giggling during the appointment because I keep coming back to see him in the office instead of just showing up at the hospital in labor like I am apparently supposed to. It's that pesky "in labor" part that is the hang up. It's not for lack of trying. In fact, when he checked me out, I harbored the secret hope that he'd find I was at 5-6cm and would just send us to the hospital. Not that I thought he would, mind you... but a girl can dream.
OBs use something called the "Bishop score" to rate the likely success of labor induction, and the higher the score, the less likely a conversion to a c-section because of failure to progress through labor (keeping in mind that a c-section may still be needed for other reasons). Well, he says, again laughing, as he prepares to leave the room: "You have a very favorable Bishop's score. In fact, it is about as high as it can get for a first-time mom." As Daniel remarked to me on the way to the car, "you always were a high achiever." Yes, that's me... going for the good scores!
They don't ask my name at the front desk anymore. Instead, they just ask who I am seeing today. Mondays are my usual appointment days, but I have been given an extra Friday appointment this week just to see if "anything has changed" before I show up before sunrise next Monday. Before we left, we ironed out a few of my concerns about the induction scenario (like making sure that it is in the written orders I have to take to the hospital with me that I am to start antibiotics 1 hour before they start with the actual induction), so that is comforting.
Many women have an elaborate "birth plan" outlining everything that they want/don't want from the birth experience. It includes important things, usually, like pain relief preferences, and may extend to details like how bright the lights are in the birthing room and what sort of music they want playing while they manage their contractions. I have decided that my birth plan is going to be one sentence (we were encouraged to make our plans clear and succinct): "Talk to us before you do anything to me or the baby, unless one of our lives depends on immediate action, and if I'm not able to make decisions for some reason, please have the discussion with my husband." There's plenty of control-freakishness in the spirit of this plan, yes... but this is from the same person who programs trips down to the hour and minute and writes three pages of instructions for the pet sitters when "please make sure the cats are fed, healthy, and have a reasonably clean litterbox" would probably suffice, so I am feeling like this is a big step for me. The last three weeks have been a rather pointed reminder that I am not in control of when or how this baby comes, but to the extent that I can make choices once at the hospital, I do want to be given the opportunity.
That's it for now. And with that... back to my book while I have the luxury of reading!
So, the doctor says, giggling through much of the appointment, that I am at 3-4cm "I can see someone calling it 4cm" and 80% effaced. I think he was giggling during the appointment because I keep coming back to see him in the office instead of just showing up at the hospital in labor like I am apparently supposed to. It's that pesky "in labor" part that is the hang up. It's not for lack of trying. In fact, when he checked me out, I harbored the secret hope that he'd find I was at 5-6cm and would just send us to the hospital. Not that I thought he would, mind you... but a girl can dream.
OBs use something called the "Bishop score" to rate the likely success of labor induction, and the higher the score, the less likely a conversion to a c-section because of failure to progress through labor (keeping in mind that a c-section may still be needed for other reasons). Well, he says, again laughing, as he prepares to leave the room: "You have a very favorable Bishop's score. In fact, it is about as high as it can get for a first-time mom." As Daniel remarked to me on the way to the car, "you always were a high achiever." Yes, that's me... going for the good scores!
They don't ask my name at the front desk anymore. Instead, they just ask who I am seeing today. Mondays are my usual appointment days, but I have been given an extra Friday appointment this week just to see if "anything has changed" before I show up before sunrise next Monday. Before we left, we ironed out a few of my concerns about the induction scenario (like making sure that it is in the written orders I have to take to the hospital with me that I am to start antibiotics 1 hour before they start with the actual induction), so that is comforting.
Many women have an elaborate "birth plan" outlining everything that they want/don't want from the birth experience. It includes important things, usually, like pain relief preferences, and may extend to details like how bright the lights are in the birthing room and what sort of music they want playing while they manage their contractions. I have decided that my birth plan is going to be one sentence (we were encouraged to make our plans clear and succinct): "Talk to us before you do anything to me or the baby, unless one of our lives depends on immediate action, and if I'm not able to make decisions for some reason, please have the discussion with my husband." There's plenty of control-freakishness in the spirit of this plan, yes... but this is from the same person who programs trips down to the hour and minute and writes three pages of instructions for the pet sitters when "please make sure the cats are fed, healthy, and have a reasonably clean litterbox" would probably suffice, so I am feeling like this is a big step for me. The last three weeks have been a rather pointed reminder that I am not in control of when or how this baby comes, but to the extent that I can make choices once at the hospital, I do want to be given the opportunity.
That's it for now. And with that... back to my book while I have the luxury of reading!
Monday, July 20, 2009
The continuing saga of baby J
We visited the doctor again this afternoon. Things are much as they have been - I'm still 3+ cm dilated and a full 80% effaced and he is at -2 station, which, we are told, is pretty low for not being in active labor.
After talking to the doctor more about my situation, we opted to schedule a date for an induction if I do not go into natural labor in the next 2 weeks. So, on 5:15 am on August 3, if not before, we'll be at the hospital. I'm not a fan of induction in principle, unless a baby is overdue, but the consensus is that I am likely to have a quick labor (I've been instructed multiple times not to dilly-dally getting to the hospital when labor starts), I'm a good candidate for successful induction, and we decided together that there may be some definite advantages for the baby if we induce, because that would mean we can have a better shot at having enough time to get sufficient penicillin in my system to lessen his strep risks before he is born than we might otherwise have with natural labor. So, it's really not about being impatient for him to get here -- although my increasing aches and pains make an earlier than later birth date sound rather nice -- it was a matter of increased safety in delivery if he has not come on his own.
Baby is, as it were, poised at the starting blocks and waiting for the signal to run. As for the grown-ups, we are circling the airport for now, waiting to be cleared for landing. We'll see whether he sprints before the tower gives us the call.
After talking to the doctor more about my situation, we opted to schedule a date for an induction if I do not go into natural labor in the next 2 weeks. So, on 5:15 am on August 3, if not before, we'll be at the hospital. I'm not a fan of induction in principle, unless a baby is overdue, but the consensus is that I am likely to have a quick labor (I've been instructed multiple times not to dilly-dally getting to the hospital when labor starts), I'm a good candidate for successful induction, and we decided together that there may be some definite advantages for the baby if we induce, because that would mean we can have a better shot at having enough time to get sufficient penicillin in my system to lessen his strep risks before he is born than we might otherwise have with natural labor. So, it's really not about being impatient for him to get here -- although my increasing aches and pains make an earlier than later birth date sound rather nice -- it was a matter of increased safety in delivery if he has not come on his own.
Baby is, as it were, poised at the starting blocks and waiting for the signal to run. As for the grown-ups, we are circling the airport for now, waiting to be cleared for landing. We'll see whether he sprints before the tower gives us the call.
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