>I Did It

>I did it! I did it!

I worked 36 hours between Friday evening and Monday morning. And I slept during the days. And I can honestly say that my baby boy consumed nothing but breast milk the entire time! Now this may not seem like a big deal to many people, but when you are dealing with supply issues, this a big enough victory to make me cry tears of happiness. I worked my ass off for that milk! I literally pumped every hour for several days to try to rebuild my supply and everything. And last night at work, I was actually able to pump 4 ounces at a time, which is double what it was earlier in the week!

I still have my appointment with the Breastfeeding Medicine doc on Wednesday. There is a chance Zach has a mild tongue tie that has been causing a painful latch and could be the reason my supply came in so strong and then dropped off. When he nurses, he literally mashes my nipples into a crease that is blanched white from the pressure. His frenulum may be preventing him from latching deeply enough and that is what the result is. If so, they can fix it by snipping it. They say this is no more painful for the baby than a standard immunization, so I don’t feel so cruel. And if it will stabilize his ability to nurse and reap the lifelong benefits of that, then it is worth it to me.

On to other boob news: I have had to pump very, very often. I was getting fed up. I already had my Medela Pump in Style, which is pretty much the pump of choice for working moms. I was looking for something to allow me to pump hands-free. They make bras for that, but have you ever tried to find those things in a 38G or H??? So I pretty much said “screw it” and took the plunge and bought the Medela Freestyle. It has adapters that allow it to connect to any standard nursing bra, has a rechargeable battery, a timer, is programmable for your favorite pumping pattern, and more. It feels so much different than the Pump in Style that I have to keep checking to make sure it is working. You can barely feel it. John asked me what I planned to do with the other pump,which has only been in use for 6 weeks and was pretty pricey. Well I set up a little station for me in my bedroom for when Evan is out and about and I need a quiet, private spot. I was able to use the Freestyle bag to set up a nursing bag for work, complete with the new pump, the cooler bag for milk, and another little bag with the parts for the Medela Symphony they have at work. This way, I don’t have to pack and unpack a bag every day before I leave the house. I hated doing that this week. It was just a matter of time before I forgot something. And I plan to use the Freestyle for times when I need to be mobile, either around the house or in transit. We are actually taking a road trip in July and I get to try this new plan out. This may seem like overkill on the pumps, but I am prepared now for every pumping need I could have, which is a pretty big deal when you have to work so hard to keep your supply up like I do.

>Bringing Out the Worst

>On most days I love my job. I honestly get to feel like I have made a difference in the lives of my patients. Sometimes that can mean the I am there when the code is called, and actively participate in life-saving measures. Sometimes this can mean I help them breathe easier with treatment. And sometimes this means I am there to help them be as comfortable as possible as they slip from this world, while other times, it is too late for them and I get to bring my experience of losing my mom to lung disease to help their loved ones through loss.

But there is one thing I cannot stand about this career I have chosen for myself. Quite honestly, if you want to see the bottled-up dysfunction in a family emerge, put them in an ICU when their loved one is critically ill. This is where you see it all. This is when the dirt comes to the surface. This is when it gets ugly.

Brothers and sisters fight over medical bills. Nobody can agree on end-of-life issues. I have even seen relatives attempting to take pictures of the patient on life support, to which I have to be the Patient Rights Police and insist that they could possibly be violating the patient’s right to privacy at a time when they cannot give consent.

I can understand the concept of someone wanting us to do all we can. I really do. But what happens when the point of medical futility is reached? Shouldn’t there be someone in the family who is able to listen to reason? To see that the medical treatment has reached the point of torture?

So what prompted this? I have resuscitated people for some reasons you would not believe. I think the worst was a 99-year-old man. He had survived cancer. He had lived with lung disease. He was getting dialysis several times per weak to overcome kidneys that had long since failed him. He had had 4 open heart procedures. He collapsed at home and the family called an ambulance. They wanted everything done. He was brought to us on a high amount of oxygen and in the end stages of heart failure. And he coded. And the family made us do everything. I felt his frail 99-year-old ribs crack under my hands as I compressed his chest. It was pitiful. But we got him back, though we all knew it wouldn’t be long before we were doing it all again. So we approached the family about signing a do not resuscitate order. And they refused. The reason? (Which I cannot believed they confessed.) They had a huge celebration planned for his 100th birthday in just 3 months and he couldn’t be permitted to die before then.

Well, though the situation was not as bad, this weekend I found myself taking care of Mrs. X. Mrs. X is not there. Neurologically, she is gone, which is the result of anoxic brain injury from a stroke that was not treated in a timely manner. She is unable to cough, and so we have to suction her almost every 2 hours to clear her secretions. She does not respond at all. Not even a gag as I threaded the tube through her nose and down her throat. Her tongue and pharynx are so swollen that I predict airway compromise any second, which will require intubation. Her team of doctors has tried and tried to explain to the family, only to have the family adamantly refuse to sign any advance directives. Yet I have not seen anyone come and visit her in the past 3 days. And it pisses me off. I am forced to torture this woman, most likely because someone is still cashing her social security checks. It is almost criminal. This is what I hate about my job.

>Da’ Hook-Up

>A coworker of mine asked if I needed any clothes for Zach last week. Zach actually has more clothes than he will ever be able to wear, but I was prepared for a preemie, and so the biggest size I bought was 0-3 months. So I said he would need fall and winter clothes later on. So my coworker told me he had large bins of baby clothes from his 2 sons, both born around the same time of year as Zach. I told him I would take them. I offered money, and he didn’t want any. I mentioned something about returningthem later, and he didn’t want them back. I don’t mean to sound unappreciative, but after that, I honestly expected the clothes to be worn out or stained or both. Ummmmm, no.

He gave me 2 enormous bins full of nothing but designer baby clothes,in pristine condition (some even had tags on them), in the perfect sizes for the seasons as Zach grows. I swear,my child will not need any new clothes for the next 2 seasons! This is what I call a hookup!

>The SSN

>It’s official. My youngest son exists. He is a real person who will grow to be an adult with a driving record, a credit history, and much more. His social security card came in the mail. There was his name in black and white on the government-issued paper.

I know, I know. I’m easily amused these days.

>Just Wrong

>I have this nameless coworker who will make some of the most off-color jokes you can imagine. In fact, if some of them came from anyone else, I would be offended. But when he says it, you just shake your head and crack up laughing. He is constantly finding stuff online that he finds funny, and so he emails it to all of us, and so the laughter continues.

So I go into work the other day, and he says, “Andrea hasn’t seen the TURTLE video!!!” Oh. Oh Sweet Baby Jesus! The Turtle Video? So he whips out his iPhone to show me the video that everyone else has already seen, as they are all laughing and staring at my face to see my reaction. Well, this is that video:

(Turn up your volume first.)

For some reason, this was both hilarious and disturbing at the same time, and has become a night shift joke. So I get home, and I am looking it up to show John. And I start seeing all of these other videos. I thought the one I was shown was a fluke. But no, it isn’t. And then I stumbled across this one:

So I guess all turtles do this and I didn’t know. So now, as a result, John will randomly go “UUUUUUUUUUUNNNNGH!” to which we both crack up!

>Supply and Demand

>For something that is supposed to be so easy and natural, breastfeeding has been insanely difficult. Somewhere around the time of the phone call from our doc about Zach’s thyroid hormones, my milk supply started to drop off. Of course this was timed perfectly with one of Zach’s growth spurts, which sucked. He wanted more milk, I was making less, and we had to rely on more and more supplements. And so the vicious cycle started. I tried everything. I tried to be stubborn and refuse to give him supplements, letting him nurse as often as every 30 minutes. I tried taking Fenugreek. I tried giving him supplements and just pumping every hour. I was seriously worried that my supply would be completely gone with the added stressor of my return to work. Unfortunately, none of these things seemed to improve the situation. It didn’t worsen, either, so I guess it could be worse. I am only able to pump a pitiful 2 ounces each time, where before I was able to get anywhere up to 6 ounces. Huge drop. So back we went to the lactation consultant. It seems the only thing left to tweak is Zach’s latch, which we worked on. If this doesn’t do the trick, I am out of options.

While there yesterday, the lactation consultant asked, “Why don’t you schedule an appointment at Children’s?” Me? At Children’s? She is of course referring to Cincinnati Children’s Hospital Medical Center, which is all of 5-10 minutes’ drive from my house. I have always felt lucky to have them there. An award-winning pediatrics center, known throughout the country. Ground-breaking research. State of the art care. Heaven forbid anything were to ever happen to either of my boys, but if it did, some of the best doctors, from every pediatric specialty, are just right there. But I had no idea there would be any reason for me to be seen there. Well, it turns out they have their Center for Breastfeeding Medicine. Breastfeeding Medicine????? Yep. I didn’t even know that specialty existed. Apparently it is a team of pediatricians specializing in working with a lactating mother and her baby to determine the cause of, and correct the underlying issue with, virtually any breastfeeding issue that may arise. In my case, there is nothing physiologically wrong since I once had a huge supply. It just dropped off as a result of stress and poor management, and I have not been able to get it back. So I have an appointment there on Wednesday of this week.

In the meantime, Zach is eating like a pig. He would literally nurse for 24 hours a day with no break if I could do it. He is up to 9 pounds, 11 ounces as of yesterday. My little chubbers. This is such a huge difference from Evan, who weighed 16 pounds on his first birthday. He was happy and healthy, but just tiny. But we equate chubbiness in babies with health, so it is nice to see Zach packing on a little bit of weight. Regardless of the problems we are having, I know he is getting the nourishment he needs.

In the meantime, I am reading a book called The Breastfeeding Mother’s Guide to Making More Milk by Diana West and Lisa Marasco. The lactation consultant recommended it, and so far it is very informative. It lays out the different causes of low supply so you can, detective-style, figure out what may be the culprit, since apparently any tiny detail could be a causative factor. This way, I am getting ideas to discuss with the doctor on Wednesday. I know them having me give Zach supplements after birth is a factor. I know stress has been a factor (and continues to be–a stressful situation caused the drop, then I got stressed about the low supply and trying to preserve the BF relationship, and so it goes…). But I am learning tons of new info, like progesterone lowers supply! Progesterone! As in the injections I got every 5 days up to the week of Zach’s birth. Like the active ingredient in the birth control pills my OB gave me, which is ironically the only safe BCP for nursing mothers. So I am gathering all of these clues and will have a list for the doctor.

What I was not prepared for was the emotional attachment I would have to nursing Zach. This whole breastfeeding issue came up initially not only because it is healthiest for both of us, but because food allergies run rampant in my family. I am allergic to everything! Evan had eczema an is following in my footsteps. I wanted to avoid this all with Zach, and BFing is the best start for that. But now? Now I feel like a broken-down, deflated failure when we have to give him more after he nurses. And I am so protective of the milk I do have, fearful that there will come a day when it will be gone completely. So I am truly hopeful that they can fix this next week. If not, I’ll just have to do the best I can with what I’ve got!

>Breaking Down

>Yep, that is the phrase of the day. I think I should go back to bed.

It all started this morning at about 4 AM. I tried to make my morning coffee. I turned it on to brew and walked away to nurse a crying baby before I got my first cup to avoid giving my sweet angel a jolt of caffeine. It sputtered to life first, so I didn’t think anything of it. But once Zachy-Poo was fed and fat and happy, I nestled him in his little bassinet and went to get my java, and guess what! Nuthin’! I thought I was seriously going to die when I had to settle for pseudo-coffee. Pseudo-coffee is the powdered frou-frou crap that you add to hot water, in case you were wondering. It tastes great, but is decidedly not real coffee. So I was seriously pissed.

Next came the vacuum. “Jaws” has been with us all of 3 years and is a Kirby. She got her name from Mr. Mom, not that I want to date myself or anything. (Incidentally, if you are too young to remember the movie, I do not want to hear a word about it.) I was suckered into purchasing it from a very good salesman those few years ago. I have allergies and so does Evan, so when they did their little demo, I bought into it. So anyhow, if Jaws was dead, there was going to be some serious drama. I figure when you pay $2K on a vacuum (errrr, excuse me, cleaning system), it should last. And John’s dad has one that I swear he has had since before John was born. So now the vacuum and coffeemaker are dead. Now I was really,really pissed.

So later in the morning, John is awake and so is Evan. Evan comes up from his room stating words any seasoned mother sees right through: “I didn’t do it!” Completely unprovoked, too. Didn’t do what, exactly? Because that usually means ” I did do it, but I want to assert my innocence first before you kill me.” It would seem that there was something wrong with the basement drain. And water was backing up, forming a small puddle in the center of the floor. No biggie. We have had rain and storms out the rear end lately, so it is probably from that. I don’t know how that all works, and usually pay people to deal with such issues as a result of my ignorance, so don’t ask me why I jumped to that conclusion when I am never, ever so laid back about anything. So anyhow, John goes down there to investigate. And comes back with the report that not only the unfinished part of the basement, but also the finished part (i.e. Ev’s room!) smells like fricken sewage, and he is going to get a snake at the hardware store to clean out the offending drain. And he leaves. Coffeemaker, vacuum, and entire basement now down for the count. And I am now seriously, seriously pissed.

So John is leaving, and he notices water company trucks lined up and down the street. A-Ha! This trips his memory. A memory of the fluorescent tag they left on our door last week that they would be working on water lines on our street from 10 AM through 7 PM today. A tag he just happened to forget to mention to me. And we are not supposed to use water today. Seriously? He tells me this right after Evan has gotten his annual summer buzz cut and has hair all over his little body. He was standing in the bathroom in his boxers, just about to get in the shower to wash off the itchy hair when John said the words. Poor kid. So we had no choice but to take his shower, anyway. And more water backed up in my basement. Beautiful. (But it turned out Evan really didn’t do it!)

So since we cannot use water, I am really cranky. What of the laundry I needed to throw in before I go to work? Zach needed a bath. I needed a shower before work. Arrrgh. So I call work because I have it written down that I am only working an 8 hr. tonight which I never do. 10:30 PM to 7 AM. I thought it may have been a mistake. But yep, it is true. Only one of my coworkers called in sick and they want to know if I want to come in at 6:30 instead and do a 12. Gah. Those 4 extra hours amount to $200. For the chick who has been off forever. How can I say no? So I tell them I will call them as soon as I know when the water situation will be resolved. And I go out to ask the men working if it will really be until 7 PM. This is when I discover that they have quietly dug a trench through the front yard. So now I have no coffeemaker, vacuum, basement, or front yard. Ummmmmm…

By this point, all I can do is stare. There is no way in hell I am going to make it into work early. I had to call and let them know that, and I feel horrible about it. It is 3:30 PM and we still have no water. I still only have pseudo-coffee. I am wearing frayed scrub bottoms and the old t-shirt in which I slept last night. I am pissy and mean right now, have been awake since 4 AM even though I have to work tonight, and my boobs hurt because I was trying to pump like a mad woman to store enough breastmilk to cover Zach for the extra unplanned time at work tonight that is now not going to happen. My family is tip-toeing around me as if I am a land mine that may explode on them.

I think I really am going back to bed.