Five things about Oliver

At 28 1/2 months.

1. He asks "What is it?" about a million times a day.  It makes me want to scream by bedtime, especially when we're reading Dr. Suess's Oh, the Thinks You Can Think, and I'll be darned if I know what some of those things are.  The only thing scarier than this is the "Why?" phase.
2. He has had no regression with potty training since baby came.  He's in underwear every day, all day.  He sometimes wears a pull-up during nap time at daycare, but his teachers say he's usually dry when he wakes up.  I think it'll be some time before we do potty training overnight, but for now this is a big step.
3. He goes back and forth between being totally independent and helpful -- putting on socks and shoes and his jacket and hat and letting the dog out and getting a blanket for Emme -- and being totally helpless and obstinate -- refusing to use the potty unless I physically put him on it and refusing to leave the zoo unless I carry him out.  I drives me crazy sometimes, and I feel like this nuts lady who switches at the drop of a hat between "Ms. Discplinarian" and loving mother.  It doesn't help when he gets upset and cries, "Daddy!" (who is inevitably at work).
4. He is adorable with Emmeline.  I keep trying to get a good picture or a few seconds on video, but as soon as I get out the camera, he says, "What is it?" (See #1.)  He talks to her and worries about her and gives her a kiss at night if she's in the room.  He likes to "fix" her chairs, which basically means snapping all of the buckles such that I have to undo them when I go to put her in them (See #3.)  He's doing great as a big brother -- so far.
5. He still loves, loves, loves the outside.  We had really beautiful weather this weekend, in the 60s both days.  We went to the park on Saturday and the zoo on Sunday (just me and the kids).  He had a great time and didn't want to leave either place.  It's one of his better qualities -- rain, snow, sleet, or hail, he wants to be outside.

Sweet Pea and Big G

Oliver likes to hold her.  The Boppy seems to help.

I love it when she's alert like this.

Now or later

When Oliver was born with congenital cutis aplasia, Wes read a lot about the condition so that he would know more about its causes and treatment.  Ollie spent two days in the NICU getting antibiotics because I was GBS positive and didn't get the meds in labor, and the doctors were worried that the combination of open skin lesions and lack of antibiotics put him at higher risk for contracting Strep B.  Fortunately, he was just fine, and a series of ultrasounds and visits from pediatric neurologists and even a neurosurgeon confirmed that his head was completely normal -- he was just missing the skin in two places.  Today, he has two thick scars on the back of his head, hardly noticeable at quick glance because of his white-blonde hair.  He wears a hat in all weather when he's outside to protect the scars -- and his super-fair complexion -- from the sun.  A month or so ago, we saw the ENT for a follow-up on his tubes, and the surgeon helpfully referred us to -- and scheduled an appointment for us with -- a plastic surgeon who specializes in cranio-facial and other scalp malformations.  (Clearly within the realm of what an ENT should concern himself with.)  I cancelled the appointment as Wes and I had previously decided to wait to do anything about the scars until Ollie was a bit older.

When Emme was born two weeks ago, Wes and I immediately looked at the back of her head (and laughed at each other for doing so).  And very quickly, Wes noticed the lesion -- only one, much smaller, and already half formed over.  Another week or so in the womb, and she might have been born with almost nothing noticeable there.  We both were and weren't surprised.  Nothing we'd read suggested that this condition would repeat in subsequent children.  No one in either of our families has had this or anything like it.  But clearly, there's something in the mix of our DNA that causes this.  Fortunately, it's subcutaneous only.  Emme, however, was born with her own additional skin deformation.  She has several congenital nevi on her body -- one small but dark spot on her left shoulder, a very large, dark and mottled band on the top of her right foot and around her right ankle, and several satellite spots, much lighter, on her right calf.  We learned a little about them from the neonatologist who saw her right after her birth, and yesterday, upon a referral from her pediatrician, she saw a pediatric dermatologist, who told us a lot more.  (Random side note: Turns out the dermatologist (Class of '77), plus his resident (Class of '02 or '03), also went to Davidson.  Four adults in a dermatology clinic in Nashville, TN, and they all went to the same, very small college.  Strange, but less so when you consider how many academic physicians Davidson turns out.)

The biggest concern with the nevi is that they can become melanoma.  The incidence of melanoma among Caucasians is 1-2%.  Small cases of congenital nevi carry a risk of 3-5% by adulthood, with most cases occurring in adulthood.  Large cases carry a risk of 5-10% with 3-5% occurring before the age of ten.  This time, it seems, we won't be able to wait.  We've been referred to a plastic surgeon, whom we'll see next Friday, to talk about doing a procedure to remove at least the large nevus on her right foot and ankle, which is the area that poses the greater risk.  The dermatologist described the procedure generally.  She'll be put under some anesthesia and have a balloon implanted in the healthy skin just above the nevus.  It will then be filled with saline every week for several weeks to stretch the healthy skin, just like what happens when a woman's pregnant belly stretches for a growing baby.  Once there is enough healthy tissue available, she'll have a surgery to remove the nevus and replace it with the healthy skin.  I hate to think of her going through this, but from a medical standpoint, it's pretty straightforward and relatively low-risk and low-pain.  It also minimizes the scarring.  The small nevi we can either treat at the same time or just watch over the years to make sure there's no change in the texture or thickness, which would be an indication of melanoma forming.  Wes and I are hoping it can be done this summer, when I'm home with her full time, so that no other caregiver has to monitor her during the process.

Dr. Smith also talked to us a little about our options for Oliver's head.  He said that it's probably best to wait until 3 or 4 years old, when the skull is fully formed and the fontanel is completely closed.  He can then undergo a straight excision and suture of the two spots, which will leave him with tiny scars that will be hidden by hair.  (Right now, the hair grows around the scars, which are each about the size of a nickel, but doesn't cover them.  It make a really interesting hair pattern in back!).  The dermatologist said it's a good age to get it taken care of, before kids start to really pick up on those kinds of differences and tease each other.  So it's something we'll consider in a year or so.  Emmeline likely won't need anything at all done, as her spot is much smaller and won't scar as thickly because it was already forming in at birth.

I think it goes without saying that I think my kids are beautiful and don't think they need to do anything at all, now or later.  I hope that my children are secure enough to wear their differences proudly and see how amazing they are, inside and out.  However, I know what kids can be like and how difficult it can be on a child to have such noticeable differences.  I'm probably more attune to it for Emmeline as a girl, knowing how, at some age, she's likely to be embarrassed or not want to wear certain clothes or shoes because of what it shows.  Part of me wishes we could wait on all of this until later, when my kids could choose for themselves what they want done.  But realistically, Emme's nevi pose some health risks that we need to consider.  And Ollie's scars are probably better dealt with before he's really aware of them and at an age when kids heal so much faster.  Wes and I feel lucky that both Ollie and Em are so healthy, despite these strange congenital issues.  I hate the thought of either of them suffering to have them fixed, especially if only for aesthetic reasons, but then, I guess that's part of motherhood.

This just in

Emmeline does not like pacifiers.  I actually tried to get both my children to take a pacifier, what with their non-stop nursing, and neither was convinced.  

Emmeline, so far

Emme has been with us in the world for 10 days now.  It's hardly enough time to get to know someone, but here's my best effort at how she's been so far.  For one thing, she's a peanut.  She's the same size as Oliver was when he was born, but she just seems so small (or maybe Oliver just seems so big).  She sleeps around 3-4 hour stretches but has had up to 5 hours, though not at night.  She nurses well.  We had some latch issues at first that made things pretty uncomfortable, but it's better now.  And I have a good supply -- there's probably 30-40 ounces in the freezer already, and two bottles in the refrigerator for the babysitter tomorrow.  Her nursing sessions are extended, though.  She nurses on one side, falls soundly asleep, then wants to nurse again ten minutes later.  I'm usually up almost an hour when I nurse at night.  She does have nice alert periods.  She picks up her head and gazes around.  She gets wrinkles in her forehead just like Ollie did and just looks so contemplative.  She was up for almost five hours, with maybe just a catnap yesterday, but I think it's because she has a little cold -- very sneezy and lots of mucus.  I got a humidifier today, and I've been using some children's saline wipes that somebody at work put in Wes's box.  When she's awake after naps, she's in a very good mood and is willing to lay on the bed or in her lamb chair and just be.  She does really like to be held, though, and she's spent increasing amounts of time in the wrap and carrier so that I can get things done.  She's started having more and more involuntary smiles in her sleep, which I love to see.  I can't decide if she has any dimples yet.  She absolutely hates to have her clothes and diaper changed, and she gets quite loud when either is done, though I think she's starting to get used to it.

As for looks, she's really different than what we expected.  She's so much darker complected than Oliver with his pale skin, pink cheeks, and blonde hair.  I honestly thought she'd look more like I did as a baby, and I'm not really sure who she does look like.  Her eyes are a deep, dark blue, so it's hard to know what they'll end up as.  She has thin lips compared to Oliver, but a similar chin and nose and brow.  She has some decent hair, but it's much darker than I would have thought.  Her eyelashes and eyebrows are coming in.  She has long, delicate, thin fingers, nothing like my beefy farmhand hands.  To us, of course, she is lovely, but in reality, she looks like just about any other newborn baby.    

We are all enjoying having her finally here.  I've yet to have a moment of wishing she were back inside me.  Wes has finally gotten some moments to snuggle.  I feel like he'd gotten to spend a lot more time with Ollie at this age, but household disasters and the presence of said first child and work have limited his time.  He did get a little face (or shoulder) time with her today during the football games.  Oliver also asks to "hold it," and now that I've introduced the Boppy to the setup, he likes to look at her and laugh.  She has her playpen and lamb chair in the living room, so she's in the mix of everything happening.

So that's our sweet girl.  So far.

A speedier delivery

Emmeline's umbilical stump fell off yesterday, which meant she was able to get her first real bath.  It almost means she's been home for more than a few days, which means a recounting of her delivery is most certainly overdue.  So here's the story.

I'd been having contractions, cervical pressure, even some rectal pressure for weeks leading up to delivery day.  I honestly began expecting an imminent delivery around 37 weeks, which is probably why it seemed like I was so late, when in reality Emme was born pretty much right on time.  So when I spent Wednesday afternoon feeling more uncomfortable than usual, I thought it was just another stage in the wait-and-see game.  By Wednesday night, though, the contractions, as I finally recognized them to be, were consistent enough that I started noting the time.  They were 15 minutes or more apart, irregular, and nothing that had me completely convinced.  I tried to sleep, but the contractions kept waking me up, so I moved upstairs to the nursery so that I wouldn't both Wes.  I tracked the contractions on and off with a timer on my iTouch.  Sometimes they were 10 minutes apart, sometimes more than 20.  I rested between then, but I didn't really get any sleep.  Many of them were painful, not just uncomfortable, and I was breathing, even groaning, through them.  By morning, they were 6-8 minutes apart.  Wes got up, got ready, and in my short time alone with Oliver, we decided he should go to daycare as I was going to get no downtime if he were to stay home.  I called the midwife, who assured me I could wait awhile to come in, and my mother, whom we asked to travel up if the roads were safe enough.  In the time I was up with Oliver and making phone calls, I got worried that the contractions seemed to drop off.  I would still have a painful one every once in  awhile, but some seemed really far apart.  It's like my labor was stalling.

I tried to go to sleep after Wes took Oliver to daycare, but once again, things were consistent enough to keep me awake.  I finally gave up and got in the bathtub, hoping it would give me some relief and either stop things all together or speed them up.  After I got out, I finished packing my hospital bag (which I'd gotten out the night before) and sat down in the rocking chair in the living room and started watching Anne of Green Gables (from which Emmeline's name comes).  My mom arrived.  Wes went in to work for a meeting, then came home and took a conference call.  The labor continued on as previously -- sometimes close together, sometimes a long time between them.  I was getting frustrated, feeling like nothing was as I expected or had experienced with Oliver.  I felt like I didn't know what to do.  Around 2pm, Wes pushed me to go to the hospital.  I was hesitant but knew I couldn't spent another 12 to 24 hours in this state and still have the energy to push a baby out.  So I called the midwife on call and instead got the triage nurse in the office.  She said I could go to the hospital or I could go to the office and get checked.  I didn't want to go home from the hospital because I wasn't far enough progressed, so I elected to go get checked in the clinic.

Wes and I got out of the house around 3pm.  I had one contraction in the waiting room (and was worried I was scaring the other very pregnant, but not laboring, woman there), then sat on the monitor for awhile with none.  I figured the midwife was going to think I was nuts, insisting I was in labor or even uncomfortable with so few contractions.  She talked about my options if I wasn't ready to head to the hospital -- including some "therapeutic rest" (which I think means some narcotics so I could sleep).  But then she checked me -- and I was 8cm, 0 station, 100% effaced with a bulging bag of waters.  She said as soon as my water broke, I would be ready to push.  And so we were off.

When I got to the check-in desk at the hospital, the woman behind the desk seemed in disbelief that I was there to have a baby.  I assured her that labor and delivery was expecting me, and she sent me back.  The nurses in L&D laughed when they saw me coming in.  They said, "We sure are impressed with Miss Elizabeth, walking in here like that at an 8."  They made me feel good about my progress, after such a strange labor.  I got changed into a gown, hooked up to a monitor, and had an IV put in so that I could receive the antibiotics for my GBS.  They asked me lots of questions -- "Highest level of education?"  Umm, still going.  The midwife came and saw me.  They weren't going to move along my labor -- by breaking my water, for example -- because they wanted me to get at least some antibiotic first.  There were no other laboring patients from the clinic, so the midwife sat with me for parts of the next hour.  She was very encouraging, told me I made it all look easy.  The contractions got slightly more regular and a little more painful.  I groaned through each contraction.  After about 6-8 of them, I started to feel pressure.  After a few more, the midwife offered for me to move, and I said I wanted off my back.  They laid the table down, and I immediately felt an overwhelming urge to push.  And so it was time.

With Oliver, I never felt the urge to push.  I got to the hospital, they told me I was complete, and they encourage me to start pushing because the situation seemed emergent.  I had to get myself to push.  This time, there was no way I could have not pushed.  The urge was so strong.  Melissa, the midwife, checked me with the next contraction and told me I could start.  And then, I couldn't stop.  I pushed so hard and couldn't get myself to stop between contractions.  I held tight to Wes's hand and just pushed and pushed.  There was a little screaming, a swear word, and a lot of self-help talk -- "We can do this.  We can do this."  (I think the "we" was me and the baby.  I don't know.)  I knew it was only going to last so long, but this pain was definitely more than I had with Oliver.  It was just all coming so fast.  There is no possible way to describe the feeling of pushing a baby out.  It feels like your body just can't possibly fit this thing out.  It hurts.  And then it's amazing.  Her head came out, and everyone told me to look down.  And strangely enough -- there was a baby there.  One I didn't recognize but that clearly was mine -- since about half of her was still inside of me.  They pulled her out and put her on my chest.  They left the cord attached until it stopped pulsing and then cut the cord.  Wes and I immediately started looking her over, both at her head, and laughed at each other for doing it.  He spotted the aplasia before I did, and though we both feared the possibility, we weren't worried when we saw it.  We knew what it was, and it clearly wasn't as serious as Oliver's case (only one spot, and almost filling in).  They let her sit with me for a little while before taking her to be examined.  Wes went with her as there were other concerns, including some skin abnormalities, and midwife tried to give me some time before putting in a few stitches.  They had some trouble getting me to stop bleeding.  I ultimately got Pitocin, Cytotec, and Methergine all to help with that.  My uterus was firm, but I was loosing large clots of blood even into the next day.  They brought Emme back to me so that I could nurse.  We had to stay in the delivery room until my bleeding was under control.  The nurse got me out of bed eventually so that I could go to the bathroom (an experience that made me very sympathetic for the my potty-training toddler, who is constantly watched to make sure he pees).  I got woozy on my way back to the bed, so they got me some applejuice.

We finally made it post-partum around 8pm.  Wes went with Emme to the nursery to get weighed and measured and have a pediatrician check her out.  They were gone awhile, and it was after 9pm by the time they got back.  Wes ended up staying the night at the hospital so that he could help me if I got woozy again, but I ended up being fine that night.  Emme slept okay, and it was mostly the endless parade of nurses, care providers, and other people checking on us that kept me from really resting.  The rest of the stay was largely uneventful.  I saw Emme's pediatrician, the lactation consultant, and the midwife the next day.  My mom and Oliver came over in the morning to meet the baby.  Wes spent Friday evening with us and then went home to sleep and came back for us the next day.

Wes asked me Thursday night if I would do it without pain medication again for the next baby, if I had to make the choice right in that moment.  And I said I would, if I were able to.  My labor this time was very, very bearable because the contractions were spaced so far apart.  But for the duration -- about 18 hours before delivery -- I never had a moment when I thought, "I wish I'd gotten an epidural."  And by the time the pain of delivery was there, it was way too late to consider that option.  And as intense as it is, there's a brief recognition of -- "Hey, that thing that really, really hurts down there is my kid coming out." And that's just cool.  

I'm coming home

Emme and I came home from the hospital on Saturday around 3pm. They made us stay almost a full 48 hours from delivery because I was GBS positive and didn't get the full dose of antibiotics while in labor. Wes and I have established a tradition of sorts (if you can call it that with just two children) of picking out a witty t-shirt for each kid to wear home from the hospital. It does not get passed down to younger siblings, but instead goes into that store of items that we will give to each child when they are older and perhaps expecting themselves. Oliver's shirt said, "I wasn't born yesterday." Emmeline's says, "I am not a boy." She's the first granddaughter, so I thought that was appropriate.

My sister has pointed out to me that this hat perhaps does not "go" with these pants, but I thought it was fun. Almost everything is too big on her right now, but this hat fits snugly. She wore it out another day last week and everyone commented.