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Archive for December, 2009

YANOB

I saw Yet Another New OB (YANOB) today. I don’t like him, but he’s willing to take me on. He didn’t give me any crap about a VBAC, nor about not wanting an epidural in place (provided that I understand that in the event of an emergency C-section, if they can’t get a spinal in, they’ll do general anesthesia and my husband won’t be present at the delivery. Frankly, that’s the least of my concerns – and anyway, if I don’t get to be there, why should he? We’ll have a lifetime to bond with the baby, so in the unlikely event of an emergency, I’m willing to forgo those few minutes).

He talks fast and doesn’t really act like he’s listening. He’ll ask a question, I’ll start to respond, and he’ll be talking over me before I’ve got two words out. I hate that. But so long as the perinatologist is on board, he’s willing to manage my care concurrently with them. He’s fine with me doing Progesterone injections for PTL prevention. If the perinatologist doesn’t want to order it, he will. He’s fine with the steroid course I’m on. He’s fine with my home health care company. The office staff is all really nice (at least the ones I’ve interacted with so far), which is a plus. It’s a huge practice, which in my opinion is a downside, but on the other hand, it also probably contributes to why they didn’t shy away from taking me on.

I just wish I had the luxury of picking a doctor that I like. Meh. I guess it doesn’t really matter.

He doesn’t deliver at the hospital that’s five minutes away (where Seth works, for crying out loud). So I’ll have to go half an hour (or more, with traffic) away to deliver, but I’ll live. It’s a fine hospital to deliver at, so I don’t really have an issue with that – it’s just way less convenient and frustrating because it would have been nice to be at the hospital my husband works for, but beggars can’t be choosers.

So, yay?

I wish I were more excited about it than I am. I would probably be more excited if I’d loved him, but I don’t. Oh well. I’m seeing my perinatologist tomorrow, and then back to YANOB in two weeks. We’ll see how it goes. At least I have someone I can call if something goes wrong now…

Um, that’s not an invitation for something else to go wrong.

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Backward

My officemate, who I haven’t seen for over a week because she was on vacation, looked at me today and said, “Every time I see you, you’re skinnier than the last time.” Admittedly, when I turned to the side to show her my profile, she knew exactly where its all going. Still, it’s disturbing that I’m thinner yet… you know, pregnant.

Well, you know? I always said I was just one triplet pregnancy away from my ideal body weight. Turns out, it’s just pregnancy. Maybe I’ll be a perfect size 6 when this is all done and over with.

Ahem. I am not counting on that, just for the record.

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The Upside

So I don’t really feel like the steroids have helped a whole lot with the hyperemesis. I felt marginally better the first few days and kept a couple crackers down here or there, but not enough improvement to really be able to say it was the steroids that made it better. But there *have* been some benefits:

  • The inflammation around my PICC site is almost entirely cleared up. I am quite certain that it is the steroids responsible for it because when it gets close to time to take the next dose, it starts gettting puffy and itchy again and recedes within half an hour to an hour of the steroid dose.
  • My headaches/migraines are much improved. Not absent, but not constant either.
  • The sciatica that had left me nearly completely immobilized last week is almost gone. I have occasional twinges here and there if I step down wrong, but nothing crippling like before I started the steroids.
  • My overall itchiness? Just about gone. Before starting the steroids, I was so agonizingly itchy that my skin was raw from all the scratching. Nothing had helped it. Also? I no longer seem to be getting a rash from the Phenergan – I don’t know if this is related to the steroids, or just that I have acclimated to the drug. Either way – less itchy is awesome.

But, by far, the most intriguing side effect of the steroids is that I have a ridiculous burst of energy much of the time. Even yesterday when I felt more dreadful than I’ve felt in weeks (possibly months) – I had plenty of energy. My husband was working in the afternoon/evening, so I was on my own from about 2:30 on. Just as the triplets were waking up from their nap. I expected this to spell disaster given how yucky I was feeling, but I had plenty of energy for them. I gave them a snack, played for a bit, and did a bunch of cooking. I made three large mac n’ cheese casseroles (2 for the freezer) and toffee/chocolate chip/pecan cookies. Last week I made a big pot of beef stew (frozen in 1-2 person portions, depending on the person), curry chicken, schnitzel, sweet potato pies (I had three of the most ginormous sweet potatoes I’ve ever seen in my life – and they made three pies!), and white-cholate-chip brownies (the brownie mix came in a box, so it doesn’t necessarily count – but J helped and had a ball. He also helped with the mac n’ cheeses and the cookies).

I have never been good at cooking and freezing things. If I cook something, I want to eat it now, not later! I always think I’ll take a Sunday and cook kugels and casseroles and soups for the freezer so that I’m not so slammed all the time when it comes to cooking. But it never works out that way. Recently, though, J has been super interested in cooking with me, and it gives us things to do together with relatively low stress. It also makes him SLIGHTLY more willing to try foods if he’s had a hand in making it. Though he still wouldn’t eat the mac n’ cheese casserole. Oh well.

I wonder if this is what "nesting" is like. It’s way too early for me to be nesting (I hope!), and with the triplets, I never got to really know what nesting was like – I was on bed rest forever and so sick I didn’t have any energy most of the time, but I did have a couple days here or there when I would freak out about needing to clean and so and purge. I remember one day when Seth and J were out doing yardwork and I suddenly freaked out about space and I waddled out and said, "We have to get rid of the piano. I never play it, I’m definitely not going to have time to play it with three babies in the house, and it’s taking up SPACE! We could put a whole shelf, a changing table, feeding table, something, ANYTHING in that space! It has to go!" Seth looked at me, looked over at J, and turned and said, "I think perhaps we’d better come inside to work instead of being out here. I spent the rest of the afternoon in the attic freaking out about all the stuff we needed to get rid of. And purge, I did. But that was the exception, not the rule. Technically I shouldn’t have been up there at all, but fortunately, that was before some of the scarier times in the pregnancy.

I have niggling little thoughts about all the crap in our attic often, reminiscent of that summer day with the triplets, but hopefully I’ll be able to squelch it this time. Surely the cooking is at least useful. And I do have in my mind that we need to have stuff in the freezer, because I’m petrified that I’ll get to a point where I just *can’t* cook and I’ll have this family who needs to eat. J could live all year on chicken nuggets and apple slices, but Seth hates cutting up apples. And surely, the triplets ought to have more variety than that, lest they end up with such a limited palate as J.

It’s not nesting, really, but the energy sure is welcome.

So the steroids kind of suck (side effects e.g. severe reflux and oral thrus aren’t any fun), but overall? I’d argue that my quaility of life, for the moment, is largely improved.

Except, you know, the throwing up part.

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We’ve joked (okay, we were never joking when we said it) that the triplets combined are still less work than J is. And really? It’s been true. Part of that is the challenge of handling a child with ADHD, learning disabilities, and anxiety, and part of that is that the older a kid is, the more complex his needs. He’s less content to sit and play with blocks all day than he was when he himself was 2. He’s got school projects, therapy appointments, field trips, friends he wants to see… it just *is* more work to care appropriately for a six year old than for a two year old… even when the two year old comes in triplicate. But mostly, it’s the ADHD et al.

Until now.

I think we’re finally reaching a point where the triplets are higher maintenance than J. (Certainly, they are higher maintenance than he was when he was 2 – he never stopped moving long enough to get into anything, climb anything, empty anything out, or wreak havoc in general…)

The triplets, see, they are a team. And they’re crafty – plus they teach their tricks to the others. Ellie’s a master climber and although Sam couldn’t get the hang of climbing for a long time, inspiration from his sister got him moving and climbing. Abby can throw a temper tantrum better than any two year old I know – and she’s taught her tricks to the others along the way. Sam and Ellie got tired of being pushed, poked, pulled upon, and hit by their sister Abby – so now they gang up on her. Ellie and Abby mastered climbing in and out of cribs and Sam had to get in on the fun (though it took him almost a year longer to figure it out than it took the girls).

And now. Now the diapers. The girls have been little houdini-diaper-escapers for a long time. At least a year, I think. We’ve tried onesies. We’ve tried duct tape. We’ve tried backwards footie PJs. We’ve tried a onesie over a backwards footie PJ over a duct taped diaper. But they can get out of anything, especially Ellie. Not Sam. He was the good one. The one I said gets to go to college on account of his good behaviour (and his apparent lack of creativity necessitating more thorough eduction! JUST KIDDING). Until yesterday, that is.

Seth was working all day, so I had the four kids on a day when, you know, NOTHING is open so no activities to take them to. Seems like there’s this universal affinity for celebrating Christmas. I don’t begrudge it, but it sure would have been nice to get out of the house to a child-friendly activity. Who am I kidding, though? I probably wouldn’t have gotten motivated enough to get out of the house anyway… it was a Friday, after all.

Anyway, yesterday I put the triplets down for a nap. And of course they have no cribs anymore, so naptime is always a crapshoot. If I’d been smart, I would have stayed in their room until they fell asleep, but I wanted to get some things done. So instead, I wasted even more time by going back to their room to put them back in their beds over and over and over. At some point, it was clear that they were having a … little TOO much fun in there, so I went to assess the situation.

And I found three completely naked babies running around like maniacs. Yes, even Sam.

It seems that no one’s going to college. ūüėČ

It could have been a fluke, right? I mean, Sam’s never done that before and it’s been WEEKS since I’ve found the girls without diapers. This was just a one-time thing, right? RIGHT????

Nope. Fast-forward to bedtime tonight… three toddlers running around like maniacs. Naked. I re-dressed them, put them down, waited for them to calm down and get sleepy, and then left the room. I heard them up afterward, but they weren’t too wild, and it was clear that they were winding down and getting tired.

Until I heard Sam screaming hysterically, so I dashed to the room as quickly as this pregnant body would allow only to find:

1 wide awake Abigail, fully clothed, and laying on her mattress sweetly,
1 frantic Samuel diaperless, PJ-less (though he still had his onesie on… and socks), soaking wet with pee,
1 sleepy Eliana, face-down on her bed, stark naked, with a moist, crumpled diaper next to her Teddy Bear.

I suspect we’re in for a few weeks of hell until they get over this particular fascination of theirs. But it’s fair to admit, at this point, that the triplets are starting to become just as high maintenance as J – in their own special ways. There’s much more refereeing to be had with the triplets, much more negotiating, much more parental attention to ensure they’re not hanging off the ceiling fans.

Why, J is looking downright low-maintenance right now. Provided he takes his medicine. At least, when all else fails, I can sit him down with a book, the computer, or a quick activity to get a break. And he’s also becoming much more helpful in general – he loves to help sweep, setting the table is a special chore I “let” him help with, he wants to cook with me as often as possible, he even helps clean up the triplets’ messes without (much) complaint. He can make his own bed (not perfect, but who cares about perfection?), he’s good at cleaning up his room (most of the time), he has simple needs when it comes to food (one benefit of being the world’s pickiest eater is that I don’t have to struggle to give him new flavors – he won’t eat them anyway… I”m kidding, of course, I do have him try new things often, but there’s comfort in knowing he’s got his old standby’s to eat and won’t get bored of them).

I wonder how I’ll feel about the high vs. low maintenance aspect when I have a ten year old, three six year olds, and an almost four year old….

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Failure

I spent a long time writing this post, erasing, re-writing, debating, questioning … and I have mixed feelings about publishing it. ¬†I know that we all struggle as parents sometimes, and I know that, for the most part, I am a good parent. ¬†It’s just that sometimes I wonder if I’m good enough. ¬†Sometimes it’s hard to admit that “good enough” has to be good enough.


They say about kids with ADHD that the adults in their lives are constantly holding their successes against them. ¬†“I know he can stop being impulsive – he did just fine yesterday!” or “I know she can sit still and concentrate – I’ve seen her do it!” ¬†The fact is that the only thing that ADHD kids are consistent about is their inherent inconsistency. ¬†There are successful moments when the whole universe falls into alignment – but that doesn’t change the underlying disorder that kids with ADHD suffer from.

This I know, and embrace, and believe. ¬†But sometimes knowing that a child can’t help themselves doesn’t change the frustration in the moment when things aren’t falling into place. ¬†Thing is, J-man went a solid six weeks with nearly no behavioural issues, with nearly no fighting about taking his medicine, with nearly no less-than-optimal days at school, with nothing but successes packed in his corner. ¬†So when things started falling apart again a couple weeks ago, well, it was really hard to remember that he can’t control this and that just because things were working for a while doesn’t mean that the current behaviour is totally within his power to change.

Two weeks ago, I called Ye Olde Developmental Pediatrician to say that it’s just getting harder, not easier, to get him to take his morning medications. ¬†It had been relatively easy when he was taking Prozac, but we found that the Prozac was over-activating the ADHD (a common side effect of Prozac in kids is hyperactivity). ¬† Our next try was Zoloft, which wasn’t helping at ALL and his anxiety about taking medicine by mouth became completely out of control. ¬†YODP and I had a heart-to-heart about it and he said, you know? ¬†Maybe we just need to accept that J just can’t take medicine by mouth right now and we need to just see how he’ll do in the short term with the Daytrana and Clonidine patches alone. ¬†If you can’t solve the problem, eliminate it.

So we tried that.

And… it was a colossal disaster.

I admit, the hardest part of the only-patches trial for me was the feeling of failure. ¬†I had failed this child, again, in trying to help him push through his anxiety so he could just take the medicine, for the love of pete. ¬†After all – we *know* he can take medicine without fighting it – he did it for six solid weeks! ¬†Surely he can do it now! ¬†Except, see? ¬†That’s me, holding his success against him rather than helping him through the less-successful times. ¬† ¬† But we pushed through it, got him back on Prozac, had a few excellent medicine-taking days, and though he was a little more active than I’d like, thanks to the Prozac, he was otherwise having success.

The trick, I found (at least for a few days) was to not allow him to see me getting tense over his medicine. ¬†He picked out a special treat ahead of time (I used to make him wait until he was done taking the medicine) and then put the treat AND his medicine on the table and walked away. ¬†Walking away was the key. ¬†If I saw him hemming and hawing or whining or crying about the medicine, I lost all sense of empathy and just got tense – which only made matters worse. ¬†Leaving him alone meant he pretty much took his medicine within a “reasonable” period of time – even if not as quickly as I would have liked. ¬†But it worked.

Until today.

Today he wouldn’t take it. “I wish I could take my medicine in the kitchen.” ¬†Fine, we moved to the kitchen. ¬†“I wish I could take my medicine at the table.” ¬†Fine. ¬†We moved back to the table. ¬†“I wish…” and I walked away, realizing I was falling into the trap I’d so gracefully avoided the rest of the week. ¬†When I came back, twenty minutes later, he had eaten his special treat – but hadn’t touched his medicine. ¬†I wasn’t graceful about it, either. ¬†I was, I’m ashamed to say, furious. ¬†And again, I was failing him.

Today was a very bad day for a lot of reasons, despite there having been a lot of good. ¬†It’s days like today that me wonder if I will simply fall into the traps my own parents fell into. ¬†My memories of my mother while I was growing up are… universally unpleasant. ¬†I know that there were lots of good times, and she did lots of good things for and with us. ¬†I know that she probably had more strong points as a mother than weaknesses. ¬†But that’s not what’s etched into my permanent memory of her in that period. ¬†Will my children see me the same way?

I realize now, that what I needed to do was walk away. ¬†Forget about the stupid medicine. ¬†Let him be unmedicated for a day. ¬†Truthfully, the consequences of an unmedicated child wouldn’t have been any worse than the consequences of fighting about it for so long. ¬†More than two hours before that kid finally took his medicine. ¬†And he didn’t do it until we had both calmed down. ¬†A lot. ¬†I went into his room once with the medicine in my hand – I had been crying from the frustration – and he said, “Are you okay?” ¬†He was concerned about me and my puffy red eyes. ¬†In the midst of this unbelievable struggle, this boy needed to make sure his mommy was okay.

The fact is, when we have days that we struggle, like today, I forget about the joy that he brings to everyone around him. ¬†I need to re-group and re-focus on all the positives that he has. ¬†He’s the most kind-hearted child I have ever met, and I can’t honestly imagine our lives without him. ¬†He cares about everyone, he’s concerned if the triplets are upset, he brings them blankets when they’re sad. ¬†If I’m sick, he covers me up and tucks me in, pats my arm and says, “I hope you feel better soon.” ¬†When he sits down for dinner he asks, “Are you going to join me? ¬†Do you think you can eat a pretzel today?” ¬†Unfortunately, I haven’t been keeping even pretzels down anymore. ¬†“That’s okay, Eema – you can just sit with me until you feel better.”

He is, in so many ways, thriving. ¬†Things are starting to fall in place with his speech pathologist and he’s really getting the hang of this reading thing – he’s started to recognize a few words on sight. ¬†He can write his name – a feat that seemed impossible a year ago (though, I admit I wasn’t so pleased to discover that he had practiced writing his name ¬†with a marker… on his wall!). ¬†He loves school and is engaged and interested in learning. ¬†On his good days, which to be honest far outweigh the less-good days, he is eager to learn, gets upset if he thinks the class isn’t going to do “centers” (when they focus on math or reading or science, or whatever). ¬†He is a beam of sunshine most days. ¬†He is a leader in his class – and all the kids look up to him. ¬†On his good days, he’s a powerful and positive leader. ¬† Fortunately, he mostly has good days.

He shares, he loves, he giggles, he laughs. ¬†And yes, he struggles. ¬†Don’t we all?

Sometimes, we get lost and can’t see the whole forest – just the one tree that isn’t faring as well as the others. ¬†But if I’m honest with myself – the positives far outweigh the hard times. ¬†It’s just that when things are going well, we forget to notice them.

But this little boy has nothing but love in his heart. ¬†He has so much joy to bring to the world. ¬† He has brought so much joy into our lives with his toothless grin ¬†and his dreams of a future filled with unlimited bionicles, bakugan, and dinosaurs. ¬†I just hope that tomorrow, when I’m struggling to hide my tension about him taking his medicine, I can remember and focus on all the good instead of focusing on that moment and ruining it all. ¬†After all – the truth is, he can’t control this right now. ¬†He can’t just decide not to fight the medicine. ¬†The medicine is treating a disorder that is characterized by a true inability to be consistent, a true inability to control impulses. ¬†Sometimes knowing that he “can’t help it” doesn’t make it easier in the moment. ¬†But it does help when you’re trying to find a tiny grain of empathy in your body for your child.

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Making the Best of It

The steroids aren’t helping the hyperemesis so much – but they are doing other things. ¬†I had crippling sciatic pain ¬†before I started the steroids and that barely flickers anymore. ¬†The inflammation around my PICC site is hugely improved. ¬†My overall itchiness is nearly gone. ¬†And I have extra energy I didn’t really expect to have (it’s still not enough – but it’s better than nothing!).

The steroids aren’t without their disadvantages – the reflux is nearly intolerable, but today I managed to keep some Zantac and Prevacid down, so hopefully tomorrow that will be better. ¬†The thrush sucks and I’d like it to be gone now, but it’s tolerable. ¬†Today was better than yesterday. ¬†Yesterday I was seriously contemplating calling my doctor on Christmas to beg them to find a 24 hour pharmacy that could fill a script to FIX IT. ¬† If you know me at all, you know that I would normally never consider interrupting a doctor’s holiday for something not life-threatening. ¬†But … honestly, I wouldn’t have been able to pick up a script regardless – I had all four kids and my husband was working. ¬†No way was I taking everyone out to pick up a prescription.

I admit, the wave of energy (well, it’s a trickle – but still more than I’ve had) has been helpful. ¬†I’ve been able to get a fair bit of cooking done, so I have some things in the freezer for the days when I just can’t bring myself to cook for the family. ¬†I’ve spent some good time with my kids. ¬†I’ve gotten somewhat caught up at work.

I love being pregnant in so many ways. ¬†This baby is squirming around a lot and I find it so incredible to know that I’m growing a whole human inside me. ¬†The miracle of this pregnancy is not lost on me and I *do* appreciate it. ¬†I love that the triplets point at my belly and say “Babies!” (though I wish they’d stick to the singular!). ¬†I love that J keeps saying “I hope it’s a brother! ¬†… or a sister!” ¬†(mostly he asks for a brother, but acknowledges that a sister would be good, too). ¬†I love that I have this baby growing. ¬†I cherish my growing “bump” (that is ridiculously huge considering that I still have months and months to go!). ¬†I joke that I am *never* doing this crap again on purpose, since it turns out that it’s pregnancy, not just triplet-pregnancy, that doesn’t agree with me ¬†– but the truth is? ¬†I’d gladly go through this all over again to have another baby if we decided that was right for our family. ¬†But there is also, oddly, some comfort in being this sick – I know that I will be comfortable deciding that our family is complete – knowing how hard we struggled to get there. ¬†I used to wonder if I would ever be comfortable with that notion, but now I know I can.

I feel dreadful, but nearly everyone tells me I look great. ¬†And you know? ¬†I feel great knowing that there’s this toy surprise at the end of all this.

I’m not really sure what my point is, but I guess, mostly, I wanted to make sure that I capture at some point the fact that pregnancy isn’t ALL misery. ¬†Even through the throwing up, I am overjoyed to be privileged enough to carry this baby. ¬†Even through my irrational fears and requisite infertile DBTs, I can’t wait to meet this little person – the next (probably final) addition to our family. ¬†I am humbled to know that I have been entrusted with another little life, and to know that my successes and failures in parenting are in my control. ¬†I know that I am not a perfect parent, but I will always strive to be the best that I can be on a given day. ¬†Some days, of course, are better than others.

I still don’t have an OB, but I have an appointment with a new practice on Tuesday and a perinatology appointment on Wednesday. ¬†One way or another, this obstetrician dealio is going to be resolved this week, and it feels good to assert that. ¬†Anyway, I still have the yurt as a back up plan.

(but hey, baby? ¬†Can you stop kicking my bladder and my cervix? ¬†That’s not nearly as much fun as the rest of this pregnancy. ¬†Seriously!)

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Insult to Injury

So I started taking IV Steroids Friday night. ¬†It definitely helped the inflammation around my PICC site, and I’m generally less itchy. ¬†I think my headaches are a tad better. ¬†But I’m still really nauseated. ¬†It helped a tiny bit the first couple days and then we started tapering it, and… ¬†disaster. ¬†I don’t know how long I can really stay on a high dose of steroids, but it’s honestly not helping enough for me to want to put up with the side effects and any inherent risk.

Truthfully, the horrific reflux was enough to make me want to get the hell off these steroids. ¬†But now? ¬†Now I have thrush on my tongue/in my throat. ¬†The last time I had oral thrush was in 2003 when I’d been on long-term heavy-duty antibiotics. ¬† The triplets and I battled thrush for five months while I was breastfeeding them, and admittedly, thrush *there* is far more painful, but I don’t really want any kind of thrush again! ¬† ¬†So now my tongue hurts, it hurts to swallow, and it’s excruciating to put anything on my tongue. ¬†Fortunately, I’m not eating anyway, right? ¬†So it’s not like I’m missing out. ¬†Much.

Is the cure worse than the disease? ¬†No. ¬†If I weren’t throwing up anymore, I’d definitely think it was worth it. ¬†But this is still like adding insult to injury.

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