Thursday, April 26, 2007

Another Thursday Sick Day

Charlotte is home sick again. This time, it's a stomach bug. Luckily it hasn't been a horrible one--I arrived at daycare yesterday just minutes after she had thrown up for the first time. Her stomach was OK yesterday evening and last night (she even ate dinner), and then threw up again this morning. This time, she actually made it to the toilet first. She's had two watery poopy diapers also--the second half of the stomach bug. The ironic thing is that I was probably going to keep her home today anyway, so that a friend and I could take the kids to the Magic House. I guess that will have to wait until next week.

Today is going slightly better than last week's sick day. Charlotte has been somewhat whiney, but really not bad, and even let me take her to the potty at one point without much protest. Nap time has not been fun. She wanted to snuggle, which I was willing to accomodate. Trystan apparently wanted to snuggle also, as he has not wanted to be put down most of the afternoon, so we attempted a Mommy sandwich (Trystan in the crook of one arm, and Charlotte in the crook of the other). All was going well, and Charlotte was nearly asleep, when Trystan started screaming. I tried to gently get up and walk him, and Charlotte woke completely up and was very upset. It took another 15 minutes to settle her back down and convince (coerce, threaten) her to lay down in her bed for "quiet time" while Trystan mostly cried in the other room. She quieted down just as I got Trystan quieted down. So, I think I've got both kids sleeping for the moment. *Yawn* This is the first quiet moment I've had all day. I'd lay down for a nap myself, but that's almost guaranteed to cause one child or the other to wake up (they're sleeping in separate beds in separate rooms...but I know how these things generally work).

Friday, April 20, 2007

Million dollar baby

The bills for Trystan's (and mine) medical care have started arriving. I guess they're not actually bills, but statements of the claims that are being made against our health insurance. It is amazing how much money the two of us have cost over the last several months. My prenatal care itself cost a fortune--I had 5ish ultrasounds, plus NST's 2x a week for 3 months, and weekly doctor visits for those same 3 months. Follow that with a C-section, though my hospital stay was a little shorter than normal (2 days instead of 4).

Then comes Trystan. First, there was a renal (kidney) scan at Missouri Baptist because of his "dilated kidneys" that had been diagnosed in-utero. Then the ambulance ride to Childrens. Two weeks in the NICU. Consultation with pediatric surgeons, followed by the colostomy. Two echocardiograms. Another kidney/bladder exam where they shot dye up his bladder and took X-rays to determine if there was any backflow (I'm sure that has a real name, but I don't remember). There were cardiologists, surgeons, an attending physician, a fellow, and our own pediatrician all following his progress during that time, in addition to the nurses and all of the supplies, medications, monitors, etc.

So far, I think I've seen bills totalling close to $200,000 for Trystan alone, and I don't think everything is yet accounted for. The largest charges are the NICU stay, and his surgery (the charge from the lead surgeon alone was over $65,000--that doesn't count the anesthesia, supplies, etc). And just think, we will have two more surgeries this year--one to repair the imperforate anus, and another to reverse the colostomy. If the recovery time on those are similar to the first one, we're talking another Half a Million dollars in healthcare expenses.

I feel so VERY VERY VERY lucky to have good health insurance right now. I haven't seen what our out-of-pocket cost will be, but I actually don't think it's very much. According to the insurance company's website, the "out-of-network" deductible is only $650 for the year for an individual, or $1500 for the family. The "in-network" deductible says "N/A", and all of the doctors, hospitals, etc that we've used are considered "in-network". I know that the prenatal care + birth was supposed to cost just the initial $10 copay (yes, that's total for the entire pregancy and birth)--I think mine was actualy double that because I had a second $10 copay for the group that did my level 2 ultrasound. Normal expenses for Trystan's hospital stay would be covered under that $10 payment, but I don't know if the transfer and surgery and all that is or not. In any case, I'm thinking that at best, we owe nothing more, and at worst, up to $650. I assume we will have co-pays for all of the follow-up care (which run from $10-50 tops).

Not bad for health insurance that doesn't even cost anything out of my paycheck. Did I mention that I love my job?

Wednesday, April 18, 2007

Painting the town red (really, Painting the Kitchen Purple)

Charlotte stayed home sick today. She was running a 103.8 temperature yesterday afternoon, and coughing, but by the time we arrived at the doctor's, she was neither coughing much nor feverish. We paid a $10 copay to be told that she probably has a virus, and to call if she gets any worse. I spent most of the appointment time with a kid on each leg, as both wanted to be held, and then I had to nurse Trystan before he would consent to returning to his carseat for the ride home. While her brother had a snack, Charlotte opened every drawer in the exam room, and then tried to wander out into the hall, leaving the door wide open behind her (not that I'm that shy about breastfeeding in "public", but other people sometimes freak out if they glimpse a little skin). That turned out to be the theme of the day: While I feed the baby, Charlotte tries to get into trouble. Today was my first attempt at handling both kids at home without help. Lucky me.

Charlotte fell asleep in the car on the way home for about 10 minutes, which she would later decide to count has her day's "nap". At home, she requested to paint with stamps--she has a craft kit that includes some craft paints, sponge roller, foam stamps, and paintbrush. I pulled out her supplies for her and set her to work on her little table, and then Trystan woke up and wanted to eat. In hindsight, I should have known that he would be hungry when he woke up (as I'd only given him half a feeding at the doctor's office), and should have planned accordingly. Just a note to any other mothers attempting to entertain a toddler while breastfeeding a new baby: activities involving paint are NOT a wise choice. Charlotte managed to paint her paper, her table, the floor, herself, her white sweater (which I'd actually taken off of her beforehand), and several of the kitchen cabinets with a pretty combination of pink, purple, lavendar, and turquoise. To be fair, she didn't actually try to paint anything but her paper, but she dropped her paint tray (a paper plate) at least once, and then opened up cabinets to find a clean towel to wash her hands with. I think she mistook the white sweater for a towel initially.

I attempted to coax Charlotte into a nap in the afternoon, but she wanted to snuggle, and then the baby wanted to eat at the same time, and Charlotte ended up wandering off to play with toys. I attempted to enforce "quiet time" where Charlotte had to stay in her room "quietly" for half an hour, but a poopy diaper cut that short (did I mention that she refused to use the potty all day, and so I ended up doing diaper changes on two kids?).

I took Charlotte to the park near our neighborhood to run off some energy. I don't think that pushing a toddler in a stroller while carrying a baby in a sling exactly counts as "exercise", but nor is it probably high on the list of recommendations for recovery from a c-section either. I'm tired. Thank goodness my husband got home early and took Charlotte to the grocery store to pick up dinner fixings, so I had at least a few minutes of quiet. It wasn't exactly downtime, as I ended up checking email with Trystan in my lap, but it was something. Speaking of which, the kiddo who's back in my lap seems to need both a diaper change and possibly to eat again.

Friday, April 13, 2007

Week in review

Friday, April 13

I'm not sure whether I have more energy or less than I did a week ago. Trystan has been home since Sunday, and I've spent most of the week hanging out in front of the TV, nursing him. A couple of nights, he's actually slept pretty well, and a couple of the nights he's rivalled his sister for the fewest minutes of consecutive sleep in a night. For most of the last day and a half, he's been cluster feeding--wanting to nurse every hour to hour and a half, pretty much around the clock. At the same time, I am starting to feel fairly normal. I'm not exactly up to olympic training or anything, but coughing and sneezing no longer hurt my c-section scar, and I can carry a load of laundry up and down the stairs ok. I'm also getting closer to wearing normal clothes again--my sweats all fit ok, and my "big" jeans (ones two sizes bigger than I normally wear) basically button.

This week, we've had a visit to the pediatrician, and two visits from a home healthcare nurse. Depending on whose scale you believe, Trystan weighs somewhere from 8lbs 4oz to 8lbs 7oz. I received a box of supplies from the medical supply company that was supposed to contain the things to take care of Trystan's ostomy--the bags that cover it and collect the stool, and the assorted accessories (adhesive, skin prep pads, etc). The box arrived and contained everything except the actual bags/pouches--when I called I was told that they were special order and wouldn't be in until next week. While the rubber gloves that they sent were oh so useful (I don't generally wear gloves when changing a diaper...maybe they'll go to daycare eventually), the actual pouches were the most important things in the order, and we are running out of the ones the hospital gave us. I got to talk to the manufacturer, who is sending me a few samples by tomorrow or Monday, so hopefully that will hold us until the real order arrives. If not, the nurse told me that there's a medical supply place in town that may stock the pouches. Worse case, I can improvise with a diaper for a day.

Yesterday was the first time I left the house alone with the baby. We went to the ped's office, and then I stopped by work--my coworkers had put together a new baby present :) I had sort of forgotten how long it can take to get out of the house with a baby, with last minute nursing sessions and crying spells as I attempted to buckle him into his car seat. I am happy to report that Trystan was quiet and even slept most of the time in the car--unlike his big sister who screamed bloody murder during every car ride for the first 4 months. I think by next week I will start picking Charlotte up from daycare in the afternoons again--I'm sure her daycare workers will be thrilled to meet Trystan :)

Monday, April 09, 2007


Daddy, Charlotte, and Trystan, attempting a nap, at home at last.

There's no chocolate bunny in this Easter basket, but somehow it didn't matter to any of us....

Look tubes!

First Night Home

Trystan's first night home has been pretty good. We had a relaxing afternoon, and then friends came over with their 2yo son to play with Charlotte after dinner time. Around then, Trystan's ostomy bag (the thing that collects the poop) started leaking, and he was due for a bath, so my husband and I prepared to bathe him and put on a fresh bag. Charlotte and her friend Gavin wanted a bath at the same time, so we had a confusing half an hour of bathing and changing 3 kids (the two big ones in the bathroom, and Trystan in the bathroom sink, which is how we always bathed Charlotte when she was this little), but with 4 parents on hand, it all worked out.

Bedtime went really well. My husband read Charlotte her books (we always give her a choice of which parent does the reading), then I nursed the baby, swaddled him up, and laid him down in the cradle next to our bed. He settled down without any trouble, and slept. In fact, he slept for nearly 5 hours before I finally got him up to eat again. He was occaisionally waking up and sucking on his fists (a sign of hunger), but would fall asleep again on his own. That was around 3am, and he then went right back to sleep and didn't wake up hungry again until 6am. After eating at 6, he (and I) snoozed again until 7ish when my husband was waking up and getting ready for work.

I know it's way too much to ask, but if he does this at least a lot of the time in the coming months, then I'll be in heaven, and basically as well rested as I was when pregnant (actually, I think I was getting up more often to pee a couple of weeks ago).

Sunday, April 08, 2007

He's Home!!!!!

Trystan came home today! My husband, Charlotte, and I went to a 9:30 Easter Mass, and then to the hospital to pick up our baby. We had a rolling cart loaded down with stuff (ostomy supplies, a cooler full of frozen breastmilk, bags of dirty baby clothes, etc) and a wagon full of children (well, a toddler and a baby in carseat--they pretty much filled the wagon, though).

This afternoon's been good, and relaxing so far. My sister-in-law and brother-in-law joined us at church, the hospital, and then back to our house for a very casual Easter lunch (a pre-cooked ham, corn, deviled easter eggs). Trystan has nursed a couple of times, and fallen asleep on my husband, and Charlotte watched her Easter Carol Veggie Tales movie. So far, he's a pretty laid back baby, as long as I don't keep him waiting for his supper for too long (his cries have gotten MUCH louder over the last week). Speaking of which, his nap must be over...

Friday, April 06, 2007

Looking forward to Easter

It looks like Trystan will be coming home on Easter Sunday!!! He has been doing well all week. Wednesday night into Thursday, he was able/willing to take all of his feeds by mouth without having the remainder fed down his feeding tube. They gave me the option yesterday morning to remove the tube for the day, but having seen how mad the poor guy got at having it inserted, I told them to wait until they were sure he wouldn't need it back. He nursed really well all day yesterday, though he was gassy (I had pepperoni pizza the night before..somehow I think that was related). Today, the nurse removed the tube, and he again nursed extremely well all day. I have a couple of photos of the little guy with no tubes attached to his head for the first time in two weeks...but I don't have the USB cable handy to get them off the camera, so ya'll will have to wait to see him.

Tuesday, April 03, 2007

How I'm doing

We have had a lot going on the last two weeks, and I have taken very little time to post, or even read my email. So far, I've posted a couple of times about Trystan. There's quite a bit more I could mention, but first, I think I'll answer a question that I get a lot: How am I doing? :)

Let's start with Trystan's birth. As I posted previously, I was hoping to have a VBAC this time. To this end, I didn't want any induction, or drugs to help contractions, or pain relief, as all of these things can make you more likely to end up with interventions. After going in and out of labor for a week or so (including a couple of false-alarm trips to the hospital), I finally went into real labor Wednesday, March 21. Early in the day, I took Charlotte to the zoo with a friend and her son, hoping to enjoy the beautiful spring weather, and to walk myself int labor, and it worked. By evening I was having contractions that were pretty regular. Around 2:30AM the contractions were strong enough to keep me from sleeping, and I labored at home on a yoga ball and walking around until closer to 4. We drove into the hospital, and I was told that I was at 4cm dilated, but that the baby's head was still pretty high. I labored all morning, and by 10AM, they checked me again, and I was still 4cm dilated, with the baby's head not at my cervix. At this point, I talked to my OB, and he suggested that we go ahead with a C-section, as my contractions (which were painful and regular), were not successful at moving the baby down. I think that was a good decision, as I was tired but not yet exhausted, and I'd been laboring for like 6 hours with no discernable change. I remember this C-section a lot better than I do Charlotte's because I wasn't as exhausted to start (not having labored for 17 hours and pushed for 2 more). Trystan was born at 12:52PM. I think my hip bones are not built to allow a baby's head out...a 6.5 pound baby got stuck, and the 7lb 12oz one never even made it to the birth canal.

The first 24 hours went pretty normally--I was a little nauseous after the delivery, but was able to nurse Trystan fairly quickly (we didn't yet know that he shouldn't be eating). By morning, my OB stopped by and OK'd solid food for me, so I didn't have to spend a day on "clear liquids" like I did last time. Mid-morning on Friday, they removed my catheter and I was able to hobble to the bathroom without assistance--I felt MUCH better and stronger than I had after Charlotte was born. That turned out to be a huge blessing, as one of the nurses discovered Trystan's lack of an anus around noon, and he was on his way to St. Louis Children's hospital by 1 or 2pm, and I could ride in a wheelchair down to the nursery to say goodbye to him before he left. I cried a lot Friday afternoon. My husband and my mom rode with Trystan to the other hospital, but I had my baby sister (she's 10) to keep me company until my mother-in-law came with Charlotte around dinner time.

Friday night, I took a shower and put on a fresh nightgown of my own, and slept OK. The nurses had brought a breastpump into my room as soon as Trystan left, and I took comfort in pumping for my baby since I couldn't hold and nurse him. Saturday morning, my OB came by and discharged me so I could go to Children's for Trystan's surgery. He, along with our family pediatrician, and all of the doctors and chaplain at Missouri Baptist were all wonderful. The nurse loaded up a cart with diapers, nursing pads, bottles, and pads for us to take home. My in-laws brought me clothes and drove me to Childrens.

I spent the next couple of days being wheeled around Children's in a wheelchair, relaxing in the recliner in Trystan's room, hobbling down the hall to the NICU's pump room, and sleeping in my own bed at night after kissing my daughter goodnight. By the Tuesday after Trystan was born, I was in good enough shape to walk (slowly) in from the parking garage instead of taking a wheelchair. By Thursday, I was able to skip the stronger painkiller and just rely on ibuprofin, so I could start driving myself to the hospital.

I am beginning to feel like a milk cow. I was instructed to pump 6-8 times a day to help my milk come in, including at least one time overnight. I have a good breastpump at home from when Charlotte was still nursing, and I can use the hosptial-grade ones in the NICU while I am there. Like my general speed of recovery, my milk supply has been a bright spot during the last two weeks. I nursed Charlotte until she was nearly 20 months old, and my milk came back in quickly, and with a vengeance. I am currently getting 6-8 ounces at every pump, which is probably twice what Trystan would be eating. I'm afraid to back off of the pumping too much, because it will be hard to rebuild later. In the mean time, we've dedicated a whole shelf of our deep freezer to the milk that I'm pumping at home. I also have a lot of milk at the hospital that I pumped while Trystan was not yet eating. I guess I won't have to stress about having enough stored milk when I go back to work in a couple of months... Now that Trystan has finally started breastfeeding again at the hospital, I'm not pumping as much there, and what I do pump is stored in a refrigerator for overnight feedings. Amusingly enough, I didn't start leaking any milk until he started nursing again, and now I have to watch my shirt after I feed him to make sure I'm still decent.

In general, I'm feeling pretty good. I am not crying all the time--I won't pretend that I'm happy-go-lucky at the moment, but I don't seem to have the baby blues. I'm able to walk and drive and am getting better at bending and stretching every day. My milk is not a source of stress. I'm able to spend my days sitting next to my baby, holding him and nursing him, much like I would do at home. I am looking forward to spending my evenings and nights with him also, which will hopefully be soon!