Tuesday, October 21, 2014

The First Two Weeks

We expected that the first two weeks at home with both the boys would be difficult, but it turned out to be even worse than we anticipated, and for a totally unexpected reason. Hand foot and mouth disease finally found its way into our house.

On the Tuesday after we came home from the hospital, Lucas started acting out much worse than we're used to. Lots of tantrums and general irritability, but since it coincided with Lincoln's arrival into our house, we all chalked it up to sibling adjustment and tried to ignore it. I felt like such a jerk of a mother when after two days of cranky Lucas, I finally made the connection with HFM that he was sick on Wednesday night when he spit out a bite of banana (his favorite food) while crying and saying "ow."

Anyone who tries to tell me that HFM is just a mild childhood illness is liable to get kicked in the teeth, because this was the worst sickness we've ever had to deal with from Lucas in his lifetime, and that includes RSV and croup. The problem was that his mouth sores caused him a lot of pain when eating or drinking, so he simply refused to eat or drink much of anything for the next four days. If you know Lucas, you know that he is King of the Hanger Tantrum, which is why I take such care to keep him fed with plenty of protein and nutrient-dense foods throughout the day. Since he wasn't eating anything, we basically had to deal with a hangry, irritable Lucas for 12 hours a day until he finally started feeling well enough to eat again. Combine this with me still in recovery from giving birth, and the constant needs of newborn care, and it was basically the worst week of all time.

We tried our best to keep the boys separated, and wash our hands whenever we switched between them, but I began to notice a marked increase in lethargy in Lincoln around Monday, just as Lucas started getting better. On Tuesday afternoon, I took his temperature - 100.4. Very low-grade fever, but with infants as young as Lincoln, you really can't take any chances so his doctor advised that we take him into the emergency room to get checked out. I was 95% certain that he had simply caught HFM from his brother (he had one visible sore inside his lip), but dutifully brought him in anyway.

Upon arrival at the Rady Children's Hospital ER, I was promptly informed that for a baby under one month, any fever meant that he needed to have a full septic work up to rule out any serious infections. This meant 48 hours of testing and hospital admission for my tiny sweet boy, including a urine catheter, blood draw, spinal tap, and two days of precautionary IV antibiotics. He was so sweet and brave during the tests, the nurses and doctors were very impressed by how calmly he took everything. I had to handle the majority of the ER and hospital stay on my own, since Brandon was stuck at home caring for Lucas. I think I held it together pretty well for someone only 10 days postpartum!

We spent the first evening in the ER, which was the worst of it because this was the only time he actually seemed sick and I had to watch him get stuck all over with needles while surrounded by screaming children in pain. Once we transferred to the pediatrics unit at a hospital nearer to home (Lincoln via ambulance, with me following close behind in the car) and were admitted to a private room for the remainder of our stay, things were a lot calmer and easier to handle. Lincoln's fever was gone by the next morning, but we were asked to stay for the full 48 hours until the tests could confirm that there was no bacterial infection and we were just dealing with a run of the mill virus.

Not feeling too good in the ER.

I started calling him Little Lionheart for being so brave during all his tests, mostly inspired by this hat.

The doctor also noted that his illness had exacerbated his mild jaundice, and prescribed him some time under the bilirubin lights to "de-yellow-fy" him a bit since we were stuck in the hospital anyway. The lights convert the bilirubin in his system into something that can come out in his poop, which I found pretty fascinating although also gross. It was amazing to see how quickly he turned pink after spending a day or so under the lights.

Spa treatment under the bilirubin lights.

His spinal tap confirmed the presence of enterovirus toward the end of our first full day in the hospital, which was actually very comforting because it meant it was almost certainly not a more serious bacterial infection. By that time he was much more alert and feeding better and for longer periods of time, so the hospital stay was more boring than anything else. I think Brandon had a much harder time caring for Lucas for two straight days alone than I had lounging in our private room on my bed, having meals brought to me and reading my book in peace for hours on end.

Chilling in our room, getting better every minute.
Still, I was ecstatic when Lincoln was discharged in the late afternoon on our second day in the hospital, and it was amazing to be back home with the whole family again. Lucas in particular was very glad to have me back, and Brandon, best husband in the world, greeted me at the door with an open bottle of red wine.

Ready to go home!

Little smirk - happy to be home again.
Brandon and I have remarked to each other in the days since Lincoln got home from the hospital that taking care of two healthy kids frankly seems like a breeze in comparison to taking care of sick ones. Hopefully we'll all remain that way for a good long time!

Monday, October 6, 2014

Lincoln's Birth Story

Because of Lucas's weight at birth, my doctor had been discussing the possibility of induction early on in this pregnancy. Although I did have a successful vaginal birth with Lucas, having had to push for four hours and end with an episiotomy and vacuum assist made me eager and willing to take steps to ensure a smaller baby and easier birth experience this time around. After my 36 week growth ultrasound indicated that the Kraken was already hovering around nine pounds, we went ahead and scheduled an induction for the beginning of my 39th week.

My body began showing signs of being ready for labor several weeks before my due date, and by three days before my induction, I was 4cm dilated, 80% effaced, and had already lost my mucus plug. My doctor offered to strip my membranes at my final regular appointment prior to the induction, on the off chance that I could go into labor naturally and we could avoid the artificial induction. My mom had flown in several days earlier so we could be sure we had childcare in place for Lucas during my labor and delivery, so I was happy to try anything that could get labor going on its own. Following the appointment, I felt crampy and "off" for the rest of the day, and had some bloody show in the afternoon and evening. I tried not to get my hopes up, but felt there was a good chance I was about to go into labor.

Around midnight on October 4, I woke up and felt a few mild contractions. After an hour so, I started timing them and woke Brandon up to let him know that labor had begun. Contractions were around 5 minutes apart for an hour, and we decided to head to the hospital because I was already so dilated that I was worried labor might progress more quickly than I was prepared for. I was anxious to get admitted and have my epidural placed before things got real. As it turned out, I did not need to worry about things going too quickly!

Once we arrived at triage, they checked me and monitored my contractions for 20 minutes or so. I was 4.5cm dilated, but my contractions had slowed to around 6 minutes apart, so my doctor requested that we walk for two hours and get rechecked before she decided whether or not to admit me. Those next two hours were the most difficult part of my labor experience. Contractions remained between 4-5 minutes apart, although they got stronger over the course of those two hours. I was very worried that we'd be sent home, especially since the final few contractions before we went to get rechecked were 5-8 minutes apart. The recheck revealed that I'd progressed to 5.5 cm in those two hours, and the doctor agreed to admit me.

Oddly enough, right after I was admitted and settled into my labor and delivery room, my contractions basically stalled out completely and slowed down to mild contractions every 10-15 minutes. I didn't request my epidural yet because I wasn't in any pain. We hung out in the room for 3-4 hours, and I bounced on a birthing ball, drank juice, listened to music, watched some sitcom reruns on TV, and chatted with my L&D nurse. Brandon even left for a little while to eat breakfast. Eventually, I met with the doctor on call, who was not from my usual practice but who I liked immediately, and we agreed that I'd get my epidural placed and then she'd come back and break my water to get labor moving again.

Hooray for epidurals! I had just as great an experience with this one as I had with the first. The final cervix check before the doctor broke my water revealed that I'd progressed to 7cm, even with the mild, irregular contractions I'd been having. I'd been in labor for about ten and a half hours at this point. Breaking my water definitely got things going again, and after two hours of strong, regular contractions (that I merely felt as slight increases in pressure thanks to my blessed and glorious epidural), dilation was complete and I felt pressure encouraging me to start pushing.

I was extremely nervous and anxious about pushing after my four-hour experience with Lucas, but my nurse assured me that a second baby would not be the same experience. She told me we'd have this baby out in three contractions worth of pushes. Brandon and I both kind of rolled our eyes at that.  But after two contractions of three pushes apiece, she told me I'd have to breathe through the next contraction and wait for the doctor to gown up and get into the room, because after the next contraction, I was going to have my new baby.

The doctor arrived, we all got ready, and sure enough, four pushes later and Lincoln Michael was born after just under twelve hours of labor and twenty minutes of pushing. He got 9/9 on his Apgars and weighed in at 9 lbs 4 oz and 20.25 inches long. We were shocked at how "small" he was, even though he was born at 38 weeks 6 days, but I can't say I was too disappointed given my easy, breezy labor and delivery experience.

Lincoln Michael's name is from my great-grandfather Charles Lincoln, and his middle name is after my dad. We love the name itself and also the symmetry of it, since Lucas Alan is named for Brandon's great-grandfather and dad.

We stayed at the hospital for another 24 hours and were excited to get home as soon as we could. Lincoln has been a dream so far and we're so happy to be a family of four.

Last photo before Lincoln's birth

So happy to meet my Littlest even if he's covered in gook

Our little peanut

Proud new dada

Big Brother gives the baby a kiss

Our Littlest Lincoln