Monday, May 23, 2011

Six days, five nights.

It has been a long almost-week.

In the last six days and five nights, we have had four doctor's appointments, two outpatient "procedures" for the Wee Ski 2.0 and a crazy nursing schedule designed to help him back on track with breastfeeding.  Thomas got to the point that if we had early morning showers for everyone, he simply asked "Baby doctor?" to clarify where we were going. 

With Thomas, we loved the nurse practitioner through the same practice, but she had recently relocated back to her hometown in Florida.  We were working with a nurse practitioner who we knew, but didn't see frequently.

John Paul was having a hard time gaining weight, and the CPNP and I were having serious debates about what was necessary weight gain and how to overcome his challenges.  Breastfed babies don't typically gain weight at the same rate as bottle-fed babies, and she was refusing to allow his circumcision until he was gaining an ounce a day, per "her chart".  He hadn't yet gained weight back to his birth weight and what weight he did gain was coming on slowly.

Add in a vacation for the pediatrician and the impending one month deadline to get the little boy surgery done, it was beyond frustrating that our super healthy little boy was coming in for weight checks (each one with it's own co-pay and cooresponding ride from Rainier to Olympia -- never mind that I wasn't driving yet!) and not getting approved for the surgery. 

She recommended pumping after every feeding (every 3 hours) and brushed things off.   I quickly learned that four hours nursing + 3-4 hours pumping each day leaves you sore and cracked and irritated (both physically and mentally).  Never having problems like this with Thomas (who nursed for two years), I started to get incredibly frustrated with her direction, or lack thereof.

When the pediatricians from St. Joe's called to check up on John Paul's progress since leaving the hospital, they were dumbfounded at the 'one ounce rule' and told me to find another pediatrician. 

Thankfully, after a direct conversation with their office manager, things started to improve.  Without any direction from the CPNP, I made an appointment with the lactation consultants at St. Joe's.  The nurse took one look at John Paul and said, "Wow, I think he's tongue-tied!  No wonder he's having problems!"

Being tongue-tied, or having ankyloglossia, means that the frenulum (or the tissue that connects the tongue to the mouth) is too short.  John Paul didn't have a good range of his tongue, and it made breastfeeding very difficult and explained where part of my soreness came from.  She was confident that a short surgery, if confirmed by the pediatric ear, nose and throat specialist, would help him dramatically both in terms of nursing and gaining weight.

She gave us a referral and taught him a few tricks to help in the meantime.  He weighed 7 pounds, 11 ounces on that day - last Wednesday - the same that Thomas weighed at birth. 

Less than two days later, we were up at MultiCare seeing Dr. Erwin, a pediatric ENT specialist.  He confirmed the diagnosis and offered to take care of it then.  We jumped at the chance (not have to make the two hour round trip again with both boys?  Yes, please!) and a few short minutes later, John Paul's frenulum had been clipped and he was nursing right away.

The lactation consultants advised nursing every two hours.  I asked the famous question from the movie Three Men and a Baby:  "Does the two hour timing begin when we START feeding or when we END feeding?"

And of course, it meant two hours from when we begin.  Since last Wednesday, life with the Wee Ski 2.0 has been in 1.5 hour bursts, with a half hour of nursing between the rest of life, round the clock.  We could expand the timing at night to 3 hours.  We hung out at home, because every place we go is at least a half hour drive each way...and Thomas wasn't what I would call a "willing participant" in hanging out in the car for an additional half hour while feeding his brother.

It was an adventure this weekend when I was coordinating a wedding at St. Columban, timing his feedings within the schedule of the rehearsal and wedding.  The exhausting weekend was capped off last night when I slipped on the tile floor while carrying Thomas, and we both sprawled on the tile.  We are both still feeling that today. 

So it was the best reward today when John Paul weighed in at 8 pounds, 5 ounces...having gained 10 ounces in 5 days!  He is finally getting the hang of nursing, and got his little boy surgery today, on his three week birthday, a week shy of the deadline for the pediatrician to perform the procedure.  Mom, Thomas and I celebrated with lunch at Anthony's and John Paul slept peacefully through it.

After his "healthy weight gain", we were advised to let John Paul sleep as long as he'd like at night, and let him feed on demand when he wakes.  Honest to God -- what a reward!  He's a super sleeper (like his big brother) and I can't wait to not have to wake him every few hours to convince him to eat. 

I'm so grateful for the lactation consultants and Dr. Erwin -- if I was still nursing + pumping for hours on end without having sought any additional insight, I would have one foot in the nut house right now!  

Super excited to have energy again tomorrow morning after a good night's sleep for all of us!  Thank you, God!


KCina said...

Continuing to keep you all in our thoughts & prayers! :)

Anonymous said...

Shelley, keep grooving on your instincts. I cannot believe Thomas has a little brother and I smile when I hear the word "brother" on your blog. I cannot wait to see all of you! I love you, Aunt Sue.

Unknown said...

Wow. That sounds like you went through one heckuva hard time. I'm so glad you took the advice of the LC and found yourself a new pediatrician. We did the same thing when Sam was 16 months and not meeting his developmental milestones. His 1st pediatrician said to just "wait and see". Clearly, that wasn't working so we found a new doctor who immediately sent Sam for developmental testing and sure enough he was diagnosed with autism.

Saying a prayer every day for you for good sleep and renewed energy. You are doing an amazing job, Mama!

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