Category: motherhood

Resolutions

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I have always loved reflecting, writing, and making resolutions. I remember New Year’s Eves in my childhood, curled up on a couch, writing furiously in my journal. I still love new beginnings, blank slates, a clean notebook.

My only problem now is time. How can I work on resolutions if I never sit to reflect and collect my thoughts? Most days now are split between racing around like a madwoman trying to get the most salient items on my to-do list completed and slowing down to enjoy time with my husband and little ones. But there is no in-between. There is no journaling while the kids play, reading the newspaper while they play with Legos, checking things off of my to-do list as my little cherubs entertain themselves. Because most tasks can’t be completed at work (unless it is a day when I am not scheduled to see patients) I spend my nights doing these things, go to sleep late, and am constantly on the verge of sleep deprivation.

Gosh, I realize this sounds pretty pessimistic, but it’s actually not. I enjoy being busy, and I’m very happy. But overall I’d like to be more intentional, despite the many directions I am pulled in.

I don’t put too much pressure on myself when it comes to resolutions, but here are a few things I’d like to focus on this year:

  1. Getting our house ready for a third. We have a few home improvement projects (some quite large) on the agenda and we now somehow need for these to be completed by August.
  2. More date nights with my husband. Since we don’t live close to family, this is always a challenge. Fortunately, we have great friends who have volunteered to mom-sit, and we need to take advantage of this a bit more.
  3. Launch a side biz. My husband and I have a specific idea in mind, in the works now for a few weeks, and we will hopefully bring this to fruition in the new year.
  4. Work out. We have struggled to fit this into our schedules since our first was born. And I have always been worried about the return of hypothalamic amenorrhea. But now, especially for purposes of a healthy pregnancy, I’m going to start working out 2-3 nights per week. We’ll probably start off taking advantage of our home exercise equipment before considering another splurge.
  5. Blog more intentionally. This has been a very sporadic endeavor in the past year, but I’ve quite enjoyed it, and need to focus my efforts a bit more.
  6. Move into more leadership roles at work.

Hoping for a healthy and happy New Year to you all!

Grateful for

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My parents grew up poor. Rationing food, wearing hand-me-downs, and walking to school in broken shoes poor. On Christmas Day, the well-off kids would show off their fancy toys and my parents, ashamed, would hide their knick-knacks and knock-off toys for fear of being teased.

To this day, my mom (now well-off), still hoards plastic bags from the grocery store to re-use in the home. She clips coupons and visits five different stores to find the best deal. She keeps clothing from twenty years ago because, who knows, she might wear it one day.

My father used to collect any money he could to buy a candy bar at the store. Years later, one of my earliest memories is stopping at a gas station to buy a Snickers bar, simply because he could. We snacked on our bars at 11 o’clock at night (this was the 80’s, people, there was less judgment around child-rearing) and listened to music on an 8-track player.

Because my parents grew up poor, they never wanted my brother and I to grow up wanting for anything. We lived in a working class suburb in my early childhood and my parents scrapped together jobs – delivering pizzas, working overnight at a factory, serving as senior home aides – to make money until they could obtain their professional licenses and move into the middle class.

Now that I have kids, my parents spoil them as well. My kids have too many things and we do our best to dwindle down the piles, to explain to our kids why they can’t buy everything, to have them understand that there are children out there who don’t have the opportunity to own allofthethings – ultimately, to have them understand that things are just things, and there is no end to the hedonic treadmill.

In my experience, it’s easier for someone who comes from modest means to understand why they can’t have everything, and to be grateful for what they do have. I wonder how I will teach my children, who are being raised in a bubble, the art of gratitude, grace, modesty.

(Barely) pregnant

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So this happened today, on Christmas Eve. I honestly can’t think of a more perfect present!

IMG_0410

Yes, I am barely pregnant at this point. And really just maybe pregnant. Maybe it’s a false positive, maybe I’ll miscarry, maybe the baby will have a birth defect that’s incompatible with life, and on and on and on. There are so many unknowns right now, at literally only 4 weeks pregnant, but part of me is already trying to wrap my head around what life could be like in August of 2018. Three little ones – 3, 2, and a newborn. Our house will be packed to the brim. The financial plan we created this week will need to scrapped and redone. My current baby will no longer be a baby – he’ll be a big brother. Will it be (our third) boy or a girl?

Right now, I’m just praying that this barely-there pregnancy sticks and that our baby is healthy.

Merry Christmas!

Trying to conceive

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My two attempts at becoming pregnant went something like this:

Pregnancy #1: Got married, starting trying to conceive (TTC), started to think that I most likely had hypothalamic amenorrhea (HA), was diagnosed with HA, underwent fertility treatment and became pregnant almost 21 months after we started trying. Those are the facts. The reality is that it was an emotional rollercoaster – hope, anxiety, disappointment, anger, sadness. And most of all, terrible fear that I would never be able to have a child.

Pregnancy #2: Oldest was 11 months, period came back naturally (hurrah), and the next month it didn’t come. I naturally thought my HA had returned (especially because I had a negative pregnancy test at 35 days), but I was actually pregnant. Second hurrah! I literally had to do nothing and I pretty much worried 0% about getting pregnant that time around.

And now, here I am. 16 months post-partum (!) and I had expected to be pregnant by now. Although I initially thought my second should have a few more months of being the baby than my first did, I really did want them fairly close together. But now, if we do get pregnant, my last two would be >2 years apart. This bothers me.

It probably bothers me because I am a Type A person and want everything my way. But it also bothers me because I am afraid that maybe it will not be easy for me to become pregnant again. I’m conflicted on this point. First, I feel somewhat selfish for wanting a third child. Is this normal? I have two perfectly healthy children! Our lives are FULL. It’s not like we have oodles of time to fit a third child into the mix. I think about people who are going through infertility struggles for the first time, and I feel terrible for having this blessing and wanting more. How greedy of me! Second, it’s giving me more time to think about logistics, and I don’t want to be dissuaded from our decision to have a third. Financially, emotionally, etc., does it make sense to have a third child?

What it boils down to is this: if we can’t become pregnant naturally (and if we are not able to, I am not sure that I know the reason because I am nowhere in HA land and cycling naturally), would we go down the infertility work-up/treatment road? I don’t know the answer to that.

But this third attempt is bringing up a lot of emotions from my first attempt, and the synopsis of my month is as follows:

Week 1: period is here, wah(!), lots of negative emotions closely followed by attempts at positive thinking and planning for the upcoming cycle (fertility window is X and baby would be born on Y)

Week 2: TTC

Week 3: More TTC, then the 2 week wait begins. This week feels like the calm before the storm – anything is possible but nothing can be done to change what’s coming down the pipeline.

Week 4: Time to type every symptom into Google to see whether it could herald a pregnancy (AND I’m a doctor AND I’m been pregnant twice!). Is nasal congestion a sign of pregnancy? How about back pain? Cramping? Bloating? What about spotting for 5 days…oh wait, that’s just my period.

And the cycle starts again. What else can I say except that it sucks. I think about myself ~5 years ago, feeling so dejected and low. I remember sitting on my “meditation” mat where I was supposed to relax with incense and practice Yoga for Fertility, except I was sobbing. It was a hard, hard time. This time, it is not as hard because the stakes are lower and part of me does feel crazy for wanting to add a third to the chaos of my life. I also do feel incredibly fortunate to be cycling naturally (without birth control) for the first time since high school!

But I am still sitting here wondering whether the new acne I’ve noticed and the low-grade back pain I’m experiencing could have anything to do with pregnancy…and what will I do next week if it is instead a sign of my period?

On the eve of your third birthday

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On the eve of your third birthday, I sat besides your crib*, singing to you and rubbing your back because you had a cough and a runny nose and were so frustrated that you couldn’t get the ‘boogies’ out and were having a hard time breathing.

This brought me back to all of the days** and nights I spent besides your crib, rubbing your back and singing. I remembered your last sleep regression, when you were 18 months and I was 8 months pregnant and sleeping on the floor besides your bed just to get a bit of sleep. I remembered how long it would take me to put you down for a nap because you would wake up the moment the hardwood floor creaked as I tried to sneak out of the room. I remembered the months of you waking up between 4:00-5:00am, how sometimes I would just load you up in the stroller when you got up and head out for a (slow) run and then to grab some coffee, letting your dad sleep. Although most of the time I would try to coerce you to fall asleep again and, when that failed, I would make some coffee and bumble through the morning like a zombie. I could go on and on – so many memories of little you.

When you wake up tomorrow, you will be 3. I can hardly believe it. Where did the time go? You have zoomed into toddlerhood before my eyes. Your words, your ideas, your compassion – I have no idea how the helpless newborn I brought into the world in 2014 has grown to be this loving, imaginative, and awe-inspiring child. You amaze me every day, little nugget.

Love,
Mom

*We are not quite ready to move X to a toddler bed. Mostly we’re afraid that he’ll recognize he has the freedom to roam outside of his room in the middle of the night/early morning.

**Naps were also not easy for this kid.

Split second

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This morning, we had a birthday party at a local playground. The kids were all 2-3 years old. I watched as other parents sat back and observed their kids playing while I chased after mine and made sure he didn’t hurt himself on the large play structure. “Why am I such a helicopter parent?” I wondered. It’s true – my husband and I tend to be very anxious, paranoid, and overprotective when it comes to our kids. As a disclaimer, I don’t think that there is a “right” or “wrong” parenting style. I would actually prefer to be more laid-back and relaxed about parenting, but it may be impossible for me.

In any case, at one point I thought to myself: “I think I can relax. I’m the only parent hovering over my child here. Let me take a step back and chat with some folks.” So I stepped a foot away from my son as he was climbing up a play ladder. One second later, he had tumbled to the ground 6 feet beneath him and had landed straight on his bottom. Shit.

I tried hard not to panic. He was crying and I scooped him and took him to a quiet area to evaluate him. “Can you feel my hands on your legs?” I asked. My heart was beating fast, imaging the worst-case scenario. “Yes,” he responded. Thank goodness. “Can you stand up and walk?”. He could. Phew. I watched him walk and wince in pain, touching his back. He was being a lot more cautious and didn’t want to play as much. I touched his spine, low back, tailbone, buttocks. “Does this hurt?” No, he said. But at first, it seemed like everything did hurt. He would start an activity and then reached down to touch his back. He was momentarily distracted by cupcakes, but then didn’t feel like playing anymore. “I’m tired, I don’t feel well…I want to go home.” Fuck.

I called our pediatrician’s advice line and it was recommended that I take him to Urgent Care. We stopped by our house first and I iced his back a bit. At that point, it seemed like he was climbing and running with less pain, so I second-guessed my logic for a minute. Still, there was no way I could live with myself if something was really wrong and I ignored it. So I took him in. At the urgent care, they have a playground in the waiting area. He climbed up the rope ladder, went down the slide, played on the seesaw. These people are going to think I’m crazy, I thought.

They didn’t say it, but the less than five minute evaluation spoke volumes. They palpated the affected areas – no pain. They asked him to walk – no pain. They asked him to run – fast, no pain. They lifted his legs up and down – no pain. “X-rays of the spine emit a lot of radiation,” the doctor said, “so I wouldn’t recommend it.” That’s all I needed to hear – we were out of there in no time.

I am still worried, of course. I think: what if he fractured his tailbone and the pain is worse when he wakes up from his nap? What if he ends up having a slipped disc/nerve injury/becomes paralyzed? I can’t help myself. Being in medicine, I see worst-case scenarios all of the time. People who didn’t have cancer until they did, were pain-free until they developed debilitating pain, lived normal lives until being diagnosed with a life-threatening condition. So any time anything happens to my kids, I shift into worst-case scenario mode. It’s a terrible way to live.

In sum: I think that helicopter parenting is in my future for a good while longer.

What my nanny knows

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For the past few weeks, whenever my husband and I would try to put our littlest pea down for a nap, he would point to his forearms. At first, we thought he was pointing at a mole, but this didn’t entirely make sense because he only has a mole on one arm.

After a few weeks, I pieced together that my nanny must be doing something to his forearms when she puts him to sleep. When I asked her, she told me that she uses her index and middle fingers to “walk” up his arms while singing a song. No wonder! He was probably like “What’s wrong with these people? Don’t they know my routine!?”

When I was a first-time mom returning to work after maternity leave, not knowing these details pained me to the core. I would agonize over what was going on: how is our nanny/my mother/my mother-in-law putting him to sleep? Were they feeding him too little/too much milk?  Did they dress him in the correct pajamas? Were they sticking to the nap schedule? Were they careful while taking him on walks? And on and on and on. The mental load was exhausting!

But there were a bunch of little things too: what songs was he learning, what books was he reading, what words was he hearing over and over again? Our first nanny taught my son to refer to his bottle as “teta”. Now “teta” translates into “boob”. Although I speak Spanish, this term is culture-specific and not something we say. So for months we dealt with our son essentially screaming “BOOB!!!” every time he wanted a bottle. Fortunately, most people in the U.S. don’t speak Spanish, so it could have been worse. The point is: when you’re not with your child all day, you give up a certain degree of authority over what happens. This can be challenging for control freaks.

2.5 years in to having other people (family, nannies, “school”) care for our kids during work day hours, here’s with I’ve learned:

  1. Most of the details don’t matter. As long as your caregivers are adhering to the “big picture” rules, you can let the small things slide. In our case, we want our caregivers to be fully engaged with our kids – loving, patient, and kind. But we don’t need to micro-manage what happens during the day.
  2. Other people often do things better than you do – be open to suggestions! Having a variety of caregivers in our kids’ lives allows us to learn from people who have more experience than we do. Our kids benefit from different types of learning, play, and knowledge. In my opinion, this adds to their lives (and ours!).
  3. Having others care for your kids earlier in life may make later transitions easier. I have friends who are heartbroken because their children are starting kindergarten (which I imagine is so tough after 5 years of being their primary caregiver!). This transition may be less stressful for parents who had had their kids in day care, preschool, etc. on a full-time basis because the schedule doesn’t drastically change. Don’t get me wrong – it’s always hard to give up this autonomy, but if you had to do it once when you went back to work, you don’t have to worry as much about doing it later on.

Early birds

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My youngest woke up at 5am this morning. Ouch. I wouldn’t mind so much if he didn’t wake up early every single morning! I know what I should do (according to my sleep consultant): set the wake-up time for him (e.g. 7:00 am) and let him fuss until that time. Eventually, babies are supposed to learn that wake-up time is at X o’clock. Logically, this makes sense. If I go to him when he wakes up at 5:15am, 5:30am, etc., then I am rewarding him for waking up early (if I wake up early I get milk! cuddles! play!).

I have a hard time doing that, for no good reason really. But I think: if he slept from 7p-5a, that’s actually pretty good! Or: maybe he’s not tired. Or: maybe he’s just an early bird (before kids, I used to be an early riser). And most times I just can’t deal with the crying. In sum, I make a lot of excuses for him. I did the same with my first. He used to wake up 4:30a-5:30a! I would prep my walking/running gear the night before, wrap him up first thing in the morning, and set off for the park to let my husband sleep in a bit. Other times I would try to see whether he would fall asleep again (he was much better at doing so than my second, who never falls asleep once he’s up in the morning). And probably 70% of the time I’d make coffee and see what games we could play that involved my laying horizontally the entire time.

Two weeks ago, I tried to nip this early wake-up behavior in the bud. I had razor-sharp focus because we were awaiting a family visit and I knew that the kids would be sharing a room. Now, I can deal with one child up at 5a, but I do not want to deal with two children up at 5a, especially when one is a toddler and nothing is worse than a sleep-deprived toddler! So when my little guy woke up at 5a, I let him fuss until 6a. It was easy to do because I was so tired that I just kept drifting in and out of sleep. Lo and behold, the first night they were in the same room, he slept until 6:45a. But this slowly deteriorated to 6:30a…6:00a…5:45a…5:30a…5:15a…and, today, 5:00a. But I don’t have the courage to let him fuss in his brother’s room at 5:00a because, again, the horror of sleep-deprived toddlers.

I just keep holding out hope that this early-rising phase will soon come to an end. My first started “sleeping in” somewhere between 18-20 months, and he was a terrible sleeper. So this little guy, who sleeps better overall, should start sleeping in soon, right? Fingers crossed. Until then, I’ll keep drinking that coffee…

The two week wait

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For people who are trying to become pregnant, the two week wait is the worst of times. Here’s how it works: there are generally 2 weeks between ovulation and the time when you may be able to find out that you are pregnant. This translates into roughly 14 days that you can obsess about being pregnant/not being pregnant and swing from disappointment to elation to hope to relief.  The pendulum can swing either way and you have no control over it and you can’t force time to pass any more quickly than it is already moving.

With my first, for whom we underwent fertility treatment, I experienced a great number of disappointing two week waits. I am not a patient person, and I spent hours Google-ing any and all symptoms to see whether they could “correlate” with pregnancy. Slight abdominal twinge? Metallic taste in mouth? More sleepy than usual? Hair slightly curlier? Seriously – there was no such thing as low-hanging fruit. I can’t even tell you how much money I spent on ovulation strips and pregnancy tests! Sometime in March of 2014, a week and change after I ovulated, I experienced terrible cramps and was certain that I was out for that cycle (my fifth of oral ovulation induction). Then, a few days later – a positive urine home pregnancy test! Finally! It was the best of times.

With my second, I wasn’t sure when I ovulated (not a medicated cycle), so I took a slew of pregnancy tests around the 28-30 day mark until I was sure that I was not pregnant. However, because I was still late, I took another test a week later and, lo and behold, it was positive.

I am ruminating on this because we’d like to have a third. The situation is different now: with my first, I didn’t know if we would ever be able to have a child, so each two week wait was a truly emotional rollercoaster (would I ever be a mother? what was wrong with me?). With my second, it was more of a surprise (although not unintended). There was less stress and more joy. Now, I am torn between wanting to BE pregnant/closing this chapter of my life, and sticking with the familiar – two kids under three, a known chaos.

Sleep desperation

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When my first was born, I pined for sleep on a 24/7 basis. X didn’t sleep, EVER, unless someone was holding him. Classic first-time parenting mistake, but also personality-driven, as I learned after having my second.

Here’s how the first few weeks went: During the day, X would nurse and fall asleep, and someone would hold him. Or he would snooze in a carrier (we used the Boba wrap the most during those first few weeks). When we lay him down, he slept less than thirty minutes. After officially giving up, he slept in this carrier until I went back to work when he was 4 months old.

At night, we would swaddle him tight and lay him on his back. He would sleep anywhere from 20 minutes to maybe 3 hours (max). We were up a lot at night. 8-9 weeks in, my husband held him for 5 hours one night just so I could sleep. It was my first time sleeping for longer than 3 hours since his birth. I was a zombie. I also felt terrible complaining – I had undergone infertility treatment to get pregnant. I felt so fortunate to have this baby in my arms – how could I complain about something as measly as sleep?

Did I mention that he had colic? This made the first few weeks even more difficult. Every night, from approximately 3-4p on, he could only be soothed by being held in the carrier. We tried every “S” that existed, but nothing helped.

We had a Pack n Play, a co-sleeper, a bassinet. He wouldn’t sleep in any of them. We tried every swaddle imaginable (except this one, which was actually my fave after our second was born). We had a consultant (a post-partum doula of sorts) visit our home to observe our interactions with him. She recommended double-swaddling, which was of no help, His startle response was intense! We spoke to two sleep consultants, including a well-known author of an infant sleep tome, who charged a steep price to give his two cents, which were unfortunately not helpful.

Somewhere around 8-10 weeks, we were desperate. Since I didn’t sleep at night, I spent the time reading every sleep book under the sun (this was my favorite).  So one day, I placed him on his stomach during nap time (NOT a recommendation from the book). He was un-swaddled and I sat next to him the entire time. He slept for 2 hours! I was in shock. At night, we started placing him on his stomach to sleep. His sleep improved marginally – regular 3 hour stretches. For the first few weeks, we watched him the entire night. At first, we had family visiting so could easily take shifts. Once they left, this became much more difficult and we were not much better off! We used a movement sensor, which put our minds at ease, but in actuality, it would not have been very helpful in the event of SIDS given the lag between breathing cessation and alarming. E spent a ton of playtime doing tummy time, and first rolled over at 8 weeks, although not reliably until 3.5-4 months. Let me be clear: I do NOT recommend that infants sleep on their stomachs. Infants should sleep on their backs. Please follow the American Academy of Pediatrics guidelines for safe infant sleep. I was terribly anxious the entire time that we did it, often waking up in the middle of the night (he slept in our room, in the co-sleeper or Pack n Play, until he was 4 months old) to frantically check on him. And with our second son, we never once placed him on his stomach to sleep. However, during those first few months of the newborn haze, it seemed like the best of bad options. We didn’t trust ourselves to stay awake while holding him (we were exhausted!), we were afraid to have him in our bed, we couldn’t justify the cost of a night nurse, and we had to sleep!

It was a tough time. When he began to roll over consistently, we moved him into his own room. He continued to wake up every 3-4 hours. However, we were (for no good reason) adamantly opposed to sleep training (Cry It Out). Our friend joked that everyone was vehemently opposed to CIO until they just couldn’t take it anymore. She was right (in our case, at least)! We reached our breaking point around month 7, when X started to wake up every HOUR and NOTHING would soothe him to sleep. Via a friend’s recommendation, we connected with an excellent remote sleep consultant. She was willing to work with a variety of parent attitudes regarding sleep training, and presented us with many options. We ultimately chose a gradual CIO (e.g. Ferber method) plan, and this worked for us. After less than a (very tough) week, our little one was sleeping through the night. Legitimately through the night! We had a few hiccups along the way – early wake-ups (we weren’t very strict on waiting until a certain time to get him), travel glitches, regressions, etc. – but we were able to reset by returning to our original plan.

X’s last regression was at 18 months. Since then (knock on wood), he has been sleeping like a champ. Some days he will sleep in until 7:30am! It’s glorious (or would be if we didn’t have a second who is an earlier riser). And he is generally in bed around 7:30-8:00pm with no tears.

So if you’re currently in the trenches, just remember that those first few weeks to months (to years) can be really tough! There’s no right answer, but eventually you’ll start sleeping again!