Sunday, March 19, 2017

Fatherhood, part 4: the first three weeks

Rough. The first two weeks were rough. They were also amazing, especially because we were able to introduce N. to my sister and her husband and my brother and his wife, and all of us were together for Christmas. But, N. didn't seem to figure out how to eat for the first two weeks, and that was rough.

I've brought up a few times about how calves (baby cow version) can stand up minutes or hours after they're born. But human babies can do almost nothing when they are born. They are totally defenseless,which is actually quite cute. It seems crazy to me that babies don't even really know how to eat when they're born. They'll just suck on the end of the nipple and get like no milk, just totally chill. You have to force the breast into their mouth and guide them along as they try to eat.

All babies lose weight after they're born. Normally, breast milk doesn't come in for a day or two until after the baby is born, and sometimes longer. They suck out colostrum for the first day or two, then get going on the milk. They expect about 10% weight loss before checking out of the hospital (c-sections), and at ours said they keep babies there if they lose more than 12%. N. lost 11% or so. We went in for his first pediatric appointment the next day, he had lost another little bit of weight. Normally by day 4 or 5 they should be gaining more weight. So we set up a lactation appointment (we had already seen the specialist at the hospital). We went down a day or two later, and he was exactly where he had been-so no weight gain. So the lactation consultant gave us some suggestions and tips and set up another visit in about a week.

During this time N. is crying a lot, not producing the poop filled diapers that he should have been, and not sleeping more than 90 minutes straight at night. Let me say right now, I don't know how single moms do it. I don't know how moms who have to go back to work do it. Being a single mom must be so, so incredibly difficult. I can't imagine. It must be so hard for people to do this if they have to get up and go to work in the morning, we are truly blessed that we both had nothing to do but help N. and we had my parents to help cook, clean, etc. as well.

This was a super stressful time. Livia felt guilty and sad that N. wasn't gaining weight, even though she was doing every single thing that the breastfeeding articles and the lactation consultants said. I felt bad because I couldn't do anything about it, and when I'd make suggestions or try to think through it with Livia she'd often feel hurt or think I was disappointed in her. And N. was waking up screaming every 90 minutes to 2 hours all night. We seriously didn't know what to do. It was rough. Getting in a fight with the woman you love at 3 in the morning while she's holding a crying baby: they don't seem to show that in the commercials. But that was my reality.

We go back for the second consultation, he's 15 days old now, and should be back to birth weight. He was 7 lbs 3 oz when born, and he weighed in, again, at 6 lbs 6/7 oz. Pretty much the same as when he checked out of the hospital. The lactation lady gives us more strict, and very clear instructions. We ramp up his supplementary formula, and Livia is instructed to pump a fair amount-to get the milk flowing. He always does breast first, but then gets pumped milk and formula in the bottle. We went back 3 days before Christmas, and he'd gained like 3 ounces in 3 days; they said we were on the right track. It was a relief to not have to go back right after Christmas, or when my siblings and their spouses were here. Two weeks later he had passed his birth weight and was doing well. We stuck with the plan for probably another 3 weeks after that. He's been cute and healthy since. But, man did we spend a lot of time washing and sterilizing bottles those first six weeks.

Later the lactation consultant, and two pediatricians all agree that what likely happened was a vicious cycle. Initially, N. wasn't sucking very well-so he took very little milk. Livia's body was likely ready to produce a lot of milk, but as the demand from N. was low, it lowered its production. Because he wasn't getting much milk, he continued to not suck very well, or very long (he would stay latched on to the breast, but just do weak, cursory sucking). So her body wouldn't produce more milk. Getting a good electronic pump, and pumping often, sent the signal to Livia's body to produce more milk, thus giving N. more to suck on and helping him learn how to suck well. Now that I think about it, I was wrong: babies can cry, poop, and pee immediately upon birth, and with no teaching necessary. You'd think we'd evolved to eat too, I mean cows can WALK!

If possible, get the electronic pump. The day they instructed Livia to pump I went and got a hand pump. I wasn't just going to jump right into buying a $150-$200 electric breast pump. The hand pump was worthless. So it took a few days, but I found out our insurance would cover it and a pharmacy that sold breast pumps and was in-network, and it was day and night.

After Christmas we did feel a lot better, he started to fill out his clothes and get noticeably chubbier. A big relief for all of us. But the lack of weight gain really was the main emotion/stress driver for the first three weeks. We had a photo session when he was 12 or 13 days old, it went really well, the pictures were incredible. We got urinated a lot those first three weeks, eventually settling on a wash cloth over the penis strategy that works very well. So well that sometimes he'll urinate and we won't even notice-which usually means that the part the wash cloth didn't soak up has rolled down onto the changing pad or his onesie. But, still better than urine all over wherever you may be changing him and my hands, arms, face.

It was a crazy time. Not a lot of sleep, a lot of crying. We were honestly still in a bit of shock that he was here. Lots of stress. But lucky to have family helping us, and for me to be on paid leave. Very lucky.

Wednesday, March 15, 2017

Fatherhood, part 3

N. was born on December 4th, 2016. It was amazing. Bewildering, a bit surreal, and totally awesome. Despite all the reading, and being right there for most of the pregnancy, it still is a bit crazy to me that a living being pops out of a woman. Seriously, I'm guessing it's something that men will really never understand. Livia found my statements about this kind of weird or odd, but I even commented to her that night that I had trouble believing that he was inside of her just hours before.

I don't like when people say you have to experience something to know what it's like. I know it's true, but I think it's a bit conceited, and inconsiderate of the many opportunities that so many people will never have. Yet obviously the birth of one's first child is one of those things. Because of the way things went, there were some big ups and downs.

One of the reasons that Livia and I decided to have N. in Iowa (or rather, the U.S.A.) was because she wanted to avoid a c-section. C-sections are super common in Latin America, including Ecuador. In Ecuador it is essentially the default way women give birth. It is certainly easier for hospital schedules and doctor's schedules-and they can bill the state health care system more. But, Livia was hoping to have a vaginal birth if possible. Additionally, episiotomies are much more common in Ecuador than in the States. While they seem to be fairly safe and not uncommon, it's not something you're exciting about having.

In the end, Livia had a c-section, after 14 hours of labor, so that did make the experience a bit difficult. She had worked so hard, and really had pushed incredibly well, for a long time, and then to have to have the surgery that you had been trying to avoid-which also makes it so you don't get to enjoy the first 30 minutes or so with your baby-that did play with our emotions. Especially because during the pushing phase, her adrenaline was going crazy, mine was too, I'm holding her legs, her arms, counting, cheering, so we are both super energized, pumped up. Then she gets wheeled down to the surgery prep, I just sat in this little waiting are, with the scrubs on, waiting for them to let me in to be there during the surgery. So, the adrenaline slowly goes away...but then when I heard N. cry and then popped up and walked to the tub where the nurse placed him at but 15 or 20 seconds old, it came back. I think I was mostly just thinking, "ok, here we go, time for a never-ending adventure." Once they told me he looked great and healthy, I was super happy. I took him over so Livia could get a look at him. She was still on the operating table with her arms strapped down, as of course they were still stitching her up. She was also really cold, I think the anesthesia plus her adrenaline/hormones all out of wack had her shivering.

And man, N. was little. Well, he was 7 pounds 3 ounces, and 19.5 inches long. So Just a shade smaller than the average baby. The thing is, though, all the images you see of babies in movies, commercials, videos, etc., are of babies at least three if not six months old. I didn't really know that until I commented about how tiny he was, and I think my mom or someone told me that. I think newborn diaper ads should have newborn babies on them, call me crazy. He was so small though, just absolutely tiny. I got over it quickly, but initially I did feel like I was going to break him. He was adorable though, lots of hair, big brown eyes, and he looked exactly like I did when I was a baby (that is apparently an evolutionary trait to help fathers identify children in less monogamous cultures).

So, in case I haven't told you yet, this is how it went. On Saturday, Livia was having frequent contractions, not exactly the 5-1-1 they tell you to wait for, but super close. So we headed out to the hospital with my mom. They hooked Livia up, and monitored her for about two hours, but she was not having frequent or strong enough contractions to warrant her staying, or for them to use the medicine they use to help the contractions along. So we headed home.

That night, at two in the morning Livia comes into the room, turns on the light and tells me to get up. I hate myself to say so, but I first said, "are you sure?" "might it just be like yesterday?" She then repeated that yes she was sure, and that she thought her water had broken. She had a plastic cup with some of the liquid in it. I quickly googled what water breaking and the liquid was like, it seemed to all match. So I got dressed, we grabbed the two hospital bags, and headed to the hospital. It's a fairly small hospital, with a small maternity section (12 rooms). Thus, perhaps the ER attendant doesn't get much action, because he was super excited, full of energy, and incredibly helpful when I pulled up and helped Livia out of the car. He got her in a wheelchair and up to the room in seconds.

My parents came by around 6:30 or 7:00 in the morning, and the labor progressed along. Livia walked around a lot, with the hopes that the baby would lower and that she'd dilate faster. She took maybe two naps, usually right after they added a bit more pain medicine to her IV. She received the drug that helps the contractions go faster, and things did proceed quickly after that. She tried all sorts of positions in the last hour or two before it was time to push. Initially, things looked great. She nor I can remember exactly how far and in how much time she progressed, but I think N. was about halfway out in less than 30 minutes of pushing. This is because I remember the doctor and nurse saying they both thought we'd have a baby in less than half an hour. And then he got stuck.

As they later explained, as he was coming down, his head was either already turned, or turned. So, instead of the center/top of his head coming through first, the side of his head was coming through the opening. This meant it was a much larger circumference trying to get through the pelvic opening. It didn't fit. Obviously they couldn't realize this at first, because just a tiny bit of hair is poking through (N. was born with a full head of dark brown hair). But, in the second hour of pushing, minimal progress was made. Because of the early good progress, the nurse was encouraging Livia to push harder and harder, as normally it requires those huge pushes to get the baby out. The doctor was very professional, possibly a bit too emotionless and detached, but looking back, I'm glad that he was. At one hour and forty five minutes of pushing, he said we could push for 15 more minutes, but if it didn't get to a certain level, we'd have to do a c-section. He said he doesn't like for women to push more than two hours. He also stated, which was helpful, that he isn't against the vacuum assistance or forceps assistance for birth, and that his daughter was born via the vacuum method, but that N. was not far enough out to do that. So Livia pushed, but he was stuck.

But, the surgery went great (well, it was an entire ordeal for them to give Livia the anesthesia because she was still having contractions and shivering. But, I was in the waiting area, so just heard the screams and cries. But, surgery was quick, no complications, Livia recovered considerably faster than usual, and we have a beautiful, healthy, relaxed, cute baby boy.

Advice for the man on birth day: completely support your wife. Don't even think about telling her how out of control she's acting, or that your skin is peeling off your neck because she's grabbed your shirt collar so hard. She said and did things that were completely unlike her, and I just let them slide (or did my best). By the next morning she was totally back to herself, and when I told her some of the things she said she just laughed and apologized. I think that's the most important thing, just do whatever she says. Having my parents there was super helpful, they could run and get food or something we'd left at the house. Also, having my mom in the room was a bit awkward at times, but overall really helpful. Because sometimes I needed to go to the restroom, or call my brother/sister, or get something to drink. So it was nice to have my mom there to talk with Livia and help her if she needed something. Having the bags packed in advance was nice. Also, at least at Iowa Methodist West, they don't tell your family that the baby was born, surgery went fine, etc. So we were both back in the room, in complete awe, just staring at and holding and kissing N. I called my brother and sister to let them know, Livia sent voice messages to her mom and sisters. At some point we wondered what my parents were doing, why they weren't in the room. So I sent my dad a message. They were five rooms away in the waiting room, but I guess the nurses aren't allowed to tell them anything (HIPPA probably) so all they said was "a baby was born." So, I guess get that figured out if it turns into a c-section. There may have been 20 more pieces of advice I would've given had I written this in December, but honestly, just do what your wife/partner says and don't make any comments and it'll go smoothly.

Saturday, March 11, 2017

Fatherhood, part 2

So I know that I'm cheating, because the whole concept of a weblog (or blog as you youngsters call it) is to log things...more or less as they happen. I'm sorry, but that just didn't happen. I'm trying in these first few posts to recount how I felt in the months leading up to my son's birth. I touched on my biggest worry in the previous post, so I'll move on to some other things I thought about.

Probably second on the list of mind occupiers was actually trying to calm myself down. A good friend of mine from Peace Corps shared with me the other day that he and his wife are expecting. He tends to worry and ponder quite a bit about things-he's a great thinker-so I tried to settle him down a bit. I asked Livia when they really needed to start getting ready and she said the last month, I tend to agree. I mean, up until month five or so, the biggest part of the job is encouraging your partner/wife to stay healthy, and being incredibly empathetic as she walks out of the bathroom (about every day) telling you she just threw up in the toilet. Well, for the first three months in our case. But, seriously, I spent a lot of time calming myself down mentally. Reading up on pregnancy and childbirth is very helpful. The Expectant Father (Brott, Ash) was the main source of my information and I'd highly recommend it. Livia used the babycenter app extensively, and it has lots of great stuff as well.

We did have a complicating factor in planning our marriage, which was mostly complicated because when you're in a position requiring a security clearance, you can't just marry a foreigner. There is a wait time (90 days) and some forms to file, interviews to be done. The wait time is the especially complicating factor (in the end we didn't wait the entire time-which is allowed-but it did delay announcing things for a while). Honestly though, planning and doing some of those things helped me feel like I was contributing and getting things done-which provided relief.

But really, for the guy, there isn't too much to do besides encourage, help, sympathize, listen, and provide/shop for your partner. So I tried to do all those things, and there was definitely a learning curve, I won't lie about that. Pretty much everything else you take care of the last month (or two). While Livia was up in Iowa and I was down in Ecuador (and Peru for a bit) my mom threw two baby showers for her, and my parents' friends lent us a pack'n'play, bassinet, and a baby rocker. A neighbor's daughter also gave Livia half a closet full of maternity clothes, as she'd given birth two months previous. I will admit, it's pretty nice that my parents (mom especially) have lived in the same place for 28 years and are involved in church, school, the neighborhood, and other organizations-people were incredibly generous. The baby showers got us almost all the clothes, blankets, burp clothes, and towels we needed until now. With all the generosity-and because we didn't outfit a room-N. hasn't cost too much-yet. We also received a bunch of stuff from some friends at the Consulate. I told my Peace Corps buddy if you have a good shower, and don't decide to redecorate-the baby won't cost you too much. As our plan was to spend six weeks in Des Moines, six back down in Guayaquil, then another month in the States, and then move to the Dominican Republic (didn't happen in the end), we really didn't know what sort of space we'd eventually have or what furniture the State Department would provide, we did not go all in on the chair/dresser/crib/bassinet purchases. While I can understand the excitement of outfitting a nursery, I tend to think it (like a lot of material consumption in American culture) is gratuitous.

When I was in Iowa with Livia for the week in October we got registries set up at buybuyBaby and Babies R Us, we toured the maternity ward and got her pre-registered at the hospital where our son was born, got the information and registered for some pre-birth classes at the hospital, and had a visit with the Ob-Gyn office and got all of Livia's medical paperwork from Ecuador translated and scanned and sent to them. So, yes, we took care of some things in month seven. But after that it's mostly eat right, exercise, take your vitamins, get the basics (clothes, towels, wash cloths, burp cloths, diapers, wipes, soap, ointment, pacifiers, sheets, blankets). But they have a list when you register, so we just used that plus whatever my mom said. And, the hospital we went to was amazing, and loaded up a goody bag when we left with pretty much everything we needed except clothes and blankets for the first week or so.

Mostly, I read somewhere, or someone told me, that, for the first six months you just have to feed them and clean their poop, so don't worry too much. While not wholly true, it's pretty close from a logistical perspective. That calmed me down a lot. Because about once a day, if not more, I thought to myself "holy shit we're having a kid." I mean it. I can't remember the date when it changed from 'Livia's pregnant' to 'we're having a kid' but towards the end there it was in my mind a lot. People at work would ask how I was doing and I'd respond "I'm having a kid in two months." Probably not what they were expecting, but that's how I was doing.

It was exciting. It was surreal. It was concerning. I was anxious. Some denial about how much it would change my/our life/lives. Livia is level-headed, relaxed, resilient. So she didn't add much worry or anxiety. Which was good. I was nervous too, but I don't think unreasonably so. We had a lot of change coming up in our lives, (marriage, then a son, then moving) so I think my emotions were understandable. Actually, with my contract not getting extended last month, add losing a job to that list, so Livia and I experienced four of the maybe ten or 12 biggest stressful events in life. Within six months. As I said, a lot of what I was doing mentally in the last three months or so was calming myself down.

A good friend in Guayaquil, and father of three, repeatedly told me it didn't matter if I was ready or not, because no one is ready. That's very true. There's a lot of value (A LOT) in learning about pregnancy so you can help your partner. I'm glad I read up on some of things I did about the first day/week/month of a baby's life. But, as for being a father, it sank in, when I held N. at two minutes old. That's when it sank in. When I stood over the tray as they cleaned him and checked this and that when he was but 30 or 40 seconds old. When I brought him over to Livia and said this is our son. She couldn't feel half her body, was shivering from the medicine, was still coming down from the adrenaline of two hours of pushing (his head got stuck in her pelvis because it came down at an angle-hence the unplanned c-section)-so that's why I brought him to her. That's when I thought: okay, let's go. Because then, it didn't matter if I was ready or not, he was there. I'd say for the last three to four months before he was born I was excited, I felt we were adequately prepared, I felt like we had good discussions about parenthood, we loved each other, and were ready to love our son. So maybe I thought that we were ready, but let me tell you, looking back on those first three weeks (heck looking back on today) we weren't ready. But, and this is probably on a Hallmark card, what mattered most was that we were committed to each other and to our little guy.

Monday, March 6, 2017

Fatherhood, post 1

So, a while back, before N. was born, I promised to a few friends that I would get back to blogging. They were specifically hoping for some posts about being an expectant father and then about being a dad after my then expected son's birth. This promise wasn't kept until now, which is pretty typical of me: late. Part of the issue was that I wanted to get all of my blogs from Ecuador and other trips posted-as that was another promise I had made (and also failed to fulfill). So, I've just recently gotten a few blogs updated, a process which I started when back in the States for paternity leave, and will keep that going. I realized that I probably won't finish that anytime soon, so better to get my thoughts up here now. I regret not getting a post or two up before his birth, and then some more in the past three months.

I say this because just the other day I was searching for an email and had an interesting find. After text search didn't work, I did the advanced search on Gmail using the date function. I found what I was looking for, an email from back in 2007 when I was studying in Spain, but also started reading through other emails in the same two week period. Emails to fraternity brothers about things at the house, emails to my sister, to my now deceased grandmother, and emails to professors/administrators at TU. It was very revealing, quite humbling, and a bit weird to read through the emails and see how I wrote (spoke/thought) then. Surely in the future this post will be just as intriguing and possibly embarrassing as those were to me the other day. Which is part of the point of doing these type of blogs. Originally, my blog was set up to keep people updated on my experience living in China. I liked that it meant I wouldn't send a regular email or newsletter, that might leave someone out who was interested in what I was doing. After a bit, I realized that it was a great way for me to keep a log of my travels and experiences, and my impressions in the moment (or a few weeks afterward). I've never kept a journal, and writing for a public audience helps me think about how to present things in a (hopefully) interesting and thoughtful manner.

I don't know how long I'll keep this up, or on the Internet, but I think it's best to just use N. instead of my son's name, as this is a fully public blog.

I got lucky from the beginning. And we have been incredibly lucky in the past three months as well. The State Department prefers that its overseas employees have their kids in the USA. I think that's mostly because they are a back-up insurer for overseas employees (and spouses) for childbirth and related medical incidents. So, they'd rather have the kid born in a reliable and familiar healthcare system. Livia and I had agreed that she'd not work for the first two years or so, so she quit her job at six months. So, the strategy for me was to use as much paternity leave after the birth, and not too much beforehand. We also decided that her staying with my parents was way better than staying in a hotel near DC (State Department's preferred method). We opted for the birth in the States not so much to follow State Department recommendation, but because they pay a not insignificant per diem the whole time Livia would be in the States-and an additional 50% after the birth. So, we came up to Des Moines at the end of October, I stayed for a week, then left Livia with my parents, and went back down to Ecuador to work (and take a long planned vacation).

The baby was due between December 6-13 (Livia had various sonograms, thus a changing due date). The doctor in the States had decided to put December 13 on everything-I think it was the most recent sonogram, but two others had said December 6 and December 7. So I bought my ticket back for November 30. The doctor said there was only a five percent or less chance that the baby would be more than 10 days early. Well, N. was born on December 4th. Like I said, I got lucky from the beginning.

And we got really lucky that day too. The labor was long, painful, and in the end very frustrating for Livia, as she had an unplanned c-section after 14 hours of labor. That was an experience worth writing a few blog posts about. It was intense. But I say we got lucky because N. was born healthy. Totally healthy. He got 8 on his immediate APGAR, and 9 on the five minute APGAR. He had 10 fingers and 10 toes. He was normal weight and length. He passed his hearing test. He had a full head of hair. He looked like a normal, healthy baby because he was. I'd be lying if I said I didn't worry about that before his birth. Livia took great care of herself, ate healthy, stayed active, abstained from alcohol throughout her pregnancy. Well, maybe a glass of champagne here or there. But nonetheless, I thought about possible complications or congenital disorders a lot. I say congenital disorders because I don't like the term birth defect. Honestly, I didn't have a big problem with it until it became really real (for me at like seven months). But then I started to think about it, to imagine it, and you don't want to consider anything a defect. I say complications, because almost any congenital disorder would complicate things. It would've complicated our marriage, it would've complicated medical care/insurance, it would've complicated decisions we'll make in the future about where to live, how/where to educate our son.

Those of you that know me know that I run through all those different possibilities fairly quickly. I had no reason to worry. As I said, Livia took care of herself perfectly, she's at a healthy age to give birth, neither of our medical histories gave any flashing indicators of any congenital disorders. But, it was one of the things I thought about fairly often. Just thinking about how I would deal with various possibilities. When you choose to have a kid, you are, in a small way, choosing to accept and love whoever is born. That's risky. People may not want to admit it, but it's risky. It is a decision in life where we have very little control. With modern technology and medicine, we have control over SO many aspects of our lives. This isn't one of them. I thought about a lot of other things, mostly because they came up in my month by month becoming-a-dad book. I had always wanted to be a father, Livia a mother. We talked about all sorts of things, what he'd look like, act like, his personality, etc. I think of myself as a positive person, but I also know that I tend to consider all possible outcomes when analyzing a choice/situation, so maybe that's why I thought about this fairly often.

Despite the crying, the 2 am, 4 am, 6 am diaper changes, the crying, the milk not coming, the stress of the milk not coming, the crying, and who knows what else in the first few days, I felt lucky. I think the previous two paragraphs demonstrate why. When people asked how we were, how I was, how N. was, I think I almost always answered "Great, fortunate, doing really well." And it was true. Granted, Livia and I were having fights at two in the morning. Granted, I was at times infuriated with N. and then hated myself for being angry at a one-week old. Admittedly, I was having a hard time wrapping my head around how was this all going to work out. Yes, I brought Livia to tears more than once in those first two weeks. But, when I said we were fortunate, I meant it. He may have messed around with gaining weight for a bit, but he was otherwise about as healthy as a baby can be. Some of that is proper care, but a lot of it is plain old luck.