Quinn

Quinn Rusen Goldfarb has arrived :) I had my scheduled c-section on Wednesday, Feb 18th 2009 at 10:00AM; everything went on time and without complication. My experience could not have been better. I was nervous in my last few pregnant days and had some fears/anxieties regarding the actual spinal anesthesia and surgery, but even with my butterflies that morning I actually enjoyed the entire day. My friends at work took fantastic care of me and made me feel truly special. My husband, daughter, parents and cousin Heather were with me before and after the main event. My anesthesiologist invited Heather to join Bruce in the O.R. so she could photograph the baby's first moments.

My beautiful, healthy and perfectly sweet daughter Quinn was born at 10:56AM on Feb 18th. I was on the operating table for a long time due to copious scar tissue in my abdomen from having had five previous abdominal surgeries. Once I had my spinal in place, I was feeling fine and dandy. I kind of liked the way the spinal made my legs so warm and tingly. At one point I got nauseated, but the anesthesiologist gave me medications which made me feel better right away. I also got very itchy from the duramorph put in my spinal for pain relief, so they gave me a drug called nubain which helped a lot but also made me sleepy. The pain control I was given was fantastic. Not only did the anesthesia work well during the surgery, but the duramorph and toradol kept me super comfortable for a full 24 hours; I was almost afraid I would overdo things because I was able to be out of bed walking around later that same day, pain free!

The hospital stay was really nice: I had the best postpartum room on the unit, a corner room featuring extra privacy due to the "ante room" (which turns the room into a suite), a large bathroom and a fantastic view of downtown Baltimore. The nurses made sure I always had fresh water and was as pain free as possible. Breast feeding is going pretty well, much better than with Kaya. I sometimes struggle getting Quinn to latch, but once she finally settles down and starts to suck she does very well. My milk is in, too. I never established a good milk supply the first time around, so it has been a priority this time. I am determined to successfully nurse this baby without using formula to supplement as I did with Kaya. Quinn did have maybe four bottles of Similac at the hospital because she lost 10% of her birth weight and because she was extra hungry and fussy at times. Now that I have enough milk to nurse her and also pump, I have been supplementing her after feedings with expressed milk in bottles. She sleeps like a drunk sailor after drinking those!

We came home last Saturday evening, and are still settling in. I am completely blissed out, and also more exhausted than I expected to be at this point. I can't keep from nodding off to sleep even as I type this. My breasts are tender, as is my abdomen (duh), but I am taking percocet and motrin which are working very well for me. Now I need to get back into the good groove I was in at the hospital with drinking lots of water and keeping track of feeds and diapers on paper. When I am disorganized, I feel anxious. I want to relax as much as I can and nap as Quinn does. So far I haven't been sleeping much at all, because I feel like there is so much to be done. At this moment she is starting to show signs of waking, and so I'll need to nurse her then pump, and then shower with my older daughter (who needs a bath, so we are going to double up to save time and also bond a little -- we missed one another so much while I was staying in the hospital!)

Preparations

In about 38 hours, my second child will be born. I know this for the simple reason that I am having a scheduled C-section (because I ended up with one the first time around, and because I am not at all interested in trying for a VBAC thank you very much). What I did not expect, seeing as I've not only been through one C-section as well as about five other surgeries but that I've also circulated during dozens of C-sections as a nurse, is that I am really scared about it. I've been looking forward to delivering this baby for ages, and very excited, and prepared too. I know EXACTLY what to expect, because I am having the baby at my own work place with my friends and colleagues all around me. I chose my team, I trust these people. So why am I afraid I might die on the table?

I spent a good deal of this morning crying. I suppose the emotions and anxiety are normal; after all, my life is about to change in a huge way. Kaya has been so sweet and affectionate lately, and though I know it will be the best thing for her to become a big sister, I am also feeling guilty about how her whole identity is about to change. She will no longer be the only center of my universe. I am so afraid our relationship will change, that she will feel less special or loved. But I know for sure she will love her baby sister, and that they will have a deep connection and special bond for life. I am so excited to watch my girls love each other.

The last weeks of this pregnancy got physically difficult, but I was able to keep working full time (three 12-hour shifts per week) up through yesterday. I have been very uncomfortable due to lower back pain, swollen feet and heartburn, and often truly exhausted. I've also been dealing with having gestational diabetes, a complication I did not have the first time around. When I was first diagnosed, I was so distraught. It was just before Christmas, so I had to miss out on many of the treats of the season. I felt very sorry for myself, but as time went on it got easier. I am proud to say that I was able to maintain excellent blood glucose levels through diet control, and am therefore hopeful that my baby will not suffer any adverse effects. I have received excellent prenatal care, and been very closely monitored with weekly non stress tests and biophysical profiles as well as monthly ultrasounds to measure the baby's growth. As of last Thursday she appears to be about 7lbs, and all of her monitoring has been really great.

There was a sweet baby shower for me at work. My friend Gail went way above and beyond by organizing the party, decorating the room, supplying a DELICIOUS Sugarbakers cake among other treats, and giving me a really nice gift on top of all that. Unfortunately for my coworkers it happened to be one of the busiest days in L&D history, so most everybody was too busy to be able to hang out and relax. They had all these gifts stacked up for me, and all of this food laid out, but each person only could dash in to get a plate of food and say how sorry they were that they couldn't stay. Of course I understood completely, but it was a bit of a bummer.

Last Sunday my mom and sister-in-law Alex threw me a very elegant and fun baby shower with my aunts and cousins. We had so much fun! I had been so sure my family wasn't planning a shower as this is my second baby. Turns out my mom had been trying to make it a surprise, and so had been keeping really quiet about it up until a couple of weeks ago when she decided to tell me after all. It really was so great, although my grandmothers were very much missed. It is still so weird that they are gone, nothing feels the same.

Bruce and I (OK, mostly Bruce) have been working on getting the house ready for baby Quinn. We had to rearrange a good bit of furniture to make way for the bassinet, changing table and baby dresser in our bedroom. Quinn will be bunking with us for a few months, as we still need to set up a play area in our basement for Kaya's larger toys (kitchen, play house, easel, and so on) which are currently taking up her entire room. Once that is organized, Quinn can move in with her big sister. And after that happens, I am getting my new bedroom furniture on way or another! The big stuff is all done, and though we still have cleaning and organizing to do, I am happy with the house in general. I can fix the details during my maternity leave. At this point, all I can focus on is making sure my hospital bag is stocked with all of the essentials and that the car seats are properly installed in the mini van. The rest will fall into place. At least baby has a bed to sleep in and a dresser full of clean clothes!

Tomorrow is my last full day of being pregnant. I'll take Kaya to school, and I have one last prenatal appointment. I've been obsessively reading the Twilight books (started the 4th and final one last night), and hope to be able to get some reading time in, and maybe a nap! Because once little Quinn arrives sleep will be a distant memory for a while. I may be scared, but more eager than ever to see my tiny one's face and kiss her all over.

As the belly grows

I am pregnant. Haven't wanted to write about it until now, because of the way I rushed things last time. I am very pregnant, in fact -- 23 weeks along and SHOWING. We are expecting another little girl in February, and couldn't be happier! So far so good, all of the prenatal testing and ultrasounds show a healthy, very active baby. I feel good, although generally exhausted.

This week I spent an hour or so at Baby's R Us, registering for gifts even though I am highly doubtful there will be a shower. I debated heavily about doing it but figured, in the end, if nothing else I will have a pre-printed and organized shopping list for myself when I need to get a few things toward my due date. It was weird, because even though it is so fun to look at baby things, it also made me very sad. Registering for this baby made me hyper aware of the loss of my grandmothers. I am missing them so much lately, and very depressed that they are not here with me during this special time. My baby will never know them, and that is really upsetting me.

There is much to celebrate within my family this year. My cousin Dominic and his wife Meg recently welcomed their second daughter, Lucie. My cousin Claire is getting married in January, my brother Jeremy is getting married in June, and my cousin Janine is getting married in August! After the many challenges and losses of 2008, we are all looking forward to a joyful 2009.

Bruce, Phil, Kaya an I recently drove to Buffalo (in our mini van, which ROCKS!) to visit Bruce's folks. His brother David was also visiting, and it was great to spend time with them. We had a really nice visit, only wish we had had more time to spend on this trip. I hope to go back for another visit this Spring so our new little one can meet her grandparents.

Last week I had an ear infection. Oh goodness, I had no appreciation for how exquisitely painful they are! It had started on Monday with sore glands in my neck, the next day had moved to my sinuses, and by Wednesday I woke with a slightly sore left ear. I went in to work, as it wasn't very painful. As the day went on, not only did my left ear grow steadily more sore and muffled, but my right ear also became involved. I was in so much pain I was fighting back tears. Tylenol helped enough to make the pain tolerable, but when it wore off I was in agony. Unfortunately, though my coworkers were very understanding, there was no way I could go home sick as two others were already out and we were busy as usual. Somehow I made it to the end of my shift, then drove straight to Patient First for antibiotics. By the next morning I was feeling much better. That is an experience I don't want to revisit any time soon!

That's about all of the news for now. There will be photos soon, this blog is very out of date!

Loving Send-Off

My maternal grandmother Teresa Marie Perella (nee Denning) passed away at 6:45PM 8/2/08. Nan did not like to be alone, so in the end she was surrounded by her children and grandchildren in a very crowded ICU room. It was the first time I have been present at the moment of death, and it was an honor.

Over the past few years her health had been declining, eventually wheelchair bound and suffering early stages of dementia. It was such an undignified time in the life of such a vibrant woman known for flitting around town and shopping her heart out. As she grew weaker, she had to give up her independence -- no more driving, no more apartment. She moved in with my uncle and aunt in Delaware for a time, until the stairs became unmanageable and she had a number of falls. A couple of months in a rehab facility flowed into permanent residence in a nursing home, but only for a few weeks as it turned out.

Last Monday Nan was taken into the hospital with pneumonia. When she grew sicker and it was clear the antibiotics and diuretics were not going to help, the decision was made to help her on her way. When everyone was gathered (all but Claire living in Texas, who was devastated she could not make it in time) Nan's CPAP mask was removed (replaced by a basic oxygen mask for comfort) and a morphine bolus was administered. The family circled her bed and all laid hands on Nan. She saw all of us and said "I love you" many times, and we all told her over and over how much we love her, too. It took about two hours, but she finally let go. It was terribly sad, but also beautiful and powerful. My family was supported by the loving care of a fantastic nurse, who helped us through the experience.

There will be no more suffering or indignities for Nan. Wherever she is, she is reunited with my grandfather, her parents, siblings and best friend. I am sure they are having a good party.

In four months I have lost both of my beloved grandmothers. Though I know how blessed I have been to know all of my grandparents so well, and to have had so much time with them, I feel a bit lost now. My parents are now the heads of the family. Holidays will be different from now on. It will take a lot of getting used to.

The Love Song of Sasha Goldfarb

My dog loves her mistress. Not that she isn't thrilled to see every member of our family, but I am the one for whom she pines. Sasha gazes at me longingly with her big brown almond shaped eyes, whimpers when I scratch her ears and throws herself at my feet, submissively rolling onto her back, giving herself to me.

Best of all is the show I get when I come home, either from a long or short absence: she sings to me and does a little dance for several minutes before finally settling down. Poor thing won't even go outside to do her business right away, even when I know she is bursting. First she must sing her love song of whoops and whines, wiggle her butt, fling her tail and flop at my feet. Then maybe she can hold still enough to give me a kiss before heading into the yard to empty her bladder.

It is great to be loved.

New Job

I am a labor & delivery nurse. To me, this is a big deal. I knew it would be a daunting task to learn a whole new set of skills, etc., and I am a bit overwhelmed. Still and all I love it, and I will never go back to doing what I did before.

I am lucky to have a fantastic preceptor with over 25 years experience on our unit, plus about seven years as a midwife in her native Cayman Islands. She is not only an expert in the field, but also patient and kind with me. She says I am coming along very well, so I have to trust her judgment even when I am feeling like a huge idiot.

What I am great at is building rapport with my patients and being a labor coach. Not so fabulous are my IV and foley catheter skills, at which I've been hit or miss. We have been concentrating on vaginal deliveries, especially inductions. I am feeling more confident with that process, even handling a couple deliveries nearly independently (though I always manage to forget something . . .) The next hurdle will be C-sections. I was circulating nurse for the first time in the OR on Friday and it went OK, although I am completely ignorant of the instruments, which makes doing the counts with an impatient scrub tech a challenge, to say the least. I'm not sure why some people seem to enjoy making a new coworker feel stupid. Anyway . . .

Part of me is eager to get the orientation process over with and be out there on my own, and the other part of me wants to cling to my preceptor forever. I still have tons to learn and more to commit to memory, but I have already come a long way. I may have finally found a job I can be happy doing for years to come. I hope!