Post-Op Babble

Wondering how Becca feels tonight?

I think she's doing okay. :) She woke up from her afternoon nap babbling away like this and didn't stop until we put her to bed. Same thing happened after her first set of tubes. I think that now she can hear better, she just wants to talk to hear herself! It's pretty hilarious to watch. By the time I filmed the video, she was getting sleepy, but, wow, she's been active this afternoon.

As far as the actual surgery...it went well. I started to get a little nervous because it took a little longer than we expected, but it turns out that her right eardrum was retracting into her middle ear so much that it was hard to get the tube in. (Basically, the pressure built up in the middle/inner ear kind of sucks the eardrum back...which sounds pretty painful to me!) It also turns out that her adenoids were "big and gross," so even though we had just planned on taking them out as a precaution, they really did need to come out. It's a really good thing we were able to get in for the surgery so quickly! Becca should be a lot more comfortable now...not that she was showing us that she was in pain, tough kid!

Like I said before, she had a rough wake-up, as usual, but it was actually a little better than normal, since she "just" cried for hours instead of screaming, wailing, and crying. Still pitiful, though. AND they gave her the D-10 IV fluids instead of the normal stuff after surgery...and I didn't even have to insist too much. I realized on the way home that though we've never had a really scary surgery, we've never gotten to take her straight home after surgery before...so it was nice to be quite boring (albeit the loudest party in the PACU).

My guess is that over the next few days we'll start to see some improvement in her speech and balance, though the balance bit might just be some wishful thinking, according to the doc. Speaking of the doctor, I was again reassured that we made a good move by switching ENT's. Dr. Goudy is a much better match for Becca's issues and my, um, anxiety.

Oh, and our favorite pirate pastor came to pray with us before surgery and even prayed in kid language. I love that he knew that Becca's spiritual needs were as important as our own, if not more so!

All in all, I couldn't ask for more out of today!

Home

Hey! Surgery went well. We're home and nearly all sleeping. (I'll be drifting off in a moment, hopefully. Last night was kind of rough and this morning was...early.) No issues with her blood sugar and no trouble with the surgery, but, as always, Becca woke up quite distraught (to put it mildly) and cried for 2 straight hours. Again, we got the "maybe if you go ahead and take her home she'll feel better" treatment. I'm not complaining about that; it's just kind of amusing to be pseudo-kicked out of the PACU. Cousin Emma knows the feeling. :) I'll give a few more details later, but now, I sleep. Thanks for the advice, kind words, and prayers!

Waiting for Surgery

This may be sideways - first time posting from my phone!

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Upcoming: Surgery #4

Yup, we're going in for another surgery this week.

At last week's audiology and ENT appointments, we determined that Becca is again having trouble hearing because she has fluid behind her eardrum. (This is the same issue that made her functionally deaf by the end of her NICU stay.) Her first set of tubes was placed at the beginning of February 2009, and her hearing dramatically improved instantaneously. Since then, we've gone through, "Hmmmm...I can't see the tubes...but they are so small, I'm not sure I would..." and, "Well, I don't know if she's hearing and just doesn't want to participate in the tests...or if she's just not hearing..." and (from our now ex-ENT), "She's got irreversible nerve damage; let's get her fitted for hearing aids ASAP," and, "No, let's sedate her and test her hearing first [this past February]...Ha! He's wrong!" and, "Hmmm....maybe she does have fluid again...let's give it a few months and see if it drains..." and then, last week, "Yep, the tubes are definitely gone, and she's definitely got fluid keeping her eardrums from moving, so it's time for surgery."

Well, at least we know we covered all our bases. :)

So, on Thursday morning at the crack of dawn (who am I kidding - before dawn!), the three of us will head up to Vandy, where Dr. Goudy will place a new set of tubes and remove Becca's adenoids. Right now we don't know if her adenoids are enlarged or anything, but when a kid gets a second set of tubes (most don't need a second), removing the adenoids reduces the chance of needing a third set by 50%. The hope, then, is that by doing both now we'll give her itty bitty ears a better chance of draining the fluid so that a) she stops getting ear infections (though she hasn't had that many...maybe 3 this year); and b) her eardrum can move, thus enabling her to hear clearly. She obviously still hears, but we have noticed that her new words are not very clear, and I'm putting the pieces together to realize that the muddled hearing might be the explanation for the mildly-delayed expressive language score we saw in her Bayley exam.

We're feeling good about the surgery. The difficult bit is figuring out how to maintain her blood sugar when she won't be getting all of her overnight tube feeding on Wednesday night. (Before surgery you have to stop all food, milk, formula, etc at midnight.) Remember, when she misses a night feeding, she gets hypoglycemic - and that's when she had her seizure in the hospital. We are working with the anesthesiologist, our endocrinologist, and our pediatrician to come up with a plan (other than mama putting the beatdown on any nurse who says that she doesn't need IV fluids, and the extra-sugary ones, to boot), and our current thought is to stop her formula at midnight and switch over to apple juice (through the tube, via the pump) until we have to stop all fluids at 4 am. While she's in surgery at 8, they will place an IV and begin fluids (D-10), which we will keep giving her the whole time she's in recovery (about 5 hours, probably). I don't know if this will be enough, since apple juice is not nearly as rich as her formula, but we'll also be checking her blood sugar periodically to make sure she's doing okay.

If none of the ear stuff made sense to you, here's a diagram that may help. (The tubes go where the eustachian tubes are labelled - they help kids with small or underdeveloped eustachian tubes drain fluid. See how enlarged adenoids could also block the tubes?) If you have specific questions, feel free to ask in a comment. Also, if you have experience with adenoid surgery, I'd love to hear any tips or stories! I hear the post-op breath is AWFUL! And, as always, we'd appreciate everyone's prayers, for the prep time/feeding issues, the surgery, and the post-anesthesia hysteria we tend to see with Becca.

Mr. Moon, Moon, Bright and Shiny Moon...

Our current 2-year-old obsession:

Make an on-line slide show at www.OneTrueMedia.com

Wednesday Weigh-In

I think I forgot to post last week, and now I don't even remember what she weighed. I think she had just gained an ounce or so? At any rate, here are this week's stats compared to 2 weeks ago.

Two weeks ago: 8.4 kg (18 pounds, 8 ounces), 30 inches

This week: 8.45 kg (18 pounds, 10 ounces), 29.5 inches

Two week's change: +50 grams/2 ounces, -0.5 inches

Net change: +750 grams/26 ounces, +0.5 inches

Two ounces in two weeks is not the kind of gain we are looking for. We'd like to see about three ounces a week. I'm not sure what else to do about it, since she throws up if I bump up the volume of milk, and she's eating her solids fairly well. Last week, the nutritionist sampled us some super-duper juice that has over 300 calories per 8 ounce juice box (compared to about 70 calories in regular juice), but we've already run out. This summer, she gave us a can of DuoCal (powder calorie booster) to put in her juice, but Becca refused to drink any of it; now we're mixing it in water and putting it straight into her tube. That gives her an extra 25-50 calories per day (depending on how much I'm able to get in there before she wiggles away again). I think she's just so darn active these days that she burns everything off. But we want her to be active! I guess we'll keep trying to push the Nutella (yum!) and "popples" (a.k.a. popsicles).

Here's a picture of Becca hanging out with her favorite Hill aunt (Jen) this weekend while I was in New York. I think it's pretty obvious just how much they love each other!

p.s. Be sure to check back tomorrow for a video! I've been getting lots of requests for videos, so I'm trying to upload some of the many that are languishing on our hard drive. This one's super cute!

Developmental Update, 2 Years Adjusted

One of our appointments last week was Becca's 2-year visit to the NICU follow-up clinic. We were sad to find out that Dr. Daily had retired, but we got to once again see Odessa Settles, who I believe has been working with preemies at Vandy for 40-some-odd years. Wow. She's extra cool because she's a vocalist on the side, appearing as a regular cast member on Tokens, "Nashville's New 'Old Time' Radio Show." In fact, they are recording an episode at the Ryman on the Sunday before Thanksgiving, and the guests include Keb' Mo' and Shane Claiborne. John and I are going, so let me know if you'd like to join us...or if you want to hug an Itty Bitty that night. ;)

But back to Becca. This visit involved a complete Bayley exam, which measures development in 5 areas: cognitive (thinking and figuring things out), receptive language (words she understands), expressive language (words she actually uses), fine motor skills (tiny movements) and gross motor skills (big movements). (The previous link describes the 5 areas in more detail, if you are interested.) For each area, I'll give you 4 scores: the overall average for kids taking the test, her score based on her actual age (27 months), her score based on her adjusted age (24 months - remember, this is based on her due date "birthday"), and her age-equivalent.

Cognitive: Average = 85-115

Actual = 95

Adjusted = 105

Age-Equivalent = 25 months

Receptive: Average = 10

Actual = 10

Adjusted = 12

Age-Equivalent = 26 months

Expressive: Average = 10

Actual = 8

Adjusted = 9

Age-Equivalent = 22 months

Fine Motor: Average = 10

Actual = 8

Adjusted = 10

Age-Equivalent = 23 months

Gross Motor: Average = 10

Actual = 6

Adjusted = 7

Age-Equivalent = 18 months

When thinking about these scores, keep in mind a few things:

• These scores are a snapshot of the tasks she was able to complete on a particular morning. I'd say that she was pretty much herself that morning, though she did get tired by the end of the 2-hour exam (go figure).
• When looking at month-by-month age equivalents, our goal is still for her to track according to her adjusted age. Many doctors, schools, therapists, etc. stop adjusting for prematurity at age 2, but folks in the NICU follow-up clinic say to give micro-preemies (preemies born weighing less than 2 pounds) until age 3 to catch up. In other words, she will look more delayed because most assessments stop adjusting, but don't get too worried about lack of developmental catch-up until she is 3. (But then again, much of a child's developmental trends are well in place by age 3; that's why many public health organizations focus on the 0-3 years.)
• Given her history, every single one of these scores is absolutely amazing and far better than we even risked imagining 2.5 years ago.
• And the usual caveat: no developmental assessment (or any standardized test) is perfect.

That being said, these scores are okay. I wouldn't say she blew it out of the water or anything, but none of these scores is really surprising. Based on her adjusted age (24 months), she is delayed in expressive language (by 2 months), fine motor skills (by one month) and, most significantly, gross motor skills (by six months). Based on her actual age, she is delayed in every category, the most dramatically so being her 9 month delay in gross motor skills. This score is even more sobering when I realize that had she not started walking this summer or had we done the assessment at our regularly scheduled appointment (the day after her birthday), she would have scored at an 11-12 month level for gross motor skills. The positive flip-side of that is that she gained 6 months worth of skills in 2 months just by learning to walk. So I'm pretty sure that Jane and Ashley (our physical therapists) deserve a very big shout-out on that one. In fact, let's take a minute to thank ALL of our incredible therapists: Cindy, Jane, Caroline, Karla, Roxanna, Ashley, Tom and Melissa. Without their help, I shudder to think of how far behind we'd be. As much as I get sick of carting the kiddo around to appointment after appointment, I am so thankful for all the work and love these therapists have poured into my sweet child. It really does pay off!

Based on these scores, we're not sure if Becca is going to qualify for special education services when she turns 3. I don't know if I've mentioned it on here or not, but at age 3, kids with special needs shift from Early Intervention to the public school system for their services. When we moved, we made it a priority to live in a school district with a very good special education program in case we needed it (whether for Becca or for our other potential preemies down the line...and yes, John and I do plan that far ahead for such extenuating circumstances...at least when buying a house!). We'll begin our transition meetings with Early Intervention and Williamson County Schools in January, and they will do another round of assessments, but it looks like she may be borderline for services, depending on which ones they consider primary vs. related. (For example, in many school systems, physical therapy is a related service, meaning that you can't qualify for special education services on physical delays alone. However, if you qualify, say, on speech, you can receive physical therapy at the school as part of your Individual Education Plan.) I know, I know, I'm getting ahead of myself here, but, wow...that's really not that far away! I would be thrilled if she flat-out didn't need services, but I'm afraid that she will fall just above the cut-off and not end up getting the services that would really benefit her. Especially if we lose our TennCare at our next review in the spring, we'd be left with muchos therapy bills. (And therapy is NOT cheap. I opened a bill from PT recently, and each 1-hour session was running about $300. Holy crap.) For now, I try not to think about it too much!

The most important point, though, is that Becca is making tremendous progress. Given the incredible odds stacked against her, she has exceeded everyone's expectations. In fact, if she were taking her O.W.L's, I would have given her straight "O's," for "Outstanding." Yes, we have lots of therapy in our future. (Now that I think of it, I was really hoping that she'd come out with amazing scores and we'd be able to drop some sessions...but we're not there yet.) Yes, we have to do a lot of hard work at home. But yes, she is -- and will continue to be -- absolutely amazing. I'm very proud of you, little girl!

Dog Park!

A couple of weeks ago, we discovered the Spring Hill Bark Park. It was a little crazy for me to take Becca and both dogs on my own, but it worked out. Given that the dogs sniffed around, ran for a minute, and then took shelter from the heat by hiding in the shade, while Becca explored just about every inch of the park, I would say that she had the most fun of all. I'm excited to go back now that the weather has turned pleasant!

Sasha, in her black fur coat, trying to cool off:

And dapper little Buster, doing the same:

Becca has recently learned to hold her nose and say "peeee-uuuu!".

The breeze catching the poop can gave her plenty of cause to exhibit this new skill:

The fascination with the fire hydrant really grossed me out.

Much hand scrubbing followed these pictures:

I love how Sasha is going into a point here - not sure why, but it's pretty cute,

as is Becca's use of the dogs' agility equipment. Perfect fit!

Becca is 2 - Again!

Today is two years from Becca's due date. That makes her two by virtually all definitions. Her actual age is 27 months, but her adjusted age is now officially 24 months. I have a 2-year-old. A lot of professionals stop "adjusting" for prematurity at 2; that is, they don't take into account the extra 3 months that she's been ex utero, but the doctors who deal most with micropreemies (preemies born under 2 pounds) suggest giving a child until 3 to fully catch up and adjust up until that third birthday. I figure at this point it's easiest just to refer to Becca as being 2, and I'll tweak when I bestow upon her 2 -and-1/2-year-old status. Unless, of course, she starts telling people her age herself. Could happen tomorrow.

I won't rehash the past 34 months for you and tell you how thankful we are to be here. I'd do it all over again in a minute if that's what it would take to have our baby girl with us today, and it's simply impossible fully to express our gratitude. I'll just skip to the best part. And here she is:

saying "Ta-Da!" (from gymnastics)

being beautiful:

telling Sasha "No!" while Daddy puts the smack down, Dog Whisperer-style:

and one more "Ta-Da!"

(The real-from-the-pro-shop leotard was her "other birthday" present...off the sale rack, of course! She loves that it's covered in stars - a big favorite these days!)

I would really, really love to write a long, eloquent post about how wonderful Becca is, give you an in-depth update on all her medical issues (some of which are non-issues now!), and tell you her birth story the way I now tell her, but, frankly, I don't have it in me tonight. I've got a million appointments this week, a trip in a day and a half, a sick husband, a very rambunctious 2-year-old with an ear infection, and 2 days of Clomid in me. Someday these posts will be written, but not tonight.

Tonight I'll just say that Becca is happy, so very happy. She loves the life that she almost never had. She takes everything she has to do in stride...and a stride that is more barreling than tiptoeing. She makes herself known and knows no fear. She has developed the funniest sense of humor and is just plain cheeky at times. She's stubborn and determined. She's everybody's friend and can charm a full waiting room in 5 seconds flat. She's a happy girl...and so am I.

I am so grateful.

Clomid Day 2

Making fudge on the first day of my Clomid run was quite possibly the best decision I have ever made.

This Week's Preview

This is one very busy girl this week.

Monday, she goes to school (hooray!) and then to see the nutritionist at Vandy.

Tuesday, she goes to gymnastics in the morning and then the ENT and audiologist in the afternoon -- AND TURNS TWO, ADJUSTED! Wowzers!

Wednesday, she has physical therapy, occupational therapy, and a pediatrician appointment (probably with a flu shot), all in a row.

Thursday, she has her 2-year (albeit late) NICU follow-up appointment, which is rumored to be 2 hours full of in-depth assessments. I, of course, am excited about this one, except that we are going to have to wake up at the crack of dawn to get there!

Friday, she has feeding therapy, like normal.

SuperDad is in Kentucky all day on Tuesday, and on Thursday night I - I'm so excited! - fly to NYC to see one of my best friends in the whole wide world (Lauren S., for you Brentwood folks) and her sweet baby Everett (or Eh-vy, as Becca calls him)! We had some vouchers from past travel so Lauren's sister, Sarah, and I are flying for $64 roundtrip! Wohoo! So it's really a busy week for all of us, but I'll try to update as we make our way through appointments. And while we don't actually (yet) use the Wii in her therapy, I do often see this hard-at-work expression on her precious face. She's such a trooper! You're doing great, Becca Hill!

Keeping the Faith, Toddler-Style

As a pastor and a mom (and a seller of books, to boot), I'm occasionally asked which Bibles or Christian books I like for kids, so I thought I'd share a few of my favorites with you.

Eager Reader Bible

(Tyndale Kids, 1994)

Even though we received several kids' Bibles as baby gifts, I wasn't really ever very happy with them and besides, I wanted to give Becca a Bible myself. I picked this Bible story book after perusing several options, and while it's not perfect, it does a great job of introducing about 100 key Bible stories from the Old and New Testaments. (I think there's also a Catholic version with a few more stories.) Each story is four pages long, and every page has a bright, colorful picture. At the end of each story there is a question that furthers reading comprehension. We're not really at the point of using the questions yet, but we'll get there soon. And since I'm being completely honest, I'll admit that there have been many days (and even weeks!) since Becca came home that this book is the closest I've come to reading Scripture. The Old Testament section is particularly good for reminding me of the different phases of Israel's history, which can often get blurry, even for folks with multiple degrees in religion! (I am particularly amused by the way some of the stories have to be sanitized. For example, Rahab is simply "the owner of a house." Niiiice.)

Psalms for Young Readers

(Marie-Helene Delval, Eerdman's Books for Young Readers, 2008; illustrated by Arno)

I love this book. It's simple and beautiful and poetic and gorgeous. And I love it. As the inscription says, "This selection of Psalms, paraphrased for young readers, uses language and imagery appropriate for children while remaining faithful to the spirit of the biblical texts." It doesn't have every psalm in it, but the 40-ish that are paraphrased and excerpted (a stanza or two each) are paired with a gorgeous illustration in the same folksy style as the cover (shown above). One of the aspects of our faith that is most important to pass on to my children is the notion that we can take any feeling, any emotion to God, and that's exactly what the psalms are: praising, ranting, raving, questioning, delighting, confessing prayers to a loving God. And it doesn't hurt that since we never read the whole book in one sitting (it's 88 pages!), I can say "one more" and only have to read one more page instead of an entire book!

The Usborne Book of Bible Stories

(Heather Amery, Usborne Books, 2007)

I promise this isn't just a shameless plug: this is a really great book. It's one of our dual-readers, meaning that --and this is a genius idea! -- on each page there are words at the top and on the bottom. If you read only the top lines (which have simpler text), it reads as a complete story, but you can also read the bottom lines for further detail. When a kid is learning to read, you can alternate; they read the top and you read the bottom, helping build their confidence and encouraging independent reading skills. Or, in toddler-world, you can get the point of the stories across reading the top lines only when you are in a hurry or when that oh-so-brief toddler attention span evaporates mid-story. So smart. These stories are a bit longer and more in-depth than the stories in the Eager Reader Bible, so they balance each other well. It's also nice that it comes with a read-along c.d. for the car or quiet playtimes. My sweet godson will definitely be getting a copy!

And one non-book recommendation:

Seeds Family Worship

When my very wise friend Marissa wrote about Seeds Family Worship cd's, I knew I needed to check them out. I'm so glad I did! All the lyrics are straight from scripture and set to -- wait for it -- non-annoying kid-friendly melodies! Amazing, I know. As far as scripture miracles goes, this one might be right up the with the translation of the Septuagint. I know that by far the best way for me to memorize scripture is through music, and I know many kids are the same way, too. (Ask me to quote any verse we say in Sonshine Choir 15 years ago, but don't ask me to quote you what I read just yesterday!) And speaking of genius ideas, how 'bout this one? Each album is sold in a twin pack: you keep one c.d. for you and give one away, all for the price of one album. Another bonus: if you are in Nashville, you can pick a couple up directly from their office, saving you shipping charges. (E-mail the contact on the website to set it up. And yes, I am that cheap.)

Now I'm curious. What books or resources do you use to teach your toddler about your faith? Are there particular faith practices you have incorporated into your family life?

Cycle Day 1

Warning: if you don't like ovaries, you might not like this post. Get over it, boys. Do I have any male readers, anyway? Speak up, if so! And it's kind of a long post.

We had a great appointment with Dr. Sizemore on Wednesday! It was a completely different experience than my typical appointments at the Vandy practice. First of all, I called last week and got an appointment at a convenient time this week. Whoa. There's just the two docs in the practice, a few nurses, a phlebotomist, and a receptionist. After the very short walk from the parking garage that had plenty of open spaces, I walked in and the receptionist (whom I had never met) called me by name. The office was calm and peaceful, but the waiting area also had a few of Becca's favorite toys, so she was happy. They took us back as soon as I finished my new patient forms. (Funny aside - John got there before we did, so he started filling out my forms, sweet man, but appeared baffled by the "gynecological history" section...like he couldn't even mark whether or not I was sexually active. When I mentioned it, he joked that he would rather put "not enough" instead of a simple "yes" or "no." :) ) After the weigh-in (down a few pounds!) and blood pressure (higher than normal - this was the 4th appointment of mine and Becca's day), we had just enough time to look up the numbers for my docs in Louisville (which we needed to request my records) before Dr. Sizemore came in.

Pause. I've got to tell the Candler folk that Dr. Sizemore looks just like Mark Rogers-Berry. Similar mannerisms and everything. I find this simultaneously weird and comforting. But the last doc looked like Dr. Brelsford, who, while he may be an excellent professor, is not someone with whom I would necessary discuss my lady issues.

Okay, picture go forward. (Special reference for Brandy H. there). After a few minutes of catching up and talking about how amazing Becca is (remember, he was the first person to lay eyes on her tiny self), we got down to business, which, thankfully did not involve an actual exam of my business. We gave him the run-down of the difficulty conceiving Becca (4 months, quick PCOS diagnosis, Metformin) and on our attempts over the past 12 months (pre-conception consult with the maternal-fetal pre-eclampsia specialist, adjustment of psych meds, temperature monitoring, 4 rounds of Clomid at 50 mg a day without monitoring from the doctors (don't get me started), irregular periods, even on the meds, a billion pee sticks, 5 months of Metformin, and a general lack of follow-through from the doctors). I also mentioned that I still have pain from my c-section, 2 years later. (The pain is internal, not at the incision site.) We wondered if that could indicate an issue, since I didn't exactly give myself much time to heal; besides, the c-section is the only difference John and I could really identify between this time and last time.

I asked him if he thought we were crazy for trying again, and he said no, that we seemed to be aware of the risks, which he didn't think were deal-breakers. Then he said that we really ought to be able to get me pregnant, and from that point on, everything was in terms of how and when and never if. That was such a change! My poor overscheduled doc at Vandy was so ready to send me over to the infertility specialists (that we can't afford), but John and I didn't feel like we had really done everything that a general OB could do (like follow through on the actual treatment plan). The root issue is that I don't ovulate reliably or predictably, even when I was on Clomid. Oligomenorrhea (infrequent periods) is a gynecological problem outside of trying to conceive, so a general ob/gyn is equipped to treat it, and insurance covers it. We all agreed that if I can ovulate, then I ought to be able to get pregnant, so that's our goal. (Of course, there may be other issues, but since I did get pregnant before and do have trouble ovulating, this is the first issue we have to deal with - until we get past it and something else crops up, we'll assume that there aren't other issues.)

So, how are we going to convince my body to ovulate? Here's the plan:

• Fortuitously, I have (mostly) started my period today, making this cycle day 1. That's convenient, because we were going to have to wait for a new cycle or jumpstart a new cycle (with progesterone) to get this party started.
• On day 3, I'll have blood drawn to measure my FSH level (follicle stimulating hormone?). These levels will tell us how my ovaries are functioning. (I don't really understand the science behind it yet, but I'm okay with that.) Turns out day 3 is going to be on a Saturday, which would make this test impossible at the Vandy practice since they aren't open on Saturday. Neither is the new practice, but the outpatient lab at the hospital (Williamson Medical) is, so they've already sent the order over, and I can just stop in on Saturday.
• On days 5 through 9, I'll take 100 mg of Clomid. Before I had been on 50 mg and ovulated 2 out of the 4 months, which is just about what my average without the medicine had been. Clomid, by the way, is not covered by insurance, but the ten pills I need for this cycle's dose only cost $16. We can handle that. :)
• Starting on day 12, I'll pee on sticks (ovulation predictor kits - OPK's) at least once a day in hopes of catching the Lh surge (a hormonal spike) that precedes ovulation by 24 - 36 hours. This could be tricky because apparently I have a quick surge and drop or something because I have never once gotten a positive OPK test. Apparently I'm not alone in this, though the doctors both looked at my quizzically when I told them so. My dear sister-in-law once referred to OPK's as "a complete racket." Still, I dropped another $40 on this month's pee sticks. (By now I totally would have gotten my money's worth out of the $200+ fancy fertility monitor that I guess I should have purchased to begin with.)
• That week is John's favorite week of the process. I'm a fan of it, too. 'Nuff said.
• On day 21, I'll go in for another blood draw. This time they will measure my progesterone level in order to determine whether or not I actually ovulated. (Progesterone is much higher in the second half of your cycle. That's why many women are really tired before they get their period.) At this point, it is too late to fertilize an egg that has been released (they only live for a day or two), but it will tell us whether the Clomid has done its job.
• About a week later, as Dr. Sizemore said, we'll get our positive test result. NBH (New Baby Hill) will (would, really) be due right around Becca's 3rd birthday. Voila!

That last point is not so much a guarantee, of course. Part of me worries about getting my hopes up too high, but most of me wants to run with the doctor's enthusiasm and optimism. We needed an injection of positivity, if you hadn't noticed.

Speaking of injections, if I don't ovulate at this level of Clomid, next cycle he may give me an HCG injection that somehow magically makes me ovulate (in some circumstances). If I do ovulate but don't get pregnant, we may do a...crap, forgot the name...they may inject my uterus with a bunch of fluid and look at it on an ultrasound or something or other and check for scarring from the c-section that might be causing problems. (He offered to go ahead and do this, but we opted to wait until we really get a good Clomid cycle with the appropriate tests before exploring this possibility further. A much better approach, I think, than the old doctor who told me I just had gas. Nice.) If we are still having trouble in a few months, we may have John tested, but with guys it tends to be a bit more all or nothing in terms of fertility, unless there has been some kind of significant illness, physical trauma, etc., and since we conceived Becca, then we don't really anticipate an issue there.

I think that's about it. I hope this makes sense; I'm incredibly tired today. Becca seems to be shifting her sleeping pattern...as in, not sleeping as much. Dislike. I also noticed while writing this that I know much less about the medicine and physiology of infertility than I do about all of Becca's medical and developmental issues. And I'm okay with that. I know enough to understand what's going on, and at the moment our issues are pretty clear-cut, unlike many of little missy's. It's kind of refreshing to have problems that doctors have seen a million times instead of always being the exception. But it's still nice to be treated like you aren't the millionth patient they've seen that day.

Oh, and as an added bonus, he wrote me a prescription for Nexium so that I can stop buying Zantac in bulk. (Turns out if you are having to take Zantac 5 days a week, you really ought to be on something stronger.) And since I had a coupon, the extra prescription got me another $10 Target gift card, so I won free money, right? (I won't mention that the Rx cost $30 on its own, though...) Still, it justified a purchase of uber-cute Halloween p.j.'s for for my favorite little witch.

All in all, we are feeling much better! Thanks for the encouragement and kind kind thoughts!

Wednesday Weigh-In

Last week: 8.3 kg (18 pounds, 5 ounces), 29 inches

This week: 8.4 kg (18 pounds, 8 ounces), 30 inches

Week's change: +100 grams/3 ounces, +1.0 inches

Net change: +700 grams/24 ounces, +1.0 inches

Good week! She up a pound and a half in exactly 2 months!

Cycle Day 63

I am officially on cycle day 63. For you lucky folks not concerned with fertility, that means my "cycle started" (um, I got my period) on July 7th and has not re-started since then.

No, it's not because I am pregnant.

It's because my ovaries are, well, constipated.

I have PCOS, meaning that my ovaries don't, you know, ovary. Or ovulate, to be more accurate. So the little eggs that would eventually turn into adorably witty mini-me's stay tucked away in their nice little home. Maybe they are just lazy. Maybe they heard what a tough go round the last egg that was impregnated had. But whatever they do, they don't, ahem, present themselves for service.

As you know, we've tried a few different medications, including the Metformin that I am not taking. I have ovulated on both Clomid and Metformin, but for whatever reason, nothing is sticking, if you will. Neither medicine has made me ovulate dependably or predictably, making scheduling some, um, quality time difficult.

I'm getting really frustrated. No, I'm not really getting frustrated...I'm more getting...dejected. And very sad. I'm nearly ready to leave this whole procreation mess behind and look at other options like fostering and/or adopting. SuperDad is not so ready to move on. Even so, I almost called it quits a couple of weeks ago. I mean, it's been almost a year (a full year next week) since we started trying to conceive, and it's not like my body's all that good at this pregnancy thing anyway. We're not getting much help -- and no support -- from my OB/GYN, especially considering that you have to fight a small war to get in to see him in a timely manner (and fertility issues tend to be rather time-sensitive). My current OB/GYN was basically selected by default anyway. (Since the high-risk folks only see you when you are pregnant, I went to the first-available regular doc at Vandy.) Our insurance has absolutely zero coverage for fertility treatments, and we couldn't even consult a specialist without having to, oh, sell a car or something. (I've seen enough specialist bills in my time!)

But then last week I stopped into a medical arts building here in Spring Hill to make a dentist appointment for Becca, and lo and behold, a new OB/GYN practice has opened there...and one of the doctors is the guy who delivered Becca during his residency at Vandy! So I got to thinking...

Sure, he's young, so he doesn't have as much experience. He's not a Vandy SuperDoctor, though he was trained by them. He's a doctor of osteopathic medicine and not an MD, which is different for me. (DO's apparently have very similar training as MD's - same boards, residencies, etc., and can specialize in anything, but they tend to take a more holistic approach.) That's probably a good thing for me. The main office is in Franklin, not far from John's work, and he's got the smaller Spring Hill office a few days a month. And, besides, he's seen the inside of my uterus. Not many doctors can claim such, um, intimate knowledge. Can't really beat that. And when I called, they were able to get my in this quarter. That's improvement.

We've got an appointment with him today. I'm excited to have some fresh eyes to take a look at me and our efforts and maybe offer a little more in the way of options or support. I don't expect to walk out pregnant or anything, but I have a feeling he'll at least be willing to work with us a little more instead of saying, "Let me write you a referral to my fine reproductive endocrinologist colleagues. Don't worry; they can work out a payment plan for you." Ugh. Or maybe he'll say, "Are you crazy? I saw you last time around! Don't try this again!" I don't know. But I'm excited to have the conversation about my fertility, and that's saying something these days.

Gymnastics!

Last week when I caught Becca doing this:

Make an on-line slideshow at www.OneTrueMedia.com

I knew that my plan to enroll her in parent-and-child gymnastics classes was a good one! (And apparently Sasha needs them, too!)

We started today at the Spring Hill location of Let It Shine, the same organization through which I took gymnastics classes as a kid. She had so much fun! (And I kind of kind of loved it, too!) We spent the first 15 minutes working our way through an obstacle course, which included activities like climbing up and going down a slide, walking on two stripes (that will eventually turn into crab walking or bear crawling), doing a very rudimentary cartwheel over a bolster, trying out a forward roll down a slope, etc. Then we moved into the big gym and bunny-hopped and/or ran down the tumbling track (think huge mattress with sides), rode a zipline (on a seat and being supported, of course), walked on balance beams, jumped on the trampoline and, yes, jumped into the foam pit! (The foam pit is a big pit with a trampoline at the bottom, filled with foam cubes. It's fun to get lost in, to wiggle in, to bounce in, really to do anything in. Everyone loves the foam pit! Is this a Let It Shine thing, or do most gyms have them?)

Becca did really, really well, considering that it was her first class and given her sensory issues. I often talk about her sensory issues in relation to her eating, but they also come into play (in a big way) with gross motor skills. Since her vestibular (balance) centers are wonky and she doesn't have good proprioception (the ability to know where you are in space and in relation to objects and such), skills like standing, walking, running, jumping (and even earlier skills like crawling) are difficult for her (hence the delays). At the same time, though (I feel like I say that all the time...sensory issues are so complicated!), since she is hypo-sensitive, generally speaking, (meaning that she doesn't really feel things correctly), she seeks sensory input she can feel well, like rolling, spinning, swinging (depending on the direction), shaking and generally rough-housing.

Gymnastics, then, is perfect therapy for her! It works many of the areas that need to be worked by doing things that she loves to do! And actually, her physical therapy sessions these days really do look a lot like gymnastics class, complete with a pit (not foam, but similar), a balance beam, stairs and a track. (There are also other exercises, like kicking a ball, that we do that aren't really gymnastic-y, but they all work together.) And since Becca is so social (if you know her in person, you are smiling now, right? Because she's really beyond social. :) ), the class setting is ideal for her. She loves to watch other kids and then jump right in. According to her (new) occupational therapist (who is great but is no Karla B. ;) ), since things feel weird and unstable to her, she depends more on watching other kids (or people in general) do things to know that they are okay. The good thing is that with her personality, she doesn't just watch for very long!

And I'm not going to lie; I really liked getting to meet other caregivers of young kids in the area (mostly moms, but one dad and one grandmother). I'll also confess that while I certainly don't want to put any pressure on Becca to become a star athlete at age 2, I also have some long-term motivation in enrolling her in gymnastics. Becca can and will do whatever she wants in terms of extracurriculars (as long as we can manage it logistically and financially), but I also want to introduce her to the areas that might be a little easier for her. Let's face it: she's not built like your average WNBA star. Of course I'd never say that she's not going to play and love basketball, but it makes sense to start her off with activities in which she's not already at a disadvantage because of her size. I mean, she is still our Itty Bitty - but I'm not about to be the one to tell her so! :)

p.s. Big thanks to Aunt Daphne and Uncle Rob (and crew), Martha S., and Cousin Mary Lou, our gymnastics "sponsors" for September and October classes! :)

Brand Power

Becca now not only recognizes Elmo, Abby, Eh-nie, Oshar, Tookie, Rover and the rest of the gang, but she also recognizes

the brand.

Today she found the logo on the inside of her new Elmo shoes (consignment sale find - $5 - but I would have paid $25!) and promptly started chanting "Seseme! Seseme! Seseme!"

At least it's a brand I can trust, I guess!

Wednesday Weigh-In

Last week: 8.25 kg (18 pounds, 3 ounces), 28.5 inches

This week: 8.3 kg (18 pounds, 5 ounces), 29 inches

Week's change: +50 grams/2 ounces, +0.5 inches

Net change: +600 grams/21 ounces, +0.5 inches

The granulation tissue is improving. After burning it with silver nitrate again on Friday (at the surgery office), I put alum on it, and it turned really disgusting. I'll spare you the gory details, but it looks like it might be on the retreat.