Christmas, and our trip to LA

We went down to LA to celebrate Christmas with both sides of the family this past week. It was Simon's first trip :). He did pretty well, except for a little whining/crying in the car when we hit traffic in LA.

Here's a summary of our trip, day by day:

Dec 22 - drove down to socal. We originally wanted to drive down at night so that he would be sleeping, but decided that would be too tiring so we opted to drive during the day. Simon spent a lot of time napping in the car, which was pretty good. In between naps I sat in the back and entertained him. It was a little tricky nursing him in the car and he didn't really eat much that day. When we got to LA we hit traffic and he got kinda fussy, didn't want to be in the car seat anymore. I can't really blame him.

Dec 23 - visited Esther, Jason and their daughter Kayla! Kayla is 4 days older than Simon (they basically had the same due date). She's a little bit shorter than Simon but chubbier and very cute :)

Dec 24 - Dinner at Jeff's parent's house. Simon met Jeff's extended family for the first time!

Dec 25 - Dinner in Arcadia. Lots of mahjong was played.

Dec 26 - drove back up to norcal. No traffic this time, so less crying from Simon.

Dec 27 - not part of our trip but had more visitors - Grace & Joyce (my cousins on my mom's side) and their babies Owen (11 mon) and Sinjin (14 mon).


Overall the trip was really great except several things. First, Simon didn't sleep that well in his pack n play and basically slept with us in bed the whole trip. Which was ok except he woke up multiple times at night and made us both kind of tired. Second, Simon came down with this weird rash which, after consulting with my pediatrician friend, was probably a viral rash. I ended up catching whatever virus he had and got sick on Christmas day...only started feeling better today. Simon also seemed a little under the weather and threw up twice the day we got home. Seems better now though.

Simon also hit so many milestones this week. Must be a wonder week. He suddenly became very interested in everything he could get his little hands on, so he would constantly be grabbing stuff and looking at it, shaking it, etc. One of his favorite items this past week was a little bell on a red string (except when he would swing it around and hit himself in the face with it :P)

He also is very motivated to try to crawl. He can't yet, of course, but he sticks his butt in the air trying to scoot forward.

Lastly, and most entertaining of all, is that he started babbling. It just started out of nowhere and now he won't shut up :). Soooo cute. He just starts saying what sounds like "bah bah bah" and looking at you as if he's talking to you. He gets the best expressions on his face when babbling. He also learned to scream/squeal - very high pitched and loud!


Anyway, I will post pictures in the next post but it's time to go to sleep. To be continued!!

December already

The last two weeks have sure gone by quickly. The end of the year, with all the holidays and get togethers, always seems to fly by. 

For me, November/December always brings up lots of time for reflection and conflicting emotions-- regret (for another year gone, and things left undone, goals not accomplished), anticipation (for the new year and things to look forward to), and excitement (for quality time with family, a break from work).

This year there have obviously been lots of changes with Simon. The holidays seem to matter a bit more with family time. Besides that, though, I've been thinking a lot about finishing residency and work next year. My mind constantly wanders to what I'll be doing after graduation. Again, a mix of emotions - excitement to be finally done with residency and long work hours, but also apprehension and a sense of uncertainty about what I'll be doing, focusing on. It's uncharted territory for me since I've had a pretty clear path since college. Get into med school. Get married. Get into residency. Have a kid.

 I just don't really know what I want. I know what I don't want more clearly than having an idea of what I'll be doing. I suppose it will be part time work and part time mom. I suppose I will have time for extracurriculars/hobbies again? Everyone tells me it gets "so much better" after residency so I guess I should be excited. And I am, for sure, especially on those days where I've been in the hospital for way too long. 

Anyway. Enough rambling on my inner angst :) time for some Simon pictures! 

Simon is getting more and more aware of his environment now. He loves to look around and gets bored with the same stuff. He is really good at rolling back to front but sometimes get stuck on his belly and can't roll back. This happens almost every night now where he gets stuck and then starts fussing, which wakes me up. Hopefully he gets better at rolling himself back so he can go back to sleep by himself.

His two favorite things to reach for now are my phone and my water bottle. Haha. Can't believe he's already into screens! 

I've tried several purees now trying to get him started on solids, since he's really into what we're eating. So far I've tried apple, pear, oatmeal and avocado. He doesn't seem to be that into eating but he does a decent job of swallowing. So I'm just taking it slowly until he really starts picking up his interest. 

Laughing at me saying "ahchoo!!"

Getting so big now. I remember when this outfit was way too big for him. Now it fits just perfectly.

30

Yesterday I turned 30. Jeff and I had a nice quiet celebration with a sushi lunch on Sunday and some desserts from Paris Baguette. It was really nice and I didn't miss having a big party with friends. I think if we had tried to organize a big get-together we would have both ended up even more exhausted than we already are. The only thing that put a damper on our weekend was a nasty stomach bug that I got on Thursday which I then gave to Jeff (sorry, Jeff). Somehow Simon was spared. 

My birthday also marks Simon's 4 month birthday :). Happy 4 months to my sweet baby! He keeps getting more and more interesting and is learning new skills so fast. It really is amazing watching him grow. I love making him smile :).

Happy Thanksgiving

It's been a very fun family filled Thanksgiving weekend. I barely had to work Friday so it was like having a four day weekend! Very precious and valued time off indeed.

Jeff's parents came up and stayed with my parents so both sets of grandparents had their fill of "Simon time". He is one very loved baby! I think he enjoyed all the attention because today, when we finally had some down time at home, he would fuss if not picked up and held. 

Simon is growing and hitting all his milestones. At his 4 month visit he dropped his weight percentile to 75%ile and his head circumference to about 75% as well but his height remains at 90%ile. We're trying to encourage him to drink a little more milk at each feeding (from 4 to 5 oz) which he sometimes does and other times still drinks 4 oz. I think maybe it dropped a bit because the week he was sick he didn't eat much at all. Anyway, his pediatrician is still happy with his growth and he now weighs a hefty 16 pounds, 3 ounces. Doubled his birth weight!

Simon can now roll over both front to back and vice versa, so we can't just leave him on the couch anymore without close supervision :). He also is much more aware of his surroundings and reaches out for objects/stares at things in front of him very intently. This includes my phone, which he tried to grab today :). 

I'm feeling extremely lucky and thankful for having such an amazing family. These are good times, indeed. Everyone is in good health, and we all have everything we could possibly want and more. I get so easily caught up in the little trials and stresses of my daily life that I forget how good I really have it. I try to remind myself when stuck in traffic and anxious to get home that it means I have something really awesome to go home to, as well as a job and a car, and at least I'm not still working. :]

Here are the latest pics of Simon. His  cheeks!! 

Milestone achieved!

Over the weekend Simon figured out how to roll over. I put him on his back and went to brush my teeth. When I came back he was on his belly! Heehee. He's not very good at it yet and can't really do it routinely, but I'm sure it won't be long before he rolls all over the place. 

Something else he learned to do was blow raspberries :). It's so cute!! I blow them back at him and he starts laughing. Jeff says I'm reinforcing bad behavior :P

Surviving the sick

I'm Last week Simon was sick, and there were a couple of miserable nights where he would wake up coughing and barf after eating. All over me in the middle of the night. Jeff and I both lost a lot of sleep from that...to top it off, I got sick also and I'm still fighting it. Blah. Jeff ended up just keeping Simon home Thursday and Friday so he could get better. 

Luckily Simon got better over the weekend and is just has a residual cough. His appetite is back to normal which is a relief :)

In terms of milestones, Simon has started to try to roll over from back to front. He basically ends up on his side but can't seem to flip all the way over. Maybe it will happen soon! 

Simon is sick :(

Over the weekend Simon and I have both come down with a cold. I was dreading this moment - although I knew it was inevitable with him attending daycare, I was still hoping he'd escape the germs for a little bit longer. He was congested starting mid-week but woke up with a cough today. We skipped church after he coughed so hard he threw up :(. Probably better for us to stay away and not spread the germs to everyone else. 

True to his nature, though, Simon stayed cheerful and easily soothed despite the cold. He did nap more than usual today, which is good. Still eating the same amount but with the barfing (he barfed in the car seat when I brought him to watch Jeff play flag football) not sure how much he actually got today. As long as he has a good appetite I'm not too concerned, though. It's just a pain to wash all the things he barfs on.

Also, we are finally putting the nose frida to good use. Simon hates it when we suck out his snot, haha. But it makes him breathe so much easier. 

My sick baby passed out in my arms. Hope he feels better soon.

Simon the shark

Updates!

Yikes, I haven't posted in a while because it's been so busy. Since my last post, I've switched rotations - now at the VA being chief (woo), Simon turned 3 months old, and life in general has been good. 

Simon has been going to daycare full time and is doing well there. He "talks" a lot now and smiles when you smile at him. He loves playing airplane and his head control is so good! When we hold him upright he looks around like a boss. Unfortunately this week we both came down with something viral. Hopefully it's just a little bit of nose congestion for Simon and nothing worse. I'm just feeling extra tired from the illness (after having diarrhea for one day, so strange).

Work is good. I've been looking for a job and it's been quite discouraging since there are very few jobs in the Bay Area right now. I haven't asked at that many places, though, and maybe I should be more proactive but from what I'm hearing from other people nobody is hiring. And I'm not terribly keen on finding a super busy private practice job either...I really want to work less after I graduate, not more...anyway, I'm trying not to stress too much about it. 

Now for some pictures!

We survived another week!

Another week has flown by. This week was special because Jeff's mom flew in from LA to stay with us and help us out with Simon-care. I think it's safe to say that all of us were very happy to have her around, especially Jeff haha. Simon also started daycare this week (3 half days) and seems to be adjusting to that well. Next week he'll be there full time. The daycare workers say that Simon is very happy and well-behaved. :) he even has managed to nap there, which is impressive considering it's kind of loud and bright. 

I was on call Tuesday and didn't get home until 3:30 am :(. I was so tired the next day. Sleep deprivation on top of chronic sleep deprivation is no joke. And I'm on call again Monday! Hopefully it's better. Regardless, it's my last 1st call of this year, so I'm looking forward to less tired-ness in the future :). 

Simon is a pretty good sleeper now. On a good night he goes to sleep at 8 pm, wakes up around 2 am to eat and doesn't wake up again until 7 am. 

Cutie pie Simon

I'm pretty biased...but Simon is so cute!! Here he is wearing his denim outfit from Kat. 

Also, he can lift his head up pretty well now when he's on his tummy.

TGIF

I am so happy that it's finally Friday and the weekend is here! This week has been exhausting for both of us, and I'm so excited for the chance to rest and spend time with Jeff and Simon.

I felt like I worked an insane amount of hours this week - I worked super late Monday and Wednesday, and today I was on call. Yikes. On top of that, poor Simon was really off Mon/Tues and woke up frequently throughout the night so I didn't get a good night's rest. It really takes a toll on your body. Not only am I physically tired, I find myself not being able to focus at work quite as well as before. I take pride in doing a good job at work so it's hard to feel like I'm not giving 100% to my patients. Anyway, it will get better so I'm just trying to hang in there and take it one day at a time. Jeff has been such a trooper throughout, helping me get my stuff ready for work even though I'm sure he's exhausted as well.

On the other hand, we received some very exciting news this week! Our daycare spot opened up early and we are going to be able to send him to daycare next week. I was telling Jeff that this is totally an answered prayer because I was getting very anxious about my mom taking care of Simon. She is generally pretty good with him, but there were some things that concerned me, mostly being that she would not listen to our directions (ie swaddling for nap, not putting pillows/blankets in his pack n play). I actually got really angry about that last example because it's dangerous. Also, I had instructed her to get the flu shot so Simon could be protected, but she basically brushed me off. I just feel that we can't fully trust her, which makes me sad. So I was praying really hard one night that the situation would improve, and God totally answered that prayer! It's so amazing.

Medically, Simon continues to do well. He had another set of TFTs last week and surprisingly his TSH continues to be low, so his levothyroxine dose got decreased again, even though his doctor has predicted that it would need to be increased. Makes me wonder if he still has some residual thyroid function. I guess we'll see! Luckily, Simon is amazing and Jeff said he barely cried when he got poked. My brave little guy! 

I'm going to crash soon so I'll post some pictures to end this post. Until next time.

Love the expression on his face. Right after his blood draw. 

Love his chubby cheeks. Yes, he's balding :(

Cheering for Cal. We won in overtime!

More milestones

Having a great day today. Not that my other days are particularly bad (except my call on Sunday which was horrible...young people need to stop doing drugs). Here are the reasons for my great day so far:

Simon slept 7 hours straight last night. Which means I did, too!! Amazing. Not holding my breath for him to do it every night, but hoping that at least he continues heading in this direction. He also turns 10 weeks old today :) happy 10 week birthday, my precious baby!! You are growing up so fast. Yesterday he was staring at his fist for a long time, so I think he's starting to learn that his hands belong to him :). So cute. 

Rain. It started raining overnight and I woke up to the sound of rain, which I love. For some reason I find it very soothing. And since we are having a very bad drought this year I'm sure farmers are excited as well. 

Bumped into one of the OR nurses leaving the parking garage this morning and he shared his umbrella with me :)

Working with a super nice attending today. He's giving me a ton of extra breaks. I feel so spoiled! 

There are, of course, many more things to be thankful for. I am richly blessed in so many ways. But especially happy today for the above mentioned things.

2 month update, and some random musings

Happy belated 2 month birthday, Simon!

I started a post on his birthday while I was at work, but it got erased somehow (blogger app on my phone is not that great). And I was on call so ended up being too busy/tired to repost.

Jeff and I were both pretty tired this week. Simon had one night of restless sleep and I ended up being pretty tired during the next day. I was so tired last night that I passed out while holding him in bed, trying to soothe him to sleep. Guess he fell asleep hardcore, too, since he slept from 9 to 3 am! Fantastic. I'm not holding my breath for him to sleep like that every night, though. Setting my expectations a bit low for the time being and just happy that he sleeps 5 hour stretches about 50% of the time :).

Today was his 2 month visit. It went okay. Simon didn't cry too much after his two shots. My brave little guy! We'll see how he does over the next few days. The pediatrician said there is a 1 in 20 chance of some sort of reaction. We got infant Tylenol just in case anyway. Our usual pediatrician is on vacation so this was her partner in the clinic. To be honest, Jeff and I both didn't like her too much. She kept pointing out all these things that were "wrong" with Simon - like the folds of his neck being rashy, that he would develop a permanent turned neck (torticollis) since he likes to turn his neck to the right, etc. The way she talked made me feel like I was being a bad parent. I'm pretty sure she didn't know I'm a doctor, but at that point I was too tired to tell her and just wanted to get the visit over with. On top of all this we had to wait about 35 min in the waiting room...I understand delays, especially since I know how difficult it is to not fall behind, but it's not fun to wait in the waiting room with a fussy 2 month old.

Anyway. Just thankful that we like our usual pediatrician a lot. And that she is much more warm/friendly/encouraging.

-----

Work has been good. I made a really difficult decision this week to not pursue a fellowship in pediatric anesthesia, at least for the time being. There were lots of reasons, including a much heavier call schedule than I had anticipated (in house call), not seeing myself working in a pediatric hospital after, not sure about how much the fellowship would help with getting a job...and now, having Simon in my life, especially with his medical condition, I just feel like I don't want to spend so much time at work anymore. I would like to have time to be with him besides 1-2 hours in the evening and the weekend. And have time to take care of myself - just simple things like exercising and cooking. Maybe this decision was influenced by the fact that I'm pretty tired, but I just couldn't see myself being on call all the time and spending all those nights in the hospital. I do feel a twinge of regret, though, when I think of taking care of kids at work...they're so cute and I do love talking to them :).

This is one of those decisions where you can't be 100% happy with either choice. Being a grown up is hard sometimes.


Getting pretty tired so I will finish with more thoughts later. Want to write a long blog post about my mom and how she has become a crazy overbearing grandparent (I exaggerate...only a little).

Working mom

It's been a little while since I last updated because I went back to work last Monday and things have been busy, busy, busy! At least I was off this past weekend but we basically spent the time resting and gearing up for another week :]. I guess that's just how it will be from now on. 

The transition itself actually went pretty well. Jeff has been doing a great job taking care of Simon. It's pretty exhausting work and he is all by himself with baby for about 12 hours every day! I try to help him out by taking care of the birds' food and making Simon's bottles but it's still a lot of work :). 

Simon's been growing and developing new skills. He learned how to stick his hand in his mouth and suck on it. I was hoping that would lead to him self soothing but he seems to do it only when he's hungry, haha. And he's not terribly coordinated yet so he still waves his arms around a lot. He continues to coo a lot (makes all sorts of sounds, it's super cute). 

He is also eating a lot - Jeff reports 4 oz at a time sometimes. But he also barfs a lot! We think he barfed both weekend mornings because I would nurse him when he woke up and my boobs would be too full. He also tends to swallow a lot of air when he gets frantic (either super hungry or fussy/tired). So anyway...lesson learned. And a lot of laundry done this weekend...

Simon has his 2 month checkup at the end of this week. Not looking forward to him getting his 1st round of shots and being on call on Sunday. We will get through it somehow!

Simon is perfect!

Had a follow up visit with Simon's pediatric endocrinologist today. She was very happy with his growth (he's now 12 lb 11 oz, wow! and 98%ile for height, no wonder he's been outgrowing his clothes like crazy) and his labs, so no changes to his levothyroxine dose for now.

I was a little concerned that his length had shot up to 98th percentile, and that he was possibly a little hyperthyroid (especially given his sleep issues) but given his good weight gain and lack of other symptoms (diarrhea, poor weight gain, labs within normal range) she didn't think that was the case. Also, his night sleep has been decent so that is also a good sign. And since levothyroxine is dosed based on weight for babies he may actually outgrow his current dose in a few weeks, so we have to recheck his levels in about 3 weeks. Another blood draw, sigh. The good news is that they will continue to get further and further apart as he ages.

So basically we have a giant baby. Which I said during our visit ("OMG, he's a giant baby!") -- to which she responded, "No, he's perfect!"

:)

---------

Some recent pictures of Simon wearing his Cal onesie (great gift from Jeff's boss):
The many faces of Simon while considering attending Cal one day (no pressure!)

Contemplative (hmm, sounds alright..)

Yay! I'm excited!

Too much pressure! I can't take it!

Annnnddd just like that, it's September! What the what.

Labor day weekend was a mix of fun and busyness and exhaustion...it was Gary and Michelle's wedding on Sunday, and Jeff was a groomsman, so he was pretty busy with the wedding rehearsal on Saturday and wedding on Sunday. That left me to be the solo parent, which for the most part was OK, except that Simon wouldn't nap on Saturday so I had to wait until Jeff got home to eat lunch. Then Sunday my parents watched Simon for several hours in the afternoon/evening so I could attend the wedding. (I had previously debated taking Simon with me, but decided it was too unpredictable given that I wasn't sure I would be able to find parking easily, and him crying during the ceremony/reception, and his bedtime being 8...etc. But after getting there I realized it would have been doable. Oh well.) It was really nice being able to go out and socialize, even though I had to leave early. (Another side note -- it's hard to stay out for long periods of time when you're breastfeeding a newborn. Boobs.)

Anyway. I had a lot of anxiety leading up to the wedding because I wasn't sure how Simon would do with my parents. He can't nap at their place for many various reasons -- too much stimulation being the main one, though. That and my mom won't swaddle him (argh). He ended up doing OK. Of course they waited until he was crying to feed him (another argh), but he survived without me/Jeff. I didn't get to their place until 7ish and he was pretty fussy by then because he hadn't slept for 4+ hours, so I rushed him home to give him his bath and get him ready for bedtime. Then he really wanted to comfort nurse, but because I hadn't had the chance to empty my breasts they were pretty full and he gulped down too much milk and air. The result? A huge barf that drenched me, him, and everything on the bed. Poor little guy. He just let out this sad little cry, like, "why did this happen to me?" That is something I'd like to not relive again, ever.

Somehow I managed to clean both of us up but by then I was SO exhausted I didn't even want to think about doing laundry and so we crashed in our master bedroom instead. The fun didn't end there, though. He woke up at 2 am to feed, which was great (5 hours!), except he couldn't go back to sleep after that...his eyes were closed but every couple of minutes he would fidget and move around. In my sleep deprived state I thought it was his diaper, so I changed it, and then again 2 hours later when I fed him again...needless to say I basically didn't sleep from 2 am - 5 am when I finally gave up and woke up Jeff. Who was sleeping on the couch downstairs because of the bed situation. The whole family was tired on Monday, hah. Luckily Simon chilled out and actually slept that day so we had a chance to recover. Just in time to have dinner with my parents and a bunch of their friends...huzzah, more stimulation for our poor baby! Simon's such a trooper, though. He did great at the dinner except towards the end he got fussy, so we had an excuse to leave, haha.

Simon's definitely starting to smile and coo more, especially when he's well rested. It's super cute but I have trouble capturing it on my phone. His cooing sounds like he's saying, "ooooh" over and over again. And while most of his smiling is still related to him farting/pooping, I think he's starting to smile socially (yay!)

-----

I didn't mean to write about that whole thing but it was a pretty eventful weekend. I'm glad it's over. I really want to enjoy this week since it's my last week of leave (insert very sad face emoticon). Jeff is also working from home this week so it'll be super nice for me! Everything is so much easier (and less lonely) when he is home. I really should take advantage and use this time to stock up on food and prepare for next week. Luckily my first two weeks back are PACU so I'll have ample time to pump and get re-acclimated to working again. Hopefully I haven't forgotten how to anesthetize people, HA.

6 weeks

Another week has flown by. I'm slowly getting things together so we can have a smooth transition when I go back to work; next week we plan to really start transitioning Simon to the bottle, have Jeff take over some more baby responsibilities, pumping more, etc. The good news is that Simon is starting to somewhat settle into a routine - he is generally good at bedtime, which is around 8-9, and wakes up around 7 am every morning. During the day it's still kind of hit or miss whether or not he will nap well, but at least it's becoming easier for me to read his tired cues and try to put him down for a nap. The bad news is...well, that I have to go back to work. Boo.

Simon continues to be overall a good-natured and mellow baby. He had one day this week where he was particularly fussy all day and refused to sleep (Jeff eventually came home early to help me because it was getting pretty bad). Otherwise he doesn't cry very much and is easy to soothe. He loves being held and propped up on my legs but hates being burped. Today he was all smiles when my dad and grandma came to visit...lucky them! When my dad was holding him he proceeded to fart a bunch of times. Ah, learning so much from the gassiest person I know. Fun times ahead... He stares at faces and things a lot more intently so I think his vision is starting to become much better.

Happy 6 weeks, Simon! We love you more every day! Can't wait to see what you're going to be like as you grow up :)

1st milestone

Simon slept from 9 pm until 2 am last night. That's right...5 WHOLE HOURS. It was amazing. I had to pump after he finished eating because there was so much milk! And I pumped again this morning!

Now that I posted this he's probably going to hit his 6 week growth spurt and go back to 3 hour feedings at night. But hopefully this means there is a light at the end of the tunnel. And that I won't die when I go back to work!

a couple of updates

I wanted to post earlier, but we had a decently busy weekend and when Jeff is around I would much rather hang out with him and be productive than sit here and type on the laptop :).

Sleep - Simon is very slowly increasing his sleep ability to sleep longer at night. In general, he's actually a pretty good sleeper at night, usually goes down right away after eating (but sometimes falling asleep before he gets a full feeding in). He has more problems sticking to a schedule of naps during the daytime. On the weekend I tried to stick to a 3 hour schedule of naps, eating, etc, but that quickly dissolved when he started becoming fussy and wouldn't go to sleep for an hour. He is always visibly tired (yawns, starts fidgeting a lot) but then fights actually falling asleep. Oh well. I'm about to give up putting him on a strict schedule during the day as it just doesn't seem to work well and it ends up causing more stress than it's worth. I'm aiming a little lower now and will try to have him get at least two chunky (>1 hr) naps per day.

Eating - for the most part, a good eater; definitely has a pattern of cluster feeding/comfort feeding at night and to some extent in the morning as well. He does have an occasional episode of vomiting up everything he's just eaten -- the last time was on Thursday and we had to wash quite a few things... We're not sure why he seems to do this on occasion - at first I thought it was because we had been supplementing with formula and he would drink too much from the bottle, but now he does it with nursing too. My guess is that he is too hungry and gulps down a lot of air while nursing, and it doesn't come out with burping. Either that or he just eats too much.

Development - Simon is definitely gaining better head control. He likes to lift his head up now when I'm burping him and can hold it there for a little bit before his head swings one way or the other (this morning he swung his head into my nose. Ow.) He is definitely tracking a lot more with his eyes and has even starting cooing (sounds like he's saying "ooooh"). He smiles a lot but I'm not sure if it's purposeful yet. Conversely, he has also been crying a lot more and starts crying more quickly when something is bothering him. I read somewhere that crying/fussing peaks at 6 weeks so hopefully this will get better.

Simon also got repeat thyroid tests on Friday. He did really well just like last time - only cried a little bit when she poked his heel and then was ok while she got the blood even though the phlebotomist this time really sucked. Ugh. Makes me upset when I specifically request someone who is good with babies, and they are not. I almost never tell people I'm a doctor in these situations, because it just makes people more nervous, but maybe next time it will actually make them take me seriously. And then the results took forever to come back, and I was starting to really freak out and think that she didn't get enough blood. Luckily our peds endocrinologist is great and checked on the results for us, and they look good.

And now, after writing all of this, I am exhausted. Time to take a break...

Comparing residency and taking care of a newborn

I know I've made comments about in previous posts comparing residency with taking care of a baby, but just for fun I thought I would list them down here. Because this is my idea of FUN. (not really, but my mind is too boggled and stressed with various things at the moment and I need a break)

There are many similarities between residency and taking care of a newborn. Here are some I can think of at the moment - and which one, in my opinion, is harder. (Side note -- does this mean I am doing the equivalent of TWO SIMULTANEOUS RESIDENCIES?? I deserve bonus life points for this! Except...nobody cares...and both are the result of my own choices. Sad.)

Similarity #1: Chronic sleep deprivation.
This one is obvious. Residency = being on call, sometimes very often, i.e 30 hour calls of death every 4 days in the ICU -- oh how I do NOT miss those! I specifically remember last year after being in the hospital approximately 28 hours one of the ICU fellows saying to me, "now, I know all you want to do is leave right now but you have to tie up all these loose ends before you go" (said in a tone that implied I was lazy and inconsiderate to even THINK of leaving before I typed one-liners about each of the ICU patients in their chart). That was not a good moment. I felt like stabbing him in the eyeball.

Newborn = lots of sleep deprivation. But on a different scale...right now, 5 weeks in, it feels more like a slow march towards mind-bending exhaustion. Because while you have to be very alert and working while on call, at least you can sleep when your baby sleeps. But it's only 2-3 hours at a time. And after being on call you do get to come home and crash for a day before going back to work, while you don't get that luxury with baby.

I could go on and on about this topic but I will not (this is not interesting to anyone except me anyway). Winner of this round = baby, because the sleep deprivation doesn't end, even though you can sleep a couple hours here and there. While with residency, even with a brutal call, it will eventually end and you can sleep for a long time afterwards.


Similarity #2: It's a thankless job for the most part.
My patients rarely thank me for doing my job -- it's not that all my patients are rude people, just that if I've done a good job they aren't conscious and we don't usually see them after we've dropped them off in recovery after their surgery. Usually all they remember of me is probably me poking them to place an IV. Sometimes this is a blessing because some patients are really annoying and/or crazy and I don't want them remembering my face anyway :).

Obviously, baby cannot thank me right now. Hopefully in the future I will get some sign of appreciation =)

Winner of this round = residency. Because when you spend 10-12 hours a day keeping sick people alive and nobody appreciates you, it sucks. And no matter how devoted one is to their job, I would like to think that being a good parent is a higher priority.


Similarity #3: Once you think you've figured something out, everything changes.
Some of the wisest advice/perspective I've gotten from other moms and parenting websites is that babies constantly change. What works one week does not work the next. You think you got the whole sleeping/eating routine down? Yeah, only worked like a charm for a few days and then - BAM - suddenly baby switches everything on you.

Residency is just like this. Our rotations switch every 2 weeks to 1 month. Every time I get the hang of what I'm supposed to be focused on during that particular rotation, and get to know all the nurses/techs/etc, it's time to switch to something else. To make things even more challenging we rotate in and out of 4 different hospitals, each with a completely different work environment. Lovely.

Winner this round = tie.  

Similarity #4: Both are very difficult jobs, but bring great satisfaction.
Finally something positive. Mostly everything difficult I've done during my life so far has produced great rewards/satisfaction and a sense of accomplishment. Hiking 5 days to Macchu Pichu? Worth it. Running a marathon? So proud of myself! Intubating someone in the ER in the middle of the night after other people tried and couldn't do it? Feels pretty awesome. So here's to parenting -- probably the most difficult thing I will ever do but hopefully also the most rewarding.

one step forward, one step back

Simon had his one month checkup yesterday. It went pretty well; he is growing appropriately (basically 75%ile across the board for height, weight and head circumference) and his pediatrician was pleased. She did think he had a bit of thrush and that he needs vitamin D supplements (don't know why she didn't tell us about this before; maybe it was because he was taking some formula which has vitamin D in it). He got his 2nd hepatitis B shot and did well (I'll never forget the look on his face, though; went from totally chill to very unhappy in one second, poor little guy). Next month he'll be getting the first round of a bunch of shots so we'll be ready for some extra fussiness. I have to keep reminding myself that he won't remember any of this, so I should stop stressing out every time he gets poked.

I've been trying to get him on a 3 hour schedule with some mixed success. One big plus these last few days is that we discovered he can indeed put himself to sleep in his crib (although he does cry for about 5-10 min before passing out), and sleep in his crib without too much fussing! Amazing! Before we tried it I totally thought he would be too young to fall asleep on his own and that he would cry forever and not get it. This is much better than what we were doing before, which is holding him and rocking him to sleep (which took forever and he would wake up as soon as we put him down).

We're still having a couple of issues with him sticking to a regular nap time during the day, though. He gets all revved up in the morning and won't take a good nap in the morning, leading a lot of fussing, which then ends up in a massive nap in the afternoon (he will sleep for 3 hours without waking up, and I have to wake him up to eat). This throws the whole schedule off. The last two nights he's done a good stretch from 8/9-12/1 but then after that it's kind of hit or miss. I think it's because in the middle of the night he has the tendency to fall asleep while eating and so he wakes up hungry an hour later. The conclusion of all this is that his sleep is still wonky and I'll have to work hard the next three weeks to make it better. Hopefully as he gets older it will also smooth out a lot more -- I suppose I shouldn't feel too much pressure at this point since he's only 4.5 weeks old.

One other thing we've noticed about Simon is that while he likes to sleep on his back, he very much prefers to sleep on the right side of his head. If we try to put him to bed with his head facing the other way he actually tosses and turns until he manages to flip his head back to the right side. I tried putting a small folded up blanket to turn his head the other way today during one of his naps and he was very unhappy. Hope he doesn't grow up with a deformed skull :(

to end on a light note - after his bath today Simon had a HUGE booger come out of his nostril. And by huge I mean as big as something that would come out of my nose :) Surprising that a big booger can come out of such a tiny nostril! He must have been really plugged up in there!

Happy one month, Simon!

One month has sure gone by fast! And the learning curve has been steep, just like the first month of intern year -- again with the analogies to residency (they have so much in common though!) Here are a few reflections of things I've learned, milestones achieved, and what's ahead:

Looking back

• Words cannot describe how much I love, adore, and care for Simon. It's something that's impossible to understand until you're a parent, I think. I definitely had no idea before he was born (even though I could feel him moving around while I was pregnant, it was still different).
• Learning baby cues. Had no idea what he wanted in the beginning. Now I kind of do but it's still difficult to figure out what to do sometimes.
• Sleep deprivation is hard. I am surprised by how little sleep I actually need to get by, and still function during the day, but it sucks. And the bad part of not sleeping enough is that it makes me more easily irritable and forgetful. One of these days I will sleep more than 3 hours at a time and it will be amazing.
• Some things I would change, looking back with some perspective and experience: 
• read a few more parenting books to get an idea of what to do prior to delivery instead of learning everything on the fly
• read more about breastfeeding and see a lactation consultant sooner. Breastfeeding might have been a little less stressful the first few weeks
• set more boundaries for my mom during the first week (she came to visit way too often, was overly intrusive with some of her advice and presence -- of course she had good intentions, but it was way too overwhelming and created unneeded stress in addition to being a new mom)
•  limit visitors (so so difficult for me to do, since it seems so rude to turn away well-meaning friends and family, but in retrospect it was really disruptive to forming a schedule, and Simon gets over stimulated with all the people, not to mention exhausting for both of us to host so many guests)

Looking forward

• His one month checkup is tomorrow, along with his 2nd hepatitis B shot
• Recheck thyroid function tests on Friday. Hoping for good results.
• I have to go back to work in 3 weeks :( not feeling ready, but hopefully we can plan enough for it to be a relatively smooth transition
• Starting sleep training. The "Babywise" book was recommended to me by a friend, and we are trying it out. I really hope it works because things would be much simpler if we had a set schedule! It certainly is hard to listen to Simon cry, though. *crossing fingers that this works*

Happy 1 month birthday, Simon. We love you.

4 weeks!

Simon, you're 4 weeks old today! Even though these last few days have been a bit rocky (but getting better) I was remembering that you are such a precious gift to us and we are so lucky to have you in our lives.

Still can't believe that we have a baby, and that we have been entrusted to raise him.

Simon's sleep was becoming a bit of an issue these last several days; on Saturday he was awake the entire day (see previous blog post); on Sunday he was ok, managed to nap in the afternoon; but Monday was rough again. He stayed awake until 5 pm and was super fussy; on top of that, Jeff had a bad migraine headache which brought him home but was sensitive to light and sound (tough luck with a fussy baby and two cockatiels who aren't getting any attention!). Tuesday was better but then overnight he woke up at 2 am and refused to feed, even though he was hungry, and in desperation I woke Jeff up to watch him while I crashed in the other room for 2 hours. We were both a bit tired yesterday but luckily he decided that afternoon naps are indeed a good thing, and has slept well since then.

My current theory about what happened was that perhaps because his thyroid level was a bit high last week it stayed in his system until Monday and made him extra fussy/irritable. That and perhaps being overtired and being unable to drift into a deep sleep (there were many times that he would close his eyes and seemingly go to sleep but then open his eyes minutes later, wide awake). OR this is all just erratic newborn behavior and I'm over analyzing everything. Regardless, I do hope his sleep patterns become better from now on.

I'll end with some cute pictures from this week:

Sleepless in Sunnyvale

I meant to update yesterday, but Simon had other ideas...let's just say yesterday was pretty terrible. Somehow, and I still have no idea why, he decided to stay awake from around 10:30 am until 9 pm at night, with only one or two 30 minute naps during the day. So bizarre, especially since he always has a few 2-3 hour naps during the day. It was difficult to get anything done because as the day went on he became more and more fussy from being overtired. No amount of rocking, holding him, putting him in the swing, swaddling, even feeding him (which usually calms him a lot and puts him to sleep) would help. The one nap he did get in was when, in desperation, I put him in his car seat/stroller and took him for a walk around the neighborhood. However, the minute I got home and brought his car seat upstairs he woke up. He's got some kind of sensor in there!

He did also seem to have a larger than usual amount of hunger, gas, and stools yesterday so maybe that in combination with being overtired just sent him over the edge. He did sleep pretty well last night, though, woke up only to eat and then went right back to sleep.

His blood draw on Friday went well. He didn't cry as much as the first one and mostly just seemed upset that someone kept holding his foot. The results were pretty good; his T4 levels are in range for his age but TSH was a little too low so we're dropping the dose of his levothyroxine a bit. And we have to recheck levels in 2 weeks, which sucks...I hope this new dosing is good so that we don't have to keep checking his levels so frequently.

3 weeks!

Simon is 3 weeks old today! He continues to have a good appetite and I swear he's getting heavier every day. It's especially noticeable when I pick him up at night to feed him. His next appointment is at 1 month so we'll see how much he's gained then.

Speaking of appointments, we're going to bring him in for a blood draw tomorrow. Poor little guy. I'm really dreading the inevitable wailing that's gonna happen when they poke him...I'm such a wimp, I can't stand to see him uncomfortable/sad even if it's only momentary. Praying that he'll have a good test result and that he won't be too irritable after.

We had a rough morning today because he was pretty fussy (he usually is in the morning but it seemed a bit worse today), and I thought he was still hungry and fed him from the bottle, and he barfed it all up right after finishing the bottle, which then required a bath and wardrobe changes for both me and him. Sometimes he doesn't seem to know when he's full (but only happens with the bottle, never with nursing) -- I need to learn to read his cues better and next time I'm going to try a pacifier and see if that helps. It's just that after he nurses I have a hard time knowing how much he actually ate (one of the annoying things about breastfeeding) so when he's fussy after feeding it's hard to know if he's still hungry or fussy for a different reason. I'm hoping it gets easier to tell because when I go back to work he's going to be bottle fed for most of the day and obviously we don't want him barfing all the time.

Sleep wise there hasn't been much change. Most nights he goes to sleep around 9 pm and usually sleeps for 3 hours during the first stretch, but then wakes up every 2 for feedings. Depending on the night he'll either go back to sleep right away or starts fussing, which then takes a bit for him to go back to sleep. It ends up being a cycle of feeding, falling asleep but then waking 5 min later hungry again, nursing again, falling asleep, but then he poops and diaper needs to be changed, which wakes him up again. Then sometimes he's still hungry/fussy at which point I start debating whether or not it's worth giving him a bottle (and risk barfing) or waking up Jeff (although helpful, does not always end up with me getting any extra sleep since Simon will want to nurse again in about 30 min to an hour). Anyway I know he's only 3 weeks old so this is expected but I strongly hope that he will start sleeping in longer stretches by the time I go back to work because otherwise I will likely keel over and die from sleep deprivation.

Two week check up

Simon went in for his two week check up today (he's actually about 2.5 weeks old) and he weighs a whopping 9 lb 10 oz now!! His pediatrician made a joke about this being some kind of record weight gain. Makes me feel better about all the times he wakes up at night to eat and how much he eats because sometimes I feel like I can't keep up!

Speaking of waking up at night, Simon does seem to be more active at night (although his sleep/wake times still vary quite a bit from day to day) - he wakes up about every 2 hours at night to eat vs every 3 hours or so during the day. Hopefully we can start to reverse this and stretch his sleep to longer at night (4 hours sounds really nice right now, haha). It's really hard to keep him awake during the day, though.

This past weekend we had a ton of visitors - Jeff's family came to visit Friday/Saturday, and then on Sunday we had some college friends over in the morning and church friends in the evening. It was simultaneously fun and exhausting to have so many people visit...I'm glad to have some down time this week to decompress.

Here are some pictures of our little chubster:

Simon is 2 weeks old!

Simon turned 2 weeks old today. To celebrate the occasion of his birth he decided to barf all over his crib in the middle of the night. Here's to washing the crib sheets 2 days in a row!

It's so cliche to comment about this, but time really does fly by. This is my 3rd week of maternity leave already, so I only have 5 weeks left. Somehow by then we'll hopefully have him on some kind of schedule and *crossing fingers* he will have increased the amount of time he's asleep at night. Getting up once in the middle of the night, I can deal with, but more than that and I'll be a zombie at work (made worse by the fact that I'm really limiting my caffeine intake these days since I'm breastfeeding).

Some fun facts about Simon:

- he smiles and/or makes a "blue steel" face when he is about to poop/fart

- loves being held (well, I guess which baby doesn't, but he is happiest when in our arms)

- when he's unhappy he doesn't cry first, instead starts flailing his arms around

- he has a good appetite (takes after mom and dad already) & was already 8 lb 10 oz at his 1 week checkup; looking forward to seeing how heavy he is at his 2 week checkup next week. My guess is that he's definitely at least 9 lb already. 

Growth spurt?

Simon is almost 2 weeks old and for the last two days he's been constantly hungry and fussy during certain times of the day (between 10 am and 2 pm and 9 pm and midnight). Not sure if he's hitting a growth spurt or just a variation of newborn behavior. Overall he's a pretty good baby and only fusses when something needs to be done (hungry, diaper, or gas). And he's slowly spending more time awake, which is nice when he's not fussing about something. Can't wait until he's more interactive! I'm looking forward to learning what his personality is like.

I still can't believe that we're parents sometimes and that we are trusted to raise this little guy. I keep trying to read up on various parenting/baby blogs only to realize more and more that it's a "learn on the fly" kind of job, much like my first few months of residency. No amount of reading or mental preparation is quite like the real thing! I'm just kind of figuring everything out by trial and error (like today, where I tried cloth diapers for the first time and he had a giant poop which leaked everywhere...my fault since he's not quite big enough for it yet).

weekend visitors

Simon had a bunch of visitors this weekend since my relatives on my dad's side are visiting (both to see Simon and for my grandma's birthday). Here are some pictures:

Newly minted great-grandmother!

 

Birth Story

Today I'll recount Simon's birth story (that seems to be a thing amongst new parents).

Simon's due date was projected to be July 11, which conveniently fell on a Friday so I scheduled my last day of work to be that day. The whole two weeks leading up to that day I kept hoping that he would come early so I didn't have to drag my butt into work every day (was getting super large/uncomfortable by that point), but alas, nothing happened. Not even any Braxton-hicks contractions. Luckily at my 2nd to last OB appointment we scheduled an induction "just in case" on July 16th. Sure enough, Simon decided not to make any indication that we was going to come out, even though my cervix was dilated to 2 cm, so we walked into labor and delivery on July 16th. Only to find out that there were no beds available. They supposedly called me the night before to let me know but there was definitely no phone call (L&D fail!) so we grumpily went home instead and then decided to run errands. Just when we were about to go eat lunch they called and said a bed was available, so we rushed over to the hospital & finally got checked in at 2 pm.

They started a low dose of Pitocin and I still felt nothing, although there were clear contractions on the monitor. So strange...I guess I had been in early labor at home and had no idea! Well, the OB on call decided that I looked "too happy" and ruptured my membranes (aka broke my bag of water) and then the fun really started. Initially the contractions weren't too bad but then they got to the point where I had to really pause and breathe through them. After about an hour of that I decided that I might as well get the epidural before I got too uncomfortable to sit for it. (I have to insert here how weird it is to be a patient and on the receiving end of something I've done hundreds of times. That and lidocaine burns when it goes in...but it works really well!) The epidural was amazing. I was able to chill and watch TV the rest of the evening with close to no pain; when his head go really low in the pelvis I could feel a lot of pressure but it wasn't terribly uncomfortable. Too bad I've already done my two months of OB anesthesia because I feel like I could really counsel pregnant women on the pros and cons of the epidural having had one myself.

I started pushing at around 1:30 am, and after one hour, Simon was born! It was incredible meeting him for the first time after feeling him move around inside me for so long. He was so alert, too, only gave a token cry and then opened his eyes and started looking around. Jeff wanted to cut the umbilical cord but Simon came out with the cord wrapped around his neck so the OB had to quickly cut it (he wasn't showing any signs of distress during the pushing so we think it wasn't very tight).

So overall it was a really good experience, and I am thankful for the excellent nurses I had and the OB who was on call, and for my anesthesia colleagues who did such a great epidural. Would definitely have one of those again ;)

an unexpected roadbump

Yesterday we received some news that rocked our world - Simon's newborn screen (the heel prick they do in the hospital to screen for a multitude of diseases) picked up an elevated TSH level indicating congenital hypothyroidism. Our pediatrician immediately referred us to the pediatric endocrinologist, but in the short time from when I got the phone call to our last minute appointment (as an aside here, our healthcare team is amazing; the same day they got the screening results back we got to see the specialist 2 hours later) I had already read up on what the internet had to offer.

So the good and the bad news: this is likely a permanent condition and he will have to be on levothyroxine for life. Not only that, but the dose has to be constantly adjusted, especially in the first few months since he's a rapidly growing infant and their thyroid hormone needs are high. Which means frequent blood tests to check his hormone levels (for some reason this part stresses me out the most; I hate the thought of him screaming in pain with the pokes. Ironic since that's what I do to patients every day at work...although for little kids they get anesthetized first before their IV...but I digress). There are other things, too; how challenging will it be when he gets older and realizes what's going on? How do I make life as normal as I can for him? Will he be developmentally delayed? The consensus is that if properly treated he will have a perfectly normal development but of course I still worry.

The good news (that I have to keep reminding myself over and over) is that this IS a treatable condition and that they caught it early. If it was diagnosed later in life he would have been in a lot more trouble development-wise. And there are many worse problems to have!

I'm also trying to be thankful for all the good things that are happening. That Jeff is already an amazing, doting father and husband. Being a dad has brought out this other side of him that is so cool to see and makes me love him even more. Also, our healthcare team is amazing, especially our pediatrician. We had a followup with her today and I love how well she connects with us and is so supportive.


Well, that was an emotionally heavy first post! But I just had to get that off my chest, especially since we haven't told many people of the diagnosis yet. Hopefully there will be some lighter, happier posts in the future :). 

Our little guy at 1 week old: