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: